Therefore, drug treatment is often difficult, it lacks long-term therapeutic effects, and various antiarrhythmic drugs often have significant and intolerable side effects. There are two main types of clinical treatment for SSS: drug therapy and pacemaker implantation.Īt present, there is no clinical consensus on the optimal medication regimen for SSS. For patients with SSS, the cause should be identified and corrected, the normal function of the sinus node should be restored, and further development of the disease should be prevented. The clinical treatment principle is to accurately determine the cause of this condition and treat it symptomatically. SSS can also be familial, and mutations in genes such as HCN4, SCN5A, MYH6 and CACNA1C can cause SSS. For example, the symptoms can be improved by discontinuing the patients’ medication. However, some exogenous causes of SSS are reversible. The endogenous aetiology is usually irreversible once it occurs, an electronic pacemaker is usually implanted. Exogenous causes include drug effects (β-receptor blockers, calcium antagonists, digoxin and antiarrhythmic drugs), vagus nerve tension, electrolyte disturbance, surgical injury, hypothyroidism and increased intracranial pressure. Endogenous causes include sinoatrial node (SAN) degenerative fibrosis, coronary heart disease, cardiomyopathy, myocarditis, pericarditis, hypertension, invasive disease and congenital heart disease. The causes of SSS are both endogenous and exogenous. Mechanisms can cause similar disease phenotypes. SSS is not caused only by a single factor. Oliguria, loss of appetite and muscle soreness also occur. Cardiac abnormalities are characterized by palpitations, congestive heart failure and angina pectoris, and these three major cardiac symptoms are interrelated. The main clinical manifestation of SSS is bradycardia as the disease progresses, cardiogenic cerebral ischaemic syndromes can appear, such as dizziness, darkening or syncope, and even SSS or sudden death. It can take 5-10 years or even longer from the onset of symptoms to severe symptoms. The onset of SSS is insidious, and the course of development is mostly slow. Journal of Cardiology and Therapy 2020 7(1): 913-921 Available from: URL: http: //Clinical manifestations and aetiology New Strategies for the Treatment of Sick Sinus Syndrome. Sick sinus syndrome Pathogenesis Traditional therapy Gene therapy This article aims to summarize the aetiology and pathogenesis of SSS, discuss the advantages and disadvantages of traditional treatment methods, and focus on the biological pacing strategies based on gene and cell therapy. Hence, there is an urgent need to develop targeted therapies in order to treat SSS. Traditional therapies for SSS include drug therapy and pacemaker implantation, which have only partially succeeded clinically and cannot cure SSS. The aetiology of the syndrome is complex, and the pathogenesis is unknown. Sick sinus syndrome (SSS) is an organic disorder of the sinoatrial node and its adjacent tissues, which causes problems in sinus node pacing function and sinus node conduction, thus leading to arrhythmias and multiple symptoms. Email: Telephone: +86-0731-88872780 Received: MaRevised: MaAccepted: ApPublished online: April 17, 2020 See: http: ///licenses/by-nc/4.0/ Correspondence to: Xiushan Wu, PhD, Director and Professor, The Center for Heart Development, Hunan Normal University, Changsha, 410081, Hunan, China. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. # These authors contributed equally to this workĬonflict-of-interest statement: The author(s) declare(s) that there is no conflict of interest regarding the publication of this paper. New Strategies for the Treatment of Sick Sinus Syndromeġ The Center for Heart Development, State Key Lab of Development Biology of Freshwater Fish, Key Lab of MOE for Development Biology and Protein Chemistry, College of Life Sciences, Hunan Normal University, Changsha, Hunan 410006, China Ģ Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China.
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