Sss and frequent sinus pauses

Hello everyone. Please delete if you feel nessesary as I do not have a pacemaker currently. I'm currently in the middle of getting diagnosed with sick sinus syndrome ( suggested by an ER doctor)  and there's very little support groups or anything with information on the internet for what I'm going through. I began getting a heart workup (normal stress test and echo)  because I started having random bouts of tachycardia and then during an er visit it was found I have a first degree AV block and have 1- 1/2 second sinus pauses, and PACS. with exercise. Doctor in the er told me I may need a pacemaker as these pauses sometimes last all day long. I seen one cardiologist who pretty much ghosted me and said I have anxiety hasn't given me results to a holter I turned in a month ago  I see a new cardiologist on Monday and I'm pretty much just freaking out. Do my symptoms seem similar to anyone else's? I'm a young mom 26 years old and the thought of something going on with my heart already is terrifying.  Pretty much only thing I could find online about sinus pauses indicate sinus node dysfunction, is this true for frequent 1 second pauses ? 


Yes sounds very familiar

by Gemita - 2022-11-06 06:25:19


Firstly welcome and be assured, we would never delete a "genuine" post.

When electrical disturbances start, it can cause pausing, skipping, strange palpitations and sensations in our chest and can lead to feelings of anxiety, but the anxiety in my experience is usually caused by the irregularity of heart rhythm.

A one second pause wouldn't concern my doctors either but it is important that all your symptoms are taken into account when assessing whether or not you have started to get sinus node problems.  I suspect though your pauses could well be due to your PACs (premature atrial contractions) and perhaps other arrhythmias?  

It is important now that you have lots of monitoring to see what is going on, although I see you have had a recent holter monitor.  I would ask for the report results.  Even short episodes of an arrhythmia like a PAC can most definitely cause symptoms and lead to other arrhythmias like Atrial Fibrillation if they are not controlled, so I would respectfully keep pushing for answers. 

PACs that last all day may be caused by electrolyte disturbances, dehydration or another health condition, so I would ask your general doctor for some checks.  I wish you the very best

Thank you both for your replies!

by Nessabeanz215 - 2022-11-06 14:11:11

Thank you both for being reassuring and leading me In the right direction. It's definitely been a rough time since I've been experiencing this. I see my new cardiologist and I'm hoping he has some good insight, my first cardiologist basically said we can ignore it until it becomes an actual issue- which scared the heck out of me as things can progress and I don't want to be driving when I get that first pause that can make me pass out. I'm definitely going to look into getting in with an EP as my heart rate also flectuates a couple times a day my rate will very briefly drop to the 40s 50s and then resume normal my PACs are mostly with exertion, I was told to "ignore" them which is just impossible to do when you can feel your heart stop and you're waiting to feel it kick back on again haha. I do think this entire thing has caused me a great deal of anxiety because I have two small children I'm afraid to die on.  It's great to know if I end up needing one most people just experience a greater quality of life.  It's so hard to find anyone in relatable positions because I'm so young and that there automatically gives you  a anxiety diagnosis and you're told you're too young for heart issues. Thank you for listening! 


by AgentX86 - 2022-11-06 19:13:39

Yes, it sounds like tachy/Brady, which often comes with SSS.  However, a 1-second pause isn't a pause at all.  It's one beat of 60bpm.  Cardiologists/EPs don't worry too much until it gets to five seconds.  I was at three seconds for a few years before it got worse. My cardiologist had me carry a Holter fairly regularly to monitor it but wasn't too worried.  A near-syncope event and then an 8-1/2 second pause was definitely PM time.


Get more information

by Gotrhythm - 2022-11-07 12:33:04

First of all, let me start with some reassurance. You don't know yet if you do have SSS, but if you must have any heart condition, SSS is the best kind to have! With a pacemaker, a person with SSS can live a totally normal life and live just as long a people who don't have any heart condition at all.

What you need right now is more information. I concur with the others who say you need to consult with an EP ( a kind of cardiologist who is also an electrophysiologist.) SSS is a problem with the heart's electrical system, and can occur even when all the usual tests done by cardiologists-- stress tests, EKG, tests of blocked arteries are normal.

I too have SSS. With 20/20 hindsight I think I had it for 10 years before I was diagnosed. And was dismissed by more than one doctor with a diagnosis of "panic attacks." I think the difficulty is that we look, and in fact, are so obviously healthy. But at heart that sometimes races and other times drops into the 40's or 50's can make you feel tired and muddle-headed and yes, nervous.

I can also say that although a one-second pause isn't considered a significant finding, if one's heart rate is normally 72, frequent one-second pauses would affect how you feel.

Missing Beats

by Stache - 2022-11-13 18:51:56

I was having prostrate surgery and was required to do a stress test as my heart rate was 31 BPM.   I failed the stress test as the staff stopped my stress test and sent me for an echo test. I was cleared for the TURP surgery but a heart doctor was in the surgery monitoring my heart.  I found out I had 2nd-degree heart block and the doctor ghosted me.  6-months later I went into a full 3rd-degree heart block early in the morning and woke up that night with a dual chamber pacer 100% pacing as I no longer have a natural heartbeat.  There was a full review at the hospital over my case of being ghosted and telling me I was okay with 2nd-degree heart block after failing a stress test.  I have a new heart doctor who has taken the time to explain the miss steps leading to my cardiac arrest event and how we should go forward.  Today I have recovered, it has been a difficult 22 months but it is what it is.  The bottom line is write down all the questions you want to be answered.  Don't be afraid to ask for a different heart doctor, and do your homework like you are doing now.   I was lucky going into cardiac arrest in the ER at a major heart hospital during COVID.  My pacer has saved my life and is part of me today.  I have learned to accept I am bionic now and will be forever grateful to the team that restarted me 6 times.

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