Background: Sick sinus syndrome(SSS) can occur in those with congenital or acquired heart disease(including coronary artery disease(CAD). But the relation between the SSS and the atherosclerosis including CAD has not well known. So we performed this study to know the relation using measurement of the carotid intima-media thickness(IMT) as a surrogate of the atherosclerosis. Methods: The study population consisted of the three groups. The first group was the patients implanted permanent pacemaker due to SSS, the second group was the patients without CAD although has the risk factor of the CAD or not, and the third group was the patients with the CAD proved by angiography. We measured the carotid IMT by unltrasonography using M���ATH software. Results: Table. Conclusion: The carotid IMT of the patients with the SSS is thicker than without CAD and has no difference with the patients with CAD. This result suggests that SSS is in part caused by atherosclerosis.