Sick sinus syndrome

- a.k.a tachy-brady syndrome
- fibrosis or fatty infiltration of sinus node, AV node, bundles of His or its branches
- characterised by periods of sinus bradycardia, sinus arrest, a combination of sinoatrial or atrioventricular conduction defect and supraventricular tachycardia
- presents with light-headedness, palpitation, syncope or stroke.
- treatment: permanent dual chamber pacemaker (single chamber pacing is associated with pacemaker syndrome)
- if patient is on beta blocker, reduce to dose slowly instead of stopping completely to avoid rebound tachycardia