WordNet

a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"
abnormally rapid heartbeat (over 100 beats per minute)
abnormally slow heartbeat

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(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
心拍急速(心臓の異常に速い拍動)　頻拍　頻脈

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/01 18:05:07」(JST)

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Electrocardiogram from a man with bradycardia-tachycardia syndrome following mitral valvuloplasty, resection of the left atrial appendage and maze procedure. The ECG shows AV-junctional rhythm resulting in bradycardia at around 46 beats per minutes. The second beat is most likely an atrial extrasystole, given the atypical P wave (negative in I, positive in aVR).

This ECG from the same patient shows atrial fibrillation at around 126 beats per minute.

Sick sinus syndrome (SSS), also called sinus node dysfunction (SND), is an umbrella term for a group of abnormal heart rhythms (arrhythmias) presumably caused by a malfunction of the sinus node, the heart's primary pacemaker.^[1] Bradycardia-tachycardia syndrome is a variant of sick sinus syndrome in which slow arrhythmias and fast arrhythmias alternate. It is often associated with ischaemic heart disease and valvular lesions.

Causes

Sick sinus syndrome is a relatively uncommon syndrome. It can result in many abnormal heart rhythms (arrhythmias), including sinus arrest, sinus node exit block, sinus bradycardia, and other types of bradycardia (slow heart rate).

Sick sinus syndrome may also be associated with tachycardias (fast heart rate) such as paroxysmal supraventricular tachycardia (PSVT) and atrial fibrillation. Tachycardias that occur with sick sinus syndrome are characterized by a long pause after the tachycardia. Sick sinus syndrome is also associated with azygos continuation of interrupted inferior vena cava

Abnormal rhythms are often caused or worsened by medications such as digitalis, calcium channel blockers, beta-blockers, sympatholytic medications, and anti-arrhythmics. Disorders that cause scarring, degeneration, or damage to the conduction system can cause sick sinus syndrome, including sarcoidosis, amyloidosis, hemochromatosis, Chagas' disease,^[2] and cardiomyopathies.

Sick sinus syndrome is more common in elderly adults, where the cause is often a non-specific, scar-like degeneration of the cardiac conduction system. Cardiac surgery, especially to the atria, is a common cause of sick sinus syndrome in children.

Coronary artery disease, high blood pressure, and aortic and mitral valve diseases may be associated with sick sinus syndrome, although this association may only be incidental. The mechanism is related to delayed escape. Congenital SSS is due to mutations of gene responsible for formation of Alpha subunit of sodium channel.

A Russian study showed that the heterozygous variant of connexin 40 polymorphism gene variant is more frequent among patients with sick sinus node syndrome and their healthy relatives than in persons of control group, suggesting a link between the gene and the disease.^[3]

Symptoms

Even though many types of sick sinus syndrome produce no symptoms, patients may present with:

Stokes-Adams attacks – fainting due to asystole or ventricular fibrillation
Dizziness or light-headedness
Palpitations
Chest pain or angina
Shortness of breath
Fatigue
Headache
Nausea
Fainting

Diagnosis

Ambulatory monitoring of the electrocardiogram (ECG) may be necessary because arrhythmias are transient.^[4] The ECG may show any of the following

Inappropriate sinus bradycardia
Sinus arrest
Sinoatrial block
Atrial fibrillation with slow ventricular response
A prolonged asystolic period after a period of tachycardias
Atrial flutter
Ectopic atrial tachycardia
Sinus node reentrant tachycardia
Wolff-Parkinson-White syndrome

Electrophysiologic tests are no longer used for diagnostic purposes because of their low specificity and sensitivity. Cardioinhibitory and vasodepressor forms of sick sinus syndrome may be revealed by tilt table testing.

Treatment

Artificial pacemakers have been used in the treatment of sick sinus syndrome.^[5]

Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy.

However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.

References

^ Dobrzynski H, Boyett MR, Anderson RH (April 2007). "New insights into pacemaker activity: promoting understanding of sick sinus syndrome". Circulation 115 (14): 1921–32. doi:10.1161/CIRCULATIONAHA.106.616011. PMID 17420362.
^ Keller KB, Lemberg L (March 2006). "The sick sinus syndrome". Am. J. Crit. Care 15 (2): 226–9. PMID 16501143.
^ Chernova, AA (2011). "[Polymorphism of Connexin 40 Gene a Novel Genetic Marker of the Sick Sinus Node Syndrome.]". Kardiologiia 51 (5): 17–9. PMID 21649591.
^ Adán V, Crown LA (April 2003). "Diagnosis and treatment of sick sinus syndrome". Am Fam Physician 67 (8): 1725–32. PMID 12725451.
^ Drago F, Silvetti MS, Grutter G, De Santis A (July 2006). "Long term management of atrial arrhythmias in young patients with sick sinus syndrome undergoing early operation to correct congenital heart disease". Europace 8 (7): 488–94. doi:10.1093/europace/eul069. PMID 16798761.

UpToDate Contents

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1. Sick sinus syndrome: Epidemiology, etiology, and natural history
2. 洞不全症候群の治療 treatment of the sick sinus syndrome
3. Sick sinus syndrome: Clinical manifestations, diagnosis, and evaluation
4. 心電図チュートリアル：洞結節での調律および不整脈 ecg tutorial rhythms and arrhythmias of the sinus node
5. 心房細動における心拍数のコントロール：薬理療法 control of ventricular rate in atrial fibrillation pharmacologic therapy

English Journal

Outcome and survival in canine sick sinus syndrome and sinus node dysfunction: 93 cases (2002-2014).

Ward JL1, DeFrancesco TC1, Tou SP1, Atkins CE1, Griffith EH1, Keene BW2.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.J Vet Cardiol.2016 Sep;18(3):199-212. doi: 10.1016/j.jvc.2016.04.004. Epub 2016 Jun 7.
INTRODUCTION: To evaluate the clinical presentation, diagnosis, treatment, and outcomes of a group of dogs with sinoatrial node abnormalities.ANIMALS: Ninety-three client-owned dogs at a referral institution.MATERIALS AND METHODS: Medical records were reviewed for clinical history, diagnostic testin
PMID 27286907

Impact of Catheter Ablation for Paroxysmal Atrial Fibrillation in Patients With Sick Sinus Syndrome　- Important Role of Non-Pulmonary Vein Foci.

Hayashi K1, Fukunaga M, Yamaji K, An Y, Nagashima M, Hiroshima K, Ohe M, Makihara Y, Yamashita K, Ando K, Iwabuchi M, Goya M.
Circulation journal : official journal of the Japanese Circulation Society.Circ J.2016;80(4):887-94. doi: 10.1253/circj.CJ-15-1384. Epub 2016 Mar 2.
BACKGROUND: The clinical efficacy of catheter ablation (CA) for paroxysmal atrial fibrillation (PAF) in patients with sick sinus syndrome (SSS) and the mechanism and predictors of recurrence are not yet completely elucidated.METHODS AND RESULTS: Of 963 consecutive patients who underwent PAF abla
PMID 26936115

Near elimination of ventricular pacing in SafeR mode compared to DDD modes: a randomized study of 422 patients.

Davy JM1, Hoffmann E, Frey A, Jocham K, Rossi S, Dupuis JM, Frabetti L, Ducloux P, Prades E, Jauvert G.
Pacing and clinical electrophysiology : PACE.Pacing Clin Electrophysiol.2012 Apr;35(4):392-402. doi: 10.1111/j.1540-8159.2011.03314.x. Epub 2012 Feb 6.
AIMS: SafeR performance versus DDD/automatic mode conversion (DDD/AMC) and DDD with a 250-ms atrioventricular (AV) delay (DDD/LD) modes was assessed toward ventricular pacing (Vp) reduction.METHODS: After a 1-month run-in phase, recipients of dual-chamber pacemakers without persistent AV block and p
PMID 22309303

Japanese Journal

失神の診断に難渋し植え込み型ループレコーダ(ILR)から徐脈頻脈症候群への診断に至った1例

藤野紀之,池田隆徳,湯澤ひとみ [他],佐藤秀之,阿部敦子,福永俊二,小林建三郎,岡野喜史,山﨑純一
東邦医学会雑誌 59(2), 68-72, 2012-03
… A diagnosis of bradycardia-tachycardia syndrome (BTS) was ultimately confirmed. …
NAID 120005306356

Success in Avoiding Reoperation through Follow-up in a Case of Sick Sinus Syndrome Despite Transient Marked Elevation in Atrial Threshold

SASAOKA Shunsuke,MURAMATSU Toshiya,SAKAI Tsuyoshi
Journal of arrhythmia 27(1), 63-67, 2011-01-25
… After termination of atrial flutter by ablation, sinus arrest was noted, allowing a diagnosis of bradycardia-tachycardia syndrome, for which the patient underwent pacemaker implantation.<BR>Twenty days after implantation, a marked elevation of atrial threshold was noted, despite absence of a change in lead resistance or position, and atrial capturing was not possible even at the maximum output (8 V/1.2 ms). …
NAID 10029598667

Progress of Sinus Bradycardia in Patients with Bradycardia-Tachycardia Syndrome: One-Year Follow-Up

Kanno Takaaki,Takenaka Sou,Aso Mizuho,Nakashima Takashi,Ozaki Hiroyuki,Nakamura Mitsuchika,Otsuka Masato,Tsurumi Yukio
Journal of Arrhythmia 27(Supplement), PJ3_029-PJ3_029, 2011
… In patients with permanent pacemaker for bradycardia-tachycardia syndrome, pacing should operate only during the periods of slow atrial and ventricular rates. … We studied 10 consecutive patients who had received permanent pacemaker implantation for bradycardia-tachycardia syndrome. …
NAID 130002130311

Related Pictures

徐脈症候群VS頻脈症候群 - 健康 - 2020 The ECG When the Patient has a Bradycardia | Thoracic Key Sinus Node Dysfunction (Sick Sinus Syndrome) • LITFL • ECG Library ECG, Conduction disturbances Arrhythmia :ECG ---Bradycardia_20120902_北區 Arrhythmia :ECG-Bradycardia_20120909_中區 Sick sinus syndrome (bradycardia-tachycardia syndrome) | myVMC

★リンクテーブル★

リンク元	「徐脈頻脈症候群」
関連記事	「tachycardia」「syndrome」

「徐脈頻脈症候群」

Sick sinus syndrome
Classification and external resources
Specialty	cardiology
ICD-10	I49.5
ICD-9-CM	427.81
DiseasesDB	12066
MedlinePlus	000161

　　[★]

英: bradycardia-tachycardia syndrome
同: 徐脈頻脈不整脈 bradytachyarrhythmia
関: 不整脈、洞不全症候群

国試

105A050

治療

無症状：経過観察
有症状：

急性期：両下肢挙上、薬剤(アトロピン、イソプロテレノール)
永続性：人工ペースメーカー(適応：心拍数が40以下、最大RR間隔が3秒以上)

「tachycardia」

　　[★]

n.

頻拍症、頻拍、頻脈症、頻脈

関: tachyarrhythmia

[show details]

tachycardia 頻脈 : 約 43,000 件
tachycardia 頻拍 : 約 61,400 件

「syndrome」

　　[★]

n.

症候群

[pmid17420362-1] Dobrzynski H, Boyett MR, Anderson RH (April 2007). "New insights into pacemaker activity: promoting understanding of sick sinus syndrome". Circulation 115 (14): 1921–32. doi:10.1161/CIRCULATIONAHA.106.616011. PMID 17420362.

[pmid16501143-2] Keller KB, Lemberg L (March 2006). "The sick sinus syndrome". Am. J. Crit. Care 15 (2): 226–9. PMID 16501143.

[3] Chernova, AA (2011). "[Polymorphism of Connexin 40 Gene a Novel Genetic Marker of the Sick Sinus Node Syndrome.]". Kardiologiia 51 (5): 17–9. PMID 21649591.

[pmid12725451-4] Adán V, Crown LA (April 2003). "Diagnosis and treatment of sick sinus syndrome". Am Fam Physician 67 (8): 1725–32. PMID 12725451.

[pmid16798761-5] Drago F, Silvetti MS, Grutter G, De Santis A (July 2006). "Long term management of atrial arrhythmias in young patients with sick sinus syndrome undergoing early operation to correct congenital heart disease". Europace 8 (7): 488–94. doi:10.1093/europace/eul069. PMID 16798761.

匿名

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案内

案内

bradycardia-tachycardia syndrome