Sick sinus syndrome, a disorder of the heart's natural pacemaker, results in irregular heartbeats.
Sick sinus syndrome is the inability of the heart's natural pacemaker (sinus node) to create a heart rate that's appropriate for the body's needs. It causes irregular heart rhythms (arrhythmias). Sick sinus syndrome is also known as sinus node dysfunction or sinus node disease.
The sinus node is an area of specialized cells in the upper right chamber of the heart. This area controls your heartbeat. Normally, the sinus node creates a steady pace of electrical impulses. The pace changes depending on your activity, emotions, rest and other factors.
In sick sinus syndrome, the electrical signals are abnormally paced. Your heartbeat can be too fast, too slow, interrupted by long pauses — or an alternating combination of these rhythm problems. Sick sinus syndrome is relatively uncommon, but the risk of developing it increases with age.
Many people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm.
Most people with sick sinus syndrome have few or no symptoms. Symptoms may be mild or come and go — making them difficult to recognize at first.
Signs and symptoms of sick sinus syndrome may include:
Talk to your doctor if you have any signs or symptoms of sick sinus syndrome. Many medical conditions can cause these problems, and it's important to get a timely and accurate diagnosis.
If you have new or unexplained chest pain or suspect you're having a heart attack, call for emergency medical help immediately.
Your heart is made up of four chambers — two upper (atria) and two lower (ventricles). The rhythm of your heart is normally controlled by the sinus node, an area of specialized cells in the right upper heart chamber (atrium).
This natural pacemaker produces electrical signals that trigger each heartbeat. From the sinus node, electrical signals travel across the atria to the ventricles, causing them to contract and pump blood to your lungs and body.
If you have sick sinus syndrome, your sinus node isn't working properly, causing your heart rate to be too slow (bradycardia), too fast (tachycardia) or irregular.
Problems of the sinus node include the following:
Abnormalities of the sinus node may be caused by the following:
Sick sinus syndrome can occur at any age, but it's most common in people in their 70s or older. Common heart disease risk factors may increase the risk of sick sinus syndrome:
When your heart's natural pacemaker isn't working properly, your heart can't work as well as it should. This can lead to:
Your doctor will perform a physical exam and ask questions about your symptoms and medical history.
Symptoms of sick sinus syndrome — such as dizziness, shortness of breath and fainting — only occur when the heart is beating abnormally. You may not have symptoms at the time of your doctor's appointment.
To determine if your symptoms are related to problems with the sinus node and heart function, your doctor may use the following tests:
This test is rarely used to screen for sick sinus syndrome. However, in some cases, it can help check the function of your sinus node, as well as other electrical properties of your heart.
During this test, thin, flexible tubes (catheters) tipped with electrodes are threaded through your blood vessels to various spots along the electrical pathways in your heart. Once in place, the electrodes can precisely map the spread of electrical impulses during each beat and may identify the source of heart rhythm problems.
The primary treatment goals are to reduce or eliminate symptoms and to manage and treat any other health conditions that may be contributing to sick sinus syndrome.
If you don't have symptoms, your doctor may recommend regularly scheduled exams to monitor your condition. For most people with symptoms, the treatment is an implanted electronic pacemaker. If your symptoms are mild or infrequent, the decision to use a pacemaker will depend on results of ECG exams, your overall health, and the risk of more-serious problems.
Your doctor will likely check your current medications to see if any could be interfering with the function of your sinus node, including some medications used to treat high blood pressure or heart disease. Your doctor may adjust these medications or prescribe alternatives.
Most people with sick sinus syndrome eventually need a permanent artificial pacemaker to maintain a regular heartbeat. This small, battery-powered electronic device is implanted under the skin near your collarbone during a minor surgical procedure. The pacemaker is programmed to stimulate or "pace" your heart as needed to keep it beating normally.
The type of pacemaker you need depends on the type of irregular heart rhythm you have. Some rhythms can be treated with a single-chamber pacemaker, which uses only one wire (lead) in the right atrium to pace the heart rate. However, most people with sick sinus syndrome benefit from dual-chamber pacemakers. One lead in the right atrium paces the upper chambers, and one lead in the right ventricle paces the lower chambers.
You'll be able to resume normal or near-normal activities after you recover from pacemaker implantation surgery. The risk of complications, such as swelling or infection in the area where the pacemaker was implanted, is small.
If you have a rapid heart rate as part of your sick sinus syndrome, you may need additional treatments to control these rhythms:
You many not necessarily prevent sick sinus syndrome, but you can take steps to keep your heart as healthy as possible and lower your risk of cardiovascular disease:
Call your family or primary care doctor if you have symptoms of sick sinus syndrome. You might be referred to a doctor trained in diagnosing and treating heart conditions (cardiologist).
Be prepared to answer questions about your medical history and symptoms. Write down your answers to help you remember details.
Questions your doctor may ask about symptoms include:
Other questions may include the following:
Write down any questions you have for your doctor. You might bring a companion to write down information during the appointment.
If exercise makes your symptoms worse, avoid exercise until your doctor has seen you.
October 28th, 2021