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Special Communication
JAMA. 1983;250(16):2160-2166. doi: 10.1001/jama.1983.03340160046030

Arrhythmias Associated With Sinus Node Dysfunction

Pathogenesis, Recognition, and Management

  1. Martin A. Alpert, MD;
  2. Greg C. Flaker, MD
  1. From the Departments of Medicine, University of Missouri Health Sciences Center and Harry S Truman Memorial Veterans Hospital, Columbia. Dr Alpert was a Teaching and Research Scholar of the American College of Physicians.

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Excerpt

DURING the past 15 years, we have become increasingly aware of the importance of arrhythmias associated with sinus node dysfunction as a cause of cardiac and neurological symptoms. These arrhythmias currently afflict more than 100,000 Americans, and as a group constitute the most common indication for permanent cardiac pacemaker implantation. The objectives of this review are (1) to discuss the pathogenesis and pathophysiology of arrhythmias associated with sinus node dysfunction, (2) to provide a clinical, electrocardiographic, and electrophysiological basis for their diagnosis, and (3) to discuss principles of management, including the use of the cardiac electrophysiology laboratory.

Anatomy and Pathophysiology The sinus node is located in the posterior right atrial wall at the junction of the right atrium and superior vena cava.1 It consists of three types of cells: P cells, transitional cells, and Purkinje's cells.2,3 The P cells, which are located in the midst of a collagen

Footnotes

  • Reprint requests to Room C-7, University of Missouri Health Sciences Center, 807 Stadium Rd, Columbia, MO 65212 (Dr Alpert).

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