What is sinus arrest?

Sinus arrest refers to the cessation of impulses in the atrial node. There are many reasons for sinus arrest, such as toxicity, disease, etc. Any suspension of broadcasting poses a great threat to the patient's health. If the sinus arrest lasts for a long time, the patient may die. If you have any heart problems, you need to seek treatment as soon as possible.

Sinus arrest refers to the failure of the sinoatrial node to produce impulses in one or more cardiac cycles, resulting in the inability to excite the atria or the entire heart. It can be seen in the toxic effects of digitalis and quinidine and sick sinus syndrome caused by various causes, and occasionally in patients with increased vagal nerve tone. Common causes of this disease include increased vagal tone or carotid sinus hypersensitivity. Acute myocardial infarction, sinus node degeneration and fibrosis, cerebrovascular accident and other diseases. Use drugs such as digitalis, quinidine, potassium salt, and acetylcholine. Symptoms include prolonged sinus arrest which can cause dizziness, blurred vision or temporary loss of consciousness, and in severe cases even convulsions. The electrocardiogram shows that there is no P wave in the interval that is significantly longer than the normal PP interval, or neither the P wave nor the QRS complex appears. The long PP interval has no multiple relationship with the basic sinus PP interval. If sinus arrest is transient and lasts for a very short time, it may be asymptomatic. When sinus arrest lasts for a long time, more than 8 seconds, and no escape beats occur, it may cause dizziness or syncope, and even Adams-Stokes syndrome. Prolonged sinus arrest without escape beats can result in death.

Disease etiology/sinus arrest

Sinus arrest CT scan atlas 1. Primary sinus arrest is more common, mainly due to damage to the sinoatrial node itself, mostly caused by organic heart disease. For example, coronary heart disease, acute myocarditis, cardiomyopathy, sick sinus syndrome, and near-death arrest are the terminal manifestations of various diseases in the late stage.

2. Secondary sinus arrest

(1) Transient sinus arrest (2-4 seconds) secondary to various rapid arrhythmias: most commonly seen in supraventricular tachycardia. After vagus nerve stimulation and drug therapy or overspeed suppression by transesophageal pacing, the supraventricular tachycardia is suddenly corrected and sinus arrest occurs. Most of the time, it is transient.

(2) Overdose or poisoning of antiarrhythmic drugs can cause sinus arrest: such as digitalis, quinidine, reserpine, amiodarone, etc. Propafenone (Propafenone), moricizine, flecainide, antazoline, adenosine triphosphate (ATP).

(3) Increased vagal nerve tone can inhibit sinoatrial node function and lead to sinus arrest: for example, compression of the eyeball, massage of the carotid sinus, stimulation of the pharynx, endotracheal intubation, etc. It may sometimes happen to normal people.

(4) Damage to the sinoatrial node during cardiac trauma or cardiac surgery: Sinus arrest may occur during or after surgery. Coronary angiography can also lead to sinus arrest.

(5) Hyperkalemia and hypokalemia can also cause sinus arrest.