Bradiarritmias

Bradyarrhythmia is a disturbance of the heart's rhythm resulting in a rate under 60 beats per minute (BPM). It is classified according to the site of the cardiac conduction system disturbance. Bradyarrhythmias are divided into two major groups: sinus node dysfunction and atrioventricular (AV) conduction disturbance. Bradyarrhythmia might present asymptomatic form, paucisymptomatic form (dizziness, fatigue, presyncope) or severe symptomatic form with syncope and cardiorespiratory arrest. A proper diagnosis is generally established by noninvasive diagnostic studies: superficial electrocardiogram (ECG), Holter electrocardiogram, ergometry and/or event recorder, implantable loop recorder. Invasive electrophysiologic testing is rarely required (EPS). Once reversible extrinsic causes of bradyarrhythmias (mainly drugs and electrolyte disturbances) or underlying treatable diseases are ruled out, cardiac pacing is usually the therapy of choice in symptomatic bradyarrhythmias in order to improve the patient's symptoms or prognosis.