Bradycardia is defined as a condition in which your heart beats less than 60 times per minute. Normally heart beats around 60-100 /minute. In healthy peoples the rhythm pace is determined by sinusal node on the right atria. When the HR is less than 50 B.P.M other cells with ectopic activity can trigger cardiac activity and arrhythmia (which are causing the palpitations).
In special groups especially in athletes the heart rate may be around 50-55 b.pm. In this category bradycardia is a completely normal condition without any symptoms.
Bradycardia may express a healthy conditions (in special populations) or it can be a manifestation of a heart disease (such as heart conduction system problems). Bradycardia and palpitations can be presented at the same time.
Bradycardia can be considered as a type of arrhythmia and arrhythmias generally give palpitation symptoms. Mechanisms of palpitations. Normally the atrial sinus suppress all other cardiac centers which are capable of generating heart beats (including ectopic cardiac cells which are responsible for ectopic or premature cardiac beats). When the HR drop below 50 b.p.m these ectopic cells which were suppress begin to be activated and are responsible for ectopic beats and palpitations.
Other mechanism vary from the cause of bradycardia which may be related to
1. drug side effects
2. cardiac disease
3. non cardiac diseases such as thyroid, electrolyte or neurological conditions.
-Hypothyroidism is a condition where your body does not produce enough thyroid hormone which is important for your heart as well. This makes your conduction system weaker and may manifest bradycardia and palpitations. You feel your heart like a kind of “beat and stop” situation.
- Electrolytes are the key of the heart conduction and contraction functions. If they are not balanced your heart won’t function normally and can manifest bradycardia and palpitations.
- Neurological disorders especially neurovegetative disorders (vaso-vagal system disorders) can be a cause of bradycardia. When vagus nerve sends too much
impulses to the heart it slows it down.
Treatment of bradycardia depends on the cause.
If it is related to the conduction system of heart than a pacemaker may be needed as well as drugs that will maintain your heart electrical system. Bradycardia and palpitations can be caused by hormonal problems such as hypothyroidism.
In this case if you cure your thyroid gland the symptoms of bradycardia may dissappear. Stressful life and depression can also cause a slow heart rate so you must avoid them as much as you can. Also lifestyle can be very important.
You must eat healthy, exercise, give up smoking and alcohol. Your diet must be suitable to lower your trigycerides and other fats in your blood. If you have hypertension regular treatment is important. Bradycardia can be stable or non stable.
- Unstable bradycardia is not necessary to be treated with drugs.
- Stable bradycardia needs urgent treatment with atropine intravenous infusions and maybe inotrope drugs like dopamine/epinefrine iv infusions.
The last option especially if bradycardia is associated with life threatening arrhythmias is to insert pacemakers.