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.
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
Changes in the heart that are the result of
short of breath and find it harder to exercise.
Have chest pain or a feeling that your heart is pounding or
Feel confused or have trouble
Faint, if a slow heart rate causes a drop in blood
Some people don't have symptoms, or their symptoms are so
mild that they think they are just part of getting older.
find out how fast your heart is beating by
taking your pulse. If your heartbeat is slow or uneven, talk to your
How is bradycardia diagnosed?
Your doctor may be
able to diagnose bradycardia by doing a physical exam, asking questions about
your past health, and doing an
electrocardiogram (EKG or ECG). An EKG measures the
electrical signals that control heart rhythm.
But 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.
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
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 improve your heart health will usually improve your overall health.
The best steps you can take are to:
Control your cholesterol and blood
Eat a low-fat, low-salt diet.
exercise. Your doctor can tell you what level of exercise is safe for you.
Quit smoking, if you smoke.
Get emergency help if you fainted or if you have chest pains 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.
People who get pacemakers need to be careful around
strong magnetic or electrical fields, such as MRI machines or magnetic wands
used at airports. If you get a pacemaker, your doctor will give you information
about the type you have and what precautions to take.
For example, 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 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.
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
Heart Rhythm Society
1400 K Street NW
Washington, DC 20005
The Heart Rhythm Society provides information for
patients and the public about heart rhythm problems. The website includes a
section that focuses on patient information. This information includes causes,
prevention, tests, treatment, and patient stories about heart rhythm problems.
You can use the Find a Specialist section of the website to search for a heart
rhythm specialist practicing in your area.
National Heart, Lung, and Blood Institute
P.O. Box 30105
Bethesda, MD 20824-0105
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Diseases affecting the heart and circulation, such as heart
attacks, high cholesterol, high blood pressure, peripheral artery disease, and
heart problems present at birth (congenital heart diseases).
Diseases that affect the lungs, such as asthma, chronic
obstructive pulmonary disease (COPD), emphysema, sleep apnea, and
Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.
Akoum NW, et al. (2008). Pacemaker therapy. In EG Nabel, ed., ACP Medicine, section 1, chap. 7. Hamilton, ON: BC Decker.
Olgin J, Zipes DP (2012). Bradyarrhythmias section of Specific arrhythmias: Diagnosis and treatment. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 813–824. 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.
Primary Medical Reviewer
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
How this information was developed to help you make better health decisions.