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| [[File:Siren.gif|30px|link= Bradycardia resident survival guide]]|| <br> || <br>
| [[Bradycardia resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{{Infobox_Disease |
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   Name          = {{PAGENAME}} |
   Name          = {{PAGENAME}} |
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   Image          = SSS for right up.jpg|
   Caption        = Sick sinus syndrome|  
   Caption        = Sick sinus syndrome|
   Width          = 250px|
   Width          = 250px|
  DiseasesDB    = 12066 |
  ICD10          = {{ICD10|I|49|5|i|30}} |
  ICD9          = {{ICD9|427.81}} |
  ICDO          = |
  OMIM          = 163800 |
  MedlinePlus    = |
  MeshID        = |
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{{Sick sinus syndrome}}
{{Sick sinus syndrome}}
{{CMG}}


{{SK}} Bradycardia-tachycardia syndrome, tachycardia-bradycardia syndrome, tachy-brady syndrome, sinus node dysfunction, SND, SSS. [[Sinus arrest]], [[sinus bradycardia]], are forms or variants of sick sinus syndrome.
'''For patient information click [[Sick sinus syndrome (patient information)|here]]'''
 
{{CMG}}; {{AE}} {{Sahar}}
 
{{SK}} Bradycardia-tachycardia syndrome, tachycardia-bradycardia syndrome, tachy-brady syndrome, sinus node dysfunction, sinoatrial arrest, SND, SSS, Sinus arrest, sinus bradycardia, are forms or variants of sick sinus syndrome.
 
== [[Sick sinus syndrome overview|Overview]] ==
 
== [[Sick sinus syndrome historical perspective|Historical Perspective]] ==


==Treatment==
== [[Sick sinus syndrome classification|Classification]] ==


Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy. However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.
== [[Sick sinus syndrome pathophysiology|Pathophysiology]] ==


==ACC / AHA Guidelines- Recommendations for Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT) <ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>==
== [[Sick sinus syndrome causes|Causes]] ==
{{cquote| 
===Class I===
1. Permanent [[pacemaker]] implantation is indicated for [[SND]] with documented symptomatic [[bradycardia]], including frequent sinus pauses that produce symptoms. ''(Level of Evidence: C)''


2. Permanent [[pacemaker]] implantation is indicated for symptomatic chronotropic incompetence. ''(Level of Evidence: C)''
== [[Sick sinus syndrome differential diagnosis|Differential Diagnosis]] ==


3. Permanent [[pacemaker]] implantation is indicated for symptomatic [[sinus bradycardia]] that results from required drug therapy for medical conditions. ''(Level of Evidence: C)''
== [[Sick sinus syndrome epidemiology and demographics|Epidemiology and Demographics]] ==


===Class IIa===
== [[Sick sinus syndrome screening|Screening]] ==
1. Permanent [[pacemaker]] implantation is reasonable for [[SND]] with heart rate less than 40 bpm when a clear association between significant symptoms consistent with [[bradycardia]] and the actual presence of [[bradycardia]] has not been documented. ''(Level of Evidence: C)''


2. Permanent [[pacemaker]] implantation is reasonable for [[syncope]] of unexplained origin when clinically significant abnormalities of [[sinus node]] function are discovered or provoked in electrophysiological studies. ''(Level of Evidence: C)''
== [[Sick sinus syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==


===Class IIb===
== Diagnosis ==
1. Permanent [[pacemaker]] implantation may be considered in minimally symptomatic patients with chronic heart rate less than 40 bpm while awake. ''(Level of Evidence: C)''


===Class III===
[[Sick sinus syndrome history and symptoms|History and Symptoms]] | [[Sick sinus syndrome physical examination|Physical Examination]] | [[Sick sinus syndrome laboratory findings|Laboratory Findings]] | [[Sick sinus syndrome electrocardiogram|Electrocardiogram]] | [[Sick sinus syndrome EKG examples|EKG Examples]] | [[Sick sinus syndrome echocardiography or ultrasound|Echocardiography]] | [[Sick sinus syndrome x ray|X-ray]] | [[Sick sinus syndrome CT scan|CT scan]] | [[Sick sinus syndrome MRI|MRI]] | [[Sick sinus syndrome other imaging findings|Other Imaging Findings]] | [[Sick sinus syndrome other diagnostic studies|Other Diagnostic Studies]]
1. Permanent [[pacemaker]] implantation is not indicated for [[SND]] in asymptomatic patients. ''(Level of Evidence: C)''


2. Permanent [[pacemaker]] implantation is not indicated for [[SND]] in patients for whom the symptoms suggestive of [[bradycardia]] have been clearly documented to occur in the absence of [[bradycardia]]. ''(Level of Evidence: C)''
== Treatment ==


3. Permanent [[pacemaker]] implantation is not indicated for [[SND]] with symptomatic [[bradycardia]] due to nonessential drug therapy. ''(Level of Evidence: C)''}}
[[Sick sinus syndrome medical therapy|Medical Therapy]] | [[Sick sinus syndrome surgery|Surgery]] | [[Sick sinus syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Sick sinus syndrome future or investigational therapies|Future or Investigational Therapies]]


==External links==
== Case Studies ==
*[http://www.nlm.nih.gov/medlineplus/ency/article/000161.htm NIH website]


==References==
[[Sick sinus syndrome case study one|Case #1]]
* {{cite journal | author=Adan V, Crown LA | title=Diagnosis and treatment of sick sinus syndrome | journal=Am Fam Physician | year=2003 | pages=1725-32 | volume=67 | issue=8  | id=PMID 12725451}}
{{Reflist|2}}


[[de:Sick-Sinus-Syndrom]]
[[ja:洞不全症候群]]
[[sv:Taky-brady-syndrom]]


[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
[[Category:Syndromes]]
[[Category:Syndromes]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Arrhythmia]]


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Latest revision as of 01:50, 16 April 2020
Resident
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Sick sinus syndrome
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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]

Synonyms and keywords: Bradycardia-tachycardia syndrome, tachycardia-bradycardia syndrome, tachy-brady syndrome, sinus node dysfunction, sinoatrial arrest, SND, SSS, Sinus arrest, sinus bradycardia, are forms or variants of sick sinus syndrome.

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differential Diagnosis

Epidemiology and Demographics

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | EKG Examples | Echocardiography | X-ray | CT scan | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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