Sick sinus syndrome electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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.
This is an electrocardiogram from a middle-aged woman treated for atrial fibrillation. The patient was doing well when this electrocardiogram was taken, and was taking digoxin and flecainide . The electrocardiogram shows an irregular rhythm which appears to be sinus. The grouping of the QRS complexes suggests a Mobitz type I AV block. In this case though, no AV block is seen and this may represent a sinus node exit block.