Tachy Brady Syndrome

The tachy brady syndrome is also known as sinus node dysfunction or the sick sinus syndrome. If we were to give a simple definition of this condition, it is an abnormality in the conduction system of the heart. It can be also described as an alternation of a fast and slow heart rate.

When a person suffers from this syndrome, he has heart rhythms that are either too fast, too slow or punctuated by long pauses. Sick sinus syndrome is relatively uncommon, but the risk of developing sick sinus syndrome increases with age.

Symptoms

As we mentioned above, the tachy brady syndrome is characterized by an increased cardiac rate. The doctors call this condition as tachycardia. It is then replaced by a sudden decrease in the normal heart rate. This is known as bradycardia. These phenomena are dangerous because they come with a lack of oxygen and nutritional supply for the heart and the whole body system. The most common symptoms that appear when a person suffers from tachy brady syndrome are the following:

  • Dizziness. It appears usually during the daytime. This is due to the inability of the heart to pump effectively the oxygenated blood.
  • Feeling of faintness. The lack of oxygen is the main responsible for this problem.
  • Palpitations are noted. This is a common manifestation of tachy brady syndrome.
  • Sweating. This is a compensatory mechanism as the heart rates become uncontrollable.
  • Chest pain and difficulty of breathing are noted.

Many of these signs and symptoms are caused by reduced blood flow to the brain when the heart beats too fast or too slowly.

Causes & risk factors

As we learned during biology classes, our hearts is made up of four chambers. There are two upper chambers also known as atria and two lower ones also known as ventricles. The rhythm of your heart is normally controlled by the sinoatrial (SA) node — or sinus node — an area of specialized cells located in the right atrium. It produces the electrical impulses that trigger each heartbeat.

From this point, the electrical impulses travel across the atria and arrive to the ventricles. Here they cause the ventricles’ contraction and pump the blood out to the lungs and entire body.

When you suffer from the sick sinus syndrome it means that your sinus node isn’t functioning properly. This means that your heart rate is either too fast, too slow or irregular.

Below you can find the main causes and risk factors that may trigger the tachy brady syndrome:

  • Age. The older you get, the more exposed you are to the tachy brady syndrome. The age is factorial as fibrosis of the sinus node may cause the abnormality of the heart rates. It’s most common in people around age 70.
  • Underlying heart disease. It has been reported that a coronary artery disease can result to tachy brady syndrome.
  • Familial attribution. When a family member suffers from this disease, it might be that you will also develop this syndrome.
  • Medications. There are certain medications that could cause tachy brady syndrome. For example, the beta-blockers, digoxin and anti-arrhythmic drugs are responsible for causing this syndrome.
  • Electrolyte imbalance. Sodium and potassium levels are essential in regulating the heart rate.

Complications

When your heart’s natural pacemaker is not doing its work as it should, your heart is not performing efficiently. This means that you may have a very slow heart rate which can cause fainting. In more severe cases, the slow or fast heart rate may be fatal.

When you have this syndrome, you may also have a higher risk of developing blood clot in your heart. The clot may lead to a stroke which can be fatal.  The fast heart rhythm that occurs in tachy brachy syndrome is usually the atrial fibrillation. It causes a chaotic rhythm of the upper chambers of the heart that can cause blood pooling in the heart. Blood clots are more likely to form when blood flow through the heart is altered in any way.

Tachy brady syndrome can become fatal, especially when treatment has not been provided accordingly and compliance has not been attained by the patient. The following complications may arise:

  • Development of embolic cerebrovascular disorders.
  • The patient may also suffer from congestive heart failure.
  • Cardiac arrest.

Diagnosis

There are several tests that can help determine if a patient is suffering from tachy brady syndrome:

  • Laboratory examination – will help the doctor determine whether the patient has any thyroid dysfunction. Moreover, the lab exams will help determine if there is any serum electrolyte imbalance.
  • An echocardiogram is mandatory. This shall include assessing any underlying heart condition. The electrocardiograph study is performed in order to assess the state of the heart. Tachycardia and bradycardia are easily assessed with this examination.

Treatments and drugs

Treatment for sick sinus syndrome focuses on eliminating or reducing unpleasant symptoms. If you aren’t bothered by symptoms, you may only need regular checkups to monitor your condition. For people who are bothered by symptoms, the treatment of choice is usually an implanted electronic pacemaker.

Medication changes

Because the natural pacemaker is no longer functioning properly, the people suffering from the sick sinus syndrome will eventually need a permanent artificial pacemaker to maintain a regular heartbeat. This small, battery-powered electronic device is implanted under the skin near your collarbone during a minor surgical procedure. The pacemaker will stimulate your heart and maintain a normal heart beating.

As soon as you recover from the pacemaker implantation surgery, you will be able to resume to your normal activities. The risk of complications, such as swelling or infection in the area where the pacemaker was implanted, is small.

Additional treatments for fast heart rate

When you want to control the fast heart rate, there are various additional treatments that your doctor may recommend:

  • Medications – like anti-arrhythmia medications to prevent fast rhythms. If you have atrial fibrillation or other abnormal heart rhythms that increase your risk of stroke, you may need a blood-thinning medicine, such as warfarin or dabigatran.
  • AV node ablation. This procedure involves applying radiofrequency energy through a long, thin tube (catheter) to destroy (ablate) the tissue around the atrioventricular (AV) node between the atria and the ventricles. It is very useful to calm down fast heart rates from reaching the ventricles and causing problems.
  • Radiofrequency ablation of atrial fibrillation. This procedure is similar to AV node ablation. It is very useful to eliminate the atrial fibrillation.

Lifestyle and home remedies

Take the following steps to treat or eliminate risk factors that may lead to heart disease:

  • Exercise and eat a healthy diet.
  • Maintain a healthy weight.
  • Keep blood pressure and cholesterol under control.
  • Try to not smoke.
  • Drink alcohol in moderation.
  • Stay away from illegal drugs.
  • Avoid unnecessary stress.
  • Go to scheduled checkups.

References:

https://www.mayoclinic.org/diseases-conditions/sick-sinus-syndrome/basics/lifestyle-home-remedies/con-20029161

https://www.webmd.com/a-to-z-guides/tc/sick-sinus-syndrome-topic-overview

Tachy Brady Syndrome

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