Sick Sinus Syndrome

Hi all,

I am 54 and had a pacemaker implanted on July 15, 2013 for third degree block. Since then, I have been using my pacemaker very little and have it set to 30 so that it only triggers when I have severe Bradycardia. Since implant, and before, I noticed exercise intolerance. Inga, very rightly (thank you) diagnosed me with Sick Sinus Syndrome. Last week they put me on a treadmill and my heart suddenly dropped to 80 Bpm from 130 while in the third phase of the test. So now, SSS is a part of my recognized heart condition- in addition to intermittant hear block, I have Right Bundle Branch.

Can anyone tell me what the prognosis is for someone with SSS- they say it is progressive and that there is a risk for Afib and all kinds of other problems. Just wondering what the rest of you with SSS have had happen down the road from diagnosis.

Many thanks in advance. I'm having a little depression related to this new diagnosis. I know I shouldn't write myself a negative story but fear creeps in. No other health issues that I know of yet!

This support group has been so helpful to me. Thank you all.

7 Comments

Sick Sinus Syndrome

by IAN MC - 2014-02-09 02:02:27

Hi Honey Badger . Welcome to the SSS club !

I have Sick Sinus Syndrome and it seems to be a term that covers lots of different problems with the sinus node.

Sometimes it means exercise intolerance, or chronotropic incompetence, call it what you will, but not always !

My SSS appears to be an intermittent condition ; I go several days with a perfectly functioning sinus node i.e. my heart is in normal sinus rhythm and then suddenly I have a " bad day " . I go out to run and find that I can't, I get out of breath after a few hundred yards but tomorrow, who knows ?

I'm not sure that anyone can tell you what the prognosis is, chances are that your sinus node will get worse with time, but not necessarily !

One common symptom of SSS is bradycardia and your PM will certainly take care of that. I will be really interested to hear other peoples' experiences with SSS.

Ian

Thank you!

by HoneyBadger - 2014-02-09 02:02:32

Thank you Ian- my situation is similar to yours. I used to be a hard core marathoner, but now even 13 or 14 minute per mile can be hard for me. The dr said I probably will never get my heart rate up past 130- now my rate response is turned on to help me keep that 130 rate if I get up to that point. Call me chicken, but I think I'll stick to walking 15 min miles- don't like the idea of being electrically stimulated....

HoneyBadger

by IAN MC - 2014-02-09 03:02:50

I did loads of marathons too and more half marathons than I can remember, but no more unfortunately as I think I have "Worn out " my sinus node.

I was fascinated by your statement that you don't like the idea of being electrically stimulated. It is totally illogical, but I feel the same, in fact I had my Rate Response switched off for that reason.

Enjoy those 15 minute miles and enjoy the scenery !

Ian

Fear Not

by Grateful Heart - 2014-02-09 04:02:39

I too have SSS as well as LBBB and a few other abbreviations. I'm 57 and I've had my CRT-D for 5 years now. My fitness level is no comparison to yours.

What is your upper limit set at? If it's 130, you may need to have that increased if you are surpassing that now. That's where the 2:1 block comes in.

I'm paced 100% with the rate response on. We've had to increase my upper limit a few times (currently at 150) and I think I'm due for another increase since I am "hitting the wall" at the gym at times with a 2:1 block, which is what you've been experiencing. Not a good feeling when you have to stop in mid exercise and your legs feel like rubber or like Ian said "a bad day".

Prognosis......I think the downhill prognosis is for people that have SSS and do not have a pacemaker or CRT. Some are not even aware they have it. Our devices basically take care of that for us.

I've had great improvement with my EF from 24% to 50-55%. Try and stay positive, eat healthy, stay hydrated and continue to exercise. You should do well.

Grateful Heart

Do you ever become Depressed...

by donr - 2014-02-09 05:02:14

...because you might develop cancer? Be involved in a car accident? Get pneumonia? Get the Flu? Be struck by lightning? Slip & fall in a shower/bathtub?

Well, A-Fib falls into the same category as those unpleasant events. Totally unpredictable & no real correlation w/ any other disease /syndrome/condition.

I did a little Google search, asking it "Does SSS progress to A-Fib?" I rec'd a ton of hits and guess what????? Not a single one of them on the first two pages even ANSWERED my question directly - just like a bunch of politicians at a presser! The first 2 para's of the best answer I found is pasted below, & comes from this link http://www.angelfire.com/az/cardiosv/af1.html:

Begin paste:
ATRIAL FIBRILLATION IS THE MOST COMMON form of arrhythmia, affecting more than 2 million people annually. Until just a few years ago health care providers thought AF to be a "nuisance" arrhythmia with few consequences. However, recent medical research has uncovered some devastating complications including stroke, congestive heart failure and cardiomyopathy that are directly related to AF.

Research has yet to uncover the definitive cause of AF. A number of other health conditions including thyroid disorders, valve disease, hypertension, sick sinus syndrome, pericarditis, lung disease, and congenital heart defects are also associated with AF. This type of arrhythmia can occur at any age, but its prevalence tends to increase with age and affects men slightly more often than women.
End Paste

There appears to be NO positive correlation w/ SSS - and A-Fib strikes a lot of people who do NOT have SSS and have NEVER had SSS..

There is, however, a positive correlation w/ Ventricular pacing & A-Fib. I read that just this AM while answering a post by Mytrose just a few posts down from yours. To read what Medtronic says about that correlation, Google "mvp, pacemaker." MVP stands for Managed Ventricular Pacing. Answer should be in first entry you get.

Which comes first; the cart or the horse?

by JerryG - 2014-02-10 03:02:05

I guess I started with afib. I didn't know I had it but my cardio picked it up during a routine echo, did an ECG and confirmed afib. He put me on warfarin for stroke prevention and as soon as my INR stabilised, he did an electro cardioversion. The cardioversion was successful and I haven't had a recurrence (yet?).

I am 66 but still walk briskly on my treadmill daily in a routine that gives me an average heart rate of around 65% of my calculated maximum HR. I developed a major problem (for me) when my HR would unexpectedly drop from 100+ to 50 instantly. Back to the cardio and diagnosed with SSS and told I needed a PM stat.

PM implanted September 2013. Problem solved after some setting changes in November. I have a Medtronic dual chamber pm with rate response on. I am going back to the cardio early March for some more changes to the rate response settings but I am getting the workout results I am looking for without too much problem.

I live in the bush a very long way from proper medical attention so I can't just go down the road to see a cardio; I have to fly to Johannesburg for that.

I haven't figured out yet which is the cart and which is the horse. I had afib before the sick sinus syndrome diagnosis and pm implant. However, was the sss there first and afib followed or did afib lead to sss? I really don't know and care less as my pm allows me to do everything I want to do, including my daily workouts. I am just thankful that technology is available to fix the problem.

JerryG

2558duke

by 2558duke - 2014-02-10 11:02:14

I two have SSS my heart rate goes from slow to fast. I developed a bad case of afib and was put on 300 mg of flecainide aday to control the fast heart rate. My EP wants to do an ablation but I have decided not to at this time. I don't really know if SSS cause afib but it came a few month's after I was told I had SSS.

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