Desynchronization of Pacemaker Activity in the Sinoatrial Node Triggered by Stress By Dong-Gyun Han June 23, 2026 Frontiers In Cardiovascular Medicine Share Summary Takeaways Listen Insight Report Clinical Scorecard Quiz 1 The sinoatrial node (SAN) consists of a heterogeneous population of pacemaker cells rather than a single dominant oscillator. 2 Stress-related arrhythmogenic vulnerability may arise from transient loss of synchronization within the SAN pacemaker population. 3 Sustained autonomic stress and structural remodeling can amplify intrinsic-frequency dispersion, reducing synchronization reserve. 4 Abrupt physiological transitions can expose latent instability in the SAN, leading to arrhythmogenic events. 5 The proposed model emphasizes the importance of population-level coherence in the SAN for maintaining normal rhythm.