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      Comparative Study of Electrophysiological and Holter Monitoring Data in Estimating Sinoatrial Function

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          Abstract

          To study the diagnostic possibilities and mechanisms involved in sinus node dysfunction (SND), 26 patients with sick sinus syndrome were evaluated by basic electrophysiological tests before and after autonomic blockade, and by Holter monitoring. Based on intrinsic heart rate (IHR), two groups, a normal and a pathologic one, were separated. With Holter recordings, significant differences were manifested in minimal heart rate during sleeping and also in sinus cycles averaged for 24 h between the two groups. In patients with pathological IHR (n = 9) abnormal intrinsic rhythmicity were verified by electrophysiological means, while we found positive ECGs referring to sinoatrial dysfunction during the first 24 h of rhythm recording. The group of normal IHR (n = 17) covers patients with intrinsic SND (intrinsic SA block, 3/17 patients) and patients (14/17) where the electrophysiologic properties of the pacemaker cells were normal: normal intrinsic recovery time, gradual return to the stable intrinsic sinus cycle length in the postpacing secondary cycles, biphasic postextrasystolic patterns with a well-estimated intrinsic sinoatrial conduction time. Repeated Holter recording (total 26 × 24 h) revealed severe bradycardia (2 cases), SA block (4 cases), SA arrest (2 cases), tachybradyarrhythmia (1 case). Electrophysiological studies have a low diagnostic value in autonomic SND; repeated rhythm monitoring is obviously the best complementary method for appreciating the role and significance of autonomic tone in sick sinus syndrome.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1983
          1983
          07 November 2008
          : 70
          : 4
          : 184-193
          Affiliations
          University of Aix-Marseille, Marseille, France
          Article
          173592 Cardiology 1983;70:184–193
          10.1159/000173592
          6640559
          b6e5c41a-1861-48b8-8c83-937f4abfbbf8
          © 1983 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 15 February 1983
          : 27 May 1983
          Page count
          Pages: 10
          Categories
          Original Paper

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Autonomic and intrinsic sinus node dysfunction,Holter monitoring,Electrophysiological tests,Autonomic blockade

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