Sick sinus syndrome due to cardiac amyloidosis

In a patient suffering from cardiac amyloidosis a case of sick sinus syndrome, manifested by markedly prolonged recovery time of the sinus node, was documented by an atrial pacing study. The first A-V junctional escape interval was markedly prolonged following the termination of the atrial pacing, pointing to a coexisting A-V nodal dysfunction. The patient required a permanent artificial pacemaker implantation.