Tachy Brady Syndrome

What is Tachy Brady Syndrome ?

Tachy brady syndrome (tachycardia-bradycardia) is a condition pertaining to the abnormality in the conduction system of the heart. Tachycardia refers to fast heart rate while bradycardia refers to slow heart rate.

In the case of tachy brady syndrome, there is an alternation of the fast and slow heart rate. There is an imbalance in the heart rate conduction system. This condition is common in people with atrial fibrillation, especially if the natural pacemaker of the heart is damaged. ⁽¹⁾

Tachy Brady Syndrome Symptoms

• The cardiac rate is increased significantly and replaced by a sudden decrease in normal heart rhythm.
• The patient feels dizzy, especially at daytime. The dizziness is caused by heart’s inability to effectively pump oxygenated blood.
• Palpitations
• Excessive sweating
• Feeling of faintness
• Difficulty of breathing
• Chest pain ^{(1, 2)}

Who are at risk for tachy brady syndrome?

1. The elderly is more susceptible to tachy brady syndrome than the young ones.
2. People with heart disease are at risk, especially those with coronary artery disease.
3. Those who have a family history of heart disease and tachy brady syndrome are susceptible too.
4. Tachy brady syndrome can be caused by certain group of medications such as anti-arrhythmic drugs, digoxin, and beta-blockers.
5. An imbalance in electrolytes, especially sodium and potassium may lead to tachy brady syndrome. ⁽³⁾

The elderly is prone to tachy brady syndrome because as the person grows old, the sinus node gets old and weak, which could greatly affect its functions. As a result, the atrium and conduction system of the heart weakens. On the other hand, a child with tachy brady syndrome is prone to other infections including cardiac related diseases. ⁽⁴⁾

Image 1 : An electrocardiogram result of a patient with tachy brady syndrome
Photo Source : ocw.tufts.edu

Figure 2 : An ECG report comparison of a normal heartbeat and irregular heartbeat
Picture Source : www.aurametrix.com

What is sick sinus syndrome of the heart?

The heartbeat starts in the atria (the top chamber of the heart), which acts as the heart’s pacemaker. It is also called sinoatrial node (SA node). It is the one responsible in keeping a normal and steady beating of the heart.

Sick sinus syndrome arise when there is a problem in the sinus node. The possible problems could be slowing of the heartbeat, a pause or stop of heartbeat, and fast heart rate episodes. An alternating fast and slow heart rhythm (tachy brady syndrome) could also arise. ⁽⁴⁾

What is the cause of sick sinus syndrome?

• It is common in people 50 years old and above. As the person gets older, the electrical pathways in the muscle tissues of the heart becomes weak and sensitive.
• It is common in children who underwent heart surgery involving the upper chambers of the heart.
• People with high blood pressure, coronary heart disease, and aortic and mitral valve disease are prone to SSS (sick sinus syndrome). ^{(5, 6)}

Symptoms of sick sinus syndrome?

Typically, sick sinus syndrome does not have symptoms at all. The symptoms the patient feels may mimic other diseases such as angina (chest pain), a feeling of fainting, easily gets tired, confusion, palpitations, dizziness, lightheadedness, and shortness of breath. ⁽⁶⁾

What is a sinus node dysfunction?

It pertains to the number of conditions that cause inappropriate atrial rates. The typical symptoms include weakness, palpitations, and syncope (temporary loss of consciousness). Patients with sinus node dysfunction requires a pacemaker. This condition is common in the elderly, especially people with heart-related disorder and diabetes. ⁽⁷⁾

Diagnostic procedures for tachy-brady syndrome

Laboratory Test

This test is done to assess the thyroid function of the patient. A serum electrolyte imbalance will be rule out, especially sodium, potassium, and calcium electrolytes. These electrolytes play an essential role in the conduction system. If their levels are altered, it could significantly affect the heart rate and rhythm.

Echocardiogram

This test thoroughly assess the underlying condition of the heart. Through this test, it would be easier to detect rapid heart rate (tachycardia) and slow heart rate (bradycardia). ⁽⁷⁾

Tachy Brady Syndrome Treatment

There are various ways to treat tachy brady syndrome. Usually, it is a combination of various medications and interventions along with diet and lifestyle modifications.

• Surgical approach – One of the surgical interventions for tachy brady syndrome is placing a pacemaker. It is a device that sends electrical impulses to the heart, which could lead to normal heart rhythm. Once you have a pacemaker, you will be required to wear a Med Alert bracelet. This is to inform the public that you have a pacemaker and to make them aware of your health condition. It is also important to take pain reliever to significantly reduce the discomfort you might have because of pacemaker placement. You should stay away from magnets and other stuff that can affect the function of the pacemaker. ⁽⁸⁾
• Lifestyle and diet modification – Once you already have the pacemaker in placed, it is now time for you to give up some foods as well as some bad habits. Say goodbye to alcoholic and caffeinated beverages. If you are smoking, then it is time for you to wave goodbye to cigarettes. It is a must to keep your blood pressure within normal range. Overweight patients are highly encouraged to lose excess weight. You should follow a low cholesterol and low salt diet.
• Stay away from illegal drugs as it could further aggravate the condition of the heart.
• Avoid stress. When under great deal of stress, you have to come up with coping techniques. It is important to handle stress in a health way to prevent any cardiac implications. ⁽⁹⁾
• Make it a habit to have a scheduled check-up. If you are experiencing discomfort or any of the above-mentioned symptoms, you should consult your doctor right away.

Are there any complications?

Tachy brady syndrome should be treated as soon as possible because it can be very fatal. Non-compliance to the treatment approach could lead to cardiac arrest, embolic cerebrovascular disease, and congestive heart failure. ⁽¹⁰⁾

References:

1. http://www.mayoclinic.org
2. https://en.wikipedia.org
3. www.secondscount.org
4. www.pacemakerplus.com
5. www.webmd.com
6. https://medlineplus.gov
7. https://syndromespedia.com
8. www.medscape.com
9. www.hxbenefit.com
10. Heart in Fours: Cardiology for Residents and Practitioners By Pothuri Radha Krishna Murthy