[ XXXX - diagnosis and treatment].

@entity1 @entity16 @entity409 @entity1163 @entity591 @entity1817 @entity16507 @entity1296 @entity943 @entity1168
The concept of @entity1817 is defined by a group of clinical and electrocardiographic features related to @entity1817 whatever its mechanism; the organicity of the disease can be proven if total or subtotal histological alterations of the sinus node are demonstrated. The most typical symptoms are neurological ( @entity1163 and @entity1296 ). @entity16507 , sinus @entity1168 or @entity1168 , and the @entity1168 - @entity591 syndrome are the most usual electrocardiographic aspects. The diagnosis is often rendered difficult by the usually intermittent and frequently nonspecific character of the symptoms and of the ECG signs. Holter monitoring is often essential to resolve these difficulties. If the diagnosis remains dubious, the use of electrophysiological methods is necessary: direct recording of the sinus nodal intracardiac potential can now be added to the classical rapid and premature atrial stimulation, possibly complemented by pharmacological tests. Finally, therapeutic indications can be considered after a correct clinical, electrocardiographical and electrophysiological evaluation of the @entity1 . Medical treatment alone is usually ineffective in controlling the attacks of @entity943 and the @entity16 . If the sinus @entity409 is obvious and symptomatic, permanent pacing is the treatment of choice. Its short and medium term results are generally excellent, while the long term results, especially with regard to survival of the @entity1 , could be improved by the most recent pacing techniques.
