scholarly journals Evaluation and Management of Asymptomatic Bradyarrhythmias

2020 ◽  
Vol 16 ◽  
Author(s):  
Göksel Çinier ◽  
Sohaib Haseeb ◽  
Giorgos Bazoukis ◽  
Cynthia Yeung ◽  
Enes Elvin Gül
Keyword(s):  
Cardiac Rhythm ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Current Evidence ◽  
Systemic Diseases ◽  
Proper Treatment ◽  
Significant Morbidity ◽  
Permanent Pacing ◽  
Cardiac Manifestations ◽  
Benign Course

: Asymptomatic bradyarrhythmias involving sinus node dysfunction and atrioventicular blocks are frequently noted in clinical practice. Its prevalence is expected to rise as devices that are developed for monitoring cardiac rhythm for longer duration become more widely available. Episodes of bradyarrhythmia that are asymptomatic are considered to have a benign course compared with those that cause symptoms, and do not necessitate further treatment. However, in certain cases, they can be a harbinger of future symptoms or cardiac manifestations of systemic diseases. The evaluation and risk stratification of individuals presenting with asymptomatic bradyarrhythmias is important not only for preventing implantation of unnecessary permanent pacing devices but also for reducing significant morbidity by implementing proper treatment as required. In this article, we will review the current evidence on the pathophysiology, diagnosis, evaluation and management of patients with asymptomatic bradyarrhythmias.

Sinus node disfunction in an adolescent with systemic lupus erythematosus

Lupus ◽  
2020 ◽  
pp. 096120332097409
Author(s):  
Miguel Fogaça da Mata ◽  
Mónica Rebelo ◽  
Helena Sofia Sousa ◽  
Alexandra Rocha ◽  
Pedro Miguel ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Normal Sinus Rhythm ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Systemic Lupus ◽  
Junctional Rhythm ◽  
Normal Sinus ◽  
Cardiac Manifestations ◽  
Juvenile Sle

Cardiac involvement in systemic lupus erythematosus (SLE) is well documented. The pericardium, myocardium and endocardium, as well as the coronary arteries, the valves and the conduction system can all be affected. While pericarditis is common, arrythmias are less frequently described. We present a 13-year-old male, who had fatigue, anorexia, weight loss, myalgias and arthralgias for four months. On physical examination, we identified bradycardia (heart rate 31–50 bpm), oral and nasal ulcers and polyarthritis. The laboratory results showed hemolytic anemia, hypocomplementemia, antinuclear and anti-dsDNA antibodies, hematuria and non-nephrotic proteinuria. Renal function was normal. Lupus nephritis class II was diagnosed by kidney biopsy. On the transthoracic echocardiogram we identified a minimal pericardial effusion, suggesting pericarditis, and, on the electrocardiogram, we detected sinus arrest with junctional rhythm, denoting sinus node dysfunction. The patient was diagnosed with juvenile SLE with cardiac, renal, musculoskeletal and hematologic involvement. Disease remission and cardiac rhythm control were obtained with steroids and mycophenolate mofetil. Currently, the patient is asymptomatic, with normal sinus rhythm. We described an adolescent with SLE who had sinus node dysfunction upon diagnosis. Other cases have been reported in adults but none in juvenile SLE. All SLE patients should have a thorough cardiac examination to promptly diagnose and treat the innumerous cardiac manifestations of this disease.

Management of bradyarrhythmias

2017 ◽  
pp. 805-810
Author(s):  
James L. Harrison ◽  
Mark D. O’Neill
Keyword(s):  
Young Adult ◽  
Sinus Node ◽  
Careful Consideration ◽  
Sinus Node Dysfunction ◽  
Significant Morbidity ◽  
Main Indication ◽  
Pacemaker Therapy ◽  
Functional Changes ◽  
Purkinje System ◽  
Symptomatic Bradycardia

The process of ageing is associated with an increased incidence of cardiac bradyarrhythmias, which are responsible for significant morbidity and mortality. Structural and functional changes, both mechanical and electrical, occur in the ageing heart, together with alterations in cardiac energetics and metabolism. By the age of 75, the number of functioning pacemaker cells is less than 10%, compared with a young adult. A reduction in automaticity and a slowing of conduction are both common, exacerbated by comorbidities and polypharmacy. Over 80% of pacemakers are implanted in those over 65 years of age. The main indication in these patients is symptomatic bradycardia, due to degenerative sinus node dysfunction or disease of the atrioventricular (AV) node and His-Purkinje system. With careful consideration of risks and benefits, age should not be seen as a contraindication to pacemaker therapy for cardiac bradyarrhythmias.

Use of Theophylline to Avoid Permanent Pacing in Post Heart Transplant Sinus Node Dysfunction.

2014 ◽  
Vol 98 ◽  
pp. 428-429
Author(s):  
G. Bhat ◽  
G. Yost ◽  
S. Sundararajan ◽  
B. Mohamedali
Keyword(s):  
Heart Transplant ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Permanent Pacing

scholarly journals Efficiency of dimephosphonum, cytochrom cand mexidol in the treatment of cardiac rhythm disorders in children

2021 ◽  
Vol 82 (1) ◽  
pp. 5-7
Author(s):  
L. A. Balykova ◽  
M. I. Almyasheva
Keyword(s):  
Ventricular Arrhythmias ◽  
Cardiac Rhythm ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Effective Drug ◽  
Supraventricular Arrhythmias ◽  
Negative Effects ◽  
Heart Functions

The efficiency of dimephosphonum, cytochrom c and mexidol in the treatment of ventricular, supraventricular arrhythmias in children is shown. Dimephosphonum (100 mg/kg i.v.), mexidol (10 mg/kg p.o.) and cytochrom c (0,5 mg/kg i.v.) were studied in comparison with cordaron, finoptin and also with the standard neurometabolic therapy. It is shown that dimephosphonum was the most effective drug in all kinds of disturbances of cardiac rhythm and conductivity in children. In supraventricular arrithmias and sinus node dysfunction it surpasses traditional drugs. At ventricular arrhythmias dimephosphonum was less effective than cordaron. However, cordaron induced cardiac (20%) and extracardiac (20%) negative effects. The dimephosphonum treatment was safe and was accompanied by favourable influence on the basic heart functions

scholarly journals Screening for ATTR amyloidosis in the clinic: overlapping disorders, misdiagnosis, and multiorgan awareness

2021 ◽  
Author(s):  
Jose N. Nativi-Nicolau ◽  
Chafic Karam ◽  
Sami Khella ◽  
Mathew S. Maurer
Keyword(s):  
Amyloid Fibrils ◽  
Sinus Node ◽  
Loss Of Function ◽  
Attr Amyloidosis ◽  
Permanent Pacing ◽  
Musculoskeletal Manifestations ◽  
Tunnel Syndrome ◽  
Lumbar Spinal ◽  
Cardiac Manifestations ◽  
Include Heart Failure

AbstractAmyloid transthyretin (ATTR) amyloidosis is a clinically heterogeneous and fatal disease that results from deposition of insoluble amyloid fibrils in various organs and tissues, causing progressive loss of function. The objective of this review is to increase awareness and diagnosis of ATTR amyloidosis by improving recognition of its overlapping conditions, misdiagnosis, and multiorgan presentation. Cardiac manifestations include heart failure, atrial fibrillation, intolerance to previously prescribed antihypertensives, sinus node dysfunction, and atrioventricular block, resulting in the need for permanent pacing. Neurologic manifestations include progressive sensorimotor neuropathy (e.g., pain, weakness) and autonomic dysfunction (e.g., erectile dysfunction, chronic diarrhea, orthostatic hypotension). Non-cardiac red flags often precede the diagnosis of ATTR amyloidosis and include musculoskeletal manifestations (e.g., carpal tunnel syndrome, lumbar spinal stenosis, spontaneous rupture of the distal tendon biceps, shoulder and knee surgery). Awareness and recognition of the constellation of symptoms, including cardiac, neurologic, and musculoskeletal manifestations, will help with early diagnosis of ATTR amyloidosis and faster access to therapies, thereby slowing the progression of this debilitating disease.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

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