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Natural History of Severe Sinus Bradycardia Discovered by 24 Hour Holter Monitoring
Author(s) -
LICHSTEIN EDGAR,
AITHAL HARTHATTU,
JONAS STERLING,
GREENGART ALVIN,
SANDERS MIGHAEL,
HOLLANDER GERALD,
WEISFOGEL GERALD
Publication year - 1982
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1982.tb02212.x
Subject(s) - medicine , sinus bradycardia , bradycardia , natural history , sinus (botany) , cardiology , heart rate , botany , blood pressure , biology , genus
This study follows patients with severe sinus bradycardia (40 beats per minute for 6 seconds or greater) in order to evaluate mortality and the effectiveness of permanent pacemaker insertion. Severe sinus bradycardia was noted on a 24‐hour Holter in 95 patients. There were 64 males and 31 females with a mean age of 69 ± 10 years. All were availahle for follow‐up at 26 ± 13 months. Twenty‐eight required a permanent pacemaker at an average of 2 ± 3 months after the Holter. Of this group 12 had the Holier for arrhythmia, 11 for cerebral symptoms, 4 for palpitations and 1 for chest pain. Only 1 was taking digitalis and no patients were taking Inderal. Six (21%) died at a mean interval of 21 ± 15 months following pacemaker insertion. Sixty‐seven did not require pacemaker insertion. The indications for Holter monitoring were arrhythmia in 16, palpitations in 19, cerebral symptoms in 20 and chest pain in 12. Four of these patients were on digitalis, 8 on Inderal, and 4 on both. Eleven (16%) died at a mean interval of 12 ± 7 months after the initial Holter recording. Dizziness and/or syncope reoccurred in 22. Five had these symptoms even after pacemaker insertion. We conclude that severe sinus bradycardia is associated with a significant mortality. Insertion of a permanent pacemaker may decrease recurrent symptoms ahd slightly increase time of survival, but does not appear to influence the overall survival rate. (PACE, Vol. 5, March‐April, 1982)