Sinus Node Dysfunction
February 15th, 2021
Overview
Sick sinus syndrome (SSS) occurs when the sinus node is not functioning correctly, due to either intrinsic or extrinsic causes.
Manifestations of Sinus Node Dysfunction
- Sinus bradycardia
- Sinus arrhythmia
- Sinus pause / arrest
- Sinoatrial exit block
- Tachy-brady syndrome
Causes of Sinus Node Dysfunction
Intrinsic
- Idiopathic degeneration
- Myocardial infarction
- Infiltrative disease - sarcoidosis, amyloidosis, haemochromatosis
- Connective tissue disease - SLE, scleroderma, RA
- Cardiac surgery - valvular surgery, correction of congenital heart disease
- Infections - Lyme disease, endocarditis
Extrinsic
- Physiologic - sleep, athletes
- Autonomic - neurocardiogenic syncope, carotid sinus hypersensitivity
- Drugs - beta blockers, calcium channel blockers, digoxin, adenosine, ivabradine, clonidine, acetylcholinesterase inhibitors
- Hypothyroidism
- Hypothermia
- Hyperkalaemia
- Obstructive sleep apnoea
- Raised intracranial pressure
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