Bradycardia
What is Bradycardia?
Bradycardia is a condition characterized by an abnormal or slow heart rate that is less than 60 beats per minute. A low heart rate may be normal for some people such as athletes and is usually not a problem if not accompanied by other symptoms. If the heart as a result is not able to pump enough oxygenated blood throughout the body, you may experience symptoms and should see a doctor.
Causes of Bradycardia
Heart contractions and heartbeats occur due to electrical impulses that are generated in the sinoatrial or SA node, the natural pacemaker of the heart. These impulses pass to the atria (upper chambers of the heart) causing them to contract and push blood into the ventricles (lower chambers of the heart). They then reach the atrioventricular or AV node that is present between the atria and ventricles from where they pass through a network of fibers called the Purkinje network resulting in the contraction of the ventricles pushing the blood out to the lungs and aorta to different parts of the body. Bradycardia is mainly caused due to the disruption of impulses from structural damage of the heart due to aging or heart disease. It may be associated with:
- Congenital heart disease
- Myocarditis
- Pericarditis
- Hypothyroidism
- Valvular heart disease
- Rheumatic fever
- Certain medications
- Heart block (blockage of electrical impulses at the AV node)
- Increased blood pressure
- Abnormal level of electrolytes in the blood
- Obstructive sleep apnea
- Inflammatory disease
Symptoms of Bradycardia
The most common symptom of bradycardia is a slow heart rate and other symptoms include:
- Breathing difficulty
- Weakness
- Chest pain
- Heart palpitations
- Fatigue
- Dizziness
- Lightheadedness
- Confusion
Diagnosis of Bradycardia
Your doctor will review your medical history and symptoms and based on this a physical examination will be performed during which your doctor will listen to your heart with a stethoscope and determine your heart rate. Your doctor may also recommend the following diagnostic tests:
- Electrocardiogram (ECG): This test records the electrical activity of your heart.
- Echocardiogram: This test helps to view the heart’s size, structure, and motion using sound waves.
- Holter monitor: Also known as 24-hour ambulatory ECG, this test measures your heart’s electrical activity for 24 to 48 hours while you perform your daily routine.
- Cardiac or treadmill stress test: This test is performed to determine the effects of exercise on the heart. It records the heart’s electrical activity while you run on a treadmill.
- Blood Test: This test helps to determine the levels of cholesterol, thyroid dysfunction, and presence of any infection.
Treatment for Bradycardia
Treatment for bradycardia may vary based on its root cause. If the slow heart rate is temporary and no other associated symptoms or conditions are present, you may not require treatment. Some of the common treatment measures include:
- Medications: Your doctor may prescribe medications to treat certain conditions associated with bradycardia. Those taking beta-blockers for hypertension may experience bradycardia and may need to have their dose adjusted. Medication for a thyroid condition can help if you have bradycardia.
- Lifestyle modifications: Your doctor will recommend
- Consuming a low-fat diet
- Regular exercise
- Regular health check-ups
- Avoiding smoking
- Regular monitoring of blood pressure
If your symptoms are severe and conservative methods fail to treat the bradycardia, surgery will be recommended which includes:
- Pacemaker Implantation: The pacemaker device includes a small battery-operated pulse generator that recognizes an abnormal heart rhythm and responds by sending electrical pulses to stimulate the heart and produce a normal rhythm.
- Implantable Cardioverter Defibrillator (ICD): This is a small electronic device that is implanted in the chest or under the skin to control the abnormal heart rhythm and prevent sudden cardiac arrest.
Prevention from Bradycardia
Preventive measures for bradycardia and heart disease in general include:
- Manage stress
- Eat healthy food
- Exercise regularly
- Control blood pressure and cholesterol
- Maintain healthy weight
- Quit smoking
- Avoid consumption of alcohol
