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August 1, 1978HeartOpen Access

Maximum heart rate in sick sinus syndrome patients was significantly lower than in age-matched normals (124 +/- 8.9 vs 163 +/- 3.7 beats/min, P < 0.001) despite similar VO2max.

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Why the study?

Does maximal treadmill exercise reveal an abnormal heart rate response in patients with sick sinus syndrome compared to normal subjects?

Population

21 subjects total: 7 patients with sick sinus syndrome without significant associated heart disease, 7…

Comparison

Maximal treadmill exercise vs Age-matched normal patients and younger…

Design

Case-control

Authors

WHWilliam HoldenJMJohn H. McAnultySRS H Rahimtoola

Discussion

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Overview

Blunted maximal heart rate on exercise testing may aid SSS evaluation; hypothesis-generating and requires prospective confirmation before changing practice.

Key Points

  • To characterize the heart rate and metabolic response to maximal exercise in patients with sick sinus syndrome who do not have other significant heart disease.
  • Assessed 7 patients with sick sinus syndrome (mean age 53.4 years, group A), 7 age-matched normal controls (group B), and 7 younger, well-trained controls (group C).
  • All subjects completed maximal treadmill exercise testing using the Bruce protocol while heart rate and oxygen consumption were measured.
  • Maximum heart rate was significantly lower in sick sinus syndrome patients than in age-matched controls (124 ± 8.9 vs 163 ± 3.7 beats/min, P < 0.001), despite comparable VO2max (23.8 ± 4.7 vs 19.9 ± 0.8 l/min/kg).
  • Patients with sick sinus syndrome exhibited a significantly reduced heart rate response slope per unit increase in oxygen consumption (deltaHR 5.20 ± 0.33/delta1 ml VO2/kg per min, P < 0.001) compared with age-matched controls.

Structured PICO

Does maximal treadmill exercise reveal an abnormal heart rate response in patients with sick sinus syndrome compared to normal subjects?

P
Population
21 subjects total: 7 patients with sick sinus syndrome without significant associated heart disease (mean age 53.4 years), 7 age-matched 'normal' patients (within 5 years), and 7 younger well-trained subjects.
I
Intervention
Maximal treadmill exercise
C
Comparator
Age-matched normal patients and younger well-trained subjects undergoing the same exercise protocol
O
Outcome
Heart rate response to exercise (maximum heart rate and VO2max)surrogate

Patients with sick sinus syndrome exhibit a blunted heart rate response to exercise despite normal oxygen consumption, which may aid in their clinical evaluation.

Cite This Study

Holden et al. (1978) studied this question.

synapsesocial.com/papers/6a77baacd8eb58afc2be1451https://doi.org/10.1136/hrt.40.8.923
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Exercise Testing in the Diagnosis of Sick Sinus Syndrome in the Elderly: Implications for Treatment1987 · 22 citations
  2. 2Heart rate responses in patients with sinus node disease compared to controls: Physiological implications and diagnostic possibilities1980 · 17 citations
  3. 3Heart rate responses in patients with sinus node disease compared to controls: physiological implications and diagnostic possibilities1980 · 7 citations
  4. 4Natural History of Sinus Node Chronotropy in Paced Patients1991 · 19 citations
  5. 5Studies on the mechanism of sinus node dysfunction in the sick sinus syndrome.1978 · 174 citations