Sick sinus syndrome is a generalized abnormality of cardiac impulse formation that may be caused by an intrinsic disease of the sinus node that makes it unable to perform its pacemaking function
- Rheumatologic disease
- Metastatic disease.
- Older Patients with tachyarrhythmias usually fast AF with associate palpitations and breathlessness and dizziness
- Other times sinus bradycardias and sinus arrest with pre syncope and syncope
- Risk of developing AF
- FBC, U&E, TFT, LFT, CXR, ECG
- 24 hour or 7 day tape
- Manage exacerbating factors such as thyroid disease or hypo- or hyperkalaemia
- Treatment should be based on the presenting rhythm depending on the heart rate and patient instability.
- Temporary pacing may be needed (AAI/DDDR/DDD) and admission for permanent pacemaker placement is frequently indicated and then this allows safer use of rate slowing antiarrhythmic drugs