[Sick sinus node syndrome ¿Pacemaker or ablation? Case report].

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Tachycardia-bradycardia syndrome, a common manifestation of Sick sinus node syndrome, typically involves atrial fibrillation with pauses, particularly in older adults.
• Associated tachyarrhythmias include atrial tachycardia and atrial flutter.
• The co-occurrence of orthodromic tachycardia and significant pauses is an infrequent clinical presentation.

Observation:

• This report details a case of an elderly patient experiencing syncope due to bradycardia-tachycardia syndrome.
• The patient exhibited an unusual presentation involving a hidden accessory pathway.
• The syncope was linked to the presence of this accessory pathway.

Findings:

• Successful ablation of the hidden accessory pathway was performed.
• Following the ablation procedure, the patient experienced no further episodes of syncope.

Implications:

• This case highlights that hidden accessory pathways can present atypically within the spectrum of Sick sinus node syndrome.
• Successful ablation offers a potential therapeutic strategy for managing syncope in such unusual presentations.
• It underscores the importance of considering accessory pathways in older adults with unexplained syncope and bradycardia-tachycardia syndrome.