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Sinus bradycardia
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Sinus bradycardia

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Contributors: Young Ju Esther Lee MD, Ryan Hoefen MD, PhD
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Synopsis

Sinus bradycardia : Dizziness, Fatigue, Syncope, Presyncope
Sinus bradycardia is a heart rhythm originating in the sinoatrial (SA) node with a slow heart rate, usually classified as a heart rate less than about 50 beats per minute. Although generally benign, patients may report transient dizziness, lightheadedness, near syncope, or syncope in some cases. Severe symptoms such as heart failure or confusion may be present in extreme cases due to poor perfusion.

The SA node is the main pacemaker of the heart's conduction system. The vagus and sympathetic nerves innervate it. The SA nodal artery, which supplies the SA node, originates from the right coronary artery or the left circumflex artery.

Potential causes of sinus bradycardia include athletic conditioning, sick sinus syndrome, rate-lowering medications (eg, beta blockers, nondihydropyridine calcium channel blockers, ivabradine, amiodarone, digoxin, lithium), obstructive sleep apnea, enhanced vasovagal activity, hypothyroidism, acute myocardial infarction, elevated intracranial pressure, familial ion channelopathies, certain infectious causes (eg, Lyme disease, babesiosis, Chagas disease), infiltrative diseases, and collagen vascular diseases.

Codes

ICD10CM:
R00.1 – Bradycardia, unspecified

SNOMEDCT:
49710005 – Sinus Bradycardia

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:02/05/2020
Last Updated:02/05/2020
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Sinus bradycardia
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Sinus bradycardia : Dizziness, Fatigue, Syncope, Presyncope

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