WordNet

deeply affected by a strong feeling; "sat completely still, sick with envy"; "she was sick with longing"
people who are sick; "they devote their lives to caring for the sick"
commit a sin; violate a law of God or a moral law (同)transgress, trespass
violent and excited activity; "they began to fight like sin" (同)hell
estrangement from god (同)sinfulness, wickedness
an act that is regarded by theologians as a transgression of Gods will (同)sinning
the 21st letter of the Hebrew alphabet
intentionally so written (used after a printed word or phrase)
urge to attack someone; "The owner sicked his dogs on the intruders"; "the shaman sics sorcerers on the evil spirits" (同)set
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"
any of various air-filled cavities especially in the bones of the skull

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Selective Service System 選抜徴兵制
(人が)『病気の』;(部屋などが)病人の[ための];(顔色などが)病気を示す(思わせる) / 《名詞的に》《the ~;複数扱い》病人 / 《補語にのみ用いて》《おもに英》(…で)むかついて,吐き気を催して,気分が悪い《+『at(『with』,『from』+『名』(do『ing』)》 / 《補語にのみ用いて》(…に)『うんざりして』,あきあきして,いや気がさして;(…に)しゃくにさわって,腹が立って《+『of』+『名』(do『ing』)》 / 《補語にのみ用いて》(…に)『がっかりして』,落胆して《+『at』(『about』)+『名』(do『ing』)》 / 《補語にのみ用いて》(…を)熱望して,こがれて《+『for』+『名』》 / 病的な,異常心理の;気味の悪い
〈U〉(宗教・道徳上の)『罪』 / 〈C〉(宗教・道徳上の)『罪の行為』,罪悪 / 〈C〉《特におどけて》違反(過失)の行為 / (宗教・道徳上の)おきてを破る,罪を犯す / (…に)違反(過失)をする,背く《+『against』+『名』》
sine
原文のまま(疑わしいまたは誤った原文をそのまま引用するときにつける)
…‘を'攻撃する / (…に対して)〈人・犬〉‘を'けしかける《+『名』〈人・犬〉+『on』+『名』》
(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
洞(どう)(骨や組織の中の穴・くぼみなど);静脈洞

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/01 22:08:37」(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, 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. 洞不全症候群の症状および原因 manifestations and causes of the sick sinus syndrome
2. 洞不全症候群の治療 treatment of the sick sinus syndrome
3. 洞不全症候群の診断および評価 diagnosis and evaluation of the sick sinus syndrome
4. 洞房結節の一時停止、停止、および進出ブロック sinoatrial nodal pause arrest and exit block
5. 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

English Journal

Cardiac involvements in myasthenia gravis associated with anti-Kv1.4 antibodies.

Suzuki S, Baba A, Kaida K, Utsugisawa K, Kita Y, Tsugawa J, Ogawa G, Nagane Y, Kuwana M, Suzuki N.SourceDepartment of Neurology, Keio University School of Medicine, Tokyo, Japan.
European journal of neurology : the official journal of the European Federation of Neurological Societies.Eur J Neurol.2013 Jul 5. doi: 10.1111/ene.12234. [Epub ahead of print]
BACKGROUND AND PURPOSE: There is no general consensus as to whether autoimmune myasthenia gravis (MG) is associated with heart diseases, despite the fact that myocarditis, a serious cardiac involvement treatable by immunotherapy, is a complication of MG. It has been observed previously that MG patie
PMID 23829303

Left Atrial Responses to Acute Right Ventricular Apical Pacing in Patients with Sick Sinus Syndrome.

Kim SM, Cho KI, Cha TJ, Heo JH, Kim HS, Lee JW.SourceDivision of Cardiology, Department of Internal Medicine, Maryknoll Medical Center, Busan, South Korea.
Echocardiography (Mount Kisco, N.Y.).Echocardiography.2013 Jul 3. doi: 10.1111/echo.12286. [Epub ahead of print]
Chronic right ventricular apical (RVA) pacing can lead to an increased risk of heart failure and atrial fibrillation, but the acute effects of RVA pacing on left atrial (LA) function are not well known. Twenty-four patients with sick sinus syndrome and intact intrinsic atrioventricular conduction we
PMID 23822568

Dose-Dependent Effect of Landiolol, a New Ultra-Short-Acting β1-Blocker, on Supraventricular Tachyarrhythmias in Postoperative Patients.

Taenaka N, Kikawa S.SourceTakarazuka City Hospital, 4-5-1 Obama, Takarazuka, Hyogo, 665-0827, Japan.
Clinical drug investigation.Clin Drug Investig.2013 Jul;33(7):505-14. doi: 10.1007/s40261-013-0093-x.
BACKGROUND: β-Adrenoceptor antagonists (β-blockers) have been reported to be effective for regulation of heart rate (HR) and restoring sinus rhythm in postoperative atrial fibrillation and atrial flutter, as well as in the prevention of those arrhythmias after open-heart surgery.OBJECTIVES: The ob
PMID 23728899

Japanese Journal

Endless loop tachycardia below the upper tracking rate of a pacemaker: A case report

Sakamoto Atsushi,Takeuchi Ryosuke,Hosoya Natsuko,Kageyama Shigetaka,Kajihara Jun,Takahashi Kosuke,Kurabe Takashi,Murata Koichiro,Nawada Ryuzo,Onodera Tomoya,Takizawa Akinori,Nomura Ryota,Nakai Masanao
Journal of Arrhythmia 28(6), 356-359, 2012
… An 82-year-old female with a history of hypertrophic cardiomyopathy (HCM), sick sinus syndrome (SSS), and an implanted DDD pacemaker was admitted to our hospital for congestive heart failure caused by rapid atrial fibrillation. … Burst pacing from the coronary sinus ostium to confirm the block line of the isthmus induced rapid, regular, ventricular pacing at a rate of 110 bpm. …
NAID 130002555725

A case of thoracoscopy-guided lead extraction with an excimer laser sheath

Ohmori Hiroya,Nitta Takashi,Sakamoto Shun-ichiro,Haraguchi Shuji,Shimizu Kazuo,Ochi Masami
Journal of Arrhythmia 28(4), 247-249, 2012
… At the age of 10 years, a dual-chamber (DDD) pacemaker was implanted via the right subclavian vein for the treatment of sick sinus syndrome. …
NAID 130002129488