The sinus node is responsible for controlling the heart's activity. It can speed up the heart when an individual is active and also slow it down depending on the level of activity. In sick sinus syndrome, the sinus node is unable to control the heart's activity effectively. It may fire irregularly causing a host of health problems. Sick sinus syndrome comes in different forms, including sinus bradycardia, which causes a slowed heart rate; atrial tachycardia, which creates a faster heart rate; sinus pauses or arrest; and bradycardia-tachycardia, which causes the irregular increase or decrease in the heartbeat. But, what causes sick sinus syndrome?
Firstly, sick sinus syndrome is more prevalent in older individuals, but it can occur at any age. The risk factors linked with this condition include advancing age, previous heart attack, certain medications used for heart diseases and blood pressure, thyroid disease, hyperkalemia, previous heart surgery, sleep apnea, and certain underlying medical conditions. Let's look at the treatment options for sick sinus syndrome now.
Currently, it's tough to find medications routinely used for the treatment of sick sinus syndrome, because most of the medications become ineffective over time. The best treatment approach for sick sinus syndrome involves addressing external causes.
In acute cases of this condition, the doctor may prescribe anti-arrhythmic medicines for an individual with an increased heart rate. However, patients under medical therapy require close and frequent monitoring to ensure the heart doesn't slow down too much. Patients taking medications that are triggering the sick sinus syndrome should consult with their doctor and safely stop taking the medication as soon as they can.
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Pacing The Heart
Pacing the heart is considered as the best treatment option when sick sinus syndrome presents as sinus bradycardia. Patients are diagnosed with bradycardia if their heart bests less than sixty times in a minute. When the heart rate is slow, the heart is unable to pump enough blood filled with nutrients and oxygen to the vital organs such as the brain, kidneys, and liver. Therefore, patients are likely to experience dizziness, shortness of breath, fainting, and fatigue, among other symptoms.
Bradycardia doesn't cause problems to most younger individuals, but to others, particularly individuals over sixty-five years old, it can be a sign of underlying problems with the heart's electrical system. For such cases, the doctor may recommend a pacemaker, which refers to a small device used to help regulate and monitor the heart's rhythm. When the heart beats slowly, the pacemaker sends signals to the heart through leads to restore the heart rate to the normal rhythm. Modern pacemakers are extremely small and can be implanted directly to the heart.
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AV Node Ablation
In some cases, abnormal heart rhythm occurs when the electrical impulse starts from another location other than the sinus node. It can also occur when the impulse follows a pathway not normally present. Such cases lead to numerous electrical short circuits in the heart's chambers. These short circuits have several consequences including inadequate pumping of blood to the body.
AV node ablation is used to treat this condition. During this procedure, the doctor will thread one or more catheters through blood vessels to the chambers of the heart. Terminals at the tip of the catheter use heat to destroy a small area of tissue. Once the tissue is dead, it prevents the atria muscles from sending false impulses to the ventricles. Symptoms are likely to improve after AV node ablation, and patients won't need medicines to control their heart rate, though doctors may prescribe blood thinners to reduce the risk of stroke.
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Radiofrequency ablation is another procedure used to put a patient's heart back into normal rhythm. It ensures electrical signals do not originate from a location other than the sinus node. In radiofrequency ablation, thin wires or catheters are threaded into the heart's chambers through a vein in an arm or leg.
One of the catheters is used to find the problematic areas in the heart while the other catheter is used to send heat energy. The heat energy (similar to microwave heat) is used to destroy the abnormal cells in the heart that cause rapid and irregular heartbeats. The procedure is minimally invasive and effective in treating the affected area without affecting the rest of the heart.
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With age, the sinus node loses its effectiveness, increasing the risk of sick sinus syndrome. Unfortunately, there is no way to counter this. However, patients can keep their hearts healthy by learning as much as possible about the condition, and also working closely with a physician to find the best treatment.
Patients can also make appropriate lifestyle changes to prevent complications brought about by sick sinus syndrome. These changes include eating a healthy diet, exercising, maintaining a healthy weight, keeping cholesterol and blood pressure under control, quitting smoking, and avoiding stress.