Chronic sinus node disease: natural course and indications for pacing

Abstract

The natural history of sinus node disease has been analysed from reported as well as original data. Because of the widespread use of pacemakers in sinus node disease the perfect study of its true prognosis will probably never be made. Nevertheless, available data strongly indicate that the outlook for identified patients with the disorder who do not have sever symptoms is favorable. Even for the severely symptomatic group, the prognosis seems to be much better than in atrioventricular conduction disease. Pacemaker implantations in this condition should therefore, in general, be restricted to the symptomatic patient in whom the symptoms have been shown to coincide with bradycardia. International differences in the extent of pacing use have been analysed from current statistics. It is concluded that different attitudes to pacing in sinus node disease account for a substantial part of these differences