Sick Sinus Syndrome (SSS)

Sick sinus syndrome is not a disease, but a group of signs or symptoms that show that the heart's natural electrical pacemaker, the sinus node, is not working properly. In SSS, the heart rate can alternate between slow (bradycardia) and fast (tachycardia), often in combination with atrial fibrillation or atrial flutter. Treatment of SSS usually involves implanting a pacemaker, often along with medication.

Sick sinus syndrome (SSS) is a relatively uncommon heart rhythm disorder. SSS is not a specific disease, but rather a group of signs or symptoms that indicate the sinus node, the heart's natural pacemaker, is not functioning properly. A person with SSS may have a heart rhythm that is too slow (bradycardia), too fast (tachycardia), or one that alternates between the fast and slow (bradycardia-tachycardia).

What is Sick Sinus Syndrome?

The sinus node is a specialized group of cells in the upper chamber of the heart, the right atrium, that creates electrical signals that regulate the pace and rhythm of the heartbeat. Normally, the sinus node produces a regular, steady pattern of signals. With SSS, the pattern is irregular. The normal heart beat should increase with activity and decrease with rest and sleep. With SSS, this function is disrupted, with a heart beat that is too slow for the patient's level of activity.

Symptoms & Signs

Most people with sick sinus syndrome have few or no symptoms. In others, symptoms may come and go. These symptoms can include:

  • Slower than normal pulse (bradycardia)
  • Fainting (syncope)
  • Feeling tired all the time (fatigue)
  • Weakness
  • Shortness of breath (dyspnea)
  • Chest pain (angina)
  • Disturbed sleep
  • Confusion
  • Heart palpitations (feeling like your heart is racing, pounding, or fluttering)

Risk Factors

While the exact cause of SSS is unknown, some factors, however, often are associated with the condition, such as:

  • Age
  • Previous heart attack (myocardial infarction)
  • Medications to treat High Blood Pressure and other heart diseases
  • Hyperkalemia (too much potassium in the blood)
  • Thyroid disease
  • Sleep apnea
  • Heart surgery

In rare cases, SSS may be associated with conditions such as:

  • Diphtheria (an infection that can damage the heart muscle)
  • Hemochromatosis (excess iron in the blood)
  • Muscular dystrophy (an inherited condition in which the body’s muscles are damaged and weak)
  • Amyloidosis (a condition in which a protein called amyloid is deposited in tissues or organs)

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