What is sick sinus syndrome?
Sick sinus syndrome (SSS) — also known as sinus node disease or sinus node dysfunction — is the name for a group of heart rhythm problems (arrhythmias) in which the sinus node — the heart’s natural pacemaker — doesn’t work properly.
The sinus node is an area of specialized cells in the upper right chamber of the heart that controls the rhythm of your heart. Normally, the sinus node produces a steady pace of regular electrical impulses. In sick sinus syndrome, these signals are abnormally paced.
A person with sick sinus syndrome may have heart rhythms that are too fast, too slow, punctuated by long pauses — or an alternating combination of all of these rhythm problems. Sick sinus syndrome is relatively uncommon, but the risk of developing sick sinus syndrome increases with age.
Many people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm.
How common is sick sinus syndrome?
Sick sinus syndrome (SSS) is a relatively uncommon heart rhythm disorder. Please discuss with your doctor for further information.
What are the symptoms of sick sinus syndrome?
Most people with sick sinus syndrome initially have few or no symptoms. In some cases, symptoms may come and go.
When they do occur, sick sinus syndrome symptoms may include:
- Slower than normal pulse (bradycardia)
- Dizziness or lightheadedness
- Fainting or near fainting
- Shortness of breath
- Chest pains
- A sensation of rapid, fluttering heartbeats (palpitations)
Many of these signs and symptoms are caused by reduced blood flow to the brain when the heart beats too fast or too slowly.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
If you have spells of lightheadedness, dizziness, fainting, fatigue, shortness of breath or palpitations, talk to your doctor. Many medical conditions can cause these signs and symptoms — including sick sinus syndrome — and it’s important to identify the problem.
What causes sick sinus syndrome?
Your heart is made up of four chambers — two upper chambers (atria) and two lower chambers (ventricles). The rhythm of your heart is normally controlled by the sinoatrial (SA) node — or sinus node — an area of specialized cells located in the right atrium.
This natural pacemaker produces the electrical impulses that trigger each heartbeat. From the sinus node, electrical impulses travel across the atria to the ventricles, causing them to contract and pump blood out to your lungs and body.
If you have sick sinus syndrome, your sinus node isn’t functioning properly, so your heart rate may be too slow (bradycardia) or too fast (tachycardia) or irregular.
Types of sick sinus syndrome and their causes include:
- Sinoatrial block. Electrical signals move too slowly through the sinus node, causing an abnormally slow heart rate.
- Sinus arrest. The sinus node activity pauses.
- Bradycardia-tachycardia syndrome. The heart rate alternates between abnormally fast and slow rhythms, usually with a long pause (asystole) between heartbeats.
What makes the sinus node misfire?
Diseases and conditions that cause scarring or damage to your heart’s electrical system can be the reason. Scar tissue from a previous heart surgery also may be the cause, particularly in children.
Sick sinus syndrome may also be set off by medications, such as calcium channel blockers or beta blockers used to treat high blood pressure, heart disease or other conditions. However, in many cases, the sinus node doesn’t work properly because of age-related wear and tear to the heart muscle.
What increases my risk for sick sinus syndrome?
There are many risk factors for sick sinus syndrome, such as:
- History of congenital heart disease (even with repairs, the heart is still weak)
- Thyroid disease history
- Sleep apnea disorder
- Coronary artery disease: The coronary artery becomes clogged, and blood flow to the heart is restricted
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is sick sinus syndrome diagnosed?
Diagnosing SSS can be difficult. You may have no symptoms or family history of heart disease. Your doctor must rely on tests that measure the function of your heart to make a diagnosis. These tests include:
- An electrocardiogram (ECG), which is a test that records the electrical activity of the heart.
- An echocardiogram, which is an ultrasonic imaging test of the heart.
- A transesophageal echocardiogram (TEE), which is a test where a special ultrasound device is put down the patient’s throat and into the esophagus to get a clear image of the heart size, the contracting strength of the heart, and any damage to the heart muscle.
- A holter monitoring, which is a test where an electrocardiogram monitor is attached to the chest and worn for at least one 24-hour period. The patient keeps a diary of his or her activities and symptoms while wearing the monitor.
How is sick sinus syndrome treated?
Treatment for mild or early cases of SSS involves relieving symptoms. Your doctors may adjust or change your medication if that is the problem. They may also prescribe additional medications that may have a direct effect on heart rhythm. Eventually, however, most people with SSS will need an artificial pacemaker implant when the sinus node is no longer able to adequately perform.
A pacemaker is a very small machine that is surgically implanted in the chest or abdomen to regulate your heartbeat. It does this through sending electrical pulses to the heart.
Almost one-half of pacemaker implantations are performed because of problems related to sick sinus syndrome. Pacemakers are generally tolerated well, and most people experience few complications.
Rare complications of a pacemaker implant include:
- Myocardial perforation (accidental hole made in the heart during surgery)
- Infection from the implant (bacteria brought in during surgery causes infection)
- Venous thrombosis (blood clot within the body’s veins)
- Collapsed lung
With modern technology, there is a growing interest in creating a biological pacemaker. This could be done by taking cells containing pace-making genes and implanting them in the heart. The cells would then grow into the heart and become a new pacemaker.
A second approach would be to use stem cells. Stem cells are immature cells capable of developing into any specific type of mature cell. The cells could potentially grow into the same type of heart tissue as the sinus node.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage sick sinus syndrome?
The following lifestyles and home remedies might help you cope with sick sinus syndrome:
- Exercise and eat a healthy diet. Live a heart-healthy lifestyle by exercising regularly and eating a healthy, low-fat diet that’s rich in fruits, vegetables and whole grains.
- Maintain a healthy weight. Being overweight increases your risk of developing heart disease.
- Keep blood pressure and cholesterol under control. Make lifestyle changes and take medications as prescribed to correct high blood pressure (hypertension) or high cholesterol.
- Don’t smoke. If you smoke and can’t quit on your own, talk to your doctor about strategies or programs to help you break a smoking habit.
- If you drink, do so in moderation. If you drink alcohol, drink in moderation. For some conditions it’s recommended that you completely avoid alcohol. Ask your doctor for advice specific to your condition. If you can’t control your alcohol use, talk to your doctor about a program to quit drinking and manage other behaviors related to alcohol abuse.
- Don’t use illegal drugs. Talk to your doctor about an appropriate program for you if you need help ending illegal drug use.
- Control stress. Avoid unnecessary stress and learn coping techniques to handle normal stress in a healthy way.
- Go to scheduled checkups. Have regular physical exams and report any signs or symptoms to your doctor.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Sick sinus syndrome. http://www.mayoclinic.org/diseases-conditions/sick-sinus-syndrome/basics/definition/con-20029161. Accessed August 25, 2017.
Sick Sinus Syndrome. http://www.healthline.com/health/sick-sinus-syndrome#overview1. Accessed August 25, 2017.
Sick Sinus Syndrome. http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Sick-Sinus-Syndrome. Accessed August 25, 2017.
Review Date: September 6, 2017 | Last Modified: September 6, 2017