Cardiovascular · UKMLA & AKT
Sinus bradycardia and sick sinus syndrome
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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