Sick Sinus Syndrome
Sick sinus syndrome is an umbrella term for several heart rhythm problems, also known as arrhythmias, that occur at the sinoatrial or SA node, which initiates the electrical signals to create a heartbeat. Sick sinus syndrome can include a slow heart rate called sinus bradycardia, can describe a fast heart rate (tachycardia), or even times where the heartbeat pauses known as sinus pauses or sinus arrest. Some patients can even experience situations in which the heartbeat alternately speeds up, and slows down called tachy-brady syndrome.
Sick sinus syndrome is often related to age and typically affects those of middle age or older. However, children can experience sick sinus syndrome as well, especially if they have undergone surgery involving the atria of the heart.
Most people experiencing sick sinus syndrome have a slower than normal heart rhythm known as sinus bradycardia. As a result, these patients may require a pacemaker.
A rapid heartbeat, known as tachycardia, may also be associated with sick sinus syndrome. These conditions may include atrial fibrillation, atrial flutter and more.
Causes of sick sinus syndrome
The primary risk factor and cause is scar tissue formation along the electrical pathways of the heart, which causes the abnormality in the heart rhythm. This is typically due to age, however as mentioned above, children who have had heart surgery can also develop this condition. Because sick sinus syndrome is not very common, we do not know all potential causes.
Symptoms associated with sick sinus syndrome
For many, sick sinus syndrome does not cause any symptoms at all. However, being that heart rhythm issues may occur concurrently, patients often experience symptoms of these other conditions including:
- The sensation of a fast heartbeat
- Shortness of breath
- Chest pain
- Brain fog
- Dizziness and fainting
- Tiredness and fatigue
How we diagnose sick sinus syndrome
Typically, when a patient complains of heart rhythm issues, they are tested using an electrocardiogram or EKG – usually at their primary care physician’s office or with their general cardiologist. This failure may not reveal sick sinus syndrome, especially if the symptoms are fleeting or occasional. Some patients will benefit from a Holter monitor, loop recorder or event monitor, which can offer longer term evaluation and observation. Some patients may require an electrophysiology study to monitor or induce the arrhythmia in real time.
Treatment for sick sinus syndrome
Treatment for this condition will mimic the treatment for associated arrythmias and disorders. If there is a slow heartbeat, the patient may require a pacemaker. A fast heartbeat may require medical intervention in the form of antiarrhythmic medication. Many patients will benefit from a curative catheter-based procedure known as cardiac catheter ablation or a similar procedure known as balloon cryoablation.
The bottom line is that whenever you experience any kind of heart rhythm issue, please visit a qualified electrophysiologist as soon as possible to ensure the most accurate diagnosis and an appropriate treatment plan.