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Causes
By Mayo Clinic staff
Your heart is made up of four chambers — two upper chambers (atria) and two lower chambers (ventricles). The rhythm of your heart is normally controlled by the sinoatrial node (SA node) — or sinus node — an area of specialized cells located in the right atrium. This natural pacemaker produces the electrical impulses that trigger each heartbeat. From the sinus node, electrical impulses travel across the atria to the ventricles, causing them to contract and pump blood out to your lungs and body.
If you have sick sinus syndrome, your sinus node isn't functioning properly, so your heart rate may be too slow (bradycardia) or too fast (tachycardia) or irregular.
Types of sick sinus syndrome and their causes include:
- Sinoatrial block. Electrical signals move too slowly through the sinus node, causing an abnormally slow heart rate.
- Sinus arrest. The sinus node activity pauses.
- Bradycardia-tachycardia syndrome. The heart rate alternates between abnormally fast and slow rhythms, usually with a long pause (asystole) between heartbeats.
What makes the sinus node misfire?
Diseases and conditions that cause scarring or damage to your heart's electrical system can be the reason. Scar tissue from a previous heart surgery also may be the cause, particularly in children. Sick sinus syndrome may also be set off by medications, such as calcium channel blockers or beta blockers used to treat high blood pressure, heart disease or other conditions. However, in most cases, the sinus node doesn't work properly because of age-related wear and tear to the heart muscle.
- Sick sinus syndrome. Heart Rhythm Society. http://www.hrsonline.org/PatientInfo/HeartRhythmDisorders/SSS/index.cfm. Accessed Feb. 6, 2011.
- Bashore TM, et al. Heart disease. In: McPhee SJ, et al. Current Medical Diagnosis & Treatment 2011. 50th ed. New York, N.Y.: The McGraw Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=3671. Accessed Feb. 5, 2011.
- Adan V, et al. Diagnosis and treatment of sick sinus syndrome. American Family Physician. 2003;67:1725.
- Sinus node dysfunction. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec07/ch075/ch075b.html#sec07-ch075-ch075b-1076. Accessed Feb. 6, 2011.
- What is a pacemaker? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/pace/pace_all.html. Accessed Feb. 6, 2011.
- Saperia GM. Treatment of the sick sinus syndrome. http://www.uptodate.com/home/index.html. Accessed Feb. 5, 2011.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 11, 2011.
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