![]() This ECG from the same patient shows atrial fibrillation at around 126 beats per minute. The ECG shows AV-junctional rhythm resulting in bradycardia at around 46 beats per minute. Complications Electrocardiogram from a man with tachycardia-bradycardia syndrome following mitral valvuloplasty, resection of the left atrial appendage, and maze procedure. Patients can also present with symptoms of congestive heart failure, stroke or transient ischemic attacks due to the abnormal rhythm. Signs and symptoms usually appear in more advanced disease and more than 50% of patients will present with syncope or transient near-fainting spells as well as bradycardias that are accompanied by rapid heart rhythms, referred to as tachycardia-bradycardia syndrome Other presenting signs or symptoms can include confusion, fatigue, palpitations, chest pain, shortness of breath, headache, and nausea. Often sinus node dysfunction produces no symptoms, especially early in the disease course. Tachycardia-bradycardia syndrome is a variant of sick sinus syndrome in which the arrhythmia alternates between fast and slow heart rates. Sinus node dysfunction ( SND), also known as sick sinus syndrome ( SSS), is a group of abnormal heart rhythms ( arrhythmias) usually caused by a malfunction of the sinus node, the heart's primary pacemaker. Telemetry strip of a 44-year-old female with asymptomatic sinus pause found while admitted for mildly symptomatic COVID-19 pneumonia. Sick sinus syndrome or sinoatrial node disease
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