Bradycardia: Slow Heart Rate

Your heart works hard to pump blood and oxygen throughout your body. Most of the time, it beats between 60 to 100 times per minute when you’re resting. But sometimes your heart rate can be too slow, a condition called bradycardia.

While bradycardia can be harmless, it can also be a sign of a serious heart issue. At Banner Health, we specialize in diagnosing and treating heart rhythm disorders like bradycardia. 

What is bradycardia?

Bradycardia is a type of arrhythmia, or irregular heartbeat, where your heart beats too slowly. Along with atrial fibrillation and tachycardia (when the heart beats too fast), bradycardia is one of the most common arrhythmias.

Your heart has its own electrical system that keeps it beating regularly. When this system does not work properly, the heart can beat too slowly. 

A normal resting heart rate for most adults is between 60 and 100 beats per minute (bpm). If your heart rate falls below 60 bpm, it is considered bradycardia. 

Some people, like elite athletes and physically active adults, naturally have a lower heart rate. But for others, bradycardia may indicate a heart problem. 

Causes of bradycardia

There are many reasons why you may have bradycardia. Some are harmless, while others may need treatment. 

• Heart problems: Conditions that affect the heart, such as heart attack, heart disease, myocarditis (inflammation of the heart muscle) or congenital heart disease (heart issues present at birth) can slow your heart rate.
• Medication side effects: Some medicines can slow the heart rate. This includes certain blood pressure medications, antiarrhythmic drugs and medicines used to treat mental health conditions.
• Sick sinus syndrome: When the sinus node, the heart’s natural pacemaker, doesn’t send regular electrical signals, the heart rate can slow down. This is common in older adults.
• Heart surgery: Complications from heart surgery can cause bradycardia. 
• Hypothyroidism: An underactive thyroid gland can slow down many body functions, including your heart rate.
• Infections: Certain infections and diseases can affect the heart and lead to bradycardia. These include Lyme disease, rheumatic fever and viral and bacterial infections like COVID-19, the flu and strep throat. 
• Electrolyte imbalance: Imbalances in minerals like potassium, calcium and sodium can affect your heart’s rhythm. 
• Sleep apnea (when breathing stops many times during sleep): This condition disrupts oxygen flow to the body, which can slow your heart rate.
• High fitness levels: Athletes and very active individuals often have lower heart rates because their hearts pump blood more efficiently. However, this doesn’t affect them because their body’s needs are still met. 

Risk factors for bradycardia

Some factors increase your chances of developing bradycardia, including:

• A history of heart attacks, heart surgery or heart disease
• Being over age 65
• High blood pressure
• High cholesterol
• Smoking
• Drinking too much alcohol
• Stress and anxiety

Symptoms of bradycardia

Not everyone with bradycardia will have symptoms. But if your heart rate is too slow, you might notice some of the following signs:

• Dizziness or lightheadedness
• Fainting or near-fainting (syncope)
• Shortness of breath
• Feeling weak or fatigued
• Chest pain
• Memory problems or confusion
• Tiring easily after exercise

If you experience any of these symptoms, it’s important to get checked by your health care provider or a Banner Health specialist. Bradycardia can be serious if it prevents your body from getting enough oxygen. 

How is bradycardia diagnosed?

To figure out if you have bradycardia, your health care provider will ask about your symptoms and health history. They may also use the following tests to diagnose this condition:

• Physical exam: Your provider will check your heart rate and blood pressure. They may listen to your heart with a stethoscope to hear if there are any problems.
• Electrocardiogram (ECG or EKG): This test measures the electrical activity of your heart. It helps your provider see if your heart is beating too slowly.
• Holter monitor or event monitor: If your provider thinks your heart rate changes during the day, they may ask you to wear a small device that monitors your heart rhythm for 24 hours or longer.
• Echocardiogram: An echocardiogram uses sound waves to create an image of the heart. This test can show any heart damage or problems with blood flow. 
• Blood tests: Lab work can help identify any underlying conditions that may be causing bradycardia.

Treatment for bradycardia

The goal of treatment is to raise your heart rate and relieve symptoms. How bradycardia is treated will depend on the cause and how severe your symptoms are. Some cases don’t need treatment, while others do. 

Here are some treatment options:

• Adjust medications: If a medication is causing bradycardia, your provider may adjust your dose or change to a different medicine. 
• Treat underlying conditions: If bradycardia is caused by a medical problem such as heart disease, an electrolyte imbalance or hypothyroidism, treating the cause can often help fix a slow heart rate.
• Make lifestyle changes: Heart-healthy habits like quitting smoking, reducing alcohol intake, increasing exercise and following a healthy diet can help.
• Implant a pacemaker: A pacemaker may be needed if the heart’s electrical system isn’t working well. A pacemaker is a small device that helps control your heart rate by sending electrical signals to the heart. It is surgically implanted (placed inside the body) and attached to the heart. 

Complications of bradycardia

Bradycardia can lead to serious problems if left untreated for too long. A slow heart rate means the body may not get enough oxygen, which can cause weakness, tiredness and dizziness.

You might faint or feel like you are going to faint. This can lead to falls or injuries. Over time, bradycardia can strain your heart and lead to heart failure. This happens when your heart cannot pump enough blood for your body.

In some cases, bradycardia can cause sudden cardiac arrest. This is when your heart stops beating, and it is life-threatening. Low blood flow to the brain can also make you feel confused or have trouble thinking clearly.

Getting treatment for bradycardia can help prevent these problems. If you have symptoms, talk to your health care provider right away.

Living with bradycardia

Living with bradycardia can seem challenging, but you can manage it and stay active with the proper care. Here are some tips to help:

• Follow your provider’s advice: Stick to your treatment plan and attend regular check-ups. These visits help monitor your heart.
• Watch for symptoms: Keep track of how you feel. If you notice dizziness, fainting, chest pain or other new symptoms, contact your health care provider right away.
• Practice healthy habits: Eat a heart-healthy diet, exercise and avoid smoking or drinking too much alcohol. These steps support your heart and overall health.
• Care for your pacemaker: If you have a pacemaker, follow your provider’s instructions to keep it working properly. Avoid strong magnets or electronic devices that could interfere with it.
• Find support: Talk to family, friends or a support group. Sharing your experiences with others can help you manage your condition.

Bradycardia doesn’t have to stop you from living a full life. You can continue doing what you enjoy while protecting your heart.

Banner Health: At the heart of your healthy life

At Banner Health, we’re dedicated to helping you understand and manage bradycardia. Our expert team of cardiologists and specialists can help diagnose and treat heart conditions. Whether you need tests, medication or a pacemaker, we provide the care you need to feel better.

If you or a loved one are experiencing symptoms of bradycardia, contact us. We’re here to help you get the care you deserve.