Sick sinus syndrome natural history, complications and prognosis

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

Overview

Sick sinus syndrome natural history progress over decades. Patients are usually asymptomatic at first, but then symptoms may present due to the insufficient blood supply. Sinus pause or severe bradycardia may present with the central nervous system (CNS) under perfusion which manifests with presyncope or syncope. Possible complications of sick sinus syndrome include cerebrovascular events, stroke, transient ischemic events, renal, gastrointestinal hypo-perfusion, thromboembolism, Fatigue and exercise intolerance. The syndrome is progressive, which means it usually gets worse over time.

Sick sinus syndrome natural history progress over decades.^[1]
Patients are usually asymptomatic at first, but then symptoms may present due to the insufficient blood supply.
Sinus pause or severe bradycardia may present with the central nervous system (CNS) under perfusion which manifests with presyncope or syncope.

Possible complications of sick sinus syndrome include:^[2]

The syndrome is progressive, which means it usually gets worse over time.^[3]
The long-term outlook is excellent for people who have a permanent pacemaker implanted.
The long-term progression of SSS is mostly related to the presence and severity of associated coronary or hypertensive cardiac disease.

↑ Lien WP, Lee YS, Chang FZ, Lee SY, Chen CM, Tsai HC (1977). "The sick sinus syndrome: natural history of dysfunction of the sinoatrial node". Chest. 72 (5): 628–34. PMID 913143.
↑ Rubenstein, Joel J.; Schulman, Charles L.; Yurchak, Peter M.; Desanctis, Roman W. (1972). "Clinical Spectrum of the Sick Sinus Syndrome". Circulation. 46 (1): 5–13. doi:10.1161/01.CIR.46.1.5. ISSN 0009-7322.
↑ Rodriguez RD, Schocken DD (1990). "Update on sick sinus syndrome, a cardiac disorder of aging". Geriatrics. 45 (1): 26–30, 33–6. PMID 2403955.