Bradyarrhythmia: Difference between revisions
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'''Bradyarrhythmias''' are arrhythmias characterised by bradycardia, a heart rate < 60/min. The most common examples are [[sinus bradycardia]] and [[sick sinus syndrome]]. | <section begin="A&IC" />'''Bradyarrhythmias''' are arrhythmias characterised by bradycardia, a ventricular heart rate < 60/min. The most common examples are [[sinus bradycardia]] and [[sick sinus syndrome]]. Bradyarrhythmias can be life-threatening if the heart rate is too low to sustain cardiac output. They can also degenerate into [[asystole]], causing [[cardiac arrest]]. Short-lived paroxysmal bradyarrhythmias can cause [[syncope]]. | ||
== Types == | |||
* [[Sinus bradycardia]] | |||
* [[Sick sinus syndrome|Sick sinus syndrome/tachycardia-bradycardia syndrome]] | |||
* 2nd degree [[Atrioventricular block|AV block]] Mobitz type II | |||
* 3rd degree [[AV block]] with a [[Junctional escape rhythm|junctional]] or [[ventricular escape rhythm]] | |||
== Etiology == | |||
* Age-related degeneration of the sinus node and AV node | |||
* [[Acute myocardial infarction]] | |||
* Electrolyte disorders | |||
* [[Myocarditis]] | |||
* Drug intoxication ([[tricyclic antidepressants]], [[digoxin]], [[beta blockers]], [[calcium channel blockers]]) | |||
== Acute management == | |||
If bradyarrhythmias are severe enough to cause haemodynamic instability, [[atropine]] (0,5 mg) can be given to increase the heart rate. Atropine can be repeated up to 3 mg. As a second choice, [[isoprenaline]] or [[adrenaline]] can be given. Transcutaneous pacing may also be used, where pads applied externally to the chest pace the heart like a [[pacemaker]].<section end="A&IC" /> | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Internal Medicine (POTE course)]] | [[Category:Internal Medicine (POTE course)]] |
Latest revision as of 11:02, 13 October 2024
Bradyarrhythmias are arrhythmias characterised by bradycardia, a ventricular heart rate < 60/min. The most common examples are sinus bradycardia and sick sinus syndrome. Bradyarrhythmias can be life-threatening if the heart rate is too low to sustain cardiac output. They can also degenerate into asystole, causing cardiac arrest. Short-lived paroxysmal bradyarrhythmias can cause syncope.
Types
- Sinus bradycardia
- Sick sinus syndrome/tachycardia-bradycardia syndrome
- 2nd degree AV block Mobitz type II
- 3rd degree AV block with a junctional or ventricular escape rhythm
Etiology
- Age-related degeneration of the sinus node and AV node
- Acute myocardial infarction
- Electrolyte disorders
- Myocarditis
- Drug intoxication (tricyclic antidepressants, digoxin, beta blockers, calcium channel blockers)
Acute management
If bradyarrhythmias are severe enough to cause haemodynamic instability, atropine (0,5 mg) can be given to increase the heart rate. Atropine can be repeated up to 3 mg. As a second choice, isoprenaline or adrenaline can be given. Transcutaneous pacing may also be used, where pads applied externally to the chest pace the heart like a pacemaker.