Understanding Low Heart Rate (Bradycardia)

Introduction

A low heart rate, also called bradycardia , is when the heart beats fewer than 60 times per minute. While this may be normal for some individuals, such as athletes, in others it may indicate an underlying health issue.

Signs and Symptoms

• Fatigue and weakness
• Dizziness or lightheadedness
• Shortness of breath
• Chest pain (rare but serious)
• Fainting (syncope)
• Confusion or difficulty concentrating

Causes of Bradycardia

Several factors can lead to a low heart rate, including: 1. Aging – The heart's electrical system may slow down over time. 2. Heart disease – Conditions such as coronary artery disease or heart attack can affect electrical signals. 3. Medications – Beta-blockers, calcium channel blockers, and some antidepressants can lower heart rate. 4. Hypothyroidism – An underactive thyroid gland can slow metabolism and heart rate. 5. Electrolyte imbalances – Low potassium or calcium levels can interfere with heart activity. 6. Sleep Apnea – Disruptions in breathing during sleep can affect heart rhythm. 7. Infections & Inflammatory Diseases – Certain conditions like Lyme disease or lupus can impact the heart.

Diagnosis and Treatment

Doctors diagnose bradycardia through: - Electrocardiogram (ECG/EKG) – To check heart rhythm. - Holter monitoring – A device that records heart activity over 24-48 hours. - Blood tests – To assess thyroid function and electrolyte levels. - Echocardiogram – To evaluate heart structure and function.

Treatment Depends on the Cause:

• If no symptoms and no underlying disease → No treatment needed.
• If medication is the cause → Adjusting or changing medication.
• If bradycardia results from heart disease → Pacemaker may be required.

When to Seek Medical Help?

Seek immediate care if you experience: - Severe dizziness or fainting spells. - Chest pain with slow heart rate. - Severe shortness of breath. - Confusion or sudden weakness.

Keeping a healthy lifestyle with regular check-ups, balanced diet, and physical activity helps prevent complications related to bradycardia.

Source recommendations

1. American College of Cardiology/American Heart Association Guidelines on the Management of Bradycardia

1. https://pubmed.ncbi.nlm.nih.gov/30412710/
2. https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2018/11/05/15/12/2018-acc-aha-hrs-guideline-on-bradycardia
3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000628
4. https://www.jacc.org/guidelines/bradycardia
5. https://www.thecardiologyadvisor.com/news/acc-aha-hrs-release-updated-bradycardia-diagnosis-and-management-guidelines/

2. European Society of Cardiology (ESC) Guidelines for Cardiac Pacing and Resynchronization Therapy

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiac-Pacing-and-Cardiac-Resynchronization-Therapy
2. https://academic.oup.com/eurheartj/article/42/35/3427/6358547
3. https://pubmed.ncbi.nlm.nih.gov/34455430/
4. https://academic.oup.com/eurheartj/article/34/29/2281/401445
5. https://pubmed.ncbi.nlm.nih.gov/23801827/