• Sick Sinus Syndrome

    (SSS; Bradycardia-Tachycardia Syndrome; Sinus Node Dysfunction)


    Sick sinus syndrome (SSS) is not one specific disease. It is the term is used to describe several heart rhythm disorders. Sick sinus syndrome disorders include:
    • Bradycardia —abnormally slow heart rate
    • Tachycardia —abnormally fast heart rate
    • Bradycardia-tachycardia—the heart alternates between too fast and too slow
    Anatomy of the Heart
    Copyright © Nucleus Medical Media, Inc.


    SSS is caused by a problem with the electrical signals of the heart. The problem begins in an area of the heart called the sinoatrial (SA) node. This node is considered to be the heart’s natural pacemaker. When the SA node is defective, the heart’s rhythms become abnormal. The dysfunction in the SA node can be due to:
    • Intrinsic causes (problems within the heart tissue), such as degeneration of the sinus node, long-term illness, or surgical injury
    • Extrinsic causes (outside factors acting on the heart tissue), such as exposure to toxins or certain pharmacological agents

    Risk Factors

    SSS is fairly rare. It occurs most often in elderly people and those who have had damage to the heart tissue. Although rare, infants and children can have SSS. In this case, it is usually due to congenital abnormalities in the heart. Certain medications may worsen symptoms.


    Often, SSS doesn't have symptoms. Some may experience a period of very rapid heart beats followed by very slow heart rate. Many of the symptoms of sick sinus disorder are mild and nonspecific. Some symptoms associated with SSS include:
    • Heart palpitations
    • Chest pain
    • Fainting
    • Confusion or lightheadedness
    • Facial flushing
    • Fatigue
    These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor.


    SSS may go undetected for some time. The symptoms are similar to ones for many disorders. Your doctor can do tests that will help to give a more definitive diagnosis. Most likely, your doctor will ask about your symptoms and medical history. A physical exam will be done. Some additional tests may include the following:
    • Electrocardiogram (EKG)—measures the electrical activity of the heart and can detect abnormal heart rhythms
    • Holter monitoring—continuous monitoring to observe episodes of tachycardia and bradycardia over an extended period of time
    • Electrophysiology study (EPS)—invasive test where electrical wires are placed into the heart to test the conduction system of the heart


    For people with no symptoms, treatment may not be needed. SSS is a progressive disorder. It can further weaken the muscles of the heart in people with previous heart damage. This can lead to heart failure . As a result, people with symptoms are treated. Most treatment plans involve separate therapy for bradycardia and tachycardia. Talk with your doctor about the best plan for you. Treatment options include the following:

    Pacemaker Insertion

    A pacemaker is a small, battery-operated device. Electrodes from the pacemaker are placed in the right side of the heart. Signals are sent to the electrodes to stimulate the heart. It helps to maintain a normal heartbeat by sending electrical impulses to the heart. It is a very effective treatment of the bradycardia. People with implanted pacemakers have a very good prognosis.


    Medication may be given to control tachycardia. It is most often given to people with a pacemaker.


    For most people, SSS is not preventable. I may not be caused by prior damage or scarring to the heart tissue. However, some strategies for minimizing your chance of developing this condition include:
    • Make sure to get treatment for any heart disorders you might have.
    • Make sure any doctor you see is aware of your heart conditions. Some medications should be avoided.


    American Heart Association http://www.heart.org

    Heart Rhythm Society http://www.hrsonline.org


    Canadian Cardiovascular Society http://www.ccs.ca

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com


    Adan V, Crown LA. Diagnosis and treatment of sick sinus syndrome. Am Fam Physician. 2003;67(8):1725-1738.

    Sick sinus syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com. Updated October 21, 2014. Accessed December 30, 2014.

    Sick sinus syndrome. Heart Rhythm Society website. Available at: http://www.hrsonline.org/Patient-Resources/Heart-Diseases-Disorders/Sick-Sinus-Syndrome#axzz3NOr35s6f. Accessed December 30, 2014.

    Sinus node dysfunction. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/cardiovascular%5Fdisorders/arrhythmias%5Fand%5Fconduction%5Fdisorders/sinus%5Fnode%5Fdysfunction.html. Updated September 2013. Accessed December 30, 2014.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.