Heart
Bradycardia
An abnormally slow heart rate of fewer than 60 beats per minute, which can cause fainting or fatigue.
Bradycardia is a heart rate below 60 beats per minute that — when symptomatic or due to conduction disease — requires specialist evaluation and may need pacemaker implantation to maintain adequate heart function.
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Bradycardia signifies an abnormally slow heart rate, which may fail to pump enough oxygen-rich blood to the body during exertion.
Types & Causes
- Sinus node dysfunction (sick sinus syndrome), including tachy-brady syndrome
- Atrioventricular (AV) block: first, second, and third degree
- Reversible causes: hypothyroidism, electrolyte imbalances, medications, Lyme disease
Symptoms
- Fatigue and reduced exercise tolerance
- Breathlessness
- Lightheadedness and fainting
- Cognitive difficulties
- Chronotropic incompetence: heart rate fails to rise appropriately during physical activity
Diagnosis
- 12-lead ECG
- Holter monitoring (24–48 hours)
- Exercise stress testing
- Echocardiography
- Blood work and medication review
- Electrophysiology study when needed
Treatment Options
- Correcting reversible causes first
- Permanent pacemaker implantation for symptomatic cases
- Leadless pacemakers for high-infection-risk patients
- Advanced pacing modalities preserving natural heart rhythm
Concerned About Bradycardia?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.