Having bradycardia (say "bray-dee-KAR-dee-uh")
means that your heart beats very slowly. For most people, a heart rate of 60 to 100
beats a minute while at rest is considered normal. If your heart beats less than 60
times a minute, it is slower than normal.
For some people,
a slow heart rate does not cause any problems. It can be a sign of being very fit.
Healthy young adults and athletes often have heart rates of less than 60 beats a minute.
other people, bradycardia is a sign of a problem with the heart's electrical system.
It means that the heart's natural pacemaker isn't working right or that the electrical
pathways of the heart are disrupted. In severe forms of bradycardia, the heart beats
so slowly that it doesn't pump enough blood to meet the body's needs. This can cause
symptoms and can be life-threatening.
Men and women age 65 and older are most
likely to develop a slow heart rate that needs treatment. As a person ages, the electrical
system of the heart often doesn't function normally.
What causes bradycardia?
Bradycardia can be caused by:
in the heart that are the result of aging.
Feel short of breath and find it harder to exercise.
Have chest pain or a feeling that your heart is pounding or fluttering
Feel confused or have trouble concentrating.
if a slow heart rate causes a drop in blood pressure.
Some people don't
have symptoms, or their symptoms are so mild that they think they are just part of
You can find out how fast your heart is beating by taking your pulse. If your heartbeat is slow
or uneven, talk to your doctor.
How is bradycardia
Your doctor may take your pulse to diagnose bradycardia. Your doctor
might also do a physical exam, ask questions about your past health, and do an electrocardiogram (EKG or ECG). An EKG measures
the electrical signals that control heart rhythm.
Bradycardia often comes and
goes, so a standard EKG done in the doctor's office may not find it. An EKG can identify
bradycardia only if you are actually having it during the test.
You may need
to use a portable (ambulatory) electrocardiogram. This lightweight device is also
called a Holter monitor or a cardiac event monitor. You wear the monitor for a day
or more, and it records your heart rhythm while you go about your daily routine.
may also have blood tests to find out if another problem is causing your slow heart
How is it treated?
is treated depends on what is causing it. Treatment also depends on the symptoms.
If bradycardia doesn't cause symptoms, it usually isn't treated.
to the heart's electrical system causes your heart to beat too slowly, you will probably
need to have a pacemaker. A pacemaker is a device placed under
your skin that helps correct the slow heart rate. People older than 65 are most likely
to have a type of bradycardia that requires a pacemaker.
If another medical
problem, such as hypothyroidism or an electrolyte imbalance, is causing a slow heart
rate, treating that problem may cure the bradycardia.
If a medicine is causing
your heart to beat too slowly, your doctor may adjust the dose or prescribe a different
medicine. If you cannot stop taking that medicine, you may need a pacemaker.
goal of treatment is to raise your heart rate so your body gets the blood it needs.
If severe bradycardia isn't treated, it can lead to serious problems. These may include
fainting and injuries from fainting, as well as seizures or even death.
What can you do at home for bradycardia?
Bradycardia is often the result
of another heart condition, so taking steps to live a heart-healthy lifestyle will
usually improve your overall health. The steps include:
Having a heart-healthy
eating plan that includes a lot of fruits, vegetables, whole grains, fish, and low-fat
or nonfat dairy foods.
Being active on most, if not all, days of the week.
Your doctor can tell you what level of exercise is safe for you.
if you need to, and staying at a healthy weight.
other health problems, such as high blood pressure or high cholesterol.
emergency help if you fainted or if you have symptoms of a heart attack or have severe shortness
of breath. Call your doctor right away if your heart rate is slower than usual, you
feel like you might pass out, or you notice increased shortness of breath.
people who get pacemakers lead normal, active lives. You will need to avoid things
that have strong magnetic and electrical fields. These can keep your device from working
right. But most electronic equipment and appliances are safe to use.
will check your pacemaker regularly. Call your doctor right away if you have symptoms
that could mean your device isn't working right, such as:
is very fast or slow, skipping, or fluttering.
You feel dizzy, lightheaded,
or like you might faint.
You have shortness of breath that is new or getting
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Epstein AE, et al. (2013). 2012 ACCF/AHA/HRS focused
update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy
of cardiac rhythm abnormalities. Circulation, 127(3): e283-e352.
Zipes DP (2015). Specific arrhythmias: Diagnosis and treatment. In DL Mann et al.,
eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed.,
vol. 1, pp. 748-797. Philadelphia: Saunders.
Vijayaraman P, Ellenbogen KA
(2011). Bradyarrhythmias and pacemakers. In V Fuster et al., eds., Hurst's The Heart,
13th ed., pp. 1025-1057. New York: McGraw-Hill Medical.
Wolbrette DL, Naccarelli
GV (2007). Bradycardias: Sinus nodal dysfunction and atrioventricular conduction disturbances.
In EJ Topol et al., eds., Textbook of Cardiovascular Medicine, 3rd ed., pp. 1038-1049.
Philadelphia: Lippincott Williams and Wilkins.
Staff Primary Medical ReviewerE.
Gregory Thompson, MD - Internal Medicine Martin
J. Gabica, MD - Family Medicine Kathleen Romito,
MD - Family Medicine Adam Husney, MD - Family
Medicine Specialist Medical ReviewerJohn M. Miller, MD, FACC - Cardiology, Electrophysiology
This information does not replace the advice of a doctor.
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