Sick Sinus Syndrome

Sick sinus syndrome is a type of abnormal heart beat (arrhythmia) that results from a dysfunction of the electrical pathway or "natural pacemaker" of the heart. Sick sinus syndrome may cause your heart to beat too fast, too slow, or both. Sick sinus syndrome usually develops slowly over many years and is mostly seen in people over 65 years of age.

CAUSES

There can be different causes of sick sinus syndrome. Some of these include:

  • The natural pacemaker system of the heart is abnormal or not working properly.

  • Coronary artery disease (CAD).

  • Inflammation of the heart muscle (myocarditis).

  • Inflammation of the sac lining the heart (pericarditis).

  • Medication-related causes from medicines such as beta blockers, some calcium channel blockers, or digoxin.

  • Abnormal thyroid or electrolyte levels.

  • Family history.

SYMPTOMS

People with sick sinus syndrome may not always have symptoms. When symptoms are present, they may include:

  • Chest pain.

  • Shortness of breath.

  • Dizziness or fainting.

  • Feeling your heart skip beats or beating very fast.

DIAGNOSIS

Sick sinus syndrome can be diagnosed in a variety of ways. The following tests can help diagnose sick sinus syndrome.

  • An electrocardiogram (ECG or EKG). This helps doctors analyze the electrical currents of your heart and determine the type of arrhythmia you have. 

  • Holter monitoring .You wear a holter monitor that is connected to electrodes that are placed on your chest. The monitor records a non-stop reading of your heart rate and rhythm over a 24-hour period. Your caregiver can then look at a printout of the recording.

  • Event monitors are devices that record your heart rhythm. You wear an event monitor for longer than 24 hours. An event monitor can record and store data for up to 30 days.

  • Loop recorders are devices that record your heartbeat. They are implanted under your skin and can be left in place for several months.

  • Electrophysiology studies (EPS) . These are done in a cardiac catheterization laboratory. A long, thin tube called a catheter is inserted in an artery in your groin and guided to your heart. Electrical impulses from your heart are sent through the catheter and mapped out. This map helps doctors find out what kind of arrhythmia you have and whether it is caused by sick sinus syndrome.

TREATMENT

  • If you do not have any symptoms, you may not need treatment for sick sinus syndrome.

  • If Sick sinus syndrome is caused by medications you are taking, your caregiver may need to change the medication or dosage.

  • Your caregiver may ask you to make lifestyle changes. You may need to exercise and change what you eat according to your caregiver's instructions.

  • If sick sinus syndrome is causing a slow heart beat (bradycardia), you may need to have a pacemaker.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have chest pain.

  • You have difficulty breathing or shortness of breath.

  • You have a very fast heart beat or your heart "skips" beats.

  • You have dizziness.

  • You faint or feel you are about to faint.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.