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Tests and diagnosis
By Mayo Clinic staffSymptoms of sick sinus syndrome — such as dizziness, shortness of breath and fainting — are also symptoms of many other diseases and conditions. However, in sick sinus syndrome, these symptoms only occur when the heart is beating abnormally. In order to diagnose and treat sick sinus syndrome, your doctor will need to establish a connection between your symptoms and an abnormal heart rhythm.
Electrocardiogram
Testing for sick sinus syndrome usually starts with a standard electrocardiogram (ECG). However, if your abnormal heart rhythms tend to come and go, they may not be detected during the brief time a standard ECG is recording. You may need additional types of ECG:
- Standard ECG. During this test, sensors (electrodes) are attached to your chest and limbs to create a graphical record of the electrical signals traveling through your heart. The test may show patterns that indicate sick sinus syndrome, including fast heart rate, slow heart rate or a long pause in the heartbeat (asystole) after a fast heart rate.
- Holter monitor ECG. This portable device is carried in your pocket or in a pouch on a belt or shoulder strap. It automatically records your heart's activity for an entire 24-hour period, which provides your doctor with an extended look at your heart rhythms. This type of monitoring can be very helpful for diagnosing sick sinus syndrome.
- Event recorder ECG. This portable electrocardiogram device can also be carried in your pocket or worn on a belt or shoulder strap for home monitoring of your heart's activity. But, unlike a Holter monitor, it doesn't record continuously. When you feel symptoms, you push a button, and a brief ECG strip recording is made. This allows your doctor to see your heart rhythm at the time of your symptoms, which can help pinpoint sick sinus syndrome.
Electrophysiologic testing
This test isn't commonly used for sick sinus syndrome. However, in some cases, electrophysiologic testing can help check the function of your sinus node, as well as other electrical properties of your heart. During this test, thin, flexible tubes (catheters) tipped with electrodes are threaded through your blood vessels to various spots along the electrical pathways in your heart. Once in place, the electrodes can precisely map the spread of electrical impulses during each beat and may identify the source of heart rhythm problems.
- Sick sinus syndrome. Heart Rhythm Society. http://www.hrspatients.org/patients/heart_disorders/sick_sinus/default.asp. Accessed March 19, 2009.
- Ferri F. Sick sinus syndrome. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/127077711-3/819048192/1701/546.html#4-u1.0-B978-0-323-04134-8..50022-7--cesec438_11555. Accessed March 19, 2009.
- Bradyarrhythmias. In: Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..X5001-8--TOP&isbn=978-1-4160-4106-1&uniq=127077711#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-4106-1..50038-8--cesec163%3Bfrom%3Dindex%3Btype%3DbookPage%3Bisbn%3D978-1-4160-4106-1. Accessed March 12, 2009.
- Arnsdorf MF. Manifestations and causes of the sick sinus syndrome. http://www.uptodate.com/home/index.html. Accessed March 19, 2009.
- Dual-chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome and/or atrioventricular block. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=8124&nbr=4526. Accessed March 19, 2009.
- What is a pacemaker? National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/pace/pace_all.html. Accessed March 19, 2009.
- Arnsdorf MF. Treatment of the sick sinus syndrome. http://www.uptodate.com/home/index.html. Accessed March 19, 2009.
