Bradycardia natural history, complications and prognosis

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Bradycardia Microchapters

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Differentiating Bradycardia from other Conditions

Epidemiology and Demographics

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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.[1]
  • 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 is not pathological and doesn't require treatment.

Complications

Prognosis

  • The prognosis is good when the rhythm is quickly identified by the healthcare provider.[3]
  • Nevertheless, people with sick sinus syndrome who have bradycardia appear to have a poor 5-year survival prognosis of 45-70 per cent.[4]

References

  1. Blömer H, Wirtzfeld A, Delius W, Sebening H (1975). "[Sinus node syndrome]". Z Kardiol. 64 (8): 697–721. PMID 1099830.
  2. "Part 7.3: Management of Symptomatic Bradycardia and Tachycardia". Circulation. 112 (24_suppl): IV-67–IV-77. 2005. doi:10.1161/CIRCULATIONAHA.105.166558. ISSN 0009-7322.
  3. Tresch DD, Fleg JL (1986). "Unexplained sinus bradycardia: clinical significance and long-term prognosis in apparently healthy persons older than 40 years". Am J Cardiol. 58 (10): 1009–13. doi:10.1016/s0002-9149(86)80029-7. PMID 3490781.
  4. "Poster Presentations From the World Congress of Cardiology Scientific Sessions 2012". Circulation. 125 (19). 2012. doi:10.1161/CIR.0b013e31824fcdb3. ISSN 0009-7322.

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