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The Sick Sinus Syndrome
Jay L. Jordan, MD;
Iwao Yamaguchi, MD;
William J. Mandel, MD
JAMA. 1977;237(7):682-684.
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"THE SICK sinus syndrome" is a term coined by Ferrer1 referring to a constellation of signs, symptoms, and ECG criteria defining sinus node dysfunction in a clinical setting. These criteria, which have been described by many investigators,2-7 include sinus bradycardia, sinus arrest, sinoatrial block, alternating bradyarrhythmias and tachyarrhythmias, and carotid hypersensitivity. Any one or combination of these features may be seen in the typical sick sinus patient who has syncope or other evidence of cerebral dysfunction. Symptoms, nevertheless, are a manifestation of failure of escape pacemaker function and not truly a feature of sinus node malfunction.
SINUS NODE AS PACEMAKER
The sinus node is a highly organized cluster of specialized cells located in the area of the junction between the superior vena cava and the right atrium. Microscopically, three cell types have been described in the sinus node: P cells, transitional cells, and working cells.8 The P
. . . [Full Text PDF of this Article]
Author Affiliations
From the Division of Cardiology, Cedars-Sinai Medical Center (Drs Jordan, Yamaguchi, and Mandel), and the Department of Medicine, UCLA Medical Center (Dr Mandel), Los Angeles.
Footnotes
This article is one of a series sponsored by the American Heart Association, edited by Richard L. Popp, MD.
Reprint requests to Division of Cardiology, Publication Office, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048 (Dr Jordan).
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