Bradycardia

Human heart usually beats 60 to 100 times a minute at rest. Bradycardia is a condition characterized by a slower heart rate, i.e., your heart beats less than 60 times a minute.

For some people, bradycardia may not cause symptoms or complications, because low heart beat may depend on your age, physical condition, and many other factors. Bradycardia can be a serious problem and may cause many complications if the heart doesn't pump enough oxygen-rich blood to the vital organs and other tissues of the body.

Signs and symptoms

A heart rhythm that is too slow, which means less than 60 BPM (beats per minute) may cause insufficient blood flow to the vital organs such as the brain. Few symptoms associated with bradycardia are:

  • Fatigue
  • Dizziness
  • Lightheadedness
  • Fainting or near-fainting spells
  • In extreme cases, cardiac arrest may occur

Causes

Low heart rate can be caused by various reasons. Problems with the sinoatrial (SA) node, also known as the heart's natural pacemaker may be the major reason for bradycardia. Other causes include problems in the conduction pathways of the heart, which occurs when electrical impulses are not properly conducted from the atria to the ventricles.

Damage to the heart due to heart attack or heart disease may also cause bradycardia. Apart from heart-related conditions, metabolic problems such as hypothyroidism may also cause bradycardia.

Risk factors

The risk factors which result in too slow heart rate include:

Age: Older adults are at a greater risk for bradycardia and associated heart problems.

Damage to the heart tissue: Conditions such as high blood pressure, smoking, drinking, drug abuse, psychological stress or anxiety causes damage of heart tissue and increase the risk of bradycardia.

Complications

Bradycardia can sometimes be asymptomatic and may not cause any complications. But if the condition is left untreated, the patient may develop complications, depending on how slow the heart rate is. Severe, prolonged, untreated bradycardia may lead to heart failure. Syncope, a condition characterized by loss of consciousness or fainting associated with high blood pressure and chest pain (Angina pectoris) is the complication associated with bradycardia.

Diagnosis

The doctor will first review your symptoms, medical and family history, and conduct a physical examination. Then a series of tests will be ordered to measure the heart rate and to identify the conditions associated with bradycardia.

An electrocardiogram (ECG or EKG) is a primary tool for evaluating bradycardia. It measures the electrical signals that control the heart rhythm. Bradycardia may come and go and hence continuous heart monitoring is required to identify bradycardia. The doctor may recommend using a portable electrogram, also called as a Holter monitor that records your heart rhythm while performing daily activities.

Blood tests help to identify the underlying conditions resulting in bradycardia, such as an infection, hypothyroidism or any electrolyte imbalance.

Treatment

Treatment for bradycardia depends on three main factors, which include the type of electrical conduction problem, the severity of the symptoms and the underlying cause of bradycardia. Treatment is not usually needed for slow heart rate except with prolonged or repeated symptoms. If there is an underlying cause for bradycardia, then treatment is given for that condition.

Some medications given to treat other condition may also result in bradycardia. Your doctor will check your medication history and may prescribe you with alternate medicines.

In the case of severe bradycardia, an artificial pacemaker can help to treat the condition, as it will speed up the heart rhythm as needed.

Prevention and self- management

Bradycardia can be prevented by two ways; reducing the risk of developing heart disease, and in the case of pre-existing heart disease, monitoring it by following the proper treatment plan.

Risk factors can be eliminated by following these steps:

  • Taking a healthy diet and exercising regularly
  • Maintaining a healthy body weight
  • Keeping blood pressure and cholesterol under control
  • Avoiding smoking and drinking
  • Avoiding drug abuse
  • Controlling stress and anxiety
  • Regular health checkups and follow-up visits

Report the changes or any other symptoms immediately to the doctor.