Bradycardia (Slow Heart Rhythm)
Bradycardia is a condition where your heart beats slower than normal - typically fewer than 60 beats per minute for adults. While this can be normal during sleep or in physically fit individuals, bradycardia can also indicate a problem with your heart's electrical system. When your heart beats too slowly, it may not pump enough oxygen-rich blood to your body, leading to various symptoms. There are different types of bradycardia, including sinus bradycardia (slow rate from the sinus node) and heart blocks (disruptions in the electrical pathways).
Causes
- Aging - The natural aging process can cause wear and tear on your heart and its electrical system.
- Heart tissue damage - Often from heart disease or heart attack, which can disrupt electrical pathways.
- Congenital heart defects - Some people are born with heart abnormalities that affect heart rate.
- Inflammation - Conditions like myocarditis (heart muscle inflammation) or infections affecting the heart.
- Medications - Beta-blockers, calcium channel blockers, antiarrhythmics, and some other drugs can slow heart rate.
- Chemical imbalances - Low thyroid hormone (hypothyroidism) or electrolyte imbalances in your blood.
- Sleep apnea - Breathing disruptions during sleep can trigger bradycardia.
- Sick sinus syndrome - A dysfunction of the heart's natural pacemaker (sinus node).
- Heart block - Disruption in the electrical pathway between the atria and ventricles.
Signs and Symptoms
- Fatigue or weakness - Due to reduced oxygen delivery to tissues.
- Dizziness or lightheadedness - Caused by reduced blood flow to the brain.
- Fainting (syncope) - From insufficient blood flow to the brain.
- Shortness of breath - Especially during physical activity.
- Chest pain or discomfort - When the heart doesn't receive enough oxygen.
- Confusion or difficulty concentrating - Due to reduced oxygen to the brain.
- Reduced exercise capacity - Becoming easily exhausted during physical activity.
- Palpitations - Awareness of heart skipping beats or beating irregularly.
Diagnosis
Electrocardiogram (ECG)
Records your heart's electrical activity and can show if your heart is beating too slowly or if there are disruptions in the electrical pathways.
Holter Monitor
A portable ECG device worn for 24-48 hours that continuously records your heart's activity as you go about your daily routine.
Event Monitor
Similar to a Holter monitor but worn for longer periods (up to 30 days), recording heart activity when activated during symptoms.
Echocardiogram
Uses sound waves to create images of your heart to check for structural abnormalities or damage that might cause bradycardia.
Exercise Stress Test
Monitors your heart during physical activity to see how it responds to increased demands.
Electrophysiology Study
An invasive procedure that tests the electrical activity of your heart to identify abnormalities in the heart's electrical system.
Tilt Table Test
Evaluates how your heart rate and blood pressure respond to changes in position, useful for diagnosing fainting related to bradycardia.
Treatment Options
Addressing Underlying Causes
If bradycardia is caused by medications, adjusting or changing prescriptions may help. Similarly, treating conditions like sleep apnea, thyroid disorders, or electrolyte imbalances may improve heart rate.
Monitoring
For mild bradycardia without significant symptoms, regular monitoring and follow-up appointments may be sufficient to track the condition over time.
Pacemaker Implantation
For significant bradycardia causing symptoms or putting you at risk, a pacemaker may be recommended. This small electronic device is implanted under the skin and sends electrical impulses to regulate heart rhythm when needed.
Home Remedies
Lifestyle Modifications
Adopt heart-healthy habits, including regular exercise (as approved by your doctor), maintaining a healthy weight, and following a balanced diet low in saturated fats and sodium.
Medication Management
Take all medications as prescribed and report any side effects to your doctor. Never stop or change medications without consulting your healthcare provider.
Position Changes
If you experience dizziness when standing, change positions slowly - sit up for a moment before standing, and stand for a moment before walking.
Avoid Triggers
Limit alcohol and caffeine consumption, which can affect heart rhythm. Avoid medications that could slow heart rate, including over-the-counter cold and allergy remedies containing stimulants.
Stress Management
Practice stress-reduction techniques such as deep breathing, meditation, yoga, or tai chi to support overall heart health.
Preventive Care
- Attend regular check-ups to monitor your heart health, especially if you have risk factors for heart disease.
- Take medications exactly as prescribed and discuss any side effects with your doctor.
- Maintain a heart-healthy lifestyle with regular physical activity, a balanced diet, and avoiding smoking.
- Manage conditions that can affect heart health, such as high blood pressure, high cholesterol, and diabetes.
- Learn to check your pulse to monitor your heart rate, and keep a record of any symptoms to share with your doctor.
- Wear a medical alert bracelet if you have significant bradycardia, especially if you take medications that slow your heart rate.
- Keep follow-up appointments with your cardiologist, especially if you have a pacemaker that needs regular checking.
- Know the signs of worsening bradycardia and when to seek emergency care.
- If you have a pacemaker, follow guidelines regarding electronic devices and medical procedures.
- Stay well-hydrated, especially during exercise or hot weather, to maintain blood volume and circulation.
Surgical Options
Pacemaker Implantation
A surgical procedure to implant a small electronic device under the skin that monitors heart rhythm and delivers electrical impulses when needed to maintain a normal heart rate. Modern pacemakers are programmed to respond to your activity levels and only activate when your heart rate falls below a preset threshold.
Learn More About This ProcedureElectrophysiology Procedures
Specialized procedures to diagnose and sometimes treat the electrical pathways causing bradycardia. These may include mapping the heart's electrical system and ablation therapy for certain types of rhythm disorders.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of bradycardia (slow heart rhythm), our expert team is here to help you find the right treatment approach for your specific needs.