Sick sinus syndrome overview

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

Overview

Sick sinus syndrome(SSS) is a term used to describe a number of different abnormal heart rhythms (arrhythmias) caused by a malfunction of the sinus node, the heart's "natural" pacemaker. It encompasses disorders causing reduced automaticity of the sinoatrial node, exit block, and sinus arrest. The syndrome primarily affects the elderly, and is associated with paroxysmal atrial fibrillation or flutter in approximately half of the patients and with distal conduction disease in up to one tenth of patients. SSS may result in sinus pauses and arrest. It may also present with bradycardia, tachycardia, and an alternation between the two referred to as the tachycardia-bradycardia syndrome which is characterized by periods of bradycardia alternating with periods of atrial fibrillation with rapid ventricular response. SSS may go largely unnoticed in mild disease but can cause a number of symptoms in severe disease including syncope, pre-syncope, palpitations, or dizziness. Management of the syndrome usually requires an implanted permanent pacemaker.