Symptomatic Bradycardia and Pacemaker Treatment

Bradycardia means a heart rate that is slower than normal. For most adults, a normal resting heart rate is between 60 and 100 beats per minute. If the heart rate drops below 60 beats per minute and causes symptoms, it is called symptomatic bradycardia.

What Causes Bradycardia?

Bradycardia can occur for several reasons, including:

• Aging of the heart’s electrical system (the sinus node wears down)
• Heart disease such as coronary artery disease or heart attacks
• Medications (some blood pressure or rhythm drugs can slow the heart too much)
• Electrolyte or thyroid problems
• Sleep apnea

Symptoms of Bradycardia

Not everyone with a slow heart rate feels unwell. But when symptoms occur, they may include:

• Fatigue or weakness
• Dizziness or lightheadedness
• Shortness of breath
• Chest discomfort
• Confusion or difficulty concentrating
• Fainting (syncope)

When is Bradycardia Dangerous?

Bradycardia is most concerning when it causes:

• Repeated fainting spells
• Very low heart rates that don’t improve with rest
• Slow rhythms that do not allow the heart to respond to activity
• Severe fatigue that interferes with daily life

How is Symptomatic Bradycardia Treated?

1. Identifying the Cause

Doctors will check if a medication, low thyroid, or another reversible cause is slowing the heart. Sometimes, stopping or adjusting a medicine is enough.

2. Emergency Treatment

If bradycardia causes severe symptoms (like fainting or dangerously low blood pressure), temporary treatments may include:

• Medications such as atropine
• Temporary pacing (using pads or a wire to keep the heart rate up until a permanent solution is ready)

3. Permanent Pacemaker

If the heart’s natural pacemaker is not working properly and the slow rhythm is ongoing, the best treatment is often a pacemaker.

What is a Pacemaker?

A pacemaker is a small device placed under the skin, usually near the collarbone. It sends tiny electrical signals to the heart to keep the heart rate from going too slow.

• Leads (wires) carry the signal from the device to the heart muscle.
• Battery and computer inside the pacemaker control when signals are sent.
• Modern pacemakers are very reliable and can adjust the heart rate depending on activity.

Living with a Pacemaker

Most people return to normal activities within a few days after the procedure. Over time, patients may notice:

• More energy and less fatigue
• Fewer dizzy spells or fainting
• Improved exercise tolerance

Regular follow-ups are needed to check the device, but pacemakers usually last many years before the battery needs replacement.

Key Takeaway

Symptomatic bradycardia happens when the heart is too slow to meet the body’s needs. If it cannot be corrected with medications or other treatments, a pacemaker provides a safe and effective long-term solution. With a pacemaker, most people can live full and active lives.