Heart rate disorders: bradyarrhythmia

By Cristiano Antonino On Mar 13, 2023

The term bradyarrhythmia is used to define heart rate disorders characterized by a reduction in heart rate

The condition may be physiological or caused by a defect in the generation and/or conduction of the cardiac electrical impulse.

Patients with bradyarrhythmia have a heart rate of less than 60 beats per minute

Bradycardia is defined as critical when the number of beats falls below 45 bpm, sometimes compromising cardiovascular output.

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Bradyarrhythmia: what it is

Bradyarrhythmia is a disorder that affects the genesis or conduction of the cardiac electrical impulse.

The condition can be caused by atrial sinus node disease or atrioventricular blocks.

More generally, the term is used to refer to heart rhythm disturbances in which the rate falls below 60 bpm.

Bradyarrhythmia: the causes

A bradyarrhythmia can be caused by several conditions including atrial sinus node disease.

In patients with this disorder, low sinus rates are present and sinus-atrial blocks may occur.

Bradyarrhythmia may also be related to the presence of atrio-ventricular blocks that occur in patients with alterations in the mechanisms of impulse conduction from the atria to the ventricles.

The pathology can be classified into three degrees: in the first degree atrial impulses arrive at the ventricles in a longer time than physiologically, in the second degree intermittent conduction occurs with some impulses arriving and others being blocked.

In the third degree (complete block) no atrial impulses are conducted to the ventricles.

Bradyarrhythmia can also be caused by taking certain drugs, such as beta-blockers, drugs, calcium antagonists and digoxin, and by myocardial infarction (particularly of the inferior wall).

Causes also include myocarditis, an inflammation that can damage the entire conduction system, generating pathological bradycardia.

In some cases, the disease is linked to the presence of hypothyroidism, which is a reduction in thyroid function, electrolyte alterations, especially decreased potassium levels.

Hypothermia, that is, the lowering of body temperature, in some cases, may result in a reduction in heart rate.

Heart rate disturbances can be brought about by infectious diseases such as brucellosis and typhoid fever.

These infections, in fact, cause a lowering of the heart rate, just like endocranial hypertension, or increased pressure inside the cranial box.

Bradyarrhythmia may be a symptom of the presence of brain tumors or meningitis.

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Bradyarrhythmia: the symptoms

Symptoms of bradyarrhythmia vary according to the severity of the disorder.

Patients with the condition tire easily and breathe with difficulty after exertion.

The disease also causes visual changes such as phosphenes (perception of small bright dots) and blurred vision and confusional state caused by poor oxygenation of the organs.

In some cases the disorder may be asymptomatic, making it more difficult to detect.

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Bradyarrhythmias: the diagnosis

The diagnosis is made by the specialist who subjects the patient to a thorough cardiological examination, also assessing any family history of heart disease.

Usually, some in-depth investigations such as electrocardiogram and 24-hour Holter ECG are performed.

An ultrasound with cholordoppler is often requested to assess any abnormalities in intracardiac flow and the morphology of the heart walls and valves.

Sometimes, in fact, these can induce a reduction in heart rate.

Finally, a blood draw is useful to determine any electrolyte or thyroid hormone abnormalities.

Diagnosing bradyarrhythmia is not always easy, particularly in individuals without symptoms.

Several cardiologic examinations are often necessary.

Finally, it is worth mentioning that many patients who play competitive sports have physiological bradycardia, that is, they tend to have a lower heart rate than the population average without posing a risk to their health.

This phenomenon, therefore, may also be physiological and degenerate only in cases of extreme slowing.

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