Which of the following is a risk factor for development of thromboembolism in patients with the tachycardia-bradycardia variant of sick sinus syndrome?
A. Age >50 years
B. Atrial enlargement
C. Diabetes mellitus
D. Prothrombin 20210 mutation
E. None of the above; there is no increased risk of thromboembolism with the tachycardia-bradycardia variant of sick sinus syndrome
The answer is B. (Chap. 239) The tachycardia-bradycardia variant of sick sinus syndrome is associated with an increased risk of thromboembolism particularly when similar risk factors are present that increase the risk of thromboembolism in patients with atrial fibrillation. Specific risk factors associated with highest risk include age >65 years, patients with prior history of stroke, valvular heart disease, left ventricular dysfunction, or atrial enlargement. Patients with these risk factors should be treated with anticoagulation.