Bradycardia

Heart Rate of <60 BPM

Symptoms:
Presyncope
Syncope
Fatigue
Dyspnoea
Exercise intolerance
Bradycardia included Ventricular arrhythmias

Sinus Node disease:
- Due to fibrotic replacement, ishaemic damage, post cardiac surgery, infiltrative causes (amyloid/sarcoid), increased vagal tone, medications including beta blockers ca channel blockers, genetic disease.
- Manifests asa sick sinus syndrome, sinus arrest or chronotropic incompetence

AV Node disease:
First degree HB
-Fixed prolonged PR (>200msecs)
Second degree HB
-Mobitz Type 1 (wenkebach)
-Type 2
Third degree HB

PPM insertion indications:
Symptomatic Bradycardia (HR <40) or sinus pauses
Symptomatic CHB or second degree HB (Type 1 or 2)
Asymptomatic HB or advanced second degree HB
AF with pauses >5 secs
Alternating Bundle branch block