What are the symptoms of bradycardia?
For many people, bradycardia doesn’t cause any symptoms. This is especially true for people who are very physically active and have bradycardia because their hearts are more efficient. For people whose hearts can’t or don’t compensate, the symptoms tend to cause the following:
These symptoms happen because of how bradycardia affects your heart and your brain.
Brain
The average human brain weighs about 3 pounds — about 1.6% of the total weight of a 180-pound person. Despite its small size, the brain gets between 15% and 20% of the blood that comes out of your heart. If there isn’t enough blood flow, that affects your brain function.
Heart
Bradycardia symptoms often look a lot like the symptoms of heart failure. Bradycardia can also look like angina, which is chest pain or pressure that’s a warning sign of heart disease.
How is bradycardia treated, and is it curable?
If you have bradycardia but don’t have any symptoms, it’s unlikely that you need treatment. For those who do have symptoms, bradycardia is almost always treatable and is sometimes curable. If you have bradycardia because of another medical condition, sometimes treating that condition is all it takes to stop your bradycardia. An example of this is when you have bradycardia because of a medication you’re taking.
What medications/treatments are used?
There are two primary ways to treat bradycardia.
Medication
If bradycardia is causing significant problems such as dangerously low blood pressure, an intravenous (IV) or injectable medication such as atropine can cause your heart to beat faster. Treatments like this are usually hospital-specific because people receiving these medications may need monitoring and additional care.
You can also take medications daily by mouth to help improve your heart function, including how strongly your heart beats or your heart rate.
Temporary pacing
This involves a device with electrical contacts that touch or attach to the skin of your chest. These contacts allow a mild electrical current to enter your body and cause your heart to beat. For people who need a permanent pacemaker or whose bradycardia will likely be short-lived, temporary cardiac pacing is an effective short-term treatment.
Permanent pacemaker
For many people with bradycardia, a permanent pacemaker is the best way to treat this condition. This is especially effective with conditions like sick sinus syndrome, where your heart’s natural pacemaker cells aren’t working properly.
While a permanent pacemaker can’t cure this condition entirely, it can be a long-term solution that treats this condition and keeps it from being a problem. Most pacemakers can last for several years, and some have batteries that can last more than a decade.
Receiving a permanent pacemaker usually involves surgery to implant the pacemaker device, which will deliver electrical pulses to your heart muscle. During this procedure, an electrophysiologist or surgeon will make a small pouch underneath your skin where your pacemaker will go. They’ll then place and connect wires (sometimes called leads) to various points on your heart.
For some people, surgery to implant a pacemaker is potentially avoidable. That’s because there are newer leadless pacemakers for bradyarrhythmias that are implantable using a catheter-based procedure. This procedure involves using a tube-like catheter device that a doctor inserts through an incision made into a major blood vessel. The provider can then steer the catheter up to and into your heart, where they can implant the pacemaker directly inside. These devices are very small (not much bigger than a large multivitamin pill), and you can go home much sooner than you would with surgery.
What are the possible complications or side effects of bradycardia or the potential treatments?
Complications from bradycardia are more likely to happen when this condition goes too long without treatment. That’s why a timely diagnosis and prompt treatment are so important.
The side effects or complications that are possible from medication vary widely based on what drugs you receive or the drugs you're already taking. Your healthcare provider is the best person to answer this question because they can tailor their answer to meet your specific situation, needs and circumstances.
How to take care of myself or manage symptoms?
Bradycardia is not a condition you should attempt to care for on your own without help from a healthcare provider. If you suspect you have it, you should see your provider (and sooner is better than later).
How soon after treatment will I feel better?
If you receive treatment for bradycardia, you should begin to feel better as that treatment happens. Many medications that treat this condition start to work quickly (especially IV medications). If you need a pacemaker, your symptoms should get better immediately after surgery, and you should feel better overall as you recover from the procedure.
Most people will recover from a pacemaker implantation procedure within a few weeks. However, your healthcare provider is the best person to tell you more about what you should expect and how long it will probably take for you to recover.
How is it diagnosed?
A doctor can diagnose bradycardia based on a combination of a physical exam and tests that measure your heart rate and analyze your heart rhythm.
What tests will be done to diagnose this condition?
The most likely tests for bradycardia include:
- Physical examination. A physical examination involves a healthcare provider looking at your body for any visible signs of conditions or problems. They may also feel any affected areas, as some problems cause changes that you can feel but not see.
- Electrocardiogram (ECG or EKG). This test is essential for diagnosing bradycardia because it can track your heart’s electrical activity very precisely. This test uses several sensors (usually 12 of them) called electrodes that stick to the skin of your chest. The electrodes can detect the electrical activity in your heart and show it as a wave on either a paper printout or a computer screen.
Lab tests are also possible for bradycardia, most of which can help rule out other problems. These tests include:
- Electrolyte levels: These tests measure the levels of electrolytes in your blood, especially calcium, potassium and magnesium.
- Thyroid hormone levels: Hypothyroidism (low thyroid function) can cause bradycardia.
- Troponin: Your heart muscle’s cells contain a specific type of troponin, a protein. Damage to those cells causes troponin to leak into your blood, which can indicate damage to your heart. Troponin is a key indicator that providers use to diagnose heart attacks.
- Toxicology screen. This test looks for toxic substances in your blood. This test can identify drugs (prescription or recreational) that can cause bradycardia, as well as other heart-damaging substances.
Other tests are possible if you have bradycardia, but many of these are only necessary if healthcare providers suspect you have another condition or problem. Your healthcare provider is the best person to explain the additional tests they recommend running and why.
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