sinoatrial exit block

Introduction

A pause in or arrest of sinus activity with the p-p interval of the pause a multiple (i.e. 2X, 3X etc.) of the baseline p-p interval (See sinus arrest/pause).

Etiology

• failure of impulse propagation
• excessive vagal stimulation
• acute myocarditis
• myocardial ischemia/infarction
• pharmacologic agents
• electrolyte imbalances
  • hyperkalemia

Clinical manifestations

• lightheadedness
• dizziness
• syncope or presyncope

Management

• therapy unnecessary in asymptomatic patients
• symptomatic patients
  • correct underlying cause
  • consider permanent cardiac pacemaker if pause > 3 seconds

More general terms

• supraventricular arrhythmia
• bradyarrhythmia (bradycardia)
• heart block

Additional terms

• sick sinus syndrome; atrial fibrillation with bradyarrhythmia; tachycardia-bradycardia syndrome
• sinus arrest/pause