According to the class definition, SSS implies an organic irreversible lesion of the node and the underlying automatic control center, resulting in a decrease in heart rate. Sick sinus syndrome (SSS) is a complex of heart conditions based on the reduced ability of the sinus node to perform the tasks of the dominant pacing or various variants of impulse conduction impairment. One of the causes of life-threatening arrhythmias is sick sinus syndrome. Among the whole cohort of heart diseases, cardiac arrhythmias and conduction abnormalities are the most important problems of cardiology, because they are the first cause of sudden death, which, according to the American Heart Association, accounts for 50% of all deaths from cardiovascular diseases. Pediatrics 1978 61:593-598.Despite modern medical achievements, cardiovascular diseases still occupy the leading position in the structure of population mortality. Yabek SM, Jarmakani JM: Sinus node dysfunction in children, adolescents, and young adults. New York: Churchill Livingstone 1984:48-66. In Yabek SM, Gillette PC, Kugler JD (eds.): The Sinus Node in Pediatrics. Kugler JD, Yabek SM: Sick sinus syndrome: Clinical features and non-invasive evaluation. Philadelphia: WB Saunders Company 1990:250-300. (eds.): Pediatric Arrhythmias: Electrophysiology and Pacing. If needed, pacemakers have proven to be effective in treating the symptoms with few changes in lifestyle needed. Often the problem causes only mild symptoms. Overall, the outlook for children and youth with sick sinus syndrome is good. What are the long-term health issues for these children? Unfortunately, there are no medications that can be used chronically to treat sick sinus syndrome. If there are symptoms caused by the slow heart rate, repeated episodes of atrial flutter/fibrillation, very slow heart rates, or long pauses between heart beats, a pacemaker may be recommended. If further information is needed, a special type of heart catheterization called an electrophysiologic study may be done. Other useful tests include a Holter monitor, echocardiogram, and/or an exercise test. The stickers are connected to a machine that records the heart’s electrical activity. This is a safe and painless test that involves putting some stickers across the chest. Medical tests: One of the first tests usually done is an electrocardiogram. The physical findings otherwise reflect any underlying heart disease. Physical findings: The pulse is slow and often irregular. Symptoms: Possible symptoms include low energy levels, low exercise tolerance, lightheadedness, chest pain with exercise, and fainting. If the heart rate is very slow with long pauses, lightheadedness or fainting can occur. The person may have decreased endurance with exercise. The health effects of sick sinus syndrome vary widely. What are the effects of this problem on my child's health? The slow, irregular heart rate also increases the risk of abnormal fast heart rhythms called atrial flutter and atrial fibrillation. The heart rate may also slow down too quickly after exercise causing fainting. This often causes decreased energy levels and low stamina during exercise. The sinus node may also fire slowly and/or irregularly and there may be long pauses between beats. In sick sinus syndrome, the sinus node is not able to adjust the heart rate to the level of activity. The sinus node speeds up the heart rate when the body is active and slows it down when the body is at rest. The heartbeat usually starts in the sinus node, a group of special cells in the upper right atrium. The incidence of sick sinus syndrome increases over time after these operations. These operations include the Fontan procedure, Mustard or Senning procedure, repair of total anomalous pulmonary venous connection, and repair of certain atrial septal defects. Sick sinus syndrome is rare in young people except when there is a history of heart surgery involving the heart’s upper chambers - the atria. Sick sinus syndrome occurs when the sinus node - the heart’s normal pacemaker - does not function normally.
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