Sinus Node Disease and Cardiac Conduction Disease

Abstract

Primary sinus node disease (SND) and cardiac conduction defect (CCD) are frequent clinical entities with significant morbidity and mortality, which are major indications for the implantation of electronic pacemakers. Throughout the previous two decades, pathogenetic mechanisms underlying both disorders have been investigated in detail, and it has been demonstrated that distinct genetic defects and/or predisposing genetic constellations play important roles in a considerable number of cases. Furthermore it has been shown that both entities often are related to a broader clinical spectrum including overlapping arrhythmia syndromes and structural cardiac abnormalities, indicating that specified genetic defects are key to distinct clinical phenotypes. This book chapter summarizes the work, which most profoundly influences the current understanding of primary excitation and conduction disorders of the heart. The novel mechanistic insight into important pathogenetic aspects of these disorders may lay the groundwork for more mechanism-based, individually tailored clinical management of patients with primary SND and CCD in the future.