Sinus Node Dysfunction Follow-up

  • Author: Yingbo Yang, MD, PhD; Chief Editor: Jeffrey N Rottman, MD   more...
 
Updated: Apr 6, 2011
 

Further Inpatient Care

Admit patients for testing and pacemaker placement when indicated.

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Further Outpatient Care

Asymptomatic patients with SND should be observed for symptoms.

In patients with a pacemaker, the following should be performed on routine pacemaker interrogations:

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Transfer

Transfer patients for complicated dysrhythmias and pacemaker implant.

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Deterrence/Prevention

Treat heart diseases related to SND and extrinsic causes to delay and prevent SND.

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Complications

  • Sudden cardiac death (rare)
  • Syncope
  • Fall
  • Thromboembolic events including stroke (especially in patients with tachy-brady syndrome)
  • Congestive heart failure
  • Arrhythmias
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Prognosis

The incidence of sudden cardiac death in patients with SND is very low[8] . The mortality in patients with SND is primarily determined by underlying heart diseases. The patients with tachy-brady syndrome have a worse prognosis than patients with isolated SND. Pacemaker therapy does not appear to affect survival in patients with SND[5, 6, 7] and is, therefore, used primarily for alleviation of symptoms.

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Patient Education

  • Educate patients to recognize symptoms of SND.
  • Educate patients on pacemakers.
  • Family members should learn cardiopulmonary resuscitation (CPR).
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Contributor Information and Disclosures
Author

Yingbo Yang, MD, PhD  Clinical Assistant Professor of Cardiovascular Medicine, Division of Cardiology, Lawrence J Ellison Ambulatory Care Center, University of California, Davis, Medical Center

Yingbo Yang, MD, PhD is a member of the following medical societies: American College of Cardiology and Heart Rhythm Society

Disclosure: Nothing to disclose.

Coauthor(s)

Yasir Batres, MD  Fellow, Division of Cardiology, University of California, Davis, Medical Center

Yasir Batres, MD is a member of the following medical societies: American College of Cardiology

Disclosure: Nothing to disclose.

Specialty Editor Board

Justin D Pearlman, MD, PhD, ME, MA  Director of Advanced Cardiovascular Imaging, Professor of Medicine, Professor of Radiology, Adjunct Professor, Thayer Bioengineering and Computer Science, Dartmouth-Hitchcock Medical Center

Justin D Pearlman, MD, PhD, ME, MA is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Federation for Medical Research, International Society for Magnetic Resonance in Medicine, and Radiological Society of North America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Brian Olshansky, MD  Professor of Medicine, Department of Internal Medicine, University of Iowa College of Medicine

Brian Olshansky, MD is a member of the following medical societies: American Autonomic Society, American College of Cardiology, American College of Chest Physicians, American College of Physicians, American College of Sports Medicine, American Federation for Clinical Research, American Heart Association, Cardiac Electrophysiology Society, Heart Rhythm Society, and New York Academy of Sciences

Disclosure: Guidant/Boston Scientific Honoraria Speaking and teaching; Medtronic Honoraria Speaking and teaching; Guidant/Boston Scientific Consulting fee Consulting; Novartis Honoraria Speaking and teaching; Novartis Consulting fee Consulting

Amer Suleman, MD  Private Practice

Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Chief Editor

Jeffrey N Rottman, MD  Professor of Medicine and Pharmacology, Vanderbilt University School of Medicine; Chief, Department of Cardiology, Nashville Veterans Affairs Medical Center

Jeffrey N Rottman, MD is a member of the following medical societies: American Heart Association and North American Society of Pacing and Electrophysiology (NASPE)

Disclosure: Nothing to disclose.

Acknowledgments

We thank Dr. Adrian W Messerli, MD and professor Alan D Forker, MD for their important contributions to this article as the authors of its previous edition.

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