Akademik Veri Yönetim Sistemi
AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, İsviçre, 25 - 28 Mayıs 2022, ss.481-482
CLINICAL CHARACTERISTICS, AND COURSE OF SINUS NODE DYSFUNCTION IN CHILDREN: A TEN
YEARS SINGLE-CENTER EXPERIENCE
Gulhan Tunca Sahin1, Hasan Candas Kafali2, Ayse Sulu3, Fatma Sevinc Sengul2, Sertac Haydin4, Alper
Guzeltas2, Yakup Ergul2
1Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and
Cardiovascular Surgery Center, Istanbul, Turkey; Deparment of Pediatric Cardiology, Saglik Bilimleri
University Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
2Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and
Cardiovascular Surgery Center, Istanbul, Turkey
3Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and
Cardiovascular Surgery Center, Istanbul, Turkey; Department of Pediatric Cardiology, Osmangazi
University Medical Faculty, Eskisehir, Turkey
4Department of Pediatric Cardiovascular Surgery, Saglik Bilimleri University M. Akif Ersoy Thoracic
and Cardiovascular Surgery Center, Istanbul, Turkey
BACKGROUND AND AIM: To evaluate the clinical characteristics and outcomes of children diagnosed
with sinus node dysfunction (SND).
METHODS: This was a retrospective review of patients diagnosed with sinus node dysfunction in a
tertiary paediatric cardiology center in Turkey from January 2011 to November 2021.
RESULTS: In all, 51 patients (34/66.6% males) were included, with a mean age of 9.3±6.4 years and a
mean weight of 29.6±19.2 kg.The age inappropriate bradycardia and pauses were the most common
rhythm disturbance, and syncope and dizziness (n:23, 45%) were the most frequent initial
symptoms.Forty of the 51 patients (78%) had structural heart disease, thirty two of them had
congenital heart disease, most commonly AV septal defect (n:10), atrial septal defect (n:5) and
transposition of great arteries (n:4). Seven of them had also left atrial isomerism.The remaining
eleven patients were isolated. Two of our patients were siblings and had SCN5A mutation.Of the
total patient population, 29 patients (57%) had previously undergone a cardiac operation and except
one patient sinus node dysfunction developed after a surgical procedure. This patient had left atrial
isomerism and SND was diagnosed during 24 hours holter monitorization before surgery. The most
common surgical procedures were fontan operation in six, closure of atrial septal defect in five,
correction of AV septal defect in four, Senning operation in three, and abnormal pulmonary venous
connection anomaly repairment in two. Twenty nine (56%) patients (17 of them were after cardiac
surgery) were underwent pacemaker implantation. The mean interval between pacemaker
implantation and the previous operation was 5,1 years (range, 0-18.4 years). Five of them had
pacemaker implantation within the first 30 days after surgery. All symptomatic patients noted
resolution of symptoms after pacemaker implantation. During the mean follow-up time of 43±33.7
months, no mortality was seen.
CONCLUSIONS: Although SND is rare in children, it has been diagnosed with increasing frequency
with structural heart disease especially in patients who have undergone corrective cardiac surgery
related with atrial tissue. Since SND can occur at any time postoperatively, these patients should be
kept under constant control. If symptomatic sinus node dysfunction is confirmed, permanent pacing
is an effective therapeutic modality.