Sick sinus syndrome is the name given to a group of arrhythmias that
occur because the normal pacemaker of the heart (the sinus node) does not work
properly. Sick sinus syndrome is also called sinus node dysfunction.
Sick sinus syndrome can occur for various reasons. It most commonly
results from the effect of age on the sinus node. As we get older, scarring of
the sinus node can occur and, in some people, it can be so severe that it
causes this syndrome.
Various irregular heart rates (arrhythmias) or combinations of
arrhythmias can occur in this condition. People with this syndrome can have
slow arrhythmias or a combination of fast and slow arrhythmias. These
Periods of time when the sinus node does not fire
at all (sinus pauses) and other areas of the heart take over and cause the
heart to beat.
Prolonged periods of time when the heart rate is
spontaneously very slow and does not increase as it should with activity
(persistent sinus bradycardia).
Periods of fast arrhythmias
(supraventricular tachycardias), especially atrial fibrillation or atrial
flutter, alternating with periods of very slow heart rates ("tachy-brady"
Treatment of sick sinus syndrome depends on the type of rhythm problem. Treatment typically is a pacemaker, and sometimes medicines is used too.
In tachy-brady syndrome, also called tachycardia-bradycardia syndrome, the
heart sometimes beats too quickly (tachy) and sometimes beats too slowly
(brady). This abnormal heart rhythm problem is often seen in people who have
been diagnosed with
atrial fibrillation. It can occur when the heart's
natural pacemaker is damaged.
Risk of complications? Yes. You may have symptoms such as palpitations and lightheadedness. You might pass out. You might have a higher risk of stroke.
Treatment. Treatment may include a pacemaker to prevent the heart from
beating too slow. Medicines might be used to prevent the heart from
beating too fast. Blood-thinning medicines are used to help prevent a stroke.
Olgin JE, Zipes DP (2012). Specific arrhythmias: Diagnosis and treatment. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 771?824. Philadelphia: Saunders.
Vijayaraman P, Ellenbogen KA (2011). Bradyarrhythmias and pacemakers. In V Fuster et al., eds., Hurst's The Heart, 13th ed., pp. 1025?1057. New York: McGraw-Hill Medical.
E. Gregory Thompson, MD - Internal Medicine
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
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