![]() ![]() ![]() Impaired sinus node pacing with sinus bradycardia or sinus arrest, where the heart has difficulty compensating for the slowed or stopped heart rate with a reduction in cardiac output per boom, may result in signs and symptoms of cardiac insufficiency ( 9). ![]() Other studies suggested that aging and myocardial fibrosis may be a common pathogenesis of SSS and atrial fibrillation, but the research could not account for all cases of SSS and more in-depth pathogenesis needs further research ( 8). In a human and animal models of atrial fibrillation, atrial fibrillation induced remodeling of the right and left atria (including the sinus node), leading to atrial fibrosis, impaired calcium channels, and abnormal gene expression in patients with SSS, which exacerbates sinus node dysfunction and the progression of atrial fibrillation ( 5– 7). Although SSS was closely associated with atrial fibrillation, the exact underlying pathogenesis remains unclear ( 4). Supraventricular tachycardia occurs intermittently in about 50% of patients with SSS, which is known as brady-tachy arrhythmia syndrome, a typical clinical manifestation of SSS ( 3). Manifestations of SSS mainly include sinus bradycardia, ectopic atrial bradycardia, sinus node outlet block, sinus arrest, sinus node arrest, brady-tachy arrhythmia syndrome, chronotropic insufficiency, and rhythmic separation, etc. SSS is asymptomatic or mildly symptomatic in the early stages, and some patients with SSS are detected on physical examination. SSS is usually diagnosed by the patient’s signs and symptoms examination as well as electrocardiogram examination. Sick sinus syndrome (SSS) is a group of syndromes in which the pacing and efferent functions of the sinoatrial node (SAN) are impaired due to organic changes in the SAN and its surrounding tissues, resulting in chronic arrhythmias with insufficient blood supply to the heart, brain, kidneys and other organs ( 1). In conclusion, bibliometric analysis provided valuable information for the prevention, treatment and future research trends of SSS. In the field of basic applied research and basic research, atrial fibrillation and pacemaker cells were the focus of research. Clinical studies on SSS found that sick sinus syndrome, atrial fibrillation, and pacemakers were the top three keywords that had the largest nodes and the highest frequency. Pacemaker implantation, differentiation and mutation are research hotspots currently. Sick sinus syndrome, atrial fibrillation and sinus node dysfunction were the top three keywords that had the strongest correlation with the study. SSS was closely related to risk factors such as atrial fibrillation and aging. ![]() The results showed the United States dominated the field, followed by Japan, Germany, and China. 2,251 publications related to SSS were retrieved from Web of Science database from 2000 to 2022 and analyzed by using VOS viewer and CiteSpace software. SSS occurring spontaneously or as a result of necessary drug therapy, with heart rate less than 40 bpm when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented.Sick sinus syndrome (SSS) is a refractory arrhythmia disease caused by the pathological changes of sinoatrial node and its adjacent tissues. In some patients, bradycardia is iatrogenic and will occur as a consequence of essential long-term drug therapy of a type and dosage for which there are no acceptable alternatives. SSS with documented symptomatic bradycardia, including frequent sinus pauses that produce symptoms. 5 Furthermore, there is no definitive way to distinguish patients with atrial fibrillation associated with sick sinus syndrome from patients with atrial fibrillation and normal sinus function this distinction is clinically important because treating atrial fibrillation with cardioversion or medications can have catastrophic consequences if the sinus node is inadequate. 2 If the patient is asymptomatic when ECG or ambulatory monitoring is performed, the dysrhythmias of the syndrome are often not present. 5 Symptoms of sick sinus syndrome may be variable, intermittent, and difficult to associate with ECG changes. 9 Some symptoms of patients with sick sinus syndrome (e.g., fatigue, irritability, memory loss, lightheadedness, palpitations, cognitive defects) are present in several other disorders that occur in elderly patients and may be misdiagnosed as those of senile dementia. The condition often goes undetected in the early stages because only sinus bradycardia may be present at its origin. The diagnosis of sick sinus syndrome may be difficult because of the slow and erratic course of the syndrome. ![]()
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