Download Bradycardia (Slow Heart Rate)

Bradycardia (Slow Heart Rate)
Table of Contents
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Topic Overview
Health Tools
Frequently Asked Questions
Other Places To Get Help
Related Information
References
Credits
Topic Overview
What is bradycardia?
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.
A slow heart rate can be normal and healthy. Or it could be a sign of a problem with the
heart's electrical system.
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.
In 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:
• Changes in the heart that are the result of aging.
• Diseases that damage the heart's electrical system. These include coronary artery
disease, heart attack, and infections such as endocarditis and myocarditis.
• Conditions that can slow electrical impulses through the heart. Examples include
having a low thyroid level (hypothyroidism) or an electrolyte imbalance, such as too
much potassium in the blood.
• Some medicines for treating heart problems or high blood pressure, such as betablockers, antiarrhythmics, and digoxin.
What are the symptoms?
A very slow heart rate may cause you to:
• Feel dizzy or lightheaded.
• Feel short of breath and find it harder to exercise.
• Feel tired.
• Have chest pain or a feeling that your heart is pounding or fluttering (palpitations).
• Feel confused or have trouble concentrating.
• Faint, 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 getting older.
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 diagnosed?
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.
You may also have blood tests to find out if another problem is causing your slow heart
rate.
How is it treated?
How bradycardia 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.
• If damage 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.
The 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 hearthealthy 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.
• Losing weight if you need to, and staying at a healthy weight.
• Not smoking.
• Managing other health problems, such as high blood pressure or high cholesterol.
Get 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.
Pacemakers
Most 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.
Your doctor 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:
• Your heartbeat 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 worse.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health
problems.
• Heart Rate Problems: Should I Get a Pacemaker?
Actionsets are designed to help people take an active role in managing a health
condition.
Frequently Asked Questions
Learning about
bradycardia:
Being diagnosed:
Getting treatment:
Ongoing concerns:
Living with
bradycardia:
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What is bradycardia?
What are the types of bradycardia?
How does the heart's electrical system work?
What is heart block?
What is sick sinus syndrome?
What is a medical history and physical examination for
slow heart rate?
What are the symptoms?
What is ambulatory heart monitoring?
What is an exercise test?
What is an electrophysiology study?
How is a pacemaker used to treat bradycardia?
Should I get a pacemaker?
What are the risks of complications with different types
of bradycardias?
How can I live heart-healthy?
How can I exercise safely?
How can I keep track of my symptoms?
Can I drive safely with bradycardia?
What do I need to know about living with a pacemaker?
What is pacemaker monitoring?
Other Places To Get Help
Organizations
American College of Cardiology: CardioSmart
www.cardiosmart.org
American Heart Association
www.heart.org
National Heart, Lung, and Blood Institute (U.S.)
www.nhlbi.nih.gov
Related Information
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Heart Block
Heart Rate Problems: Should I Get a Pacemaker?
Sick Sinus Syndrome
Types of Bradycardia
References
Other Works Consulted
• 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.
• Olgin JE, 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.
Credits
By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Adam Husney, MD - Family Medicine
Specialist Medical Reviewer John M. Miller, MD, FACC - Cardiology, Electrophysiology
Current as of April 7, 2017
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