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Sinus Node Suppression in Acute Strokes—Case Reports

San Francisco Heart Institute, Seton Medical Center, Daly City, California, School of Medicine, University of California in San Francisco, San Francisco, California

Michael S. Cohen

San Francisco Heart Institute, Seton Medical Center, Daly City, California, School of Medicine, University of California in San Francisco, San Francisco, California

Colman Ryan

San Francisco Heart Institute, Seton Medical Center, Daly City, California, School of Medicine, University of California in San Francisco, San Francisco, California

Charles Antonini

San Francisco Heart Institute, Seton Medical Center, Daly City, California, School of Medicine, University of California in San Francisco, San Francisco, California

The authors report on 5 patients, 4 of them observed over a period of only two months in one community hospital, who developed profound sinus node suppression in the early phase following acute strokes. This complication re sulted in the death of 2; in the remaining 3, it was controlled by electrical car diac pacing or intravenous atropine. In 3 patients, the strokes were due to subarachnoid hemorrhage, and in 2, they were secondary to vascular occlusion. In at least 4 patients, the prognosis seemed favorable from a neurologic stand point. Vagally mediated sinus node arrest may, therefore, represent a poten tially fatal complication of strokes and may be more frequent than currently appreciated. Continuous monitoring in the early phase of acute strokes and pacemaker therapy may be lifesaving in some patients. This and the general phenomenon of functional failure of the sinus node due to a variety of causes are discussed.

Angiology, Vol. 39, No. 12, 1048-1055 (1988)
DOI: 10.1177/000331978803901208


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