Sick sinus syndrome

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Bradycardia-tachycardia syndrome; Sinus node dysfunction

• Fainting or near-fainting
• Dizziness or light-headedness
• Confusion or other changes in mental status
• Sensation of feeling the heart beat (palpitations)
• Chest pain or angina
• Shortness of breath
• Fatigue

Usually, no symptoms occur.

The symptoms are non-specific and may mimic other disorders. The patient's heart rate may be very slow at any time. Blood pressure may be normal or low.

Sick sinus syndrome may cause symptoms of heart failure to occur or worsen. Sick sinus syndrome is diagnosed when the symptoms occur only during episodes of arrhythmia. However, this often is difficult to prove.

An ECG may show various arrhythmias characteristic of sick sinus syndrome. Exercise testing has not proven particularly effective as a screening tool.

Holter monitoring is an effective tool for diagnosing sick sinus syndrome because of the episodic nature of the disorder. Extremely slow heart rate and prolonged pauses may be seen during Holter monitoring, along with episodes of atrial tachycardias. An EPS (intracardiac electrophysiology study) is a very specific test for this disorder, although it is often unable to confirm the diagnosis.

Review Date: 11/06/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.