Intrinsic causes tend to be responsible for permanent sinus node dysfunction while extrinsic causes are more commonly temporary. Intrinsic causes can include degeneration, dysfunction, or remodeling of the sinus node while extrinsic causes can create or worsen underlying atrial arrhythmias. Sinus node dysfunction can be caused by intrinsic and extrinsic factors that affect the normal functioning of the sinus node. Sinus node dysfunction has a close association with the presence of atrial fibrillation due to their shared etiology of remodeling. ĭeveloping sinus arrest, sinus node exit block, sinus bradycardia, atrioventricular block, and other types of abnormal rhythms are also common complications. These rhythms increases the risk of clot formation in the atrium, embolization, and stroke.
The most common complication of sinus node dysfunction is the development of tachycardia-bradycardia syndrome with abnormal atrial rhythms such as atrial tachycardia, atrial fibrillation, and flutter. This ECG from the same patient shows atrial fibrillation at around 126 beats per minute. Patients can also present with symptoms of congestive heart failure, stroke or transient ischemic attacks due to the abnormal rhythm. Signs and symptoms usually appear in more advanced disease and more than 50% of patients will present with syncope or transient near-fainting spells as well as bradycardias that are accompanied by rapid heart rhythms, referred to as tachycardia-bradycardia syndrome Other presenting signs or symptoms can include confusion, fatigue, palpitations, chest pain, shortness of breath, headache, and nausea. Often sinus node dysfunction produces no symptoms, especially early in the disease course. Tachycardia-bradycardia syndrome is a variant of sick sinus syndrome in which the arrhythmia alternates between fast and slow heart rates. Sinus node dysfunction (SND), also known as sick sinus syndrome (SSS), is a group of abnormal heart rhythms ( arrhythmias) usually caused by a malfunction of the sinus node, the heart's primary pacemaker. Telemetry strip of a 44-year-old female with asymptomatic sinus pause found while admitted for mildly symptomatic COVID-19 pneumonia. Sick sinus syndrome or sinoatrial node disease Medical condition Sinus node dysfunction (SND)
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