Sick Sinus?

8 yrs since first flutter episode...now once a month, self converting. Rhythm more and more irregular when not in afib with frequent bigeminy.

Recently, exertion results in rapid onset tachycardia: HR from 70 to 145 within 5 seconds (not afib/flutter) and quickly returning to 70 with rest/deep breathing....or sustained for a couple hours. Kardia shows regular or irregular rhythm but not afib (p waves present). Two months ago, the same exertion would have resulted in HR of maybe 95. This is new to me.

Anyone have similar experience? Is this a sinus node issue?

thanks for any thoughts. S

Unlikely. Sick sinus syndrome usually produces bradycardia, not tachycardia (not always, just usually). You said this rhythm is irregular but you see P waves. Do you have the 6L or the original Kardia? Seeing P waves on the original is often difficult or impossible.

I had similar rhythms in 2021 prior to my flutter ablation in Austin 8-5-21
Id have what Holshouser & Natale called Atrial Tachycardia’s. Natale put an end to those
They were at the septum. Rate would be 115-125 5-60 mins then converted. Flutter was a different animal 125-180
And not self converting. Now im 58-62. Lower than ever. Holshouser says my ablations may be the cause of lower rate now
About 10 bpm lower.m than old days

At times I will go back and forth between brady/tachy within a couple of minutes. But I normally have low HR, so .....
I have an old Kardia and you're right at times difficult to detect p waves... but at times they are sufficiently clear when HR is high.

thanks. I had a consult with Natale and will probably have an ablation this year. I am trying to understand what he can and can't address.

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swhanson
thanks. I had a consult with Natale and will probably have an ablation this year. I am trying to understand what he can and can't address.

If you ask here about what he can and can't address, we can share our experiences with what he has been able to do for us. In my touch up in April he did fix a bit of tachycardia that had been occurring.

He's an electrophysiologist, so he can address virtually any rhythm disturbance, which whatever you have certainly is. If it's a sinus node problem, he'll see it. I don't believe SSS can be treated with ablation, but it can often be managed medically and/or with a pacemaker. An AV node ablation and pacemaker would eliminate all your atrial arrhythmias, but it would leave you pacemaker dependent for life. These days, that's actually not such a bad thing.

In any case, he can diagnose and either treat or advise you no matter what it is. If he's unaware of your current concerns, you might want to book another consult. He might want you to wear a monitor for a while.

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Carey
I don't believe SSS can be treated with ablation, but it can often be managed medically and/or with a pacemaker.

I have sick sinus syndrome and a pacemaker plus a Natale ablation fixed it. Medical management didn't work for me, though now I have a lovely steady beat.

Although I didn’t have sick sinus syndrome, I had recurring episodes of flutter and/or atrial tachycardia. My recent Natale ablation got rid of both. Before the ablation my resting heart rate averaged around 90, now it's closer to 60.

~ Linda

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Daisy

I don't believe SSS can be treated with ablation, but it can often be managed medically and/or with a pacemaker.


I have sick sinus syndrome and a pacemaker plus a Natale ablation fixed it.

As I recall, the ablation didn't really have anything to do with your sinus node. It's the pacemaker that fixed your SSS. Or do I remember incorrectly?

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Carey
"I have sick sinus syndrome and a pacemaker plus a Natale ablation fixed it."

As I recall, the ablation didn't really have anything to do with your sinus node. It's the pacemaker that fixed your SSS. Or do I remember incorrectly?

The pacemaker fixed the bradycardia aspect but I still occasionally had tachycardia and the ablation fixed that.

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Daisy
The pacemaker fixed the bradycardia aspect but I still occasionally had tachycardia and the ablation fixed that.

Right, but the ablation didn't involve the sinus node, right?

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Carey

The pacemaker fixed the bradycardia aspect but I still occasionally had tachycardia and the ablation fixed that.

Right, but the ablation didn't involve the sinus node, right?

Right, the ablation did not involve the sinus node.