Document ID: chunk:federal_register_of_legislation:F2022L00920:reg:9:p1
Version: federal_register_of_legislation:F2022L00920
Segment Type: reg
Provision Reference: reg 9 (pt 1/3)
Character Range: 4190–7423

9               Factors that must exist
At least one of the following factors must exist before it can be said that, on the balance of probabilities, sick sinus syndrome or death from sick sinus syndrome is connected with the circumstances of a person's relevant service:
(1)          having atrial fibrillation or atrial flutter at the time of the clinical onset of sick sinus syndrome;
(2)          having hypertension at the time of the clinical onset of sick sinus syndrome;
(3)          having ischaemic heart disease at the time of the clinical onset of sick sinus syndrome;
(4)          having heart failure at the time of the clinical onset of sick sinus syndrome;
(5)          having rheumatic fever at the time of the clinical onset of sick sinus syndrome;
(6)          having pericarditis at the time of the clinical onset of sick sinus syndrome;
(7)          having cardiomyopathy at the time of the clinical onset of sick sinus syndrome;
(8)          having non-infectious myocarditis at the time of the clinical onset of sick sinus syndrome;
Note 1: Non-infectious myocarditis can be acute or chronic.
             Note 2: Non-infectious myocarditis can be of autoimmune, infiltrative or immunological origin. Examples of causes of non-infectious myocarditis include immune checkpoint inhibitor therapy and giant cell myocarditis.
(9)          having viral myocarditis at the time of the clinical onset of sick sinus syndrome;
Note 1: Viral myocarditis can be acute or chronic.
             Note 2: Examples of viral causes of myocarditis include severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus, group B coxsackieviruses and dengue virus.
(10)      having a non-viral infection of the myocardium at the time of the clinical onset of sick sinus syndrome;
             Note 1: A non-viral infection of the myocardium can be caused by bacteria, protozoa, fungi or parasites.
Note 2: Examples of non-viral infections of the myocardium include:

               (a)        Borrelia burgdorferi (Lyme disease);
               (b)       Cysticercus species (cysticercosis);
               (c)        Echinococcus species (hydatid disease);
               (d)       Toxoplasma gondii (toxoplasmosis); and
               (e)        Trypanosoma cruzi (Chagas disease).
(11)      having a benign or malignant neoplasm involving the sinoatrial node before the clinical onset of sick sinus syndrome;
            Note: A neoplasm involving the sinoatrial node can be primary or metastatic. An example of a primary neoplasm involving the sinoatrial node is cardiac lymphoma.
(12)      having a non-neoplastic lesion which compresses the sinoatrial node at the time of the clinical onset of sick sinus syndrome;
            Note: Examples of non-neoplastic lesions which compress the sinoatrial node include cardiac tamponade and coronary artery aneurysm.
(13)      having hypothyroidism, including Hashimoto thyroiditis that has resulted in hypothyroidism, at the time of the clinical onset of sick sinus syndrome;
(14)      having a thoracic surgical procedure or an invasive cardiac procedure within the 1 year before the clinical onset of sick sinus syndrome;
             Note 1: Examples