Diagnostic Value Of Autonomic Nerve Detection In Senile Pathological Sinus Node Syndrome

Background and purposeSick sinus node syndrome is a common bradyarrhythmia in clinical practice.Its etiology is mainly coronary heart disease,chronic degenerative changes,myocarditis,cardiomyopathy,etc.The pathogenesis remains unclear.Sudden death often occurs in patients with sinus node dysfunction because of severe bradycardia or tachycardia,which is a serious threat to human health.The cardiac autonomic nervous system plays an important role in cardiac electrophysiology.The electrical stability of myocardium depends on the balance between vagus,sympathetic and humoral regulation.Some bradyarrhythmias are caused by increased vagal dystonia.Such patients often have palpitations,fatigue,shortness of breath,dizziness and syncope and other symptoms,which significantly reduce the quality of life of patients.In severe cases,pacemaker implantation is needed for treatment,but pacemakers are expensive and the battery service life is limited,so patients may need to change pacemakers several times in their life,which not only aggravates the economic burden of patients,but also easily causes other complications related to pacemaking.This article aims to explore the diagnostic value of autonomic nerve detection in pathological sinus node syndrome,and to further clarify the relationship and role of cardiac autonomic nerve in the course of pathological sinus node syndrome in the elderly,and to provide a new idea for the treatment strategy of patients with sinus bradycardia.Methods119 symptomatic patients with sinus bradycardia were enrolled in this study and divided into two groups.Firstly,they were divided into two groups according to their age:(1)Old age group: age >60 years old;Young group: ≤60 years old.Then according to the results of esophageal pacing,the patients were divided into diseased sinus group and non-diseased sinus group.All patients had completed clinical examinations such as heart color ultrasound,blood test,12-lead electrocardiogram,24-hour dynamic electrocardiogram and esophageal pacing.The serum creatinine,triglyceride,total cholesterol,BNP and other biochemical indexes,heart color ultrasound results,24 hours dynamic electrocardiogram and esophageal pacing were compared among the groups.Results(1)There was no statistical significance in gender,serum creatinine,triglyceride,total cholesterol,upper and lower diameter and left and right diameter of right atrium,anterior and posterior diameter of left atrium,diastolic diameter of left ventricle and ejection fraction in aged group and young group(P > 0.05).The BNP level in the aged group was higher than that in the young group(P < 0.05).(2)According to esophageal pacing results,SDNN,SDANN,r MSSD,p NN50 and LF/HF in the diseased sinus group increased compared with the non-diseased sinus group,and the differences between the two groups were statistically significant(P < 0.05).Then,the diseased sinus group was divided into the elderly group and the young group according to their age.Correlation analysis showed that LF/HF was positively correlated with age,suggesting that the sympathetic tension of patients with senile diseased sinus increased.In the non-diseased sinus group,LF/HF was negatively correlated with age,suggesting increased vagal tone in patients with slow sinus of young age.ConclusionsCorrelation analysis showed that age in the patients with sinus bradycardia was positively correlated with LF/HF,suggesting that sympathetic hyperactivity and relatively weakened vagus nerve activity in elderly patients with sinus bradycardia may be related to age-related aging of the sinoatrial node,and senile patients with sinus bradycardia may have sinoatrial node dysfunction.There was a negative correlation between age and LF/HF in the non-affected sinus group,suggesting that sinus bradycardia in the younger patients may be caused by increased vagal tone,which was manifested as bradycardia without sinoatrial node dysfunction.The detection of autonomic nerve function can be used as a diagnostic factor in the prediction of senile pathological sinus node syndrome.