ECG Guru - Instructor Resources - Sick sinus syndrome https://www.ecgguru.com/ecg/sick-sinus-syndrome en SICK SINUS SYNDROME https://www.ecgguru.com/blog/sick-sinus-syndrome-0 <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/sick-sinus-syndrome-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/sick%20sinus.jpg" width="3463" height="1399" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>In this tracing, we see the limb leads + V1/V2. The first two beats are sinus node beats, there is a sinus bradycardia with approx. 55 bpm. Then there is a sinus arrest with a pause of 3000 ms, which is interrupted by a junctional escape beat. After this, the sinus bradycardia is re-established. </p> <p>Perhaps Dawn would like to add some text here, as I have kept my comments here very brief.<br /> DAWN: Thank you, Dr. Roeschl. For those who are unfamiliar with the diagnosis of "sick sinus syndrome", it is a group of rhythm disturbances that occur when there is SINUS NODE DYSFUNCTION. The dysfunction can either be due to impaired pacemaker function of the node, or impaired ability of the impulse to be transmitted out of the sinus node. SSS can produce bradycardia, tachycardia, or an alternation between the two. During periods of bradycardia, escape beats can occur, making the rhythm even more irregular. There are many causes of sinus node dysfunction, the most common being age-related sinus node degeneration. Many diseases, genetic factors, and even surgery can affect the sius node. The most effective treatment, after eliminating causes that can be corrected, is permanent electronic pacing.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/180/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give SICK SINUS SYNDROME 1/5</option><option value="40">Give SICK SINUS SYNDROME 2/5</option><option value="60">Give SICK SINUS SYNDROME 3/5</option><option value="80">Give SICK SINUS SYNDROME 4/5</option><option value="100" selected="selected">Give SICK SINUS SYNDROME 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >5</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-MiGfFu6QVhlXnYDiokyF_kG-CF8FzixYllNtKgkcZE0" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsick-sinus-syndrome-0&amp;title=SICK%20SINUS%20SYNDROME"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Wed, 20 Dec 2023 15:24:54 +0000 Dr A Röschl 889 at https://www.ecgguru.com https://www.ecgguru.com/blog/sick-sinus-syndrome-0#comments SICK SINUS SYNDROME https://www.ecgguru.com/blog/sick-sinus-syndrome <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/sick-sinus-syndrome"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Ventr%20Ersatz%20Brady%20Tachy.jpg" width="3226" height="1845" alt="" /></a></div><div class="field-item odd"><a href="/blog/sick-sinus-syndrome"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/escape.jpg" width="3067" height="1849" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>This EKG shows the classic features of sick sinus syndrome. Initially, there is an accelerated atrial rhythm/atrial tachycardia. After a pre-automatic pause of 2609 ms, a ventricular premature beat occurs, followed by a junctional escape rhythm. Pre-automatic pause is a pause after a tachycardia and before an automatic rhythm, like sinus rhythm or, in this case, junctional escape rhythm. Therefore, there is an alternation between tachycardic phases and very bradycardic rhythms, the classic bradycardia/tachycardia syndrome. Paper speed is 12.5 mm/sec. The ECG is digitized, so the grid printed will allow for accurate measurement of rate (notice that the "squares" are now rectangles).</p> <p>For more about sick sinus syndrome, see <a href="https://www.aafp.org/pubs/afp/issues/2003/0415/p1725.html">https://www.aafp.org/pubs/afp/issues/2003/0415/p1725.html</a></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/180/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give SICK SINUS SYNDROME 1/5</option><option value="40">Give SICK SINUS SYNDROME 2/5</option><option value="60">Give SICK SINUS SYNDROME 3/5</option><option value="80">Give SICK SINUS SYNDROME 4/5</option><option value="100">Give SICK SINUS SYNDROME 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="empty">No votes yet</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-Js6h_HVmAbtSc6w2e7qMMsFJW1LIvCr2uHmXuztfuig" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsick-sinus-syndrome&amp;title=SICK%20SINUS%20SYNDROME"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Tue, 29 Aug 2023 06:31:17 +0000 Dr A Röschl 868 at https://www.ecgguru.com https://www.ecgguru.com/blog/sick-sinus-syndrome#comments SSS (SICK SINUS SYNDROME) https://www.ecgguru.com/blog/sss-sick-sinus-syndrome <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/sss-sick-sinus-syndrome"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/SSS%20ecgguru.jpg" width="2802" height="1784" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>Why does this EKG indicate a sick sinus node? First, we observe a sinus rhythm with a rate just below 60 bpm. Then, there is a pause of approximately 3000 ms, followed not by a sinus beat, but by a junctional escape beat (retrograde/inverted P-wave immediately after the QRS complex). This ECG was recorded at the general practitioner's office, and it can be assumed that no vagal stimulus contributed to the arrhythmia. The same pause recorded in a Holter monitor during the night under the influence of vagal tone, without any other symptoms from the patient, would be evaluated quite differently.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/180/feed" method="post" id="fivestar-custom-widget--3" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--6" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give SSS (SICK SINUS SYNDROME) 1/5</option><option value="40">Give SSS (SICK SINUS SYNDROME) 2/5</option><option value="60">Give SSS (SICK SINUS SYNDROME) 3/5</option><option value="80" selected="selected">Give SSS (SICK SINUS SYNDROME) 4/5</option><option value="100">Give SSS (SICK SINUS SYNDROME) 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.7</span></span> <span class="total-votes">(<span >9</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--3" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-fg0w3cbqp7_WutZX7LZJLAVHjOF43Aqc4Dg1ye3AY0o" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_3"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsss-sick-sinus-syndrome&amp;title=SSS%20%28SICK%20SINUS%20SYNDROME%29"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Thu, 03 Aug 2023 07:37:06 +0000 Dr A Röschl 862 at https://www.ecgguru.com https://www.ecgguru.com/blog/sss-sick-sinus-syndrome#comments Jason's Blog: ECG Challenge of the Week for August 5-12. What's the cause of the pause? https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-august-5-12-whats-cause-pause <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/jasons-blog-ecg-challenge-week-august-5-12-whats-cause-pause"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%201g%20answer.png" width="765" height="519" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>&nbsp;</p> <p class="MsoNormal"><span style="text-decoration: underline;"><strong><span style="font-size: 12pt; line-height: 115%; font-family: 'Calibri','sans-serif'; color: #009900; text-decoration: underline;">Patient's clinical data:</span></strong></span><span style="font-size: 12.0pt; line-height: 115%;">&nbsp; 55-year-old white man on spinal cord ward.<br><br><em style="mso-bidi-font-style: normal;"><span style="text-decoration: underline;">To the computer's original statements (bottom 3 lines with grey background), the cardiology fellow free-hand texted the capitalized word in blue.&nbsp; He also added the diagnostic statement behind it (top line):</span></em> <br><br><span style="color: blue; background: #BAC1DA;">MARKED</span><span style="background: #BAC1DA;"> Sinus bradycardia with Sinus arrhythmia<br></span><span style="background: silver; mso-highlight: silver;">Incomplete right bundle branch block<br>Nonspecific T wave abnormality<br>Abnormal ECG</span></span></p> <p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%;">DO YOU AGREE WITH THE COMPUTER AND/OR THE CARDIOLOGY FELLOW?</span></strong><span style="font-size: 12.0pt; line-height: 115%;"><br><br><strong><span style="text-decoration: underline;"><span style="font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; color: red;">Questions:</span></span></strong><strong><span style="font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; color: red; font-weight: normal; mso-bidi-font-weight: bold;"> <br></span></strong><strong><span style="font-family: 'Calibri','sans-serif'; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: minor-bidi; font-weight: normal; mso-bidi-font-weight: bold;">(1.)<span style="mso-spacerun: yes;">&nbsp; </span>What’s the most common cause of a sudden, unexpected pause?<br>(2.)<span style="mso-spacerun: yes;">&nbsp; </span>Are the ventricular cycles waxing and waning here?<br>(3.)<span style="mso-spacerun: yes;">&nbsp; </span>What’s the differential diagnosis?</span></strong></span></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/180/feed" method="post" id="fivestar-custom-widget--4" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--8" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for August 5-12. What&amp;#039;s the cause of the pause? 1/5</option><option value="40" selected="selected">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for August 5-12. What&amp;#039;s the cause of the pause? 2/5</option><option value="60">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for August 5-12. What&amp;#039;s the cause of the pause? 3/5</option><option value="80">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for August 5-12. What&amp;#039;s the cause of the pause? 4/5</option><option value="100">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for August 5-12. What&amp;#039;s the cause of the pause? 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >2</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--4" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-YsxkFFsJ_7nfe4hPvkoYHPjeDaR5GBCQh2pxYAUxXHk" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_4"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fjasons-blog-ecg-challenge-week-august-5-12-whats-cause-pause&amp;title=Jason%27s%20Blog%3A%20ECG%20Challenge%20of%20the%20Week%20for%20August%205-12.%20What%27s%20the%20cause%20of%20the%20pause%3F"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Sat, 04 Aug 2012 14:40:52 +0000 jer5150 285 at https://www.ecgguru.com https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-august-5-12-whats-cause-pause#comments