Things to look for is the failure of appropriate chronotropic response to exercise, defined as less than 80 percent of the predictable heart rate response to exercise. If the diagnosis could not be made based on history, and ECG then exercise stress testing is necessary. It is also beneficial to review previous ECG tracing to check for any changes in the rhythm upon the start of the symptoms. The key to diagnosing sinus node dysfunction is to establish a correlation between the patient symptoms and the ECG findings at the time of symptoms. Miscellaneous: Other disorders that can rarely cause sinus node dysfunction to include hypothyroidism, hypothermia, and hypoxia.Īlternating tachycardia and bradycardia, referred to as a tachy-brady syndrome, which could also be associated with other supraventricular tachycardias. įamilial: Sinus node dysfunction in rare cases can be the result of cardiac sodium channel mutations of SCN5A and HCN4 genes. Almost all such cases are present in inferior myocardial infarction. Narrowing of this artery can lead to impairment of the sinus node function leading to sinus node dysfunction that can be potentially reversible. Ischemia: The sinus node is perfused by the sinoatrial nodal artery, which arises from the right coronary artery in 60 % of the time and from the left circumflex artery in 40 % of the time. Infiltrative disease: The SA node tissue can be affected during the disease process of some of the infiltrative diseases such as amyloidosis, sarcoidosis, scleroderma, hemochromatosis, and pericarditis leading to sinus node dysfunction. Medication: Prescription medications can depress the sinus node function, potentially resulting in sinus node dysfunction include: beta blocker, non-dihydropyridine calcium channel blockers, digoxin, antiarrhythmic medications, and acetylcholinesterase inhibitors. Sinus Node Fibrosis: Replacement of the sinus node tissue by fibrous tissue is the most common cause of sinus node dysfunction, the replacement can also include other parts of the conduction system, including the AV node. Both could result from abnormal mechanisms, including fibrosis, atherosclerosis, and inflammatory/infiltrative processes. (n.d.).Sinus node dysfunction results from the abnormal automaticity, conduction, or both of the sinoatrial node and surrounding tissues. Insights into sick sinus syndrome from an inducible mouse model. Long-term management of atrial arrhythmias in young patients with sick sinus syndrome undergoing early operation to correct congenital heart disease. New insights into pacemaker activity: Promoting understanding of sick sinus syndrome. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. The cells could potentially grow into the same type of heart tissue as the sinus node. Stem cells are immature cells capable of developing into any specific type of mature cell. The cells would then grow into the heart and become a new pacemaker.Ī second approach would be to use stem cells. This could be done by taking cells containing pace-making genes and implanting them in the heart. With modern technology, there’s a growing interest in creating a biological pacemaker. venous thrombosis (blood clot within the body’s veins).infection from the implant (bacteria brought in during surgery causes infection).myocardial perforation (accidental hole made in the heart during surgery).Rare complications of a pacemaker implant include: Pacemakers are generally tolerated well, and most people experience few complications. It does this by sending electrical pulses to the heart.Īlmost one-half of pacemaker implantations are performed because of problems related to sick sinus syndrome. They may also prescribe additional medications that may have a direct effect on heart rhythm.Įventually, however, most people with SSS will need an artificial pacemaker implant when the sinus node is no longer able to adequately perform.Ī pacemaker is a very small machine that’s surgically and subcutaneously implanted in the chest or abdomen to regulate your heartbeat. Your doctors may adjust or change your medication if that’s the problem. Treatment for mild or early cases of SSS involves relieving symptoms.
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