The sinus node is the body’s natural pacemaker. Located in the heart’s upper right chamber, the sinus node sends out electrical signals that keep the heart beating in perfect rhythm. Unfortunately, sometimes the electrical signals malfunction and the electrical impulses become irregular causing a particular type of arrhythmia known as sick sinus syndrome.
In simplest terms, an arrhythmia means that the heart is either beating too fast, known as tachycardia, too slow, referred to as bradycardia, or the irregular heart rhythm. Persons with sick sinus syndrome may experience one or all types of irregular heartbeats.
Sick Sinus Syndrome Symptoms
Most sick sinus syndrome symptoms occur as a result of reduced blood flow due to the irregular heartbeat. Sick sinus syndrome symptoms may vary but generally include the following: bradycardia or a slow pulse rate, fainting, dizziness, lightheadedness, fatigue, shortness of breath, chest pain, confusion, difficulty concentrating or remembering things, rapid heartbeat, and trouble sleeping or interrupted sleep.
Some people may not experience any symptoms while others may experience just a few. It’s also possible for sick sinus syndrome symptoms to be intermittent. Since it’s possible for conditions other than sick sinus syndrome to cause these symptoms, it’s important to see your doctor immediately if you experience sick sinus syndrome symptoms.
Sick Sinus Syndrome ECG
Sick sinus syndrome is generally detected through an electrocardiogram or ECG. An ECG is a test that measures the electrical impulses that travel through the heart. This test helps doctors to identify when the heart is beating irregularly, too fast, or two slow.
A standard ECG is not invasive. Electrodes which are able to sense the heart’s electrical impulses are attached to the chest. Physicians are then able to view the electrical activity.
Because sick sinus syndrome is an arrhythmia, it may come and go. Because of the intermittent nature of arrhythmias, a standard ECG may not detect sick sinus syndrome. Your doctor may order a special sick sinus syndrome ECG.
The two most common sick sinus syndrome ECG’s are the Holter monitor ECG and the event record ECG. Both the Holter monitor and event recorder ECG’s are portable devices which you carry with you. Holter monitor ECGs are generally used to record all heart rhythms for a 24-hour period. This provides your physician with a picture of what is happening to your heart rhythm for an extended time making it much easier to diagnose sick sinus syndrome.
Unlike the Holter monitor, event recorders are often used for extended periods of time such as a few weeks or a month. Event recorders do not record all heart activity during that time. Instead, the patient pushes a button every time they feel symptoms. The event record then takes a snapshot of the heart activity when the patient is symptomatic allowing the physician to see exactly what is occurring with the heart at that moment in time.
Sick Sinus Syndrome Treatment
Sick sinus syndrome treatment varies depending on the severity of the symptoms. Person with few or infrequent symptoms may simply need ongoing monitoring and not require any treatment. On the other hand, sick sinus syndrome treatment for those with multiple or frequent symptoms may require treatment focused on treating the symptoms.
Some medications, such as those designed to treat high blood pressure or heart disease, have been linked to increasing heart arrhythmia problems. It’s important that your physician know all of the medications that you’re taking so that it can be adjusted if necessary to improve your sick sinus syndrome condition. For those with bothersome or more severe sick sinus syndrome symptoms, a pacemaker is generally required to keep the heart beating normally.
Sick Sinus Syndrome. The Mayo Clinic. 20 May 2011. http://www.mayoclinic.com/health/sick-sinus-syndrome/DS00930
What is an Arrhythmia? National Heart Lung and Blood Institute. 01 Jul 2011. http://www.nhlbi.nih.gov/health/health-topics/topics/arr/
Who Needs a Pacemaker? National Heart Lung and Blood Institute. 01 Dec 2009. http://www.nhlbi.nih.gov/health/health-topics/topics/pace/whoneeds.html
Reviewed December 20, 2011
by Michele Blacksberg RN
Edited by Jody Smith