Lüderitz B
Fortschr Med. 1981 Apr 23;99(16):597-602.
The basic disorder in sinoatrial disease is a functional and/or anatomical defect in the sinus node and the atrium respectively. The clinical feature includes palpitations, angina pectoris, heart failure, giddiness and systemic emboli. Associated diseases are coronary heart disease, hypertension, diphtheria, myocarditis or rheumatic fever. Diagnosis is primarily made by clinical symptoms and conventional or long term ECG-monitoring. However, impaired sinus node function including sinusbradycardia, sinus arrest, sinoatrial block and the bradycardia-tachycardia syndrome cannot easily be assessed, when rhythm disturbances are occurring intermittently, as the recording of electrical activity of sinus node pacemaker cells is not available in man. Therefore methods of provocative atrial stimulation (rapid atrial stimulation, premature atrial stimulation) have been developed for (indirect) estimation of sinus node recovery time and sinoatrial conduction time. Treatment depends on symptoms. In most cases implantation of an electric pacemaker is mandatory since drug treatment usually is unsatisfactory. The natural history of the sinoatrial disease is imperfectly known but probably covers 5--10 years.
窦房结疾病的基本病变分别是窦房结和心房的功能和/或解剖学缺陷。临床特征包括心悸、心绞痛、心力衰竭、头晕和全身性栓塞。相关疾病有冠心病、高血压、白喉、心肌炎或风湿热。诊断主要依据临床症状以及常规或长期心电图监测。然而，当心律失常间歇性发作时，由于无法在人体记录窦房结起搏细胞的电活动，窦房结功能受损，包括窦性心动过缓、窦性停搏、窦房传导阻滞和心动过缓-心动过速综合征，难以轻易评估。因此，已开发出刺激性心房刺激方法（快速心房刺激、房性早搏刺激）用于（间接）估计窦房结恢复时间和窦房传导时间。治疗取决于症状。在大多数情况下，由于药物治疗通常效果不佳，植入电子起搏器是必要的。窦房结疾病的自然病程尚不完全清楚，但可能长达5至10年。
