• Inderbir Padda, Sneha Annie Sebastian, Nimrat Khehra, Arun Mahtani, Yashendra Sethi, Venkatesh Panthangi, Matthew Fulton, Dhrubajyoti Bandyopadhyay, and Gurpreet Johal.
• Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA. Electronic address: ipadda@rumcsi.org.
• Dis Mon. 2024 Feb 1; 70 (2): 101637101637.

AbstractSudden alterations in the heart rate may be associated with diverse symptoms. Sinus node dysfunction (SND), also known as sick sinus syndrome, is a sinoatrial (SA) node disorder. SND is primarily caused by the dysfunction of the pacemaker, as well as impaired impulse transmission resulting in a multitude of abnormalities in the heart rhythms, such as bradycardia-tachycardia, atrial bradyarrhythmias, and atrial tachyarrhythmias. The transition from bradycardia to tachycardia is generally referred to as "tachy-brady syndrome" (TBS). Although TBS is etiologically variable, the manifestations remain consistent throughout. Abnormal heart rhythms have the propensity to limit tissue perfusion resulting in palpitations, fatigue, lightheadedness, presyncope, and syncope. In this review, we examine the physiology of tachy-brady syndrome, the practical approach to its diagnosis and management, and the role of adenosine in treating SND.Copyright © 2023 Elsevier Inc. All rights reserved.

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