Sick sinus syndrome vs/lone atrial fib

[Ron]

I am 52 y/o male and have had paroxysmal atral fib for 6 yrs...tried every type of medication but nothing has been effective long term. I have had all tests,including cardiac cath, and all is normal..dx has been lone atrial fib.I am currently on verapamil for rate control and coumadin. I just had results of Holter and was told by my Cardiologist that I had a rate ranging from 50-150, and 6 episodes of "pauses" of 2.3 seconds..I have had absolutely no symptoms. He tells me that I will need a pacemaker if the pauses reach 3 sec or if I am symptomatic,i.e. dizziness,loss of consciousness,etc. Now, my Dx is apparently sick sinus syndrome which will eventually result in my having a pacemaker..this is very disturbing to me..My question is: if someone has lone atrial fib, are pauses of 2.3 sec normal for atrial fib, or is that always an indication that my sinus node is aging and I will need a pacemaker...also, is it possible that I could never go beyond the current 2.3 sec pauses and never need a pacemaker???
I appreciate your feedback. Thank you!

[Cleveland Clinic, MD]

It could be due to the sinus node or the medication you are taking to control your afib.  2.3 second pauses are not "typical" for individuals with afib and this is a problem that, as you doctor has said, could lead to a pacemaker.  However, no one has a crystal ball and if you don't develop symptoms a pacemaker will not be required.