Some tests use to diagnosis for Sick sinus syndrome include:
1. ECG:
severe sinus bradycardia, less than 50 times per minute.
sinus arrest and sinoatrial block.
alternating bradycardia and tachycardia, atrial fibrillation or flutter.
chronic atrial fibrillation after electrical cardioversion to sinus rhythm can not.
lasting slow atrioventricular junction escape beat, some can be combined in patients with atrioventricular block and bundle branch block.
2. determination of sinus node function: can be suspected in patients with the application of the method to choose.
Movement and the atropine test: movements or intravenous atropine 1.5-2mg, respectively, after injection PsG 1,2,3,5,10,15,20 minutes Oscillographic ECG or continuous observation, such as sinus can not by almost 90 times / min and (or) of sinoatrial block, junctional rhythm, supraventricular tachycardia positive. such as sinus rhythm faster> 90 times / divided into negative, most of the vagus nerve hyperthyroidism, and patients with glaucoma or prostatic hypertrophy obviously be used with caution.
transesophageal atrial pacing and direct detection of sinus node function: this is sick sinus syndrome, a more reliable diagnostic methods, especially the combination of drugs block the effects of the autonomic nervous system, it may increase the sensitivity. Inserted through the esophagus bipolar pacing catheter electrode placed behind the left atrium, and then received an artificial heart pacemaker, the rapid pacing, frequency from 90 times per minute, 100 times, 120 times, and gradually increased to 150 times per minute, per transfer pump for 1 minute, then the termination of pacing, and ECG polygraph to see how long the sinoatrial node can experience temperature jump up and rehabilitation, since the cessation of pacing stimulus to the resumption of sinus P wave of sinus node recovery time to time. disease intrinsic heart rate sinus syndrome were 80 times / min following (2mg of atropine to increase after the intravenous injection of propranolol 5mg Determination), sinus node recovery time> 1500m.s, sinoatrial conduction time> 180m.s.
Holter monitoring: show the fastest and the slowest heart rate, sinus arrest, sinus arrhythmia.
Sick sinus syndrome is diagnosed by ECG characteristics as follow:
Sinus node dysfunction, including ECG itself and secondary to sinus node dysfunction and the escape beat or escape rhythm, but also complicated by the rapid burst arrhythmia and other parts of the conduction system involvement quietly ECG performance.
1. sinoatrial block and sinus static and marked sinus bradycardia;
2. escape, or continuous burst escape rhythm, escape capture bigeminy, wandering rhythm;
3. associated with atrial tachyarrhythmias, such as frequent atrial premature beat. paroxysmal burst or recurrent atrial fibrillation, atrial flutter or atrial tachycardia, sinus rhythm with the slow formation of the bradycardia-tachycardia syndrome. After the automatic cut-off tachyarrhythmias, regular sinus rhythm in up to more than two seconds after the interval;
4. pacing atrioventricular junction and (or) conduction dysfunction, performance appears to delay escape beat atrioventricular junction, the atrioventricular junction slow escape rhythm (cycle of escape> 1.5s), or atrioventricular block, occasionally combined bundle branch block.
