Sinus Arrhythmia Disorder: Symptoms, Causes, and Further Details
Sick Sinus Syndrome (SSS) is a heart rhythm problem that can cause bradycardia (slow heart rate) or tachycardia (fast heart rate). This condition is often associated with aging, thickening or scarring of the sinus node tissue, damage to the sinus node, congenital heart abnormalities, arrhythmias, heart failure, infiltrative diseases, heart surgery, and certain medications [1][5].
People with risk factors such as smoking, low levels of physical activity, high blood pressure, diabetes, or a family history of heart disease should discuss these with their doctor. Quitting smoking, exercising, managing stress, following a healthy diet, and controlling blood pressure and cholesterol levels can help reduce the risk of developing heart problems [2].
When symptoms of sinus bradycardia (slow heart rate) cause problems, a permanent pacemaker is typically implanted to maintain normal heart rhythm. A pacemaker helps manage SSS symptoms by delivering electrical pulses to the heart to prompt it to beat at a normal rate [1][2]. This is essential because in SSS, the heart’s natural pacemaker (the sinus node) is dysfunctional, causing irregular rhythms or abnormally slow heartbeats that may lead to dizziness, fatigue, or fainting [1].
Medication may also be used to manage symptoms, but must be managed carefully, especially when there are fast heart rates or risk of heart block [1][5]. Medications such as beta-blockers, calcium channel blockers, digitalis (digoxin), or anti-arrhythmic drugs may be used to control heart rate and rhythm. However, medications alone are often insufficient for symptomatic bradycardia in SSS, making pacemaker implantation the most definitive and effective therapy [5].
Additional treatments may include management of coexisting arrhythmias such as atrial fibrillation or procedures like cardioversion and ablation if abnormal fast rhythms coexist. Heart ultrasounds or echocardiograms can help assess the heart's function and structures, while electrophysiologic studies involve specialized cardiologists inserting tiny electrodes through veins into the heart using a catheter to diagnose specific arrhythmias [1][3].
Remote cardiac monitoring devices, such as Holter monitors or event monitors, can be used to monitor the heart's activity for 24 hours and help diagnose irregular heartbeats. The outlook for SSS is generally positive, and pacemaker implantation can help control symptoms [1]. However, it's important to note that pacemaker implantation can also lead to complications such as blood clots, infection, and collapsed lung [4].
Without treatment, people with SSS may experience hypotension (low blood pressure) and fainting. SSS can cause symptoms such as fatigue, fainting, dizziness, shortness of breath, chest pain, a slower pulse, and palpitations. If a person is experiencing bradycardia symptoms, doctors may recommend a pacemaker implantation to take over the role of the sinus node [1].
In summary, medication, permanent pacemaker implantation, and other procedures like cardioversion or ablation can be used to manage SSS. This approach allows patients with SSS to have a controlled heart rhythm, reducing symptoms and improving quality of life [1][2][5].
[1] Mayo Clinic. (2021). Sick sinus syndrome. https://www.mayoclinic.org/diseases-conditions/sick-sinus-syndrome/symptoms-causes/syc-20372871
[2] American Heart Association. (2021). Sick Sinus Syndrome. https://www.heart.org/en/health-topics/arrhythmia/sick-sinus-syndrome
[3] Cleveland Clinic. (2021). Electrophysiologic Studies: What You Need to Know. https://my.clevelandclinic.org/health/treatments/16741-electrophysiologic-studies
[4] Johns Hopkins Medicine. (2021). Pacemaker Complications. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pacemaker-complications
[5] National Heart, Lung, and Blood Institute. (2021). Sick Sinus Syndrome. https://www.nhlbi.nih.gov/health-topics/sick-sinus-syndrome
- In addition to pacemaker implantation, managing Sick Sinus Syndrome (SSS) might involve carefully prescribing medical devices such as Holter monitors for 24-hour heart activity monitoring or event monitors to diagnose irregular heartbeats.
- Although scientific advancements in medicine have improved treatment options for SSS, it's crucial to consider the potential side effects and complications associated with pacemaker implantation, including blood clots, infection, and collapsed lung.
- Beyond pacemaker implantation and medication management, other medical-conditions like atrial fibrillation may require specific treatments such as cardioversion or ablation to manage coexisting arrhythmias and improve cardiovascular health.
