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sinoatrial exit block
A pause in or arrest of sinus activity with the p-p interval of the pause a multiple (i.e. 2X, 3X etc.) of the baseline p-p interval (See sinus arrest/pause).
Etiology:
1) failure of impulse propagation
2) excessive vagal stimulation
3) acute myocarditis
4) myocardial ischemia/infarction
5) pharmacologic agents
6) electrolyte imbalances
- hyperkalemia
Clinical manifestations:
1) lightheadedness
2) dizziness
3) syncope or presyncope
Management:
1) therapy unnecessary in asymptomatic patients
2) symptomatic patients
a) correct underlying cause
b) consider permanent cardiac pacemaker if pause > 3 seconds
Related
sick sinus syndrome; atrial fibrillation with bradyarrhythmia; tachycardia-bradycardia syndrome
sinus arrest/pause
General
supraventricular arrhythmia
bradyarrhythmia (bradycardia)
heart block
References
Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 272