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Bradycardia

Bradycardia is a type of abnormal heart rhythm that causes a slow heartbeat of less than 60 beats per minute. When your heartbeat is slow, your body may not receive the blood and oxygen it needs to function properly.

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What Is Bradycardia?

A normal heart rate in adults is usually between 60 and 100 beats per minute. Bradycardia is a type of arrhythmia that causes the heart to beat so slowly that the body does not get enough blood and oxygen to function properly.

Doctors define bradycardia as a heart rate of less than 60 beats per minute.

How common is bradycardia?

Your heart rate naturally slows as you age. Bradycardia is more common in older adults but can happen at any age. It can also occur in athletes and other people who are highly active, although it doesn’t usually cause noticeable symptoms.

What causes bradycardia?

Bradycardia is caused by a problem with your heart's natural pacemaker or electrical system. It occurs when one of the main nodes in the upper chambers of your heart is not working properly, resulting in a heartbeat that is too slow. Causes of bradycardia may include:

  • Changes in your heart due to aging.
  • Heart disease.
  • Low thyroid level.
  • Medications for high blood pressure or other heart problems.

What are bradycardia risk factors and complications?

Bradycardia risk factors

Aging and a personal or family history of heart disease are two major risk factors for bradycardia. Other risk factors include:

  • Excessive alcohol use.
  • High blood pressure.
  • Smoking.
  • Use of recreational drugs.

Complications of bradycardia

Bradycardia can prevent your body from getting the oxygen-rich blood it needs. In serious cases, bradycardia can cause complications such as:

  • Cardiac arrest.
  • Chest pain.
  • Fainting and related injuries.
  • Heart failure.

What is the lowest heart rate you can safely have?

Having a resting heartbeat of less than 60 beats per minute doesn’t always cause symptoms, especially if you are younger or in very good shape. If you are having symptoms of a slow heart rate, you should see your doctor.

How can I prevent bradycardia?

You may not be able to control some of your risk factors for bradycardia, such as aging and family history. However, eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, quitting smoking, limiting alcohol, avoiding recreational drugs, and controlling chronic conditions such as high blood pressure and high cholesterol may help to lower your risk.

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What Are the Signs and Symptoms of Bradycardia?

Symptoms of bradycardia vary from person to person. In fact, some people may experience very mild symptoms or no symptoms at all.

In addition to an abnormally slow heartbeat (less than 60 beats per minute), symptoms of bradycardia may include:

  • Breathlessness.
  • Chest pain.
  • Dizziness or lightheadedness.
  • Fainting.
  • Fatigue.
  • Feeling confused or having trouble concentrating.
  • Getting tired easily during physical activity.

When should I see a doctor about my bradycardia symptoms?

Your doctor will listen to your heartbeat as part of your annual physical exam or during other medical appointments. If you have chest pains, severe shortness of breath, or experience fainting, call 911 or go to the Emergency Department. If you experience any unusual symptoms, you should call your doctor right away.

At what low heart rate should you go to the hospital?

You should go to the hospital Emergency Department or dial 911 if you are having symptoms of a heart attack or severe symptoms of a slow heart rate such as fainting, dizziness, fatigue or shortness of breath.

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How Do You Diagnose Bradycardia?

Our experts use leading-edge technology and techniques to diagnose hundreds of cases of cardiac arrhythmias each year, including bradycardia.

What to expect during your visit

During your physical exam, your doctor will:

  • Ask about your symptoms and when they started.
  • Discuss your medical history.
  • Listen to your heart with a stethoscope.

Following your exam, your doctor may order additional tests and procedures to confirm a diagnosis of bradycardia.

Tests to diagnose bradycardia

We offer a full range of tests for bradycardia, including:

  • Electrocardiogram (ECG) – This noninvasive test measures the electrical activity in your heart.
  • Holter monitor – This wearable ECG device records your heart’s activity throughout the day.
  • Event recorder – This portable device is similar to a Holter monitor. However, it only records when you are having symptoms.
  • Echocardiogram – This noninvasive test uses sound waves to create images of your heart.
  • Electrophysiology (EP) study – This test uses a special catheter that is threaded through your blood vessels and into your heart to map electrical impulses.

Other tests for bradycardia may include:

  • An exercise stress test.
  • A tilt table test.
  • Blood tests to screen for infection, problems with your thyroid gland, or electrolyte imbalances.

Bradycardia prognosis

Bradycardia is a common, treatable condition. With proper treatment, most people with bradycardia are able to control symptoms and live a normal, active life.

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How Do You Treat Bradycardia?

Bradycardia treatment depends on your test results and the cause of your condition. Your doctor at UPMC will go over your test results and discuss treatment options.

Ongoing monitoring

Treatment may not be required, or your doctor may monitor your heart rhythm periodically if test results show:

  • Heart's response to exercise is normal.
  • No symptoms of low cardiac output.
  • No underlying heart disease is detected.

Lifestyle changes

Your doctor may recommend adopting heart-healthy lifestyle changes, including changes to your diet and activity level.

What foods should I avoid if I have bradycardia?

You should limit alcohol, sugar, and sodium if you have bradycardia. Focus on eating fresh, healthy, whole-foods such as fish, chicken, beans, vegetables, nuts, fruits, and whole grains.

Nonsurgical treatments for bradycardia

  • Changing or adjusting medications – Some medications, including those used to treat high blood pressure and other heart conditions, can cause your heart to beat too slowly. Your doctor will review the medications you are taking and may recommend different medications or lower doses of your current medications to treat your slow heart rate.
  • Treating other medical problems – Other medical problems, such as thyroid conditions or obstructive sleep apnea, can cause your heart to beat too slowly. In some cases, treating these underlying medical conditions may correct your slow heartbeat.

Surgery for bradycardia

If bradycardia is caused by a problem with your heart's conduction system, you may need an implantable device that produces electrical impulses, when needed, to control your heart rate.

Our physicians perform hundreds of surgical procedures each year to treat bradycardia and other irregular heart rhythms using implantable devices. Implantable devices include:

  • A pacemaker – A small battery-powered device that is permanently implanted under your skin. It sends electrical signals to start or regulate a slow heartbeat.
  • Implantable cardioverter defibrillator (ICD) – A small electronic device that is implanted under your skin to continuously monitor your heart's electrical activity. If an irregular heartbeat is detected, your ICD will send an electric impulse to your heart that will restore normal rhythm.

What happens during a pacemaker or ICD insertion procedure?

Pacemaker and ICD procedures are performed by a cardiologist called an electrophysiologist who specializes in heart rhythm disorders. You may be sedated or asleep during your procedure. Your doctor will:

  • Make a small incision in your collarbone.
  • Connect the device to your heart using small wires, called leads.
  • Test the leads to make sure they are working.
  • Attach the leads to a generator that is placed under the skin of your collarbone.

After your procedure, you will need to spend a night in the hospital to make sure your device is working properly. After you are discharged, you should be able to resume your normal activities in a few days. However, you should not drive until your doctor says it’s OK.

How effective is bradycardia treatment?

Your doctor will follow up with you to see how well you are responding to nonsurgical treatments. If nonsurgical treatment isn’t effective enough your doctor may recommend getting a pacemaker or ICD. These devices are more than 95 percent effective for treating abnormal heart rhythms.

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Why Choose UPMC for Bradycardia Care?

UPMC has one of the premier electrophysiology programs in Pennsylvania, and one of the largest in the United States. Our program offers:

  • A full range of diagnostic tests and treatment options for bradycardia.
  • Convenient subspecialty centers for evaluating and managing bradycardia and other heart rhythm disorders.
  • Pioneering research, including studies on novel ablation procedures for restoring normal heart rhythm.

Last reviewed by a UPMC medical professional on 2024-10-01.