Sick Sinus Syndrome: Aetiology & Pathophysiology

Which of the following is the most common cause of sick sinus syndrome?

Sick sinus syndrome primarily affects younger adults.

What is the term for a pause of three seconds or more without any atrial activity (P waves) on an ECG?

___________ syndrome is identified by periods of bradycardia or sinus arrest interspersed with periods of tachycardia, most commonly atrial fibrillation.

Match the following extrinsic causes to the electrolyte imbalance:

Which of the following medications is least likely to contribute to sick sinus syndrome?

The clinical presentation of sick sinus syndrome is highly specific, making it easy to diagnose.

What type of device may be implanted to monitor the heart rhythm over a longer period of time if ambulatory ECG fails to reveal a diagnosis?

An _________ may arise from atrial tissue, the AVN, or the ventricular myocytes to prevent asystole and syncopal episodes.

Match the following escape rhythms with their origin:

Which of the following is NOT a typical symptom of sick sinus syndrome?

A single-chamber pacemaker with only a ventricular lead is preferred over a dual-chamber pacemaker for treating sick sinus syndrome.

Besides electrolyte correction and stopping unnecessary medications, what is the definitive management for symptomatic bradycardia in sick sinus syndrome?

Patients with _________ syndrome will require beta-blocker therapy and pacemaker implantation.

Match the following investigations with their primary purpose in diagnosing sick sinus syndrome:

Which of the following is a potential complication of sick sinus syndrome?

Pacemakers are appropriate for patients with sick sinus syndrome who are asymptomatic.

What is the underlying issue in sinoatrial exit block?

_______ is often caused by rate-related myocardial ischaemia

Match the type of arrhythmia with the ECG finding:

What is the primary function of transitional cells within the sinoatrial node?

Hyperthyroidism can never cause sinus node dysfunction.

What is the gold standard investigation for sick sinus syndrome?

During periods of profound ________ (e.g. fast AF) patients may experience rate-related myocardial ischaemia, which can cause a troponin rise.

Match the following intrinsic causes to their description:

Which of the following is the BEST method for monitoring infrequent symptomatic episodes of bradycardia?

Beta-blocker therapy is contraindicated in patients with tachy-brady syndrome.

What is the term for when the heart may utilise pacemaker tissue that is outside of the SAN to generate a new action potential and allow systole to occur?

In sick sinus syndrome, dysfunction of the SAN leads to an atrial rate that is __________ for normal requirements.

Match the cause of sick sinus syndrome to it's example:

Which of the following is of least benefit when initially assessing a patient with suspected sick sinus syndrome?

Sick sinus syndrome accounts for less than 10% of pacemaker implantations in the United States.

Name one of the important cells that the SAN contains:

To prevent _________ and syncopal episodes, the heart may ‘rescue’ a severe sinus bradycardia or sinus arrest by utilising pacemaker tissue that is outside of the SAN to generate a new action potential and allow systole to occur.

Match the symptom to the cause: