![]() Pacemakers do not reduce mortality, but they can decrease symptoms and improve quality of life. Treatment of sick sinus syndrome includes removing extrinsic factors, when possible, and pacemaker placement. Electrophysiologic studies also may be used but are not routinely needed. ![]() If electrocardiography does not yield a diagnosis, inpatient telemetry monitoring, outpatient Holter monitoring, event monitoring, or loop monitoring may be used. Diagnosis may be challenging, and is ultimately made by electrocardiographic identification of the arrhythmia in conjunction with the presence of symptoms. ![]() Cerebral hypoperfusion is most common, with syncope or near-fainting occurring in about one-half of patients. They are commonly related to end-organ hypoperfusion. Practice Essentials The sinoatrial (SA) node is innervated by the parasympathetic and the sympathetic nervous systems the balance between these systems controls the pacemaker rate. Signs and symptoms are often subtle early on and become more obvious as the disease progresses. The longer the unwanted ventricular pacing continues. For patients with sick sinus syndrome but normal atrioventricular conduction, atrial lead dislocation may cause excessive unnecessary ventricular pacing, resulting in nonphysiological pacing leading to heart failure. Extrinsic factors can be pharmacologic, metabolic, or autonomic. Background Pacemaker lead dislodgement may cause malfunction in the pacing system, which may lead to severe adverse events. Intrinsic causes include degenerative fibrosis, ion channel dysfunction, and remodeling of the sinoatrial node. ![]() Sick sinus syndrome results from intrinsic causes, or may be exacerbated or mimicked by extrinsic factors. Twenty-two patients (mean age, 63 years) were asymptomatic after pacer insertion, six of whom died (11 deaths per 100 patient follow-up years). The sinus node is an area of specialized cells in the upper right chamber of the heart that controls the rhythm of. At least 50 percent of patients with sick sinus syndrome develop alternating bradycardia and tachycardia, also known as tachy-brady syndrome. Sick sinus syndrome also known as sinus node disease or sinus node dysfunction is a group of heart rhythm problems (arrhythmias) in which the heart's natural pacemaker (sinus node) doesn't work properly. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. Sick sinus syndrome refers to a collection of disorders marked by the heart's inability to perform its pacemaking function. Sick sinus syndrome (also known as sinus node dysfunction) is a group of related heart conditions that can affect how the heart beats. ![]()
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