BRADYCARDIA IN ECG,CAUSES AND ITS MANAGEMENT

BRADYCARDIA CAUSES AND ITS MANAGEMENT

1. BRADYCARDIA Dr.G.VENKATA RAMANA MBBS DNB FAMILY MEDICINE

2. Overview Bradycardia refers to heart rate <60/min in an adult Types of bradycardia Narrow complex bradydysrhythmias Regular Irregular Wide complex bradydysrhythmias Regular Irregular

3. Narrow complex bradydysrhythmias Regular Sinus bradycardia Junctional bradycardia Complete AV block ( junctional escape) Atrial flutter with high degree block Irregular Sinus arrhythmia, pause or arrest Sinoatrial exit block (second degree) Atrial fibrillation with slow ventricular response Atrial flutter with variable block Second degree AV block, type I Second degree AV block, type II

4. Wide complex bradydysrhythmias Regular Idioventricular rhythm Complete AV block (ventricular escape) Sinoventricular rhythm Regular bradycardias with aberrancy or bundle branch block Irregular Second degree AV block, type I Second degree AV block, type II Sinoatrial exit block (second degree) with bundle branch block Irregular bradycardias with bundle branch block

5. Differential diagnosis of bradycardia Physiological (e.g . athletes,sleep,vagal stimuli ) Pathological H ypoxia H ypothermia H ypothyroidism Electrolyte disturbance (e.g. H yperkalemia) O bstructive jaundice C ardiac disease Myocardial ischaemia / infarction Myocarditis Congenital disorders Cardiomyopathies His-Purkinje fibre degeneration R aised intracranial & intraocular pressure D rugs, poisonings and toxic exposures (e.g. digoxin, beta blockers, calcium channel blockers, amiodarone , clonidine, organophosphates I nfections (e.g. Lyme disease, diphtheria, typhoid fever) I nfiltrative disorders (e.g. sarcoidosis , amyloidosis ) A utoimmune (e.g. systemic lupus erythematosis ) S ick sinus syndrome U raemia