Sick sinus node syndrome ¿Pacemaker or ablation?

Abstract

The tachycardia-bradycardia syndrome is the most common presentation of sick sinus node syndrome and is commonly characterized by episodes of paroxysmal atrial fibrillation followed by significant pauses, especially in older adult. Other frequently associated tachyarrhythmias are atrial tachycardia and atrial flutter. The association between orthodromic tachycardia and significant pauses in these patients is an unusual presentation. We present the case of an older adult with bradycardia-tachycardia syndrome and syncope, who had episodes of incessant tachycardia through a concealed accessory pathway and, after its successful ablation, did not experience syncope again.