Cardiovascular · UKMLA & AKT
Sinus bradycardia and sick sinus syndrome
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise sinus bradycardia and sick sinus syndrome — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Sinus bradycardia - rate <60 bpm; key question is physiological vs pathological, and whether symptomatic
- Sick sinus syndrome (SSS) - intrinsic SA node degeneration (fibrosis/fatty infiltration with age); one of the most common indications for permanent pacemaker in the UK (~50% of implants)
- Tachy-brady syndrome - hallmark of SSS; paroxysmal tachyarrhythmia (AF/flutter) alternates with sinus bradycardia/pauses; most dangerous moment is the prolonged post-tachycardia pause as the diseased SA node recovers slowly
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