Cardiopulmonary arrest due to sick sinus syndrome - A case report -

Abstract

Sick sinus syndrome (SSS) is an abnormality of sinus nodal impulse formation by intrinsic or extrinsic causes. Patients with SSS often are asymptomatic, or have mild or nonspecific symptoms, including dizziness, palpitations, fatigue, and confusion related to the decreased cardiac output. SSS can rarely cause conditions like syncope, congestive heart failure, thromboembolism, pulmonary edema, cardiac arrest, or sudden death. We report here on a severe bradycardia during general anesthesia for aneurysmal clipping and tachycardia-bradycardia syndrome followed by cardiac arrest postoperatively in the ICU, which was subsequently diagnosed as SSS with 24-hour Holter monitoring.

Profound bradycardia with lidocaine during anesthesia induction in a silent sick sinus syndrome patient

“…Because only sinus bradycardia may be present without symptoms, sick sinus syndrome often goes undetected in the early stages. Cardiac arrest has been reported in patients with undiagnosed sick sinus syndrome during and after surgery [6,7]. Diagnosis of sick sinus syndrome is usually made by 12-lead ECG or ambulatory monitoring, which show severe bradycardia, sinus pause or arrest, and tachyarrhythmia.…”