Bradycardia is an abnormally slow heartbeat, or heart rhythm. An abnormal heart rhythm is called an arrhythmia. Arrhythmias result from a problem in your heart’s electrical system.
A typical heart rate is about 60-100 beats per minute. lf you have bradycardia, your heart rate is slower than 60 beats per minute. The slower your heart beats, the less blood it pumps to your body. lf your heart beats too slowly, your body may not get enough blood and oxygen to function properly.
Another name for bradycardia: bradyarrhythmia.
Bradycardia is caused by an abnormality in your heart’s electrical system. In sorne cases, your heart’s natural pacemaker (the sinoatrial node) may not create enough electrical signals in your heart. In other cases, the electrical signal does not travel down the typical pathways. To learn more about your heart’s electrical system, go to the Heart & Blood Vessel Basics section.
However, the underlying cause of bradycardia varies from person to person. Sometimes doctors cannot identify the cause. Other times bradycardia is caused by aging, medications, or an existing heart condition.
Sorne people with bradycardia don’t have any symptoms. Others may have episodes of:
Even routine activities- going up a few stairs or walking to the mailbox-can give you symptoms like shortness of breath. Usually the symptoms of bradycardia appear gradually. People sometimes think the symptoms are due to aging, rather than a heart problem.
To find out if you have bradycardia, your doctor may suggest one or more of the tests listed below. The test results can also help your doctor choose the best treatment(s) for you.
In sorne cases you may be sent to specialists for diagnosis and testing- and sometimes for treatment. To learn more, go to the Your Treatment Team section.
What is an echocardiogram?
An echocardiogram (also called an echo) is a three-dimensional, moving image of your heart. An echo uses Doppler ultrasound technology. lt is similar to the ultrasound test done on pregnant women. The echo machina emits sound waves at a frequency that people can’t hear. The waves pass over the chest and through the heart. The waves reflect or “echo” off of the heart, showing:
The shape and size of your heart
How well the heart valves are working
How well the heart chambers are contracting
The ejection fraction (EF), or how much blood your heart pumps with each beat
What can I expect?
When you have an echocardiogram, you undress from the waist up, put on a hospital gown, and lie on an exam table. The technician spreads gel on your chest and side to help transmit the sound waves. The technician then moves a pen-like instrument (callad a transducer) around on your chest or side. The transducer records the echoes of the sound waves. At the same time, a moving picture of your heart is shown on a special monitor. You may be asked to lie on your back or your side during different parts of the test. You may also be asked to hold your breath briefly so that the technician can get a good image of your heart. An echo is a painless test. You feel only light pressure on your skin as the transducer moves back and forth.
What is an ECG?
An electrocardiogram (ECG or EKG) reveals how your heart’s electrical system is working. The ECG senses and records your heartbeats, or heart rhythms. The results are printed on a strip of paper. An ECG can also help your doctor
diagnose whether:
In all, there are three kinds of tests that record your heart’s electrical activity, each for a different period of time:
What are the parts of an ECG strip?
The peaks on an electrocardiogram (ECG) strip are called waves. Together, all the peaks and valleys give your doctor important information about how your heart is working:
What can I expect?
When you have an electrocardiogram (ECG) you undress from the waist up, put on a hospital gown, and lie on an exam table. As many as 12 small patches called electrodes are placed on your chest, neck, arms, and legs. The electrodes, which connect to wires on the ECG machina, sense the heart’s electrical signals. The machina then traces your heart’s rhythm on a strip of graph paper.
What is an EP study?
An electrophysiology (EP) study is a test of your heart’s electrical system. While an electrocardiogram (ECG) gives an overview of your heart’s electrical system, the EP study gives a more in-depth view. The test helps find out details about abnormal heart rhythms, called arrhythmias. The EP study can reveal:
The EP study begins when one or more leads are insertad into a blood vessel, usually in the groin. The doctor gently “steers” the leads toward your heart. Once in place, the leads sense your heart’s electrical activity. One special lead also delivers electrical signals to your heart to trigger an arrhythmia. That’s to help find out how easily your heart can produce arrhythmias on its own.
During the EP study, your doctor closely monitors your heartbeats. lf an arrhythmia occurs, the doctor treats you with:
In sorne cases, ablation (a form of treatment) is done at the same time as your EP study. (To learn about ablation, go to the Procedures part of the Medications & Procedures section.) Or your doctor can suggest other types of treatment after the EP study.
What can I expect?
Your test will be performed in a “cath lab.” You undress, put on a hospital gown or sheet, and lie on an exam table. An intravenous (IV) line put into your arm delivers fluids and medications during the test. The medication makes you groggy, but not unconscious. Patches called electrodes are put on your chest. The electrodes monitor your heart’s electrical signals during the test. A blood pressure cuff on your arm also regularly takes your blood pressure.
The doctor makes a small incision (usually in the groin) for the catheter. The groin area will be numbed so you shouldn’t feel pain, but you may feel sorne pressure as the catheter is insertad. lf the doctor delivers electrical signals to your heart, you might feel your heart racing or pounding. You won’t be fully asleep, so during the test your doctor or nurse might ask you questions.
Afterwards you may be in the hospital overnight, but most people have a fairly rapid recovery.
What is Holter monitoring?
Holter monitoring uses a small recording device called a Holter monitor. The monitor tracks and records your heart’s electrical activity, usually for 24-48 hours.
Holter monitoring can help your doctor find out if you have abnormal heart rhythms, or arrhythmias. Arrhythmias might happen rarely, yet it is still important for your doctor to know about them and to treat them.
In all, there are three kinds of tests that record your heart’s electrical activity, each for a different period of time:
When the heart rhythms from any of these three tests are printed out, they all look the same: the electrical signals look like peaks and valleys. A doctor may suggest Holter monitoring when you have symptoms at least once every day or two.
Your doctor may ask you to write down any symptoms you have during the test. Symptoms might include faintness, dizziness, or fluttering in the chest. You should note the time and how long the symptoms last. Your doctor might also ask you to write down when you exercise, take medications, or get upset. This can help your doctor see if there is a connection between your heart rhythms and your symptoms or activities.
What can I expect?
As many as seven 4-7 sticky patches called electrodes are placed on your chest.
The electrodes connect to wires on the Holter monitor. The electrodes sense your heart rhythms, while the monitor records and stores the rhythms. Since the electrodes cannot get wet, you should shower or bathe before you begin the Holter monitoring, and not at all during the testing. The Holter monitor device itself is the size of a small portable tape recordar. lt fits easily on a belt or can be worn on a shoulder strap.
You should be able to do most or all of your daily activities at home and work while using the Holter monitor. You won’t feel anything while the Holter monitor is tracking your heart rhythms. After 24-48 hours, you return the monitor. A technician examines the recordings, notes whether you had any arrhythmias, and prepares a report for your doctor.
What is a stress test?
A stress test is a type of electrocardiogram (ECG or EKG). Regular ECGs examine how your heart beats at rest. Stress tests examine your heart’s response to exercise, or stress. There are many variations of stress tests. But the purpose of most stress tests is to find out if your heart is getting enough blood and oxygen.
Stress tests are often done to reproduce symptoms like chest pain or shortness of breath. The test looks at:
The test can show:
In one of the simpler types of stress tests, you walk on a treadmill or pedal a stationary bike. You begin at an easy pace. The machina is slowly adjusted to make you work harder. You continua exercising until you feel symptoms or until you get too tired. A stress test is also known as an exercise test, a treadmill test, or an exercise ECG.
During a nuclear stress test, the technician or nurse inserts an intravenous (IV) line-usually in your arm. A small amount of a radioactiva substance called thallium is injected through the IV into your bloodstream. Usually a nuclear stress test is done as part of a regular stress test, since the thallium can give your doctor more information about whether your heart gets enough blood and oxygen. But a nuclear stress test can be done even if you are unable to exercise, since another medication can also be given to make your heart work harder.
After the thallium is injected, you lie on a table underneath a special camera. The camera then takes images of your heart. Any part your heart that doesn’t receive enough blood and oxygen also receives less thallium. Therefore that part of your heart shows up as a lighter color on the image.
What can I expect?
When you have a stress test you undress from the waist up and put on a hospital gown. As many as 12 small patches called electrodes are placed on your chest, neck, arms, and legs. The electrodes connect to wires on the electrocardiogram (ECG). The machina then records the electrical activity in your heart from each of the electrodes. A blood pressure cuff is also put on your arm, and your blood pressure is checked often. lf you have a nuclear stress test, you will also have an IV insertad (usually into your arm).
A stress test itself does not usually cause any pain, although sometimes it reproduces painful symptoms. However the test gives you a workout, since you exercise until you’re very tired. Usually a nurse talks to you and gives you instructions throughout the test. The nurse continuas to monitor your symptoms, your blood pressure, and your heart rate for about 10-15 minutes after you stop exercising.
Your treatment depends on your test results. Your doctor may recommend one or more of these medications or procedures.
Medications
Antiarrhythmics
Procedures
Pacemaker lmplant
Tips for Taking Heart Medications
lf you have a heart or blood vessel condition, you might want to know more about sorne of the medications you take. The information in this section describes sorne medications commonly prescribed for heart or blood vessel conditions. lt also includes sorne tips to help you take your medications as ordered.
Make sure you tell your doctor-or any new doctor who prescribes medication for you-about all the medications and supplements you take. Your doctor can then help make sure you get the most benefit from your medications. Telling your doctor this information also helps avoid harmful interactions between medications.
You may also want to discuss these topics with your doctor or nurse each time you get a new medication:
In sorne cases, your heart needs several months to adjust to new medications. So you may not notice any improvement right away. lt also may take time for your doctor to determine the correct dosage.
Blood tests are sometimes necessary for people who take heart medications. The blood tests help your doctor determine the correct dosage- and therefore help avoid harmful side effects.
Never stop taking your medication or change the dosage on your own because you don’t believe you need it anymore, don’t think it’s working properly, or feel fine without it.
Be sure to talk to your doctor or nurse if you have:
And don’t hesitate to ask your pharmacist if you have questions about how and when to take your medications.
Antiarrhyth mics
Antiarrhythmics affect the electrical system in your heart. You can understand the purpose of antiarrhythmics by looking at the root words of the term. Anti = counter or against; arrhythmia = an abnormal heartbeat or heart rhythm.
Sorne generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a specific patient group or condition. Only your doctor knows which medications are appropriate for you.
Sometimes other categories of medications-beta blockers and calcium channel blockers-are used to help prevent arrhythmias.
What they’re used for
To prevent and treat arrhythmias (abnormally fast or slow heartbeats, or heart rhythms)
To restore normal heart rhythms
How they work
Antiarrhythmic drugs work in different ways to change the electrical activity in your heart. Different drugs are used because the source of the arrhythmia can come from different places in the heart.
Taking antiarrhythmics can:
What is a pacemaker?
A pacemaker is a small implantad device that treats abnormal heart rhythms called arrhythmias. Specifically, a pacemaker treats slow arrhythmias called bradycardia. A pacemaker can usually eliminate symptoms like shortness of breath, fatigue, and dizziness caused by bradycardia.
Arrhythmias result from a problem in your heart’s electrical system. Electrical signals follow a certain path throughout the heart. lt is the movement of these signals that causes your heart to contract. During bradycardia, however, too few signals flow through the heart. To learn more about your heart’s electrical system, go to the Heart & Blood Vessel Basics section.
A pacemaker restores your heart to a normal rhythm. The pacemaker can also adjust to your body’s needs. This is because the device has sensors that can detect:
Perhaps your heart does a good job of regulating your heart rhythm most of the time. A pacemaker is used as backup treatment only when your heart needs it.
In other cases, a person’s heart can no longer create its own electrical signals, or send them down the proper pathways. For example, sometimes aging, or an ablation procedure in certain parts of the heart, can make particular therapy necessary. In such cases the pacemaker might deliver continua! treatment, in order to cause each heartbeat.
The pacemaker delivers electrical signals to the heart. The device does this by sending tiny amounts of electrical energy (too small to feel) to either the top or the bottom chambers of the heart, or both.
A device implant is a procedure that uses local numbing. General anesthesia usually is not needed.
An implantad device needs to be checked regularly to review information that is stored in the device and to monitor settings.
How is the implant procedure done?
A pacemaker system has two parts.
Device-the device is quite small and easily fits in the palm of your hand. lt contains small computerized parts that run on a battery.
Leads-the leads are thin, insulated wires that connect the device to your heart. The leads carry electrical signals back and forth between your heart and your device.
Your doctor inserts the leads through a small incision, usually near your collarbone. Your doctor gently steers the leads through your blood vessels and into your heart. Your doctor can see where the leads are going by watching a video screen with real-time, moving x-rays called fluoroscopy.
The doctor connects the leads to the device and then tests to make sure both work together deliver treatment. Your doctor then places the device just underneath your skin and stitches the incision closed.
What can I expect?
Usually you are told not to eat or drink anything for a number of hours before the procedure. You undress and put on a hospital gown or sheet. Your procedure will be performed in a “cath lab.” You lie on an exam table and an intravenous (IV) line is put into your arm. The IV delivers fluids and medications during the procedure. The medication makes you groggy, but not unconscious.
The doctor makes a small incision near your collarbone to insert the leads. The area will be numbed so you shouldn’t feel pain, but you may feel sorne pressure as the leads are insertad. You may be in the hospital overnight, and there may be tenderness at the incision site. Most people have a fairly quick recovery.
Our knowledgeable and courteous staff will help set up a consultation for you, schedule surgical procedures, discuss your insurance, and answer any questions you may have.
