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Arrhythmias
 
 

Sinoatrial Exit Block

 
 
 
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Overview

Sinoatrial exit block is a delay in conduction between the sinoatrial node and atrial myocardium.

Pathogenesis

  • Causes of Sinoatrial Exit Block

  • Idiopathic degeneration
  • Myocardial infarction
  • Infiltrative disease - sarcoidosis, amyloidosis, haemochromatosis
  • Connective tissue disease - SLE, scleroderma, RA
  • Cardiac surgery - valvular surgery, correction of congenital heart disease
  • Infections - Lyme disease, endocarditis

Diagnosis

  • ECG Findings

  • First degree - not detectable on ECG
  • 2nd Degree: type I (Wenckebach) - progressively shortened PP intervals, followed by a pause
  • 2nd degree: type II - constant PP interval, with a pause that is a multiple of the PP interval.
  • 3rd degree - complete failure of transmission to the atria; indistinguishable from sinus arrest on ECG
  • Examples

  • 2nd degree SA exit block: type I
  • 2nd degree SA exit block type I
     
  • 2nd degree SA exit block: type II
  • 2nd degree SA exit block type II
     
  • 3rd degree SA exit block
  • 3rd degree SA exit block
     
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