Sinus Bradycardia


Pathophysiology

Etiology

Types of Bradycardia

Treatment

Usually does not require specific tx unless the HR < 50 & there is evidence of hypoperfusion.

  1. Transcutaneous Cardiac Pacing is only Class I treatment for unstable pts.
  2. Atropine 0.5 mg IV push, repeat q 3-5 min prn up to total of 3 mg IV. If given via ET tube, increase dose by 2 - 2.5 x over the IV dose. Slow administration or lower doses may cause paradoxical bradycardia. Atropine may not be effective in cardiac transplant pt since heart is denervated and has no vagal stimulation.
  3. Epinephrine 2 - 10 mcg/min IV, or Dopamine 3 - 10 mcg/kg/min IV may be used if external pacing is not available.
  4. Isoproterenol 2 - 10 mcg/min IV infusion may be effective but carries a risk of increased myocardial oxygen demand & hypotension.