Sick sinus syndrome electrocardiogram

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

Electrocardiogram

Ambulatory monitoring of the electrocardiogram (ECG) may be necessary because arrhythmias are transient. The ECG 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 (irregularly irregular rhythm) stopping abruptly.

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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.

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For EKG examples of sick sinus syndrome click here.