What is bradycardia?

Bradycardia is a slower than normal heart rate.

A normal adult resting heart rate is generally between 60 and 100 beats per minute (bpm). If you have bradycardia, your heart rate is less than 60bpm.

Depending on the cause, bradycardia can last a short time or a long time.

Bradycardia (a heart rate of 40 to 60bpm) can be normal if:

• you're sleeping or resting
• you are a young, healthy adult
• you're very physically fit

You may notice your heart rate is slower than normal if you have a wearable device that measures your heart rate.

Bradycardia can sometimes be a sign of problems with your heart.

What are the symptoms of bradycardia?

If you have any of these symptoms and you have a slow heart rate, you should see a doctor straight away or go to your nearest emergency department.

Symptoms of bradycardia can include:

• feeling faint, lightheaded or dizzy
• shortness of breath when moving or exercising
• feeling tired or weak

Sometimes bradycardia can lead to:

• low blood pressure
• fainting
• angina or chest pain
• confusion or loss of consciousness

Some people have no symptoms of bradycardia.

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What causes bradycardia?

Bradycardia is normal for some people, especially if you're extremely fit.

Bradycardia can also be caused by:

• damage to your heart from conditions such as a heart attack or cardiomyopathy
• hypothyroidism (when your thyroid gland doesn't make enough thyroid hormone)
• an electrolyte (salt) imbalance in your blood
• a congenital heart defect (heart disorder present at birth)
• some medicines
• sleep apnoea

When should I see my doctor?

See a doctor straight away or go to your nearest emergency department if you have chest pain, confusion or loss of consciousness.

If you have a pulse rate that is less than 60bpm and have any symptoms, see your doctor. It might help to note the times you notice your heart is beating slowly, and how you're feeling at the time.

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How is bradycardia diagnosed?

Your doctor will ask you about your symptoms and your medical and family history. They will want to know if anything brings on your symptoms or makes them better. They will ask about your lifestyle and any medicines you are taking.

Your doctor will examine you and measure your pulse rate. They may also listen to your heart.

Tests that may be recommended include:

• an electrocardiogram (ECG)
• a heart monitoring device that records your heart rate at home
• blood tests

Your doctor may refer you to a cardiologist (heart specialist) for more tests and treatment.

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How is bradycardia treated?

Your treatment will depend on the cause of your bradycardia. If you have no symptoms, you may not need any treatment.

Treatment for any underlying conditions, such as hypothyroidism, can help restore a normal heart rate.

Your doctor may recommend stopping or changing your medicines if they are affecting your heart rate. But do not change your regular medicines without talking to your doctor first.

Urgent treatment for bradycardia

If you have a sudden episode of bradycardia with severe symptoms, you will need urgent treatment.

This treatment may be with medicines or a temporary pacemaker to stabilise your heart rate.

Ongoing treatment for bradycardia

Some people with bradycardia need ongoing treatment with an implantable device, such as a pacemaker or defibrillator.

Devices to stabilise your heart rate can be implanted as a day procedure. Sometimes you may need to stay overnight in hospital. You don't usually need to have a general anaesthetic.

You may need to limit your activities for a few weeks after the procedure. Your doctor will give you information on:

• what happens during the procedure
• the risks and benefits of the procedure and having a pacemaker or other device
• your activities after the procedure, including driving, travel and exercise
• follow-up appointments

What are the complications of bradycardia?

Complications of bradycardia can include:

• fainting
• heart failure
• other heart arrhythmias (abnormal heartbeats)

Can bradycardia be prevented?

There are no specific things you can do to prevent having bradycardia.

If you have been diagnosed with bradycardia, it's important to have regular follow-up with your doctor or specialist. Make sure to report any symptoms you notice.

Resources and support

The Heart Foundation has information and support for people with heart disease, including bradycardia.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.