Key Points about sinus bradycardia 

  • Sinus bradycardia is a slow heart rate (typically under 60 beats per minute) caused by slow electrical signals from the sinus node. 
  • It can be normal in athletes or during sleep but may also signal an underlying heart condition if symptoms occur. 
  • Causes include heart disease, thyroid problems and medications like beta-blockers. 
  • Diagnosis involves an ECG, Holter monitor and blood tests. 
  • Treatment depends on the severity of symptoms and may include medication or a pacemaker, if necessary.
Common related conditions
Atrial Tachycardia Bradycardia Arrhythmia Arrhythmias Sinus Tachycardia

Sinus bradycardia causes 

Sinus bradycardia may be caused by: 

  • Heart conditions, like coronary artery disease, heart attacks or heart failure. 
  • An overactive vagus nerve, which naturally slows the heart rate. 
  • Hypothyroidism (underactive thyroid). 
  • Electrolyte imbalances, particularly if you have high potassium levels. 
  • Medications, like beta-blockers, calcium channel blockers or digoxin (which slow the heart rate). 

Sinus bradycardia risk factors 

The following factors may increase your risk for sinus bradycardia: 

  • Older age, as the heart’s conduction system can slow over time. 
  • A history of heart disease, including previous heart attacks or heart failure. 
  • Use of medications that affect heart rhythm, including beta-blockers and digitalis. 
  • Hormonal imbalances like hypothyroidism. 
  • Being an athlete or having high physical fitness, which naturally results in a lower heart rate. 

Sinus bradycardia symptoms 

Symptoms of sinus bradycardia include: 

  • Fatigue or general weakness. 
  • Dizziness or lightheadedness, especially when standing up. 
  • Shortness of breath or difficulty during physical activity. 
  • Fainting or near-fainting episodes (syncope). 
  • Chest discomfort in some cases, particularly with exercise or exertion. 

Sinus bradycardia diagnosis 

Doctors diagnose sinus bradycardia through: 

  • Electrocardiogram (ECG or EKG) to measure the heart rate and rhythm. 
  • Blood tests or blood panels to check for an electrolyte imbalance or any thyroid disorders. 
  • A Holter monitor to record heart activity over 24-48 hours, capturing any random episodes. 
  • A stress test to evaluate heart function under physical exertion. 

Sinus Bradycardia Treatment 

Treatment options for sinus bradycardia depend on its severity and underlying causes: 

  • No treatment may be needed if the condition is asymptomatic or due to physical fitness. 
  • Medications, such as thyroid hormone replacement for hypothyroidism, may be prescribed. 
  • In severe cases with symptoms, a pacemaker may be implanted to regulate the heart rate. 
  • Adjusting medications that may be causing the bradycardia can also be effective. 

When to Seek Care 

You should seek medical attention if you experience: 

  • Symptoms like dizziness, fainting or difficulty breathing. 
  • A sudden or unexplained decrease in heart rate, especially with chest pain or discomfort. 
  • Fatigue or weakness that interferes with daily activities or exercise. 
  • Any irregular heart rhythms or palpitations. 

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