Circulation, Vol 55, 8-15, Copyright © 1977 by American Heart Association
RC Dhingra, F Amat-y-Leon, C Wyndham, PC Deedwania, D Wu, P Denes and KM Rosen
Prolonged (greater than 152 msec) calculated sinoatrial conduction times
(SACT) were found in 24 of 470 patients studied by the atrial extrastimulus
technique, ranging from 155 to 220 msec (180+/-4.4; mean+/-SEM). There were
18 males and six females with ages of 29 to 85 (mean 65+/-2.6).
Electrocardiographic monitoring revealed significant sinus or atrial
dysrhythmias in 19 (79%) patients. Of these 19, 15 had persistent sinus
bradycardia and/or sinoatrial block, three had sinus bradyarrhythmia with
paroxysmal atrial tachycardia, and one had isolated atrial tachycardia.
Additional electrophysiological evidence of sinus node or atrial
dysfunction was present in 11 patients. Four patients needed permanent
pacing during follow-up (mean follow-up period of 427+/-39 days) because of
symptomatic bradyarrhythmia. Three patients died, none suddenly. In
conclusion, prolonged calculated SACT was associated with a high incidence
of electrocardiographic and electrophysiologic abnormalities of sinus node
and/or atrium. Despite this, bradyarrhythmic morbidity was relatively low,
suggesting that prolonged sinoatrial conduction time in the absence of
symptoms is not an indication for prophylactic pacing.
ARTICLES
Clinical significance of prolonged sinoatrial conduction time
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