What is the first-line treatment for symptomatic bradyarrhythmias due to sick sinus syndrome?

The first-line treatment for symptomatic bradyarrhythmias due to sick sinus syndrome is the placement of a permanent pacemaker. Sick sinus syndrome is characterized by inappropriate sinus bradycardia, leading to symptoms such as dizziness, syncope, or fatigue due to inadequate cardiac output. In cases where patients exhibit symptoms correlating with their bradyarrhythmia, a permanent pacemaker provides an effective means of regulating heart rate by delivering electrical impulses to stimulate heartbeats at appropriate intervals, thus alleviating the symptoms and improving quality of life.

Other treatments, like radiofrequency ablation, are generally used for different arrhythmias rather than bradyarrhythmias. Antiarrhythmics may not be appropriate for this condition since they can potentially worsen bradycardia. Anticoagulation therapy is primarily indicated for conditions related to thromboembolic risks, such as atrial fibrillation, but is not relevant for treating bradyarrhythmias associated with sick sinus syndrome. Therefore, the pacemaker remains the definitive and most effective solution in managing symptomatic cases.