Because of the nature of the symptoms, sick sinus syndrome (SSS) often is not diagnosed until its advanced stages. If the syndrome is detected even though it is producing no symptoms, no treatment is necessary. However, if the patient is taking medications that may worsen the condition, those medications likely will be stopped and/or replaced with safer alternatives.

Treatment is necessary once SSS enters the advanced stages. The most common treatment is a combination of an artificial pacemaker and antiarrhythmic medications.

Pacemakers are devices implanted into the patient’s chest to replace the sinus node as the pace setter for the heart’s rhythm. They are implanted during a minor surgical procedure, and a short stay in the hospital may be required. When treating SSS, a dual-lead (or dual-chamber) pacemaker is the most common type used. Dual-lead pacemakers send electrical leads to both an atrium (one of two upper heart chambers) and a ventricle (one of two lower heart chambers), stimulating both chambers. This helps prevent the atrial fibrillation commonly associated with SSS. In addition, the dual–chamber pacemaker has the ability to synchronize the contraction of the atrium and ventricle to more closely resemble the natural action of the heart.

Patients may still experience certain arrhythmias following pacemaker insertion, including:

Antiarrhythmic medications may be prescribed along with the pacemaker to control the abnormal heart rhythms. The most common antiarrhythmic medications prescribed for SSS are calcium channel blockers. Also called calcium antagonists, these are non-habit-forming medications that prevent the flow of calcium ions into the muscle cells of the heart and blood vessels, causing them to widen and relax. As a result, the heart and blood vessels relax, increasing the supply of oxygen-rich blood to the heart, lowering blood pressure and reducing the heart’s workload.

The pacemaker protects the patient from having their heart rate drop too low from these medications. That is why the same medications that are avoided by SSS patients without a pacemaker are then sometimes prescribed once the pacemaker is in place. The pacemaker is a safety mechanism to prevent the heart from slowing down, while the antiarrythmic drugs prevent the heart from going to fast. The pacemaker/antiarrhythmic drug combination helps keep the heart rate in a normal range depending on the body's needs. 

Occasionally, SSS is accompanied by angina (chest pain caused by a restriction in blood flow to the heart). In these cases, one or more catheter-based procedures may be performed to remove, breakup or compress any plaque buildup that may be causing the restriction in blood flow.

Other than making healthy lifestyle changes to promote overall health (e.g., reducing use of alcohol and caffeine, losing weight), there is no known strategy to prevent SSS.