Sick Sinus Syndrome, Complete AV Block Quiz
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Fainting when walking
Off-balance like floating
Irregular heartbeat
Dizziness
Blacking out
Dizziness multiple times
Walking then suddenly fainted / passed out
Not seeing your symptoms? No worries!
What is Sick Sinus Syndrome, Complete AV Block?
These conditions involve issues with the heart's electrical conduction system. Signals may be transmitted too fast, too slow, or not at all to some areas of the heart. Both men and women are affected, and the risk increases with age.
Typical Symptoms of Sick Sinus Syndrome, Complete AV Block
- Losing consciousness during a physical activity
- Fainting
- Family history of sudden death under 50 years old
- Small involuntary eye movements
- Irregular heartbeat
- Dizziness
- Swelling in any body part
- Diagnosed with heart failure at age 45 or younger
Diagnostic Questions for Sick Sinus Syndrome, Complete AV Block
Your doctor may ask these questions to check for this disease:
- Did you faint while walking or doing something?
- Have you fainted recently?
- Do you have a family history of early sudden death (under 50)?
- Do you have small involuntary eye movements?
- Have you been experiencing an irregular heartbeat?
Treatment of Sick Sinus Syndrome, Complete AV Block
Treatment depends on the type of signaling problem and symptom severity. Mild cases may not need treatment, while in some cases a doctor may recommend a pacemaker implantation to deliver electrical impulses if the heart rate is too slow or pauses.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Tatsuya Shiraishi, MD (Cardiology)
Dr. Shiraishi graduated from the Kyoto University School of Medicine. He worked as a cardiologist at Edogawa Hospital, and after joining Ubie, he became the Director of East Nihonbashi Internal Medicine Clinic.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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FAQs
Q.
Nebivolol Side Effects? Why Your Heart is Slowing & Medically Approved Next Steps
A.
Nebivolol often slows the heart on purpose to lower blood pressure, but if your resting rate drops below about 50 or you develop dizziness, fainting, chest discomfort, or irregular beats, it may indicate a dose issue or an underlying conduction problem. There are several factors to consider; see below for what’s normal versus too slow and who is at higher risk. Medically approved next steps include not stopping the drug abruptly, checking your resting pulse correctly, and contacting your clinician about dose changes, an EKG or Holter monitor, and labs, with urgent care warranted for fainting, severe shortness of breath, chest pain, or a heart rate under 40. For fuller guidance and red-flag details that could change your next steps, see below.
References:
* Padgett, S. M., et al. (2013). Acute bradycardia and ventricular pause following nebivolol administration. *Journal of Emergency Medicine*, 44(1), e1-e3. PMID: 22018899.
* Cicero, A. F. G., et al. (2007). Nebivolol: a new generation β-blocker. *Pharmacological Research*, 56(3), 160-167. PMID: 17765660.
* Ambrosioni, E., et al. (2005). A comparative study of nebivolol versus metoprolol in patients with essential hypertension: a multicenter, randomized, double-blind, parallel-group trial. *Cardiology*, 104(2), 77-83. PMID: 15923769.
* Safar, M. E. (2012). Nebivolol: an update. *Journal of Clinical Hypertension (Greenwich, Conn.)*, 14(11), 748-755. PMID: 23110531.
* Khurram, I., et al. (2019). Clinical Management of Beta-Blocker Withdrawal Syndrome. *Journal of the American Heart Association*, 8(23), e013752. PMID: 31747864.
Q.
Sinus Bradycardia? Why Your Heart is Beating Slow & Medical Next Steps
A.
Sinus bradycardia means your heart is beating under 60 beats per minute in a normal rhythm; it is often normal in athletes or during sleep, but becomes concerning if you have symptoms like dizziness, fainting, chest pain, shortness of breath, or if the rate is very low such as under 40. There are several factors to consider. See below to understand more. Seek urgent care for fainting, chest pain, or shortness of breath; otherwise, talk to a clinician if symptoms persist or your resting rate stays under 50, since evaluation with ECG or monitoring and targeted treatment such as adjusting medications, correcting thyroid or sleep apnea, or in some cases a pacemaker may be needed; full next steps and red flags are detailed below.
References:
* Da Silva KR, Fernandes G, de Oliveira B, dos Santos F, Rodrigues B. Bradycardia: From diagnosis to therapy. Rev Port Cardiol (English Ed). 2020 Feb;39(2):107-118. doi: 10.1016/j.rpcjoe.2019.09.006. Epub 2020 Jan 25. PMID: 32063529.
* Brignole M, Reboldi G, Ungar A, Bartoletti A, Deharo JC, Fanciulli A, Fedorowski A, Furlan R, Giada F, Halimi F, Ivanova R, Jrah M, Krahn AD, Kuku O, Lekawanvijit S, Piras P, Ricci F, Sciaraffia E, Tomasoni L. Diagnosis and management of sinus node dysfunction: an expert consensus statement from the European Heart Rhythm Association. Europace. 2021 Jul 1;23(7):1011-1033. doi: 10.1093/europace/euab049. Epub 2021 Mar 3. PMID: 33534571.
* Gupta V, Koneru M. Sinus Bradycardia. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: StatPearls [Internet]. PMID: 32965934.
* Singh GP, Singh AK. Physiologic and Pathologic Bradycardia. Cardiol Clin. 2018 Nov;36(4):479-487. doi: 10.1016/j.ccl.2018.06.002. Epub 2018 Sep 26. PMID: 30390848.
* Semelka M, Gera J, Usman S, Sethi A, Aronow WS. Sinus node dysfunction: pathophysiology, evaluation, and management. Am J Cardiol. 2012 Mar 22;109(6):894-901. doi: 10.1016/j.amjcard.2011.10.046. Epub 2011 Nov 22. PMID: 22464741.
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References:
Kozanoglu E, Uygur F, & Irmak MK. (2002). The effects of manual lymphatic drainage technique… Support Care Cancer, 12446494.
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Biggins SW, Kim WR, & Terrault NA. (2006). Evidence-based incorporation of serum sodium… Liver Transplantation, 16785667.
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Debruyne, P., Rossenbacker, T., & Collienne, C. (2018). Unifocal right-sided ablation treatment for neurally mediated syncope and functional sinus node dysfunction under computed tomographic guidance. Circulation …, 2018.
https://www.ahajournals.org/doi/abs/10.1161/CIRCEP.118.006604John, R. M., & Kumar, S. (2016). Sinus node and atrial arrhythmias. Circulation, 2016.
https://www.ahajournals.org/doi/abs/10.1161/circulationaha.116.018011Peigh, G., Leya, M. V., Baman, J. R., & ... (2020). Novel coronavirus 19 (COVID-19) associated sinus node dysfunction: a case series. … Heart Journal.
https://academic.oup.com/ehjcr/article-pdf/doi/10.1093/ehjcr/ytaa132/35930156/ytaa132.pdf