Treatment of persistent sinus bradycardia with intermittent symptoms: are guidelines clear?
There is uncertainty in the aetiology of syncope in subjects with persistent sinus bradycardia (SB) (sick sinus syndrome). The results of pathophysiological studies suggest a reflex origin of syncope in the vast majority of subjects with SB. From a nosological point of view, 'syndrome' is defined as the association of signs and symptoms that have a pathophysiological correlation. Since in most cases the causal relationship between syncope and persistent SB appears very weak, 'reflex syncope with associated SB' appears to be the most appropriate diagnosis.
Alboni
Paolo
P
Division of Cardiology, Arrhythmologic Center, Ospedale Civile di Cento, 44042 Cento (FE), Italy. p.alboni@ausl.fe.it
Gianfranchi
Lorella
L
Brignole
Michele
M
D001919:Bradycardia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D006801:Humans; D010138:Pacemaker, Artificial; D017410:Practice Guidelines as Topic; D012804:Sick Sinus Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013575:Syncope / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*