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Last update 08 May 2025

Sinus Arrest, Cardiac

Last update 08 May 2025

Basic Info

Synonyms

Cardiac Sinus Arrest, Cardiac Sinus Arrests, Cardiac Sinus Pause

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Introduction

The omission of atrial activation that is caused by transient cessation of impulse generation at the SINOATRIAL NODE. It is characterized by a prolonged pause without P wave in an ELECTROCARDIOGRAM. Sinus arrest has been associated with sleep apnea (REM SLEEP-RELATED SINUS ARREST).

Drugs associated with Sinus Arrest, Cardiac

Sodium Chloride/Potassium Chloride/Magnesium Chloride/Calcium Chloride Hydrate/Sodium Bicarbonate

Target-

Mechanism-

Active Org.

Fuso Pharmaceutical Industries Ltd.

Originator Org.

Fuso Pharmaceutical Industries Ltd.

Active Indication

Sinus Arrest, Cardiac

Inactive Indication-

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

Japan

First Approval Date19 Nov 1999

Clinical Trials associated with Sinus Arrest, Cardiac

NCT06166277

/ RecruitingNot Applicable

Cardioneuroablation for the Management of Patients With Recurrent Vasovagal Syncope and Symptomatic Bradyarrhythmias: The CNA-FWRD Registry

The CNA-FWRD Registry is an international prospective observational multicenter registry of patients with symptomatic vasovagal syncope and bradyarrhythmias managed under routine care by medical therapy and radiofrequency catheter ablation of ganglionated plexi or permanent pacemaker implantation.

Start Date01 Aug 2024

Sponsor / Collaborator

Rush University Medical Center

100 Clinical Results associated with Sinus Arrest, Cardiac

100 Translational Medicine associated with Sinus Arrest, Cardiac

0 Patents (Medical) associated with Sinus Arrest, Cardiac

292

Literatures (Medical) associated with Sinus Arrest, Cardiac

01 Feb 2025·Journal of Clinical Sleep Medicine

REM sleep-related bradyarrhythmia syndrome

Article

Author: Quan, Stuart F. ; Shah, Misty ; Sridharan, Aadhavi ; Patel, Imran ; Patel, Salma I. ; Perez, Karolina ; Moukabary, Talal

Rapid eye movement sleep-related bradyarrhythmia syndrome is a rare condition marked by abnormal sinus arrest or atrioventricular conduction disturbance blocks during rapid eye movement sleep unassociated with sleep-disordered breathing. We present a case of a young male without a cardiovascular history exhibiting pauses of up to 9.7 seconds during polysomnography. Initially referred for suspected obstructive sleep apnea due to nocturnal awakenings with shortness of breath, confusion, and dizziness. Polysomnography results were unremarkable apart from electrocardiogram findings revealing prolonged sinus pauses related to rapid eye movement sleep. Evaluation via extended 14-day patch monitor revealed an overall normal sinus rhythm with the lowest heart rate recorded at 14 beats per minute and 412 pauses exceeding 2 seconds, with the longest pause lasting 12.5 seconds during nocturnal hours. A permanent pacemaker was considered, but after shared decision making with the patient, the decision was to continue monitoring without any intervention.CITATIONPerez K, Shah M, Sridharan A, et al. REM sleep-related bradyarrhythmia syndrome. J Clin Sleep Med. 2025;21(2):435-438.

01 Feb 2025·Journal of Cardiovascular Electrophysiology

Feasibility and Clinical Efficacy of Focal Pulsed Field Ablation in Patients With Non‐Pulmonary Vein Triggered Atrial Arrhythmia From the Superior Caval Vein

Article

Author: Abdelwahab, Hytham ; Borisov, Georgi ; Alothman, Obaida ; Bartoli, Lorenzo ; Frommhold, Markus ; Raffa, Santi ; D'Ambrosio, Gabriele ; Keelani, Ahmad ; Geller, J. Christoph ; Shehri, Sultan Al

ABSTRACTIntroductionIn patients with atrial arrhythmias originating from the superior vena cava (SVC), the use of radiofrequency energy to isolate the SVC is associated with a significant risk of injury both to the phrenic nerve and the sinus node. Pulsed field ablation (PFA) may overcome the disadvantages of thermal energy and improve both ablation efficacy and safety.ObjectiveWe report the feasibility, safety, and clinical efficacy of focal monopolar PFA in patients with the origin of their atrial arrhythmia in the SVC.MethodsNine patients (7 men, age 66 ± 8 years) with SVC‐induced paroxysmal AF (n = 3), persistent AF (n = 5), or frequent premature atrial beats (n = 1) underwent SVC isolation using focal monopolar PFA.ResultsAcute circumferential SVC isolation was achieved in all cases, using 22 Ampere (A) or 25 A in areas with or without phrenic capture, respectively. The safety profile was excellent: two patients had transient sinus arrest and two had transient phrenic nerve stunning. Sinus node and phrenic nerve function recovered during the procedure, and no permanent damage was observed at follow‐up. Coronary vasospasm occurred (and quickly resolved after injection of nitroglycerin) in one patient during additional ablation of a focal atrial tachycardia at the coronary sinus ostium. Kidney function remained stable before and after ablation in all patients.ConclusionsIn this patient cohort with SVC‐triggered atrial arrhythmia, isolation using focal monopolar PFA was feasible, effective, and safe. No permanent injury to the phrenic nerve or sinus node was observed.

25 Jan 2025·Cureus

Intermittent Sinus Pause/Asystole in the Setting of Anticholinergic Overdose

Article

Author: Kwong, Raymond ; Collins, Courtney

Anticholinergic toxicity typically presents with symptoms of cutaneous vasodilation, delirium, mydriasis, urinary retention, hyperthermia, anhidrosis, and tachycardia. This case report presents a 68-year-old female patient who exhibited some of these signs and symptoms after ingesting an unknown quantity of dicyclomine. However, she displayed one notable exception to the classic toxidrome. On hospital day 2, the patient experienced multiple incidences of prolonged sinus pause, culminating in witnessed asystole lasting 5-10 seconds. The patient continued to have numerous episodes of sinus pause that lasted 5-10 seconds each over the next two days. Treatment involved placement of multiple temporary transvenous pacemakers until the episodes of sinus pause eventually self-resolved, facilitating discharge home on hospital day 6. The patient recovered without any known complications. After considering alternative diagnoses such as sick sinus syndrome, electrolyte derangements, and intracranial hypertension, multiple hospital medical services ultimately attributed the arrhythmia to anticholinergic toxicity. There are no other documented cases of intermittent sinus pause associated with anticholinergic overdose. While rare, clinicians should consider anticholinergic toxicity as a potential cause of intermittent sinus pause, especially in patients taking anticholinergic medications. Increased clinical vigilance could impact treatment decisions, including potentially avoiding unnecessary procedures such as permanent pacemaker placement, if symptoms resolve with cessation of the offending agent.

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