Sick Sinus Syndrome - Key Symptoms, Causes, Risk Factors, Diagnosis, and Treatment

Sick Sinus Syndrome: What You Need to Know

Sick sinus syndrome or sinus node disease is a group of cardiac disorders involving heart rhythm disturbances due to sinus node dysfunction. The sinus node is the natural pacemaker that regulates the heart rhythm. Sinus rhythm means the regular, healthy pattern in which the heart beats.

Sinus node dysfunction can cause irregular heart rhythm (sinus arrhythmia), which can become slower, uneven, missed, or alternating between high and low with long gaps. It ffects 1 in 600 cardiac patients >65 years, often requiring pacemaker implantation.

Patients with this condition ultimately require the implantation of an artificial pacemaker to regulate the heartbeat pattern. Thus, it is essential to consult a medical professional for early detection and resolution. Read more to understand its symptoms, causes, diagnosis, and treatment.

Table of Contents

1. What are the Key Symptoms of Sick Sinus Syndrome?
2. What are the Causes of Sick Sinus Syndrome?
3. What are the Risk Factors for Sick Sinus Syndrome? 
4. How is Sick Sinus Syndrome Diagnosed?
5. How is Sick Sinus Syndrome Treated?

What are the Key Symptoms of Sick Sinus Syndrome?

Most people with sinus node disease are asymptomatic, i.e., no evident symptoms. If symptoms are present, they are usually mild and wax and wane.

Some key symptoms of this syndrome include:

• Heart palpitations
• Chest pain or angina
• Mental confusion or lack of clarity
• Dizziness
• Fainting
• Extreme tiredness
• Shortness of breath, especially after physical exertion
• Slower pulse rate (sinus bradycardia)
• Memory issues
• Sleep disturbances 

What are the Causes of Sick Sinus Syndrome? 

There can be several causes of sinus node disease. All of them involve damage to the sinus node.

The causes of sick sinus syndrome are as follows: 

• Age-induced damage or wear and tear of the sinus node
• Damage to the sinus node due to heart surgery
• Atrial fibrillation (abnormal heart rate)
• Coronary artery disease
• Heart failure
• Medicines for high blood pressure, including calcium channel blockers and beta blockers
• Medicines for arrhythmia
• Inflammatory heart conditions such as myocarditis, rheumatic fever, etc.
• Cardiac conditions such as sarcoidosis
• Severe hypothyroidism
• Electrolyte imbalances
• Neuromuscular conditions such as muscular dystrophy
• Rare genetic family diseases
• Sleep apnea
• Trauma 

What are the Risk Factors for Sick Sinus Syndrome?

The high-risk factors of heart disease, like coronary artery disease, can also increase the chances of developing sinus node disease.

Some of the common risk factors include:

• Smoking
• Hypertension or high blood pressure
• High blood cholesterol
• Obesity or excessive body weight
• Sedentary lifestyle

How is Sick Sinus Syndrome Diagnosed?

A healthcare provider may use the following diagnostic tests to assess the patient's symptoms:  

1. Electrocardiogram (ECG or EKG)

This easy-to-perform and reliable test measures the heartbeat as electrical impulses. Electrodes on the patient's chest and legs help record the heart's electrical activity, which is seen as waves on a printer strip or computer screen.

A healthcare professional can examine and interpret the results to look for disturbances in the heart rhythm in case of sinus node dysfunction.

2. Holter Monitoring

Holter monitoring is a unique diagnostic method for sinus node disease and other cardiac conditions. A small portable device (Holter) is worn for 1-3 days while the patients perform their routine activities.

The Holter records the heartbeat during this period. A healthcare professional then obtains an electrocardiogram using the information on the Holter to assess the function of the heart and the sinus node.

3. Event Recorder 

This diagnostic method also employs a mobile device that needs to be worn for up to one month or until an uneven heartbeat or other key symptoms present themselves. The patient switches on a button to note any arising symptoms.

4. Tech Monitors

With the advancement of technology, some wearable devices like smartwatches also have the option of electrocardiogram monitoring. It’s important to discuss using this device with your healthcare provider.

5. Implantable Loop Recorder 

This method uses a concise recording device placed under the chest. It's used for long-term monitoring of the heart's electrical activity or heart rhythm, especially in asymptomatic people or those with fewer symptoms.

6. Electrophysiology (EP) Diagnosis

Though rarely employed, this diagnostic study can also screen for sinus node disease by checking the heart's electrical activity.

How is Sick Sinus Syndrome Treated?

The treatment for this syndrome aims to decrease or resolve symptoms and address any underlying medical conditions contributing to symptoms. Treatment options for this syndrome include:

1. Regular Medical Checks

If the patient shows no symptoms, the medical professional may advise timely health checkups to monitor and assess the cardiac function and overall health.

2. Medicine Intake

If the patient is taking high blood pressure or cardiac disease medication, it may disrupt sinus node functioning. A healthcare professional is likely to adjust their dose or prescribe alternatives to control the development or worsening of symptoms.

In sinus node disease, there is an elevated risk of blood clot formation in the heart and consequent danger of stroke. To counter this, blood thinners or anticoagulants such as dabigatran or warfarin are prescribed to the patient.

3. Pacemaker Implantation 

The most common and reliable treatment for patients with sinus node dysfunction is to place a permanent device called a pacemaker in place of the damaged sinus node to regulate the heartbeat. A pacemaker is a battery-run implant placed under the chest in a surgical procedure that induces a normal heart rate.

In this case, the pacemaker helps increase sinus bradycardia. Different pacemakers, such as single-chamber pacemakers, dual-chamber pacemakers, and biventricular pacemakers, can treat this syndrome based on the type of sinus arrhythmia in the patient.

4. Cardiac Ablation

Cardiac ablation is a technique that uses a catheter to correct an irregular heart rhythm despite a pacemaker implant. Catheters are narrow, flexible tubes that can be inserted through the heart's arteries and veins.

Sinus node disease is typically a sinus bradycardia condition, the most common reason for which is increasing age. Other notable symptoms include palpitations, chest pain, mental confusion, and fainting. Consult a medical professional to make a customized plan to treat symptoms effectively.

However, it’s always wise to have health insurance to safeguard your health and finances. At Star Health, our insurance policies cover a wide range of diseases. We also provide hassle-free claim settlements with reduced turnaround time across over 14,000 network hospitals in India.