Tachy-brady syndrome is a condition which is often associated with atrial fibrillation. The tachy part is the fast atrial fibrillation which suppresses the sinus node (the original pacemaker). When the atrial fibrillation breaks (stops), it takes a while for the sinus node to "wake-up" causing a bradycardia (slow heart rate). Most of the time, this is asymptomatic, but some patients do develop lightheadedness and occasionally pass out. This is further exacerbated by some of the meds that treat atrial fibrillation. When medical therapy for atrial fibrillation is necessary, and the bradycardia is severe in terms of symptoms, we usually recommend pacemaker implantation. The pacer prevents the bradycardia from causing symptoms, but you still have to take medications to prevent the atrial fibrillation (the tachycardia).
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