Sick sinus syndrome electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Sick sinus syndrome is a collection of heart rhythm disorders that include sinus bradycardia, sinus pauses and sinus arrest. Sick sinus syndrome can evolve towards causing atrial fibrillation, atrial flutter, ectopic atrial tachycardia, sinus node reentrant tachycardia, and tachycardia-bradycardia.

Electrocardiogram

Ambulatory monitoring of the electrocardiogram (EKG) may be necessary because arrhythmias are transient. The EKG may show any of the following

• Inappropriate sinus bradycardia
• Sinus arrest
• Sinoatrial block
• Atrial fibrillation with slow ventricular response
• A prolonged asystolic period after a period of tachycardias
• Atrial flutter
• Ectopic atrial tachycardia
• Sinus node reentrant tachycardia

Electrophysiologic tests are no longer used for diagnostic purposes because of their low specificity and sensitivity. Cardioinhibitory and vasodepressor forms of sick sinus syndrome may be revealed by tilt table testing.

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Shown below is an EKG demonstrating sick sinus syndrome. Atrial fibrillation is present (an irregularly irregular rhythm) which stops abruptly due to sinus arrest.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG showing the termination of a supraventricular tachycardia at about 130/min. which terminates and leaves a pause and then sinus bradycardia. This is a from of "tachy/brady" syndrome where a tachycardia is followed by a bradycardia.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page

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For more EKG examples of sick sinus syndrome click here.