Bradycardia

What is bradycardia?

Bradycardia is a slow heart rate of less than 60 beats per minute. A slow heart rate is normal for some people, such as athletes, and needs no treatment. Bradycardia can also signal other health conditions that do need treatment.

What causes bradycardia?

Your bradycardia may have a cardiac (heart) or non-cardiac cause:

• Early stage of a heart attack, heart block, heart failure, or heart node (tissue that generates electrical signals) problems
  
  
• Conditions that affect how electrical signals travel through your heart and cause your heart to beat
  
  
• Life-threatening emergencies such as low body temperature or problems that cause low oxygen levels
  
  
• Sleep apnea (brief period of no breathing)
  
  
• Coughing, vomiting, or severe pain that causes a nerve reflex response and briefly slows your heart rate
  
  
• Low thyroid hormone levels, low blood sugar levels, or electrolyte balance problems
  
  
• Some infections
  
  
• Certain medicines

What are the signs and symptoms of bradycardia?

You may have no signs or symptoms, or you may have any of the following:

• Tiredness and shortness of breath
  
  
• Dizziness when you walk or exercise
  
  
• Lightheadedness or fainting
  
  
• Confusion
  
  
• Chest pain
  
  
• Cool and pale or bluish skin

How is bradycardia diagnosed?

Your caregiver will ask about your symptoms and when they started. He will ask what triggers your symptoms and if they get worse with exercise. He may ask if you have a heart condition or take any medicines. Caregivers use monitors and tests to find the cause of your bradycardia. Once caregivers find the cause, you may need other tests to help guide your treatment:

• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about pain.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV (intravenous) tube.
  
  
• ECG: You will have a test called a 12-lead electrocardiogram (ECG). This test will check your heart rate and how electrical impulses travel through your heart. Sticky pads are placed on your skin to record your heart rate.
  
  
• Heart monitoring: You will be on a heart monitor to track your heart rate and rhythm if you are in the hospital. You may need to wear a Holter heart monitor for several days at home. Ask your caregiver for more information about Holter monitoring.

How is bradycardia treated?

Bradycardia is usually treated if it causes symptoms, such as dizziness or fainting. Bradycardia from a non-cardiac cause usually goes away after short-term treatment. Bradycardia from a cardiac cause can be a permanent problem that requires long-term treatment.

• Emergency treatments:
  
  
  • Oxygen: Your body may not get enough oxygen if your heart pumps too slowly or too weakly. You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils.
    
    
  • Rewarming: Caregivers use warm IV fluids and oxygen to increase your body temperature if it falls too low. Ask your caregiver for more information about acute hypothermia.
    
    
  • Heart medicines: You may need medicines to increase your heart rate. These medicines are given through an IV.
    
    
  • Other medicines: You may receive medicines to correct blood sugar, electrolyte, or thyroid hormone problems.
    
    
  • Temporary pacemaker: A temporary pacemaker is a short-term treatment in the hospital. The pacemaker is applied to your skin with sticky pads or placed into a neck or chest vein. A pacing device about the size of a small book helps keep your heartbeat stable.
  
  
• Antibiotics: Caregivers will give you antibiotics if a bacterial infection such as Lyme disease, diphtheria, or endocarditis caused your bradycardia.
  
  
• Permanent pacemaker: A permanent pacemaker is implanted under the skin of your chest or abdomen during surgery. A tiny battery creates electrical impulses that keep your heart rate regular.

How do I manage bradycardia?

• Take your medicine as directed: Your caregiver may order medicine to treat a medical condition that caused your bradycardia. Contact your caregiver if you think your medicine is not working as expected. Do not stop taking your medicine without talking with your caregiver first.
  
  
• Keep follow-up appointments: You may need to see specialists for more treatment. If you get a pacemaker, your caregiver needs to make sure it is working as it should. Ask your caregiver when and how he will check your pacemaker.
  
  
• Ask about activity: Ask your caregiver when you can return to your normal activities. Ask about activities you may need to avoid. Lie down if you feel lightheaded.

What are the risks of bradycardia?

You may be injured if you faint because your heart rate gets too low. You may get an infection during surgery to implant a pacemaker. Without treatment for bradycardia, you may develop chest pain, life-threatening shock, or heart failure.

Where can I find more information?

• American Heart Association
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.heart.org
  

• Heart Rhythm Society
  1400 K Street NW, Ste 500
  Washington , DC 20005
  Phone: 1- 202 - 464-3400
  Web Address: www.hrsonline.org
  

When should I contact my caregiver?

Contact your caregiver if:

• You are more tired than usual, even with treatment. Daily activities and exercise are harder to do.
  
  
• You have questions about using the Holter monitor.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• Lightheadedness returns or worsens.
  
  
• You have new or worsening dizziness, shortness of breath, chest pain, or confusion.
  
  
• You faint or lose consciousness.
  
  
• Your pulse rate is lower than your caregiver says it should be, even with treatment.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Bradycardia