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Europace Advance Access originally published online on February 12, 2009
Europace 2009 11(5):562-564; doi:10.1093/europace/eup014
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

REVIEWS

Treatment of persistent sinus bradycardia with intermittent symptoms: are guidelines clear?

Paolo Alboni1,*, Lorella Gianfranchi1 and Michele Brignole2

1 Division of Cardiology, Arrhythmologic Center, Ospedale Civile di Cento, 44042 Cento (FE), Italy; 2 Department of Cardiology, Arrhythmologic Center, Ospedali del Tigullio, Lavagna, Italy

There is uncertainty in the aetiology of syncope in subjects with persistent sinus bradycardia (SB) (sick sinus syndrome). The results of pathophysiological studies suggest a reflex origin of syncope in the vast majority of subjects with SB. From a nosological point of view, ‘syndrome’ is defined as the association of signs and symptoms that have a pathophysiological correlation. Since in most cases the causal relationship between syncope and persistent SB appears very weak, ‘reflex syncope with associated SB’ appears to be the most appropriate diagnosis.

Key Words: Carotid sinus massage, Sick sinus syndrome, Sinus bradycardia, Syncope, Tilt testing

* Corresponding author. Tel: +39 51 6838219, Fax: +39 51 6838471, Email: p.alboni{at}ausl.fe.it

Manuscript submitted 15 October 2008. Accepted after revision 14 January 2009.


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