Cardiology Case Report: Sick Sinus Syndrome and Palpitations

Our latest cardiology case report from Brady Pregerson, MD, features a woman in her 60s with a history of sick sinus syndrome presenting with palpitations, SOB, and lightheadedness. Can you determine the correct diagnosis?


A patient in their mid-60’s with a history of sick sinus syndrome diagnosed 3 years ago presents to the hospital with palpitations, shortness of breath and lightheadedness that started around 6 PM. She denies any chest pain, syncope or other complaints.


Vital signs are normal except for a pulse in the 120’s. The physical exam is otherwise normal.

Computer printout of an EKG Strip | Credit: Brady Pregerson, MD

Computer Read: Accelerated junctional rhythm, low voltage QRS, cannot rule out anterior infarct, age undetermined

Other Info: Her cardiologist was contacted and found a normal echo and normal myocardial perfusion study in about 3-4 years ago.

What is the most likely rhythm in this patient?

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