Sinus Arrest
February 15th, 2021
Overview
Sinus arrest is the temporary interruption of sinoatrial node automaticity, that may occur due to intrinsic or extrinsic factors affecting the sinoatrial node.
Look For
- A pause of at least three seconds, without P waves or QRS complexes
- An escape rhythm may be present
Causes of Sinus Arrest
Intrinsic
- 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
Extrinsic
- Physiologic - sleep, athletes
- Autonomic - neurocardiogenic syncope, carotid sinus hypersensitivity
- Drugs - beta blockers, calcium channel blockers, digoxin, adenosine, ivabradine, clonidine, acetylcholinesterase inhibitors
- Hypothyroidism
- Hypothermia
- Hyperkalaemia
- Obstructive sleep apnoea
- Raised intracranial pressure
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