Sick sinus syndrome (SSS) is a type of abnormal heartbeat, or arrhythmia. If you have SSS, you may have episodes when your heart beats very slowly, stops beating for a short while, or beats very rapidly. SSS is not just one disease, but a collection of arrhythmias.
Normally, a structure in your heart called the sinoatrial (SA) node regulates your heartbeat. Your SA node should keep your heart beating at the right pace. If you have SSS, your SA node no longer controls your heart's rate and rhythm.
Possible causes of SSS are many. The most common is a gradual loss of SA node function that comes with age. Other possible causes include drug side effects, growths inside your heart, infections that affect your heart, and heart surgery that damages your SA node.
You may have SSS with few or no symptoms. If you do have symptoms, they may include:
Shortness of breath, especially with exertion
SSS affects men and women equally. It can occur at any age, but most often begins at about age 68. Doctors see SSS in about one of every 600 people who have heart disease and are older than age 65. You may have an increased risk for SSS if:
You have another type of heart disease
You take drugs for heart conditions or high blood pressure
You have a history of heart surgery
You were born with heart disease and needed open heart surgery
SSS has been passed down through your family
Your doctor may suspect SSS based on your symptoms, but they are common in many other diseases. To diagnose your condition, your doctor will perform an electrocardiogram (ECG), a machine that records your heart's rate and rhythm. If you do not have symptoms at the time of your ECG, it may look normal.
Other possible tests include:
An ECG while you walk on a treadmill
A Holter monitor, a recorder you wear for over 24 hours that takes an ECG
An event recorder, a recorder you wear over several days that samples your heart rate
Electrophysiologic testing, a hospital procedure that involves threading catheters into your heart through a vein in your thigh
Echocardiogram or ultrasound of your heart, which checks for structural heart problems
You may have SSS without symptoms and not need treatment. However, if you do have symptoms and need treatment, there are options, such as:
Medication change. Your doctor may change your medications if you are taking any drugs known to cause SSS.
Pacemaker. The most common treatment for people with SSS symptoms is a pacemaker implant. This is a small, battery-powered device that takes the place of your SA node and regulates your heartbeat. A doctor places a pacemaker under the skin of your chest during an outpatient surgical procedure.
Blood thinners. Because there is an increased risk for blood clots forming in your heart and causing a stroke, you may need to take a blood thinner as a preventive step.
SSS tends to start slowly, but gradually worsens over time. When your heart beats too slowly or too quickly, it can lead to complications:
You may be injured if you pass out during an arrhythmia.
A clot may form in the upper chambers of your heart, break loose, and travel to your brain, causing a stroke.
Your heart may get too weak to move blood efficiently through your body, resulting in heart failure.
If you need to have a pacemaker, you may have complications from the procedure, such as infection, bleeding, or a collapsed lung.
The aging of your SA node treatment causes most cases of SSS, and, of course, there’s no way to prevent that. But you can help prevent SSS complications by learning as much as you can about the disease and working closely with your cardiologist to find the best treatment.
You can also make healthy lifestyle changes:
Work with your doctor to keep conditions like high cholesterol and high blood pressure under control.
Eat a heart-healthy diet.
Maintain a healthy weight.
Get regular exercise.
Tell your doctor if you experience any SSS symptoms.