Sick Sinus Syndrome - ECG

Sick sinus syndrome (SSS) is a relatively common pathology in the elderly. It is related to failures of proper electric impulse creation in the SA node. This disorder may manifest in several ways that may combine. Sick sinus syndrome can cause occurrence of pathologies such as sinus bradycardia, AV blocks of all degrees and atrial fibrillation (both tachyfibrillations and bradyfibrillations). Rarely, we may be even able to capture on record the transition of one form into another.

 

Sick Sinus Syndrome - ECGThis is a one lead-record of ECG in a patient with suspected SSS. Quite severe bradycardia (blue arrow) changes to tachycardia (red arrow) and then back to the bradycardia (blue arrow).
 

Conclusion: Clinically, the SSS may cause fatigue, exertional shortness of breath, palpitations and syncope. We should think about it in every case of sinus bradycardia that does not resolve after discontinuation of bradycardia-inducing drugs. Holter monitor is an ideal method for more reliable confirmation of the diagnosis. Implantation of a pacemaker is the best solution in symptomatic patients suffering from bradycardic forms of the SSS.