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Sinus Arrest, Cardiac

MedGen UID:
363039
•Concept ID:
C1955864
•
Pathologic Function
Synonyms: Cardiac Sinus Arrest; Cardiac Sinus Arrests; Cardiac Sinus Pause; Cardiac Sinus Pauses; Sinus Arrests, Cardiac; Sinus Pause, Cardiac; Sinus Pauses, Cardiac

Definition

The omission of atrial activation that is caused by transient cessation of impulse generation at the SINOATRIAL NODE. It is characterized by a prolonged pause without P wave in an ELECTROCARDIOGRAM. Sinus arrest has been associated with sleep apnea (REM SLEEP-RELATED SINUS ARREST). [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSinus Arrest, Cardiac

Professional guidelines

PubMed

2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients.
Writing Committee Members, Shah MJ, Silka MJ, Silva JNA, Balaji S, Beach CM, Benjamin MN, Berul CI, Cannon B, Cecchin F, Cohen MI, Dalal AS, Dechert BE, Foster A, Gebauer R, Gonzalez Corcia MC, Kannankeril PJ, Karpawich PP, Kim JJ, Krishna MR, Kubuš P, LaPage MJ, Mah DY, Malloy-Walton L, Miyazaki A, Motonaga KS, Niu MC, Olen M, Paul T, Rosenthal E, Saarel EV, Silvetti MS, Stephenson EA, Tan RB, Triedman J, Bergen NHV, Wackel PL
Heart Rhythm 2021 Nov;18(11):1888-1924. Epub 2021 Jul 29 doi: 10.1016/j.hrthm.2021.07.038. PMID: 34363988
2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD
Circulation 2019 Aug 20;140(8):e382-e482. Epub 2018 Nov 6 doi: 10.1161/CIR.0000000000000628. PMID: 30586772
2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD
J Am Coll Cardiol 2019 Aug 20;74(7):e51-e156. Epub 2018 Nov 6 doi: 10.1016/j.jacc.2018.10.044. PMID: 30412709

Recent clinical studies

Etiology

Acute Sinus Node Dysfunction after Atrial Ablation: Incidence, Risk Factors, and Management.
Killu AM, Fender EA, Deshmukh AJ, Munger TM, Araoz P, Brady PA, Cha YM, Packer DL, Friedman PA, Asirvatham SJ, Noseworthy PA, Mulpuru SK
Pacing Clin Electrophysiol 2016 Oct;39(10):1116-1125. Epub 2016 Sep 20 doi: 10.1111/pace.12934. PMID: 27530090
Congenital Central Hypoventilation Syndrome: Neurocognition Already Reduced in Preschool-Aged Children.
Charnay AJ, Antisdel-Lomaglio JE, Zelko FA, Rand CM, Le M, Gordon SC, Vitez SF, Tse JW, Brogadir CD, Nelson MN, Berry-Kravis EM, Weese-Mayer DE
Chest 2016 Mar;149(3):809-15. Epub 2016 Jan 12 doi: 10.1378/chest.15-0402. PMID: 26378991
A Literature Review Revisiting Phenytoin-Induced Sinus Arrest.
Parsai S, Hariri I, Taleb M, Yoon Y
Am J Ther 2016 Jul-Aug;23(4):e1091-3. doi: 10.1097/MJT.0000000000000159. PMID: 25549077
Assessment of heart rate variability in breath holding children by 24 hour Holter monitoring.
Yilmaz O, Ciftel M, Ozturk K, Kilic O, Kahveci H, Laloğlu F, Ceylan O
Cardiol Young 2015 Feb;25(2):317-23. Epub 2013 Dec 19 doi: 10.1017/S1047951113002333. PMID: 24351939
Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation.
Pecha S, Schäfer T, Yildirim Y, Ahmadzade T, Willems S, Reichenspurner H, Wagner FM
J Thorac Cardiovasc Surg 2014 Mar;147(3):984-8. Epub 2013 Apr 6 doi: 10.1016/j.jtcvs.2013.03.012. PMID: 23566511

Diagnosis

Syncope and Twitching at the Emergency Department.
Scutelnic A, Prange U, Jung S, Heldner MR
Am J Case Rep 2019 Aug 26;20:1259-1263. doi: 10.12659/AJCR.916945. PMID: 31447480Free PMC Article
Chinese Patent medicine to treat a 32-year-old man with sinus bradycardia and cardiac sinus arrests: A case report.
Yan D, Xu XR, Qian YL, Peng HY, Qian H, Yue BW, Zhao LL, Zhang ZH, Fang ZY
Medicine (Baltimore) 2019 May;98(19):e15536. doi: 10.1097/MD.0000000000015536. PMID: 31083205Free PMC Article
A case of sinus arrest and post-hiccup cough syncope in medullary infarction.
Takazawa T, Ikeda K, Kano O, Kabuki T, Kawabe K, Iwasaki Y
J Stroke Cerebrovasc Dis 2014 Mar;23(3):566-71. Epub 2013 May 7 doi: 10.1016/j.jstrokecerebrovasdis.2013.04.016. PMID: 23660345
The longest pause.
Matthews IG, Norton M, Jaafar AF
Heart 2013 May;99(9):670-1. Epub 2012 Dec 1 doi: 10.1136/heartjnl-2012-303289. PMID: 23204496
Pseudopauses.
Hoffmayer KS, Goldschlager N
J Electrocardiol 2008 Sep-Oct;41(5):435. doi: 10.1016/j.jelectrocard.2008.05.002. PMID: 18754150

Therapy

Chinese Patent medicine to treat a 32-year-old man with sinus bradycardia and cardiac sinus arrests: A case report.
Yan D, Xu XR, Qian YL, Peng HY, Qian H, Yue BW, Zhao LL, Zhang ZH, Fang ZY
Medicine (Baltimore) 2019 May;98(19):e15536. doi: 10.1097/MD.0000000000015536. PMID: 31083205Free PMC Article
Acute Sinus Node Dysfunction after Atrial Ablation: Incidence, Risk Factors, and Management.
Killu AM, Fender EA, Deshmukh AJ, Munger TM, Araoz P, Brady PA, Cha YM, Packer DL, Friedman PA, Asirvatham SJ, Noseworthy PA, Mulpuru SK
Pacing Clin Electrophysiol 2016 Oct;39(10):1116-1125. Epub 2016 Sep 20 doi: 10.1111/pace.12934. PMID: 27530090
Sinus arrest following angioplasty and stenting for superior vena cava syndrome.
Tempelhof M, Campbell J, Ilkhanoff L
J Invasive Cardiol 2014 Feb;26(2):E21-3. PMID: 24486673
Sinus arrest caused by occlusion of the sinus node artery during percutaneous coronary intervention for lesions of the proximal right coronary artery.
Kotoku M, Tamura A, Naono S, Kadota J
Heart Vessels 2007 Nov;22(6):389-92. Epub 2007 Nov 26 doi: 10.1007/s00380-007-0990-0. PMID: 18043996
The role of nicardipine during anesthesia and surgery.
Kaplan JA
Clin Ther 1989;11(1):84-93. PMID: 2655908

Prognosis

Incidence and timing of potentially high-risk arrhythmias detected through long term continuous ambulatory electrocardiographic monitoring.
Solomon MD, Yang J, Sung SH, Livingston ML, Sarlas G, Lenane JC, Go AS
BMC Cardiovasc Disord 2016 Feb 17;16:35. doi: 10.1186/s12872-016-0210-x. PMID: 26883019Free PMC Article
Suicide left ventricle due to conduction disturbance following transcatheter aortic valve replacement and reversal with restoration of sinus rhythm: is there life after death?
Ibrahim H, Barker CM, Reardon MJ, Kleiman NS
J Invasive Cardiol 2015 Jun;27(6):E107-9. PMID: 26028658
Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation.
Pecha S, Schäfer T, Yildirim Y, Ahmadzade T, Willems S, Reichenspurner H, Wagner FM
J Thorac Cardiovasc Surg 2014 Mar;147(3):984-8. Epub 2013 Apr 6 doi: 10.1016/j.jtcvs.2013.03.012. PMID: 23566511
Acute lymphoblastic leukemia with hyperleukocytosis, sinus pauses, and hypoxemic respiratory failure in an infant.
Sykes JA, Kalyanaraman M, Kamalakar P, Sharma N
Pediatr Emerg Care 2011 Mar;27(3):212-4. doi: 10.1097/PEC.0b013e31820d8de9. PMID: 21378524
Cardiac arrest after intracisternal papaverine instillation during intracranial aneurysm surgery. Case report.
Baltaci B, Basar H, Ozcan A, Gulhan Y, Aytunur CS
J Neurosurg 2010 Oct;113(4):760-2. doi: 10.3171/2009.11.JNS09899. PMID: 19961315

Clinical prediction guides

Syncope and Twitching at the Emergency Department.
Scutelnic A, Prange U, Jung S, Heldner MR
Am J Case Rep 2019 Aug 26;20:1259-1263. doi: 10.12659/AJCR.916945. PMID: 31447480Free PMC Article
Congenital Central Hypoventilation Syndrome: Neurocognition Already Reduced in Preschool-Aged Children.
Charnay AJ, Antisdel-Lomaglio JE, Zelko FA, Rand CM, Le M, Gordon SC, Vitez SF, Tse JW, Brogadir CD, Nelson MN, Berry-Kravis EM, Weese-Mayer DE
Chest 2016 Mar;149(3):809-15. Epub 2016 Jan 12 doi: 10.1378/chest.15-0402. PMID: 26378991
Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation.
Pecha S, Schäfer T, Yildirim Y, Ahmadzade T, Willems S, Reichenspurner H, Wagner FM
J Thorac Cardiovasc Surg 2014 Mar;147(3):984-8. Epub 2013 Apr 6 doi: 10.1016/j.jtcvs.2013.03.012. PMID: 23566511
Persistent electrical scar in the atrium evaluated on voltage mapping with a CARTO system in suspected acute myocarditis.
Ito S, Kamegai A, Murakami Y, Nakasuka K, Sekimoto S, Miyata K, Inomata M, Yoshida T, Tamai N, Saeki T, Suzuki S, Sato K, Morino A, Shimizu Y
Circ J 2012;76(12):2895-7. Epub 2012 Aug 22 doi: 10.1253/circj.cj-12-0475. PMID: 22971841
Impact of pulmonary vein isolation on the autonomic modulation in patients with paroxysmal atrial fibrillation and prolonged sinus pauses.
Miyanaga S, Yamane T, Date T, Tokuda M, Aramaki Y, Inada K, Shibayama K, Matsuo S, Miyazaki H, Abe K, Sugimoto K, Mochizuki S, Yoshimura M
Europace 2009 May;11(5):576-81. Epub 2009 Apr 10 doi: 10.1093/europace/eup082. PMID: 19363052

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