1/150. Predominant tricuspid stenosis secondary to bacterial endocarditis in a patient with permanent pacemaker and balloon dilatation of the stenosis.In a 49-year-old woman with sick sinus syndrome and a permanent VVI pacemaker, severe tricuspid stenosis and its clinical consequences developed 4 years after the attack of endocarditis. Besides the quite unusual occurrence of lead related tricuspid stenosis, successful treatment with balloon dilatation is the unique feature of this case.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
2/150. Possible involvement of hypothyroidism as a cause of lithium-induced sinus node dysfunction.Although several reports have stated that even therapeutic levels of lithium can induce sinus node dysfunction, the mechanism has not been fully elucidated. We present here two patients with sinus node dysfunction after long-term lithium therapy. Following lithium discontinuation, sinus node function recovered completely. After resuming lithium, however, irreversible sinus node dysfunction recurred and a permanent pacemaker was implanted in one patient. The serum concentration of lithium was within therapeutic levels. Nevertheless, hypothyroidism was associated with the sinus node dysfunction in both patients. Thus, thyroid function may play an important role in sinus node dysfunction induced by lithium.- - - - - - - - - - ranking = 10keywords = sinus (Clic here for more details about this article) |
3/150. Dynamic left ventricular arterial pressure gradient and sick sinus syndrome with heterozygous Fabry's disease improved following implantation of a dual chamber pacemaker.A 63-year-old woman with heterozygous Fabry's disease, sick sinus syndrome, sinus pauses, congestive heart failure, syncope, and a dynamic pressure gradient between the left ventricle and systemic arteries underwent implantation of a dual chamber (DDD) pacemaker. Following pacemaker implantation, the pressure gradient has been reduced and congestive heart failure controlled for the past 3 years.- - - - - - - - - - ranking = 6keywords = sinus (Clic here for more details about this article) |
4/150. exercise-induced uncommon atrioventricular nodal reentrant tachycardia with sick sinus syndrome: a case report.exercise seldom provokes tachycardia in patients with paroxysmal supraventricular tachycardia (PSVT). This report presents a case of exercise-induced uncommon atrioventricular nodal reentrant tachycardia (AVNRT) with sick sinus syndrome. Treadmill exercise testing provoked AVNRT of long RP' with good reproducibility. Uncommon AVNRT was confirmed by the lack of atrial pre-excitation during PSVT and para-Hisian pacing. The patient has been successfully treated with verapamil and DDD pacing for 5 years.- - - - - - - - - - ranking = 5keywords = sinus (Clic here for more details about this article) |
5/150. Intermittent sinus bigeminy as an expression of sinus parasystole: a case report.A case of sinus parasystole is reported. The diagnosis of sinus parasystole is relatively difficult because there is no difference between the basic sinus P wave and the parasystolic wave. Sinus parasystole is diagnosed according to the following electrocardiographic criteria: (1) premature P waves having contour identical to P waves of basic beats; (2) intervals between premature P waves mathematically related. In the case reported, the coupling intervals during long phases of intermittent sinus bigeminy were nearly fixed, because there was little variability in the returning cycles, making the diagnosis of sinus parasystole difficult.- - - - - - - - - - ranking = 13keywords = sinus (Clic here for more details about this article) |
6/150. Successful treatment of severe orthostatic hypotension with cardiac tachypacing in dual chamber pacemakers.Orthostatic hypotension is an evolving and disabling disease usually observed in elderly patients with dramatic consequences on morbidity, mortality, and impairing the quality of life. We studied the effects of the pacing rate and AV interval on the blood pressure drop in the upright position in two patients with previously implanted pacemakers for sinus node dysfunction. Although the AV interval did not affect the blood pressure drop in the upright position, tachypacing at 100 paces/min improved it dramatically and prevented syncope. Cardiac tachypacing is a useful therapeutic option in severe refractory orthostatic hypotensive patients, especially those with chronotropic incompetence.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
7/150. Minimally invasive removal of infected pacemaker lead.A 37-year-old woman with sick sinus syndrome suffered complications with recurring local infection at the generator pocket. Repeated debridement and antibiotic therapy was ineffective. Several attempts to remove leads via the implantation vein by direct traction were unsuccessful. We operated using cardiopulmonary bypass and applied a minimally invasive lower ministernotomy to obtain pleasing cosmetic results. After a right atriotomy, leads were removed. The minimally invasive approach gave satisfactory results, especially cosmetically.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
8/150. Effects of theophylline on exercise indices in a patient with chronotropic incompetence.Several investigators have documented the successful use of oral sustained-release theophylline in treating symptomatic bradycardia and sick sinus syndrome. This paper reports a case of chronotropic incompetence in which specific exercise indices, including the chronotropic response index, were used to measure the therapeutic efficacy of theophylline.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
9/150. sick sinus syndrome in a patient with single coronary artery anomaly.Single coronary artery anomaly is very rare. The reported manifestations include angina pectoris and congestive heart failure. Here we describe a case of single coronary artery anomaly presenting as sick sinus syndrome, which has no literature precedence. A 47-year-old woman had complained of intermittent dizziness for years. A Holter electrocardiogram showed sinus bradycardia and junctional or ventricular rhythm with a maximal ventricular pause of up to 3.2 seconds. Electrophysiologic study revealed prolonged corrected sinus nodal recovery time. coronary angiography showed that the left anterior descending artery had a long course with a side branch originating from the proximal part and coursing anteriorly to the territory of the proximal portion of the right coronary artery. The sinus node is usually supplied by the sinoatrial branch via the right coronary artery. aortography showed that the right coronary artery ostium was absent. A permanent pacemaker was implanted and the patient was discharged in good condition. The present case suggests that coronary artery anomaly may lead to compromised blood supply to the sinus node, and hence sick sinus syndrome.- - - - - - - - - - ranking = 10keywords = sinus (Clic here for more details about this article) |
10/150. Case 4: a patient with symptomatic bradycardia.Both the clinical and electrocardiographic presentations of sick sinus syndrome are highly variable. As illustrated by this month's case of Interactive Grand Rounds, the initial challenge to the clinician is to establish the correct diagnosis in the patient who has symptomatic bradyarrhythmias.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
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