Arrhythmia Sick Sinus Syndrome
- The sick sinus syndrome is a presentation with dizziness, confusion, fatigue, syncope, and heartTricuspid Stenosis and Tricuspid Regurgitation Symptoms Investigations and Treatment. Read more ... » failure caused by SA node dysfunction.
Several electrocardiographical abnormalities caused by a malfunction of the sinoatrial node of the heart, in which there are episodes of tachycardia alternating with episodes of heart block or severely decreased heart rate, often with loss of consciousness
- It is manifested by sinus bradycardiaSINUS Bradycardia Bradyarrhythmia Symptoms Causes Diagnosis with Treatment. Read more ... », sinoatrial block, sinus arrest, bradycardia – tachycardia syndrome, atrial fibrillationAtrial fibrillation Causes and Treatment Indications of DC Cardioversion. Read more ... », atrial flutterATRIAL FLUTTER Symptoms Causes Diagnosis with Treatment. Read more ... », atrial tachycardias.
- Failure of sinus impulse formation is called sinus arrest.
- Sick sinus syndrome (SSS) is characterized by chronic sinoatrial (SA) nodal dysfunction, a sluggish or absent SA nodal pacemaker after DC cardioversionAtrial fibrillation Causes and Treatment Indications of DC Cardioversion. Read more ... », and/or frequently depressed escape pacemakers
- When sinus arrest occurs there is no impulse formation by the sinus node but the junction or the ventricle take
- If, after the sinus arrest there are only 1 or 2 beats formed by the junction or ventricle they are called junctional
- or ventricular escape beats. After a few escape beats sinus rhythm may be restored.
- If there is impulse formation but there is block of conduction of sinus impulses to the surrounding atrial tissue it is called sinus exit block.
- over and start generating impulse.
- This is seen as absence of PQRST sequence in ECGTricuspid Stenosis and Tricuspid Regurgitation Symptoms Investigations and Treatment. Read more ... » followed by junctional or ventricular rhythm.
- ‘This new rhythm by the junction or ventricle is called junctional escape rhythm or ventricular escape rhythm.
- The junctional escape rhythm has no preceding P and has narrow QRS complexes.
- The ventricular escape rhythm has no preceding P and has QRS complexes.
- It is seen as a pause or a missing of complete PQRST sequence in ECG.
TreatmentCardiac Arrest Causes Symptoms Features and Management. Read more ... » of the sick sinus syndrome
- Treatment of SSS is directed at symptomsCardiac Arrest Causes Symptoms Features and Management. Read more ... ».
- These include presyncope, syncope,lightheadedness, and, less often, dyspnea on exertion or worsening angina.
- along with that, patients with tachy-brady syndrome may present with palpitations and other symptoms associated with a rapid heart rate.
- Treatment of SSS should begin with a search for remediable causesCardiac Arrest Causes Symptoms Features and Management. Read more ... » of sinoatrial (SA) nodal depression, such as drugs (eg, beta blockersHeart Failure Treatment Heart Failure GENERAL PRINCIPLES. Read more ... », digoxinDigoxin. Read more ... », sympathetic blockers, lithium,calcium channel blockers, cimetidine, and antiarrhythmic agents), ischemia, and autonomic imbalance.
- Symptomatic SSS is usually treated with a pacemaker, and SSS accounts for over one-half of pacemakers implanted
First degree sino atrial exit block
- This cannot be recognized on ECG.
Second degree SA block –
- There are intermittently absent P waves.
Third degree or complete SA block –
- There is no atrial activity and another pacekmaker takes over.
- Sinus pauses of more than three seconds are abnormal.
- Sinus pauses of more than five seconds require a pacemaker.
- Maneuvers which slow the sinus rate are carotid sinus massage and Valsalva maneuver.
Treatment of sinus node diseaseCardiac Arrest Causes Symptoms Features and Management. Read more ... »
- Atropine – 0.5 to 2 mg IV.
- Isoproterenol – 1 mg IV to be repeated.
- DrugCardiac Arrest Causes Symptoms Features and Management. Read more ... » therapy is not of use in sinus node disease and pacemaker implantation is the only treatment. A dual chamber pacemaker is the best option.