In view of the adverse effects of AF on the treatment of SSS, researchers have focused on evaluating different pacing modes and algorithms to reduce the risk of AF during pacing. Pacemaker implantation is the first-line treatment for symptomatic patients with SSS and documented bradycardia history.

Although the exact mechanism is not clear to date, the extensive structural and electrical remodeling of the atrium are considered to be the important mechanism for the occurrence of AF in patients with SSS. The combination of these diseases will adversely affect the condition of patients and the efficiency of subsequent treatment. Age-related interstitial fibrosis is considered to be the common pathophysiological mechanism between SSS and AF. As a common result in the natural history of the disease, SSS coexisting with atrial fibrillation (AF) forms the basis of bradycardia–tachycardia syndrome. The clinical presentation is inconspicuous in the early stage, but with the progression of this disease, patients may present with symptoms and signs of end-organ hypoperfusion.

Sick sinus syndrome (SSS) is a set of diseases with abnormal cardiac pacing, which manifests as diverse cardiac arrhythmias, especially bradycardia.

Sick sinus syndrome wikipedia