Bradycardia
Your heart is a remarkable engine. At rest, it typically beats 60 to 100 times per minute. But when that number dips below 60, especially during waking hours, we call it bradycardia—a slow heart rate.
Continuous ECG monitoring helps track heart rhythm
When the Heart Slows Down: Understanding Bradycardia and How to Take Control
It often starts subtly—feeling unusually tired after a walk, struggling to stay awake at work, or experiencing that strange lightheaded sensation when standing too quickly. For some, it’s a passing moment. But for others, it’s the first sign that the heart may be beating too slowly.
What Is Bradycardia?
Your heart is a remarkable engine. At rest, it typically beats 60 to 100 times per minute. But when that number dips below 60, especially during waking hours, we call it bradycardia—a slow heart rate.
Sometimes, bradycardia is perfectly normal. Elite athletes often have resting heart rates in the 40s or 50s because their hearts are so efficient. But when the sinus node—the heart’s built-in pacemaker—slows down too much or fails to transmit electrical signals correctly, it can limit blood flow to vital organs, including your brain. That’s when symptoms begin to appear.
Symptoms: Listening to Your Body’s Signals
Not everyone with bradycardia feels unwell. But when your heart can’t pump enough oxygen-rich blood, you may notice:
- Persistent fatigue or low energy
- Dizziness or feeling lightheaded
- Chest discomfort or palpitations
- Shortness of breath during mild activity
- Fainting or near-fainting spells
- Memory fog or poor concentration
If you’ve experienced these symptoms, especially if they come on suddenly or worsen over time, don’t ignore them. Your heart may be trying to tell you something important.
What Causes Bradycardia?
Bradycardia isn’t a one-size-fits-all condition. It can stem from multiple sources:
1. Age and Heart Disease
As we age, the heart’s conduction system can deteriorate. Coronary artery disease or prior heart attacks may also damage the heart’s electrical pathways.
2. Electrical Conduction Issues
Conditions like heart block or sick sinus syndrome prevent the heart’s chambers from syncing properly, leading to irregular or slowed beats.
3. Underlying Medical Conditions
- Hypothyroidism
- Sleep apnea
- Lyme disease, rheumatic fever, or other infections
4. Medication Side Effects
Some heart medications—especially beta blockers, calcium channel blockers, and anti-arrhythmics—can cause the heart to slow down too much.
5. Alcohol and Drug Use
Heavy alcohol use or recreational drugs may interfere with your heart’s rhythm and should be evaluated.
Risk Factors to Know
You may be at greater risk of developing bradycardia if you have:
- A history of heart surgery or congenital heart defects
- Past heart attacks
- Chronic conditions like high blood pressure
- Sedentary lifestyle or poor dietary habits
How Bradycardia Is Diagnosed
When I see a patient for possible bradycardia, I start with a detailed evaluation that may include:
- Physical Exam: Checking pulse, blood pressure, and medical history
- Electrocardiogram (ECG): Captures the heart’s electrical activity in real time
- Exercise Stress Test: Reveals how your heart responds to physical exertion
- Tilt Table Test: Helpful for those with fainting episodes
- Blood Tests: Rule out thyroid issues, infections, and electrolyte imbalances
Treatment: Restoring Rhythm and Quality of Life
Treatment depends on the cause and how much bradycardia is affecting your life.
1. Lifestyle Adjustments
Heart-healthy living is foundational. This includes:
- A balanced, low-sodium diet
- Regular, moderate exercise
- Avoiding alcohol and recreational drugs
- Managing stress and sleep
2. Medication Review
If medications are the culprit, your doctor may reduce the dosage or switch to an alternative.
3. Addressing Root Causes
Treating conditions like sleep apnea or thyroid disorders can often improve your heart rate naturally.
4. Pacemaker Implantation
For severe or persistent bradycardia, a pacemaker may be the best solution. This small device helps regulate your heartbeat, improving both symptoms and safety.
Living Well with Bradycardia
A diagnosis of bradycardia doesn’t mean giving up your lifestyle. In fact, most people—once properly diagnosed and treated—go on to live full, active lives.
Here's how you can stay on track:
- Monitor your heart rate regularly
- Keep your follow-up appointments
- Report new symptoms early
- Stay active, eat well, and sleep soundly
- Avoid known triggers like extreme stress or stimulants