You are here

Sick Sinus Syndrome G046

Document
Last amended 
29 October 2019
Current RMA Instruments
Reasonable Hypothesis SOP
15 of 2014
Balance of Probabilities SOP
16 of 2014
Changes from previous Instruments

SOP Bulletin 171

ICD Coding
  • ICD-9-CM Codes: 427.81
  • ICD-10-AM Codes: I49.5
Brief description

Sick sinus syndrome is a group of cardiac arrhythmias caused by acquired dysfunction of the sinoatrial node.  The sinoatrial node is the primary pacemaker in the heart. The condition results in an atrial heart rate that is inappropriate for physiological needs.  The dysfunction and resulting symptoms may be intermittent or persistent. The atrial heart rate may be too slow, too fast, punctuated by pauses, or there may be an alternating combination of these problems.

Confirming the diagnosis

The diagnosis is made based on the combination of symptoms and ECG findings.  The symptoms are non-specific and the ECG findings are not diagnostic on their own.  A correlation between the reported symptoms and the ECG findings is needed for the diagnosis to be confirmed.  Exercise stress testing may be necessary and specialist opinion will typically be required.

The relevant medical specialist is a cardiologist.

Additional diagnoses covered by SOP
  • Bradycardia tachycardia syndrome
  • Sinus arrest
  • Sinus bradycardia
  • Sinus node dysfunction
  • Sinus pause
  • Sinus tachycardia
Conditions excluded from SOP
  • Congenital sick sinus syndrome
Clinical onset

Most people present with non-specific symptoms such as fatigue, lightheadedness, palpitations, presyncope (feeling faint), syncope (fainting), or shortness of breath.  Some cases are identified following an ECG performed for another reason.  The condition is more common with advancing age but can occur in younger adults and children.

Clinical worsening

The usual course of the condition is for manifestations to evolve and progress over time.  Treatment is directed at relieving symptoms and addressing any underlying causes.  Many patients require implantation of a permanent pacemaker.