Recognising sick sinus syndrome

Karen Phillips



Sick sinus syndrome is not a life-threatening condition but it can cause significant morbidity, especially in the elderly. Permanent pacemakers remain the treatment of choice.

Key Points

  • The prevalence of sick sinus syndrome increases with age and it is the most common indication for implantation of a permanent pacemaker.
  • Symptoms of sick sinus syndrome may be intermittent and nonspecific – for example, fatigue, confusion and exercise intolerance.
  • ECG monitoring and a high level of suspicion remain the cornerstones of diagnosis.
  • Exercise testing can be helpful to diagnose chronotropic incompetence causing exertional symptoms.