The sick sinus syndrome. Natural history of dysfunction of the sinoatrial node

W. P. Lien, Y. S. Lee, F. Z. Chang, S. Y. Lee, C. M. Chen, H. C. Tsai

Research output: Contribution to journalJournal Article peer-review

29 Scopus citations


Fifty-two patients with disease of the sinoatrial node were reviewed for the purpose of clarifying the natural history of the sinoatrial nodal dysfunction. Of these, 38 were observed for periods of time ranging from 1 to 23 years (average, six years). All available electrocardiograms of each patient were analyzed. A long duration of the disease was more frequently observed in patients with sinus bradycardia with sinoatrial block or sinus arrest and in patients with persistent atrioventricular junctional rhythm. The duration of the disease in patients with the latter condition with total sinus arrest ranged from 7 to 29 years (average, 13 years). Patients with a normal sinus rate with concomitant sinoatrial block or sinus arrest did not have a different average duration of the disease, as compared with those observed who had sinus bradycardia as the basic rhythm. One-third of the patients had documented paroxysmal supraventricular tachycardia, which occurred irrespective of the underlying arrhythmias. Occasional complete recovery of normal sinus mechanisms and rate could be noted during a long course of the disease and irrespective of the underlying electrocardiographic manifestations. Only one patient died in relation to the dysfunction of the sinoatrial node. The authors concluded that only with difficulty was the sinoatrial node destroyed by the disease process, and dysfunction of the sinoatrial node seemed to have a better prognosis than advanced atrioventricular block.

Original languageEnglish
Pages (from-to)628-634
Number of pages7
JournalUnknown Journal
Issue number5
StatePublished - 1977
Externally publishedYes


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