Sick Sinus Syndrome

By | June 10, 2022

The term sick sinus syndrome encompasses a series of cardiac arrhythmias, which are based on a malfunction of the sinus node. This disease mainly affects older people and is one of the most common indications for the implantation of a pacemaker.

What is sick sinus syndrome?

In healthy people, the sinus node is nothing more than a collection of specialized cells in the right ventricle that emit electrical signals at regular intervals. For ichthyosis definitions, please visit

In people with sinus node syndrome, these electrical impulses are delivered at the wrong time, resulting in a slow heart rate, a fast heart rate, or a combination of the two. Basically, the term sick sinus syndrome includes a large number of heart diseases which, in addition to the eponymous sinus dysfunction, can also be based on a blockage of the excitation conduction via the atria.

A universal definition of sick sinus syndrome is still pending. However, the term is used diagnostically to justify the indication of therapies with pacemakers and also when there is a tachycardia-brachycardia syndrome, a special form of sick sinus syndrome, characterized by the alternating occurrence of a sinus rhythm that is too slow, followed by a too quick.


The causes of sick sinus syndrome are often idiopathic, i.e. without a known cause. In the course of life, small injuries to the sinus node tissue can occur, which lead to the formation of scar tissue, which blocks the conduction of impulses.

Sick sinus syndrome can also have mechanical causes, for example if the right atrium is overstretched during an operation. However, the most common cause is high blood pressure, which puts a constant strain on the heart and can lead to overstretching due to the permanent overstraining of the atria.

Furthermore, a sick sinus syndrome can also have its origin in an inflammation of the heart muscle ; the same is true for a number of other heart diseases such as mitral valve defects and coronary artery disease. Often, however, it is hardly or only with difficulty possible to infer the causes of a diagnosed sick sinus syndrome.

Symptoms, Ailments & Signs

Sick Sinus Syndrome can manifest itself through a variety of symptoms, signs and symptoms. Cardiovascular problems primarily occur: tachycardia and high blood pressure or low pulse as well as cardiac arrhythmias. In addition, the symptom picture resembles that of an AV block, which can lead to circulatory problems, dizziness, cramps and stabbing chest pain, among other things.

In extreme cases, sick sinus syndrome leads to cardiac arrest. The sick sinus syndrome also promotes the development of heart failure, which greatly reduces physical resilience and can trigger secondary diseases such as arteriosclerosis or arterial hypertension. Those affected feel increasing shortness of breath and a feeling of anxiety.

An inner restlessness that leads to growing discomfort is characteristic. This often leads to mental problems, such as fear of death or depression. The cardiac arrhythmia can also cause visual disturbances. These manifest themselves in the patients seeing everything blurred or double. The visual problems are temporary and occur mainly during physical exertion.

They disappear again after a few minutes to hours. Nevertheless, they can have a negative impact on the quality of life and well-being of those affected. If sick sinus syndrome is treated in time, long-term consequences and serious complications can be avoided. An untreated cardiac arrhythmia can be fatal.

Diagnosis & History

The diagnosis of sick sinus syndrome can be made when the EKG shows certain abnormalities, such as atrial fibrillation and other abnormal heart rhythms. The first choice for diagnosis is the long-term ECG, which allows the doctor to see whether bradycardia, tachycardia or even asystoles are evident on the ECG.

In addition to this diagnostic measure, a stress ECG may also be necessary for diagnosis in order to determine whether physical exertion leads to an increase in frequency. Long-term blood pressure measurements or heart catheter examinations may also be necessary from time to time, but remain an exception as a diagnostic tool for diagnosing sick sinus syndrome.


In most cases, patients with sick sinus syndrome suffer from various heart problems. In the worst case, these can lead to the death of the person concerned or significantly reduce life expectancy. The patients suffer from tachycardia and a low pulse. This can lead to a loss of consciousness, which can lead to a fall and injury.

Furthermore, the illness causes breathing difficulties and general inner restlessness. Those affected feel uncomfortable and also suffer from severe visual disturbances. In most cases, the visual problems are only temporary and disappear again. The symptoms can occur particularly during physical exertion and have a negative effect on the patient’s everyday life and quality of life.

In most cases, a healthy lifestyle has a very positive effect on the disease and can reduce many symptoms. In severe cases, however, the use of a pacemaker is necessary to limit the symptoms of sick sinus syndrome. This can prevent further complaints or complications. Further regular examinations by the doctor are also necessary.

When should you go to the doctor?

Sick sinus syndrome should always be treated by a doctor. Early medical treatment is the only way to prevent further symptoms and complications that could otherwise limit the life expectancy of the person affected. In the worst case, the person affected suffers heart failure and dies from it. A doctor should be consulted for sick sinus syndrome if the patient suffers from heart problems. This leads to high blood pressure or heart palpitations, although these symptoms also occur without exertion and without any particular reason.

Furthermore, severe cramps or dizziness can indicate this disease and significantly reduce the quality of life of those affected. Most patients also suffer from shortness of breath and severe visual problems. It is not uncommon for cramps or dizziness to indicate sick sinus syndrome and should also be examined by a doctor. The severity of the symptoms can be very different and depends heavily on the severity of the disease.

Usually, sick sinus syndrome is diagnosed and treated by a cardiologist. The life expectancy of those affected may also be reduced as a result of the disease. Since sick sinus syndrome can also lead to psychological upsets or depression, psychological evaluation and treatment should also be carried out.

Treatment & Therapy

When choosing the treatment method of choice, a distinction must be made between chronic and acute cardiac arrhythmias. In the case of chronic sick sinus syndrome with bradycardia, i.e. phases in which the heart beats too slowly, the implantation of a pacemaker is generally recommended.

The pacemaker then takes over the function of the sinus node. The implantation of a pacemaker eliminates the symptoms and thus ensures a significant improvement in the patient’s quality of life. If tachycardia occurs in the course of chronic sick sinus syndrome, i.e. an excessive increase in heart activity, it can often be treated with antiarrhythmic medication and a cardiac pacemaker can only be considered after a follow-up observation with medication.

If bradycardia and tachycardia occur alternately, cardiac pacemaker implantation is unavoidable. In addition, to prevent tachycardic phases, antiarrhythmic medication must also be taken after implantation. In acute cases of bradycadia, intravenous administration of atropine is given. If the atrium is enlarged and atrial fibrillation occurs, treatment is usually given with anticoagulants, drugs that inhibit blood clotting, to prevent complications such as a stroke.


There are hardly any prophylactic measures to prevent the occurrence of sick sinus syndrome, since the causes are usually different for each individual and often cannot be determined with certainty. Checking blood pressure regularly and treating high blood pressure if necessary is probably one of the few concrete measures to prevent sinus node disease.

Basically, what is good for the heart is also good for preventing sick sinus syndrome. This means that a healthy lifestyle, sufficient exercise and a balanced diet go a long way towards maintaining a healthy, functioning heart.


Those affected with sick sinus syndrome usually only have a few options for aftercare, so ideally the patient should see a doctor at an early stage to prevent other symptoms and complications from occurring. As a rule, self-healing cannot occur either, so that the person concerned is always dependent on medical treatment.

The sooner a doctor is consulted, the better the further course of this disease. Many of those affected are dependent on taking various medications due to sick sinus syndrome. Regular intake and the correct dosage should always be observed. If you have any questions or are unclear, you should always contact a doctor first.

The doctor should also be consulted in the event of side effects. In many cases, the help of friends and relatives is also very important in everyday life in order to alleviate the symptoms. Contact with other patients can also be useful in the case of sick sinus syndrome, as this leads to an exchange of information that could make everyday life easier for the person affected.

You can do that yourself

Patients with sick sinus syndrome should definitely pay attention to the relief of the heart. In everyday life, emotional and physical stressors should therefore be reduced to a minimum. Physical overexertion leads to a stimulation of the activity of the cardiovascular system. It is therefore important to ensure that the physical movements do not lead to severe stress. Sporting and professional activities must be coordinated with the requirements of the organism and should not be exceeded.

As soon as the first irregularities or changes in health become apparent, breaks should be taken. The organism needs time for sufficient regeneration. If the physical signals are ignored, life-threatening complications can occur.

In addition to physical resilience, emotional stress factors must also be minimized. Conflicts, a hectic daily routine or numerous interpersonal disagreements can represent an immense mental burden. Relaxation techniques help to better cope with and process the events of everyday life. In addition, cognitive methods are to be used when circling thoughts occur and the person concerned experiences severe inner restlessness. Breathing techniques and clear demarcations in everyday life can be helpful in alleviating the symptoms. In states of fear, awareness processes help to minimize them. If the person concerned needs help, he should seek the cooperation of a therapist.

Sick Sinus Syndrome