Bradycardia Study

heart rhythm

Sinus Bradycardia is a heart rhythm that is organized and originates from the Sinus Atrial (SA)node.  However the heart rate is slow.  Sinus Brady is known as a heart less than 60 beats per minute (bpm). Using an EKG Strip (6 sec. strip), counting the R points and multiplying by 10 we quickly derive a heart rate of 40 beats per minute, using the strip above. For your AHA ACLS course Bradycardia is applied when a heart rate is less than 50 beats per minute.  

Identify: 

Heart Rate: less than 50/min

Rhythm: Normal Heart Conduction - slow rate

P wave: present for each QRS

QRS Complex: Normal

ST segment: Normal

Check the Patient:

  • Level of Consciousness (Can be fine or Symptomatic)
  • Hypotension (Systolic Less than 90mmHg.)
  • Chest Discomfort or Shortness of Breath
  • Saturation: less than 92% 
  • HR less than 50/ Bradycardia is present

Initial Steps: 

  • Consider Oxygenation
  • Monitor and Continue Observing
  • Obtain IV/IO Access
  • Consider Reversible Causes - H's & T's 
  • Consult Physicians 
Determine Stability

Stable Treatment Plan

  • Oxygenation
  • Drugs
    • Atropine 1mg
    • Max Dose 3mg
  • Reversible Causes

Unstable Treatment Plan 

  • Pacing

Causes: 

  • Chest trauma                                                            
  • Ischemic heart disease
  • Acute myocardial infarction
  • Acute and chronic coronary artery disease
  • Repair of congenital heart disease
  • Sick sinus syndrome
  • Radiation therapy
  • Amyloidosis
  • Pericarditis
  • Lyme disease
  • Rheumatic fever
  • Collagen vascular disease
  • Myocarditis
  • Neuromuscular disorder
  • X-linked muscular dystrophy
  • Familial disorder
  • Inherited channelopathy


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