Heart Block and Bradycardia Treatment

What are bradycardia and heart block?

Bradycardia (slow heart rate) is when the heart beats slower than it should. For many people (excluding those who are very physically fit), this can be fewer than 50-60 beats per minute and pose a danger of insufficient oxygen delivery to the body. Symptoms may include lightheadedness, chest tightness, shortness of breath and fainting.

Bradycardia can be related to two primary conditions:

  • Sick sinus syndrome (or sinus node dysfunction) is when the heart’s group of cells (sinus node) that determines the heart rate becomes sluggish.
  • Heart block is when the atrioventricular node (AV node) malfunctions and fails to provide a pathway for electrical impulses from the top chamber to bottom chamber.

Detection and diagnosis of bradycardia and heart block

Physicians use an electrocardiogram to detect and diagnose bradycardia and heart block. An electrocardiogram is an electrical tracing of the heart.

Because many episodes of bradycardia and heart block happen intermittently, patients may be required to wear a heart monitor (also known as mobile telemetry). The monitor records heart activity around the clock and can detect abnormal rhythms, which are recorded and provided to your physician for review in making a diagnosis for cardiac arrhythmia.

Treatment of bradycardia and heart block

Treatment options may include:

Heart pacemaker surgery

Bradycardia and heart block arrhythmias are typically treated with implantation of a device called a pacemaker. This is often performed as outpatient surgery with patients discharged the same day of surgery or the following day. Scripps cardiac surgeons work with the newest pacemaker technologies, including devices that do not require lead wires.

The pacemaker implantation is typically performed in a special room of a pacemaker lab and involves local anesthetic and a small incision through which the artificial pacemaker is placed. Pacemaker implantation usually requires an overnight stay in the hospital. A pacemaker increases the heart rate when required and ensures that electrical impulses from the top chamber are transmitted to the bottom chamber.