Bradycardia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ibtisam Ashraf, M.B.B.S.[2]

Overview

Common complications of bradycardia include heart failure, syncope, angina pectoris, hypotension and hypertension. The prognosis is good when the rhythm is quickly identified by the healthcare provider. Nevertheless, people with sick sinus syndrome who have bradycardia appear to have a poor 5-year survival prognosis of 45-70 per cent.

Natural History, Complications and Prognosis

Natural History

• Sinus bradycardia occurs in healthy patients as an adaptive response, particularly in well-conditioned persons or while sleeping, but it can also occur as a pathologic response in a variety of conditions.
• Sinus bradycardia itself does not cause symptoms directly, although a patient with comorbid conditions that may be exacerbated by decreased cardiac output (e.g. angina, heart failure) may have worsening symptoms related to comorbidity.
• Slower sinus rates are often very well tolerated. Asymptomatic resting bradycardias, particularly in trained athletes and young individuals are not pathological and doesn't require treatment.

Complications

• Common complications of bradycardia include:
  • Heart failure
  • Syncope
  • Angina pectoris
  • hypotension
  • hypertension

Prognosis

• The prognosis is good when the rhythm is quickly identified by the healthcare provider. Nevertheless, people with sick sinus syndrome who have bradycardia appear to have a poor 5-year survival prognosis of 45-70 per cent.