Sinoatrial arrest causes: Difference between revisions

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__NOTOC__
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{{Sinoatrial arrest}}
{{Sinoatrial arrest}}
{{CMG}}
{{CMG}}; {{AE}} {{M.P}}


==Overview==
==Overview==
Sinus arrest is fairly uncommon. It can be observed in the setting of myocardial disease ([[myocarditis]]) and [[ischemia]] or [[infarction]] (particularly acute inferior or posterior [[ST segment elevation MI]]). It can be a manifestation of [[digitalis]] or [[lidocaine]] toxicity.
Sinus arrest is fairly uncommon. It can be observed in the setting of myocardial disease ([[myocarditis]]) and [[ischemia]] or [[infarction]] (particularly acute inferior or posterior [[ST segment elevation MI]]). It can be a manifestation of [[digitalis]] or [[lidocaine]] toxicity.


==Causes==
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
*[[Acute coronary syndrome]]
*[[Acute renal failure]]
*[[Diabetic ketoacidosis]]
*[[Lateral medullary syndrome]]
*[[Myocardial rupture]]
*[[NSTEMI]]
*[[organophosphate|Organophosphate poisoning]]
*[[parathion|Parathion poisoning]]
*[[spider bite#spider venom|Poisonous spider bites]]
*[[Septic shock]]
*[[brain damage|Severe brain injury]]
*[[STEMI]]
===Common Causes===
===Common Causes===
*[[Acetylcholine]]
*[[Acetylcholine]]
*[[Carotid sinus hypersensitivity]]
*[[Acute coronary syndrome]]
*[[Cough]] related [[syncope]] in patients with [[sick sinus syndrome]]
*[[Amiodarone]]
*[[Digitalis]] including [[digitalis toxicity]]
*[[Beta blockers]]
*[[Endotracheal intubation]] due to heightened [[vagal tone]]
*[[Calcium channel blockers]]
*[[Digoxin]]
*[[Dilated cardiomyopathy]]
*[[Hyperkalemia]]
*[[Hyperkalemia]]
:* Decreased [[P wave]] amplitude occurs when the K is > 7.0 meq/li
*[[Hypermagnesemia]]
:* [[P wave]]s may be absent when the [[Potassium|K]] is > 8.8 meq/li
*[[Hypertrophic cardiomyopathy]]
:* The impulses are still being generated in the [[SA node]] and are conducted to the ventricles through specialized atrial fibers without depolarizing the atrial muscle
:* Moderate or sever [[hyperkalemia]] can cause [[sinus arrest]] <ref name="pmid16792034">{{cite journal |author=Bonvini RF, Hendiri T, Anwar A |title=Sinus arrest and moderate hyperkalemia |journal=[[Annales De Cardiologie Et D'angéiologie]] |volume=55 |issue=3 |pages=161–3 |year=2006 |month=June |pmid=16792034 |doi= |url= |issn=}}</ref>
*[[Lidocaine]]
*[[Myocarditis]]
*[[Myocarditis]]
*[[Percutaneous coronary intervention]] of the proximal [[right coronary artery]] can obstruct the origin of the SA nodal artery in about 17% of patients (14 of 80 in one series).  <ref>Munenori Kotoku, Akira Tamura, Shigeru Naono and Junichi Kadota.Sinus arrest caused by occlusion of the sinus node artery during percutaneous coronary intervention for lesions of the proximal right coronary artery. Heart and vessels,2007, p.389-392</ref> Sinus arrest with junctional escape rhythm went on to develop in 4 of the 14 patients and one patient required a temporary ventricular pacing. There was resolution of the the junctional escape rhythm in all patients within 3 days of the sinus node artery occlusion.
*[[Pericarditis]]
* Nasal stimulation as part of a nsaocardiac reflex similar to the oculocardiac reflex during [[alfentanil]] - [[nitrous oxide]] anesthesia
*[[Sick sinus syndrome]]
* [[Quinidine sulfate]]
*[[sinus node disease|Sinus node fibrosis]]
* [[Sinus node]] degeneration
*[[STEMI]]
* [[Sleep apnea]]
* [[ST elevation myocardial infarction]] particularly inferior myocardial infarctions and posterior infarctions.
* [[Vagal reaction|Vagal tone]]


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cough]] related [[syncope]] in patients with [[sick sinus syndrome]], [[Myocarditis]], Obstruction of artery to [[SA node]] during [[PCI]], [[Sinus node]] degenration, [[ST elevation myocardial infarction]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Acute coronary syndrome]], [[acute rheumatic fever]], [[Andersen cardiodysrhythmic periodic paralysis]], [[Brugada syndrome]], [[cardiac tumor#heart in lymphomas|cardiac lymphoma]], [[cardiac tumor]], [[Carotid sinus hypersensitivity|cardio inhibitory syncope]], [[congenital heart disease]], [[congestive heart failure]], [[reperfusion injury|coronary reperfusion therapy]], [[dilated cardiomyopathy]], [[hypertensive heart disease]], [[hypertrophic cardiomyopathy]], [[ischemic heart disease]], [[Jervell and Lange-Nielsen syndrome]], [[long QT syndrome]], [[myocardial infarction]], [[myocardial rupture]], [[myocarditis]], [[NSTEMI]], [[pericarditis]], [[Romano-Ward syndrome]], [[sick sinus syndrome]], [[sinus bradycardia]], [[sinus node disease|sinus node fibrosis]], [[STEMI]], [[tachycardia-bradycardia syndrome]], [[Timothy syndrome]], [[valvular heart disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Berberine]], [[grayanotoxin]], [[organophosphate|organophosphate poisoning]], [[parathion|parathion poisoning]], [[pyrethroid|pyrethroid poisoning]], [[Arizona bark scorpion|scorpion toxin]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 43: Line 54:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Acetylcholine]], [[Digitalis]], [[Lidocaine]], [[Quinidine]]
|bgcolor="Beige"| [[Acetylcholine]], [[alfentanil]], [[amiodarone]], [[anthracyclines]], [[barbiturate]], [[beta-blockers]], [[bortezomib]], [[bupivacaine]], [[calcium channel blockers]], [[cholinesterase inhibitors]], [[clonidine]], [[dexmedetomidine]], [[digitalis]], [[digoxin]], [[diltiazem]], [[donepezil]], [[edrophonium]], [[fentanyl]], [[flecainide]], [[granisetron]], [[guanethidine]], [[guanfacine]], [[halothane]], [[ibutilide]], [[idarubicin]], [[lacosamide]], [[lidocaine]], [[lithium]], [[magnesium]], [[mepivacaine]], [[mesalamine]], [[methyldopa]], [[mexiletine]], [[neostigmine]], [[nitrous oxide]], [[pentostatin]], [[phenothiazine]], [[phenytoin]], [[procainamide]], [[propafenone]], [[propofol]], [[pyridostigmine]], [[quinidine]], [[remifentanil]], [[rescinnamine]], [[reserpine]], [[rilmenidine]], [[ropivacaine]], [[tacrine]], [[thiamylal]], [[vecuronium]], [[verapamil]]
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Diabetic ketoacidosis]], [[periodic  paralysis|thyrotoxic periodic paralysis]], [[pheochromocytoma]], [[hypothyroidism|profound hypothyroidism]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Berberine]], [[hypothermia]], [[spider bite#spider venom|poisonous spider bites]], [[Arizona bark scorpion|scorpion toxin]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 63: Line 73:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Andersen cardiodysrhythmic periodic paralysis]], [[Brugada syndrome]], [[congenital heart disease]], [[Emery-Dreifuss muscular dystrophy]], [[Jervell and Lange-Nielsen syndrome]], [[Kearns-Sayre syndrome]], [[Limb-girdle muscular dystrophy|limb-girdle muscular dystrophy type 1B (LGMD1B)]], [[muscular dystrophy]], [[myotonic dystrophy]], [[Romano-Ward syndrome]], [[Timothy syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hemochromatosis]], [[multiple myeloma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Cardiac catheterization]], [[cardiac transplantation]], [[coronary artery bypass grafting]], [[Fontan procedure]], [[heart surgery]], [[regional anesthesia|infraclavicular brachial plexus block]], [[Maze procedure]], [[catheter ablation|post catheter ablation for arrhythmias]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acute rheumatic fever]], [[Chagas disease]], [[diptheria]], [[Lyme disease]], [[myocarditis]], [[pericarditis]], [[septic shock]], [[sarcoidosis]], [[systemic lupus erythematosus]], [[tuberculosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Muscular dystrophy]], [[myotonic dystrophy]], [[Timothy syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Carotid sinus hypersensitivity]], [[lateral medullary syndrome]], [[vagal reaction]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Hyperkalemia]]
|bgcolor="Beige"| [[Hypermagnesemia]], [[metabolic acidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[cardiac tumor#heart in lymphomas|Cardiac lymphoma]], [[cardiac tumor]], [[multiple myeloma]], [[pheochromocytoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Sjogren's syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acetylcholine]], [[amiodarone]], [[anthracyclines]], [[barbiturate]], [[bortezomib]], [[cholinesterase inhibitors]], [[digitalis]], [[edrophonium]], [[nitrous oxide]], [[phenytoin]], [[propofol]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Takotsubo cardiomyopathy]], [[anorexia nervosa|severe anorexia nervosa]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| [[Sleep apnea]]
|bgcolor="Beige"| [[Hypoxia]], [[sleep apnea]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acute renal failure]], [[hyperkalemia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acute rheumatic fever]], [[sarcoidosis]], [[Sjogren's syndrome]], [[scleroderma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Myocardial contusion]], [[myocardial rupture]], [[brain damage|severe brain injury]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 139: Line 149:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Carotid sinus hypersensitivity]], [[Vagal reaction]]
|bgcolor="Beige"| [[Amyloidosis]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Acetylcholine]]
*[[Acute coronary syndrome]]
*[[Acute renal failure]]
*[[Acute rheumatic fever]]
*[[Alfentanil]]<ref name="pmid2248851">{{cite journal| author=Bailey PL| title=Sinus arrest induced by trivial nasal stimulation during alfentanil-nitrous oxide anaesthesia. | journal=Br J Anaesth | year= 1990 | volume= 65 | issue= 5 | pages= 718-20 | pmid=2248851 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2248851  }} </ref>
*[[Amiodarone]]
*[[Amyloidosis]]
*[[Andersen cardiodysrhythmic periodic paralysis]]
*[[Anthracyclines]]
*[[Antiarrhythmic drugs]]
*[[Barbiturate]]
*[[Berberine]]
*[[Beta-blockers]]<ref name="pmid15688675">{{cite journal| author=Mills TA, Kawji MM, Cataldo VD, Pappas ND, O'Meallie LP, Breaux DM et al.| title=Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs. | journal=J La State Med Soc | year= 2004 | volume= 156 | issue= 6 | pages= 327-31 | pmid=15688675 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15688675  }} </ref>
*[[Bortezomib]]
*[[Brugada syndrome]]
*[[Bupivacaine]]
*[[Calcium channel blockers]]
*[[Carbamazepine]]
*[[Cardiac catheterization]]
*[[cardiac tumor#heart in lymphomas|Cardiac lymphoma]]
*[[Cardiac transplantation]]
*[[Cardiac tumor]]
*[[Carotid sinus hypersensitivity|Cardioinhibitory syncope]]
*[[Chagas disease]]
*[[Cholinesterase inhibitors]]
*[[Clonidine]]
*[[Congenital heart disease]]
*[[Congestive heart failure]]
*[[Coronary artery bypass grafting]]
*[[reperfusion injury|Coronary reperfusion therapy]]
*[[Dexmedetomidine]]
*[[Diabetic ketoacidosis]]
*[[Digoxin]]
*[[Dilated cardiomyopathy]]
*[[Diptheria]]
*[[Diltiazem]]<ref name="pmid15688675">{{cite journal| author=Mills TA, Kawji MM, Cataldo VD, Pappas ND, O'Meallie LP, Breaux DM et al.| title=Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs. | journal=J La State Med Soc | year= 2004 | volume= 156 | issue= 6 | pages= 327-31 | pmid=15688675 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15688675  }} </ref>
*[[Edrophonium]]
*[[Emery-Dreifuss muscular dystrophy]]
*[[Fentanyl]]
*[[Fontan procedure]]
*[[Granisetron]]


{{col-break|width=33%}}
*[[Grayanotoxin]]
*[[Guanethidine]]
*[[Guanfacine]]
*[[Halothane]]<ref name="pmid1678901">{{cite journal| author=Lines D, Shipton EA| title=Severe bradycardia and sinus arrest after administration of vecuronium, fentanyl and halothane. A case report. | journal=S Afr Med J | year= 1991 | volume= 80 | issue= 4 | pages= 200-1 | pmid=1678901 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1678901  }} </ref>
*[[Heart surgery]]
*[[Hyperkalemia]]<ref name="pmid16792034">{{cite journal |author=Bonvini RF, Hendiri T, Anwar A |title=Sinus arrest and moderate hyperkalemia |journal=[[Annales De Cardiologie Et D'angéiologie]] |volume=55 |issue=3 |pages=161–3 |year=2006 |month=June |pmid=16792034 |doi= |url= |issn=}}</ref>
*[[Hypermagnesemia]]
*[[Hypertensive heart disease]]
*[[Hypertrophic cardiomyopathy]]
*[[Hypothermia]]
*[[Hypoxia]]
*[[Ibutilide]]
*[[Idarubicin]]
*[[regional anesthesia|Infraclavicular brachial plexus block]]
*[[Ischemic heart disease]]
*[[Jervell and Lange-Nielsen syndrome]]
*[[Lacosamide]]
*[[Lateral medullary syndrome]]<ref name="pmid23386489">{{cite journal| author=Koay S, Dewan B| title=An unexpected Holter monitor result: multiple sinus arrests in a patient with lateral medullary syndrome. | journal=BMJ Case Rep | year= 2013 | volume= 2013 | issue=  | pages=  | pmid=23386489 | doi=10.1136/bcr-2012-007783 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23386489  }} </ref>
*[[Lidocaine]]
*[[Limb-girdle muscular dystrophy|Limb-girdle muscular dystrophy type 1B (LGMD1B)]]
*[[Lithium]]
*[[Long QT syndrome]]
*[[Lyme disease]]
*[[Magnesium]]
*[[Maze procedure]]
*[[Mepivacaine]]
*[[Mesalamine]]
*[[Metabolic acidosis]]
*[[Methyldopa]]
*[[Muscular dystrophy]]
*[[Myocardial infarction]]
*[[Myocardial rupture]]
*[[Myocarditis]]
*[[Myotonic dystrophy]]
*[[Neostigmine]]
*[[NSTEMI]]
*[[organophosphate|Organophosphorus poisoning]]
*[[parathion|Parathion poisoning]]
*[[Paroxysmal supraventricular tachycardia]]
*[[Pericarditis]]
*[[Phenothiazine]]
{{col-break|width=33%}}
*[[Phenytoin]]
*[[Pheochromocytoma]]
*[[spider bite#spider venom|Poisonous spider bites]]
*[[catheter ablation|Post catheter ablation for arrhythmias]]
*[[Procainamide]]
*[[hypothyroidism|Profound hypothyroidism]]
*[[Propafenone]]
*[[Propofol]]
*[[pyrethroid|Pyrethroid poisoning]]
*[[Pyridostigmine]]
*[[Remifentanil]]
*[[Rescinnamine]]
*[[Reserpine]]
*[[Rilmenidine]]
*[[Romano-Ward syndrome]]
*[[Ropivacaine]]
*[[Sarcoidosis]]
*[[Scleroderma]]
*[[Arizona bark scorpion|Scorpion toxin]]
*[[Septic shock]]
*[[anorexia nervosa|Severe anorexia nervosa]]
*[[brain damage|Severe brain injury]]
*[[Sick sinus syndrome]]
*[[Sinus bradycardia]]
*[[Sinus node disease|Sinus node fibrosis]]
*[[Sjogren's syndrome]]
*[[Sleep apnea]]
*[[STEMI]]
*[[Systemic lupus erythematosus]]
*[[Tachycardia-bradycardia syndrome]]
*[[Tacrine]]
*[[Takotsubo cardiomyopathy]]
*[[Thiamylal]]
*[[periodic  paralysis|Thyrotoxic periodic paralysis]]
*[[Timolol]]
*[[Timothy syndrome]]
*[[Tuberculosis]]
*[[Vagal reaction]]
*[[Valvular heart disease]]
*[[Vecuronium]]<ref name="pmid1678901">{{cite journal| author=Lines D, Shipton EA| title=Severe bradycardia and sinus arrest after administration of vecuronium, fentanyl and halothane. A case report. | journal=S Afr Med J | year= 1991 | volume= 80 | issue= 4 | pages= 200-1 | pmid=1678901 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1678901  }} </ref>
*[[Verapamil]]<ref name="pmid15688675">{{cite journal| author=Mills TA, Kawji MM, Cataldo VD, Pappas ND, O'Meallie LP, Breaux DM et al.| title=Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs. | journal=J La State Med Soc | year= 2004 | volume= 156 | issue= 6 | pages= 327-31 | pmid=15688675 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15688675  }} </ref>
{{col-end}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Crowdiagnosis]]
[[Category:Cardiology]]
[[Category:Electrophysiology]]
[[Category:Arrhythmia]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Disease]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Cardiology]]
[[Category:Disease]]
[[Category:Electrophysiology]]

Latest revision as of 14:38, 15 June 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Overview

Sinus arrest is fairly uncommon. It can be observed in the setting of myocardial disease (myocarditis) and ischemia or infarction (particularly acute inferior or posterior ST segment elevation MI). It can be a manifestation of digitalis or lidocaine toxicity.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute coronary syndrome, acute rheumatic fever, Andersen cardiodysrhythmic periodic paralysis, Brugada syndrome, cardiac lymphoma, cardiac tumor, cardio inhibitory syncope, congenital heart disease, congestive heart failure, coronary reperfusion therapy, dilated cardiomyopathy, hypertensive heart disease, hypertrophic cardiomyopathy, ischemic heart disease, Jervell and Lange-Nielsen syndrome, long QT syndrome, myocardial infarction, myocardial rupture, myocarditis, NSTEMI, pericarditis, Romano-Ward syndrome, sick sinus syndrome, sinus bradycardia, sinus node fibrosis, STEMI, tachycardia-bradycardia syndrome, Timothy syndrome, valvular heart disease
Chemical / poisoning Berberine, grayanotoxin, organophosphate poisoning, parathion poisoning, pyrethroid poisoning, scorpion toxin
Dermatologic No underlying causes
Drug Side Effect Acetylcholine, alfentanil, amiodarone, anthracyclines, barbiturate, beta-blockers, bortezomib, bupivacaine, calcium channel blockers, cholinesterase inhibitors, clonidine, dexmedetomidine, digitalis, digoxin, diltiazem, donepezil, edrophonium, fentanyl, flecainide, granisetron, guanethidine, guanfacine, halothane, ibutilide, idarubicin, lacosamide, lidocaine, lithium, magnesium, mepivacaine, mesalamine, methyldopa, mexiletine, neostigmine, nitrous oxide, pentostatin, phenothiazine, phenytoin, procainamide, propafenone, propofol, pyridostigmine, quinidine, remifentanil, rescinnamine, reserpine, rilmenidine, ropivacaine, tacrine, thiamylal, vecuronium, verapamil
Ear Nose Throat No underlying causes
Endocrine Diabetic ketoacidosis, thyrotoxic periodic paralysis, pheochromocytoma, profound hypothyroidism
Environmental Berberine, hypothermia, poisonous spider bites, scorpion toxin
Gastroenterologic No underlying causes
Genetic Andersen cardiodysrhythmic periodic paralysis, Brugada syndrome, congenital heart disease, Emery-Dreifuss muscular dystrophy, Jervell and Lange-Nielsen syndrome, Kearns-Sayre syndrome, limb-girdle muscular dystrophy type 1B (LGMD1B), muscular dystrophy, myotonic dystrophy, Romano-Ward syndrome, Timothy syndrome
Hematologic Hemochromatosis, multiple myeloma
Iatrogenic Cardiac catheterization, cardiac transplantation, coronary artery bypass grafting, Fontan procedure, heart surgery, infraclavicular brachial plexus block, Maze procedure, post catheter ablation for arrhythmias
Infectious Disease Acute rheumatic fever, Chagas disease, diptheria, Lyme disease, myocarditis, pericarditis, septic shock, sarcoidosis, systemic lupus erythematosus, tuberculosis
Musculoskeletal / Ortho Muscular dystrophy, myotonic dystrophy, Timothy syndrome
Neurologic Carotid sinus hypersensitivity, lateral medullary syndrome, vagal reaction
Nutritional / Metabolic Hypermagnesemia, metabolic acidosis
Obstetric/Gynecologic No underlying causes
Oncologic Cardiac lymphoma, cardiac tumor, multiple myeloma, pheochromocytoma
Opthalmologic Sjogren's syndrome
Overdose / Toxicity Acetylcholine, amiodarone, anthracyclines, barbiturate, bortezomib, cholinesterase inhibitors, digitalis, edrophonium, nitrous oxide, phenytoin, propofol
Psychiatric Takotsubo cardiomyopathy, severe anorexia nervosa
Pulmonary Hypoxia, sleep apnea
Renal / Electrolyte Acute renal failure, hyperkalemia
Rheum / Immune / Allergy Acute rheumatic fever, sarcoidosis, Sjogren's syndrome, scleroderma
Sexual No underlying causes
Trauma Myocardial contusion, myocardial rupture, severe brain injury
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Amyloidosis

Causes in Alphabetical Order

References

  1. ↑ Bailey PL (1990). "Sinus arrest induced by trivial nasal stimulation during alfentanil-nitrous oxide anaesthesia". Br J Anaesth. 65 (5): 718–20. PMID 2248851.
  2. ↑ 2.0 2.1 2.2 Mills TA, Kawji MM, Cataldo VD, Pappas ND, O'Meallie LP, Breaux DM; et al. (2004). "Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs". J La State Med Soc. 156 (6): 327–31. PMID 15688675.
  3. ↑ 3.0 3.1 Lines D, Shipton EA (1991). "Severe bradycardia and sinus arrest after administration of vecuronium, fentanyl and halothane. A case report". S Afr Med J. 80 (4): 200–1. PMID 1678901.
  4. ↑ Bonvini RF, Hendiri T, Anwar A (2006). "Sinus arrest and moderate hyperkalemia". Annales De Cardiologie Et D'angéiologie. 55 (3): 161–3. PMID 16792034. Unknown parameter |month= ignored (help)
  5. ↑ Koay S, Dewan B (2013). "An unexpected Holter monitor result: multiple sinus arrests in a patient with lateral medullary syndrome". BMJ Case Rep. 2013. doi:10.1136/bcr-2012-007783. PMID 23386489.

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