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Patient education: Bradycardia (The Basics)

Patient education: Bradycardia (The Basics)

What is bradycardia? — Bradycardia is the term doctors use for when a person's heartbeat is slower than normal.

How do normal heartbeats happen? — A normal heartbeat happens when an electrical signal starts in 1 spot near the top of the heart. This electrical signal follows a path to spread across the heart. As it spreads, the signal causes the heart muscle to squeeze. Each time the heart squeezes or "beats," it pumps blood all over the body.

Normally, the heart beats in a regular way about 60 to 100 times a minute. Your heart rate is lower when you are resting, and higher during physical activity.

What causes the heart to beat too slowly? — The heart can beat too slowly if:

Electrical signals don't start often enough.

The electrical signal gets slowed down or blocked as it spreads across the heart.

Having a slow heartbeat does not always mean that there is a problem. Both children and adults can have bradycardia and still be healthy. For example, it is common for athletes to have a "resting" heart rate of less than 60 beats per minute. It is also common for people to have a slower heartbeat when they are sleeping.

Certain medicines, especially medicines used to treat heart problems or high blood pressure, can also cause bradycardia.

Other times, bradycardia is caused by a problem or condition, such as:

A problem with the heart's electrical system

Other heart problems, including recent heart surgery or a heart attack

Certain infections

Sleep apnea – This is when people stop breathing for short amounts of time when they are asleep.

Anorexia – This is an eating disorder that makes people lose more weight than is healthy.

What are the symptoms of bradycardia? — Some people have no symptoms.

Other people have symptoms with their bradycardia. These can include:

Feeling lightheaded or dizzy

Fainting or feeling like you are going to faint

Feeling tired, either all of the time or only when you exercise

Chest pain

Trouble breathing

Eating less than usual or acting tired (in babies)

Should I call my doctor or nurse? — Yes. If you or your child has symptoms of bradycardia, call your doctor or nurse.

Is there a test for bradycardia? — Yes. The doctor or nurse will ask about your symptoms and do an exam. During the exam, they will check your pulse and listen to your heart.

To see if your heartbeat is slower than normal, they will do an electrocardiogram ("ECG"). An ECG is a test that measures the electrical activity in the heart (figure 1).

Your doctor might want to record your heartbeat over the course of hours or days. If so:

They will have you wear or carry a heart monitor device around at home (figure 2). This device, called a "Holter monitor," measures and record your heart's electrical activity.

Keep doing your normal activities while you wear or carry the monitor.

While you wear the monitor, write down any symptoms you have. That way, your doctor can see if bradycardia is causing your symptoms.

After your doctor knows for sure that you have bradycardia, they might do tests to look for the cause. These can include:

Blood tests

Tests to see how your heartbeat changes when you get certain medicines

How is bradycardia treated? — Treatment depends on your symptoms and what's causing your bradycardia:

People who have no symptoms usually do not need treatment.

People who have symptoms will likely need treatment. Your doctor might change or stop any medicines that could be slowing your heartbeat.

Some people with bradycardia are treated with a device called a "pacemaker." A pacemaker sits under the skin near a person's heart and sends electrical signals to the heart. These signals help the heart beat at a normal rate.

More on this topic

Patient education: Pacemakers (The Basics)
Patient education: Syncope (fainting) (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Sinus node dysfunction (The Basics)

Patient education: Syncope (fainting) (Beyond the Basics)
Patient education: Pacemakers (Beyond the Basics)

This topic retrieved from UpToDate on: Oct 01, 2023.
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