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OVERVIEW

What is sick sinus syndrome?

Sick sinus syndrome is the name for several conditions in which the sinus node does not work the right way. The sinus node (also called the sinoatrial node) is a natural pacemaker in your heart that helps your heart beat steadily. An electric current starts in one of the upper chambers (called the atria) of the heart and goes through the heart to the bottom chambers (called the ventricles). The sinus node can increase your heart rate during times of high demand, such as during exercise. If you have sick sinus syndrome, your heart rate may be too slow or too fast to meet the needs of your body.

About 1 in 600 people with heart problems have sick sinus syndrome. It usually affects people who are at least 70 years old. Women are affected about as often as men.

SYMPTOMS

What are the symptoms of sick sinus syndrome?

Some people with sick sinus syndrome do not feel ill or have only mild feelings of illness. Other people have symptoms that come and go. The following are some possible symptoms of sick sinus syndrome:

• Feeling like you are going to pass out
• Feeling like your heart is skipping beats or beating too fast or too slow
• Feeling dizzy
• Having chest pain
• Being short of breath
• Having difficulty thinking or remembering things
• Feeling tired

DIAGNOSIS & TESTS

How does my healthcare provider know that I have sick sinus syndrome?

Other medical problems can cause the same symptoms as sick sinus syndrome, so it’s important to find out what is causing your symptoms. Your healthcare provider may be able to tell whether you have sick sinus syndrome by doing some tests.

One of these tests is electrocardiography (also called ECG). During this test, your healthcare provider will have you lie down so your heart can be monitored. The ECG machine makes a picture, or tracing, that shows your heart’s electrical signals. Your healthcare provider may also have you wear a special monitor, called a Holter monitor, for a few days to keep track of your heart’s electrical signals.

TREATMENT

How is sick sinus syndrome treated?

Most people who have sick sinus syndrome will need to have an artificial pacemaker put into their body. A pacemaker is a small electronic device that is put under the skin on your chest. It helps your heart keep a regular beat, especially when your heart beats too slowly.

If you have a pacemaker and your heart rate is too fast, your healthcare provider may prescribe medicine to control it. In addition, your healthcare provider may want to change some of your other medicines because some medicines can make sick sinus syndrome worse.

Some people who have sick sinus syndrome and also have other medical problems may be at greater risk of having a stroke. These people might be prescribed a blood-thinning medicine, such as warfarin.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• What is the likely cause of my symptoms?
• What is the best treatment option for me?
• Will I need a pacemaker? What does that procedure involve?
• How will my life change after I have a pacemaker?
• Will I be able to return to my normal levels of activity?
• Is it safe for me to exercise? What kind of exercise should I do?
• Does sick sinus syndrome put me at risk for any other health problems?

Sources

Diagnosis and Treatment of Sick Sinus Syndrome by V Adan, MD; LA Crown, MD (04/15/03, http://www.aafp.org/afp/20030415/1725.html)