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Bradycardia is a heart rate that’s too slow. What’s considered too slow can depend on your age and physical condition. Elderly people, for example, are more prone to bradycardia.

A resting heart rate of fewer than 60 beats per minute (BPM) can be called bradycardia for adults. But there are exceptions. Your heart rate may fall below 60 BPM during deep sleep. And physically active adults (and athletes) are so fit that they often have a resting heart rate slower than 60 BPM.

Bradycardia can be a serious problem if the heart doesn't pump enough oxygen-rich blood to the body. For some people, however, bradycardia doesn't cause symptoms or complications.

What happens once you have bradycardia?

A heart rate that’s too slow can cause insufficient blood flow to the brain. Symptoms of bradycardia include:

  • Confusion.
  • Shortness of breath.
  • Fatigue or feeling weak.
  • Dizziness or lightheadedness.
  • Difficulty when exercising.
  • Fainting (or near-fainting) spells.
  • Cardiac arrest (in extreme cases).

Left untreated, severe or prolonged bradycardia can cause:

  • Heart failure.
  • Fainting (syncope).
  • Chest pain (angina pectoris).
  • Low blood pressure (hypotension).
  • High blood pressure (hypertension).

What causes bradycardia?

Causes of bradycardia include:

  • Problems with the sinoatrial (SA) node, sometimes called the heart’s natural pacemaker.

  • Problems in the conduction pathways of the heart that don’t allow electrical impulses to pass properly from the atria to the ventricles.

  • Metabolic problems such as hypothyroidism (low thyroid hormone).

  • A number of medications, including some to treat other heart conditions, can cause bradycardia.

  • Damage to the heart from heart disease or heart attack.

  • Certain heart medications that slow the heart beat as a side effect.

What types of tests are used to diagnosis bradycardia?

To diagnose your condition, your doctor will also order tests.

An electrocardiogram also called an EKG, is a primary tool for evaluating bradycardia. Small sensors (electrodes) attached to your chest and arms record electrical signals as they travel through your heart.

Your doctor might use an EKG monitor while performing these tests:

  • Tilt table test: This test helps your doctor better understand how your bradycardia contributes to fainting spells.

  • Exercise stress test: Your doctor might monitor your heart rate while you walk on a treadmill or ride a stationary bike to see whether your heart rate increases appropriately.

Your doctor might also have you measure your heart rate at home. These methods include:

  • Holter monitor: Carried in your pocket or worn on a belt or shoulder strap, this device records your heart's activity for 24 to 48 hours.

  • Diary: Your doctor might ask you to keep a diary during the same 24 hours. You'll describe any symptoms you experience.

  • Event recorder: This device monitors your heart activity over a few weeks. You push a button to activate it when you feel symptoms.

Your doctor may also order blood tests to screen for conditions that might be contributing to bradycardia, such as an infection, hypothyroidism, or an electrolyte imbalance.

If sleep apnea is suspected of contributing to bradycardia, you might undergo tests to monitor your sleep.

What types of treatments and procedures are used to treat bradycardia?

Treatment for bradycardia depends on the type of electrical conduction problem, the severity of symptoms, and the cause of your slow heart rate. If you have no symptoms, treatment might not be necessary.

If a disorder such as hypothyroidism or obstructive sleep apnea is causing bradycardia, your doctor will need to treat the disorder to correct your heart rate.

When other treatments aren't possible, a pacemaker may be necessary. This device is implanted under your collarbone. It monitors your heart rate and generates electrical impulses as necessary to maintain an appropriate rate.

What can I do to support my health when I have bradycardia?

There are steps you can take to lower your risk of developing bradycardia or any heart rhythm disorder:

  • Follow the plan: Be sure you understand your treatment plan and take all medications as prescribed.

  • Report changes immediately: If your symptoms change or worsen or develop new symptoms, tell your doctor immediately.

Lifestyle changes are also important ways to improve the outlook of a person with bradycardia. 

Lifestyle changes you can make to improve your heart health include:

  • Reduce salt in your diet.
  • Maintain a healthy body weight.
  • Never smoke, or stop smoking.
  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.
  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.
  • If you have diabetes, work closely with your doctor to make sure it is controlled.
  • Get at least 150 minutes of moderate to intense physical exercise every week.

Why choose Presbyterian for bradycardia treatment?

Presbyterian’s Heart and Vascular team has many different options to help you manage your heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans for your heart health needs. Depending on the type of heart condition you have and its underlying cause, the team can recommend a wide variety of treatment options, including lifestyle modifications, medications, and procedures. Our cardiologists and cardiovascular surgeons work closely together for cases in which surgery is the best treatment option. We also offer a customized cardiac rehabilitation program at our Healthplex, where clinically appropriate, which can improve your endurance and exercise tolerance, as well as improve heart-related symptoms. Your cardiologist will work with the rehabilitation team to create a plan that will be tailored to your individual health needs.