Sick Sinus Syndrome

Sick sinus syndrome, also called sinus node dysfunction, is a group of abnormal heart rhythms (arrhythmias) presumably caused by a malfunction of the sinus node, the heart’s primary pacemaker. It is likely to affect adults older than age 70. Many people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm.

Types of sick sinus syndrome and their causes include:

  1. Sinoatrial block where electrical signals move too slowly through the sinus node, causing an abnormally slow heart rate
  2. Sinus arrest where the sinus node activity pauses
  3. Tachycardia-bradycardia syndrome where the heart rate alternates between abnormally fast and slow rhythms, often with a long pause (asystole) between heartbeats.


Scar tissue from a previous heart surgery may cause Sick sinus syndrome, particularly in children. It may also be set off by medications, such as calcium channel blockers or beta blockers that are used to treat high blood pressure, heart disease or other conditions. However, in most cases, the sinus node doesn’t work properly because of age-related wear and tear to the heart muscle.

Signs and symptoms:

  1. Slower than normal pulse (bradycardia)
  2. Fatigue
  3. Dizziness or lightheadedness
  4. Fainting or near-fainting
  5. Shortness of breath
  6. Chest pains
  7. Trouble sleeping
  8. Confusion or difficulty remembering things
  9. Palpitations

Diagnostic Evaluation:

  1. Standard electrocardiogram (ECG)
  2. Holter monitor ECG a portable device is carried in a pocket or shoulder strap, which automatically records the heart’s activity for an entire 24-hour period, which provides the doctor with an extended look at the heart rhythms
  3. Event recorder ECG -portable electrocardiogram device that can be carried in a pocket or worn on a belt or shoulder strap for home monitoring of heart’s activity. But, unlike a Holter monitor, it doesn’t record continuously. Whenever there is an occurrence of symptoms, you push a button, and a brief ECG strip recording is made.

Medical Management:

Treatment for sick sinus syndrome focuses on eliminating or reducing unpleasant symptoms. Regular checkups to monitor the condition are very important. For people who are bothered by symptoms, the treatment of choice is usually an implanted electronic pacemaker. But if you have a pacemaker and your heart rate is still too fast, your doctor may prescribe anti-arrhythmia medications to prevent fast rhythms. If you have atrial fibrillation or other abnormal heart rhythms that increase your risk of stroke, you may need a blood-thinning medicine, such as warfarin (Coumadin).

Nursing Management:

  1. Encourage regular check-up to a cardiologist.
  2. Encourage also proper compliance to medications as well as in the diet regimen.
  3. Avoid activities that are strenuous
  4. Always be up to date about the status of the evaluations as well as the therapy needed.
  5. Listen to concerns of the patient and the family with the several lifestyle changes.

Photo Credits:

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

What Do You Think?