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==Causes==
==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===
*[[Acetylcholine]]
*[[Acute coronary syndrome]]
*[[Amiodarone]]
*[[Beta blockers]]
*[[Calcium channel blockers]]
*[[Digoxin]]
*[[Dilated cardiomyopathy]]
*[[Hyperkalemia]]
*[[Hypermagnesemia]]
*[[Hypertrophic cardiomyopathy]]
*[[Myocarditis]]
*[[Pericarditis]]
*[[Sick sinus syndrome]]
*[[sinus node disease|Sinus node fibrosis]]
*[[STEMI]]
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|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"
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[Berberine]], [[grayanotoxin]], [[organophosphate|organophosphate poisoning]], [[parathion|parathion poisoning]], [[pyrethroid|pyrethroid poisoning]], [[Arizona bark scorpion|scorpion toxin]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|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"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetic ketoacidosis]], [[periodic  paralysis|thyrotoxic periodic paralysis]], [[pheochromocytoma]], [[hypothyroidism|profound hypothyroidism]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Berberine]], [[hypothermia]], [[spider bite#spider venom|poisonous spider bites]], [[Arizona bark scorpion|scorpion toxin]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|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"
| '''Hematologic'''
|bgcolor="Beige"| [[Hemochromatosis]], [[multiple myeloma]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|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"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Acute rheumatic fever]], [[Chagas disease]], [[diptheria]], [[Lyme disease]], [[myocarditis]], [[pericarditis]], [[septic shock]], [[sarcoidosis]], [[systemic lupus erythematosus]], [[tuberculosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Muscular dystrophy]], [[myotonic dystrophy]], [[Timothy syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Carotid sinus hypersensitivity]], [[lateral medullary syndrome]], [[vagal reaction]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Hypermagnesemia]], [[metabolic acidosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[cardiac tumor#heart in lymphomas|Cardiac lymphoma]], [[cardiac tumor]], [[multiple myeloma]], [[pheochromocytoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| [[Sjogren's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Acetylcholine]], [[amiodarone]], [[anthracyclines]], [[barbiturate]], [[bortezomib]], [[cholinesterase inhibitors]], [[digitalis]], [[edrophonium]], [[nitrous oxide]], [[phenytoin]], [[propofol]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Takotsubo cardiomyopathy]], [[anorexia nervosa|severe anorexia nervosa]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Hypoxia]], [[sleep apnea]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Acute renal failure]], [[hyperkalemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Acute rheumatic fever]], [[sarcoidosis]], [[Sjogren's syndrome]], [[scleroderma]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Myocardial contusion]], [[myocardial rupture]], [[brain damage|severe brain injury]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Amyloidosis]]
|-
|}
===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}}


==Differentiating Sinoatrial block from other Diseases==
==Differentiating Sinoatrial block from other Diseases==

Revision as of 20:04, 29 August 2013

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

Synonyms and keywords:

Overview

The sinoatrial (SA) node represents the original pacemaker of the heart. It's formed of cells, sometimes called P cells, in a compact region at the junction of the high right atrium and the superior vena cava. The surrounding cells or Perinodal cells, sometimes called (T) cells, transmit the electrical impulse from the SA node to the right atrium. Each of these cell types has distinct expression profiles of ion channels and gap junctions. SA nodal dysfunction typically results from either abnormalities in signal generation by the P cells or abnormalities in conduction across the T cells. Sinoatrial nodal dysfunction includes pauses, arrest, exit block and ultimately sick sinus syndrome. Here we will discuss sinoatrial block.

Causes

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

Differentiating Sinoatrial block from other Diseases

Other types of types of SA nodal dysfunction include:

  • Sinus pause or sinus arrest; this abnormality is an alteration in discharge by the SA pacemaker; as a result, the duration of the pause is variable and presents as a pause with no P waves on EKG.
  • Sinus arrhythmia; small changes in the sinus cycle length. The formal definition of sinus arrhythmia is a variation in the P-P interval by 0.12 sec (120 msec) or more in the presence of normal P waves and the usual PR interval. This type is common in the young, usually related to variation with respirations and is not considered abnormal.
  • Wandering atrial pacemaker; which represents three or more ectopic foci within the atrial myocardium that serve as the dominant pacemaker.
  • Sick sinus syndrome

Diagnosis

Treatment

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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