Sick sinus syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Sick Sinus Syndrome Differential Diagnosis

Sick sinus syndrome must be differentiated from other cause of syncope, lightheadedness, dizziness, and tachycardia-bradycardia syndrome. This algotithm shows different types of bradycardia:

Bradycardia Differential Diagnosis

Bradycardia

Narrow complex

Wide complex

Regular

Irregular

Regular

Irregular

• Sinus bradycardia • Junctional bradycardia • Complete AV block (junctional escape) • Atrial flutter with high degree block

• Sinus arrhythmia, pause or arrest • Sinoatrial exit block (second degree) • AF with slow ventricular response • Atrial flutter with variable block • Second degree AV block, type I • Second degree AV block, type II

• Idioventricular rhythm • Complete AV block (ventricular escape) • Sinoventricular rhythm • Regular bradycardias with aberrancy or bundle branch block

• Second degree AV block, type I • Second degree AV block, type II • Sinoatrial exit block (second degree) with bundle branch block • Irregular bradycardias with bundle branch block