The goal of treatment for sick sinus syndrome is to eliminate or reduce unpleasant symptoms. Those who have no symptoms may only need to be monitored to make sure more serious cardiac arrhythmias do not develop. In cases where a medication is found to cause symptoms of sick sinus syndrome, the dose of the medication should be adjusted, or the drug should be eliminated. Treatment for sick sinus syndrome often includes pacemaker therapy to control an abnormal heart rate. If your heart rate is too rapid, you may be treated with an anti-arrhythmic medication to slow the heart rate.

Treatment for sick sinus syndrome may include:

• Pacemaker therapy for sick sinus syndrome
• Medications that may require a dosing change:
• Diltiazem
• Verapamil
• Beta-blockers
• Amiodarone
• Disopyramide
• Dofetilide
• Flecainide
• Ibutilide fumarate
• Procainamide
• Propafenone
• Sotalol
• Antiarrhythmics:
• Prescribed if your heart rate is too fast.
• Blood thinners (Coumadin)
• May be prescribed if you have an abnormal heart rhythm (e.g. atrial fibrillation) that increases your risk for stroke.
• AV node ablation procedure:
• Applies radiofrequency energy to the AV node using a special catheter. This stops the fast heart rates from reaching the ventricles.
• Radiofrequency ablation of atrial fibrillation:
• Similar to AV node ablation but targets tissue that triggers atrial fibrillation.

Some people with sick sinus syndrome require treatment with a pacemaker. Pacemakers are electronic devices that regulate the heart rate within a normal range.

Pacemakers require an electrical wire inserted into the heart, which is connected to an electronic device that generates electrical impulses that stimulate the heart. Most pacemakers are placed under the skin.

Pacemaker Functions
All pacemakers do two things:

• They sense the electrical signals from a normal heartbeat. As long as the heart is beating fast enough, nothing else happens.
• The pacemaker sends a tiny electrical impulse to stimulate the heart to beat when the heart is beating too slowly.

• Wear a Medic Alert bracelet, showing that you have a pacemaker.
• Take acetaminophen for pain.
• Magnets should be kept away from the chest.
• The metal in a pacemaker may set off metal detectors in airport and other security stations. Keep your pacemaker wallet card with you at all times.

• Unusual palpitations or chest pain
• Unusually rapid pulse rate
• Pulse rate below 60 beats per minute

Physicians from the following specialties evaluate and treat sick sinus syndrome:

• Cardiology

Last Updated: Jun 14, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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