Bradycardia

Bradycardia is an abnormally slow heart rate of below 60 beats per minute. It’s a condition that many people experience.

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What are symptoms of bradycardia?

Bradycardia describes a heart rate that's below 60 beats per minute (BPM). It's not always a concern. However, your heart may not be pumping blood around your body efficiently if you have bradycardia. This affects the supply of oxygen to your brain and other organs.

Common bradycardia arrhythmia symptoms include:

Slow pulse (below 60 beats per minute)
Heart palpitations (a thumping or fluttering feeling in your chest)
Feeling short of breath after minimal exertion
Dizziness or lightheadedness
Fatigue (tiredness)

Less common but still worth investigating are:

Fainting or blackouts (syncope)
Confusion, memory loss or difficulty concentrating

When to see a doctor

These symptoms don't necessarily mean you have bradycardia. Several bradycardia symptoms are also associated with other heart conditions, as well as stress, anaemia and hormonal imbalances.

Many healthy people also live with bradycardia without experiencing any symptoms. Whether you have symptoms – and how severe they are – will depend on the underlying cause of your condition and your fitness levels.

If you're concerned about bradycardia or any of the symptoms above, contact your doctor as soon as possible or make an appointment with one of our electrophysiologists (heart rhythm specialists) for diagnostic tests. We’re specialists in bradycardia diagnosis, treatment and management, and will confirm an appointment with a leading electrophysiologist within 24 hours of you getting in touch.

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When to call emergency services

Bradycardia can have serious symptoms and complications. Call emergency services immediately if you have:

Chest pain that remains after a few minutes
Difficulty breathing

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The most trusted provider for private bradycardia treatment

Ranked #1 for private cardiac and electrophysiology care: We've cared for over 79,000 cardiac patients in the last three years, more than any other private provider in the UK, helping us deliver better outcomes for everyone. Our patient surveys show 99% would recommend us to family or friends.
Leading consultants and specialist teams: We have electrophysiologists delivering excellent care across our facilities. They're supported by subspeciality multi-disciplinary teams who share their knowledge to ensure you receive holistic, personalised care.
Quality facilities and technology: We invest heavily in our private facilities to improve your options and experience. Our network includes five cardiac hospitals and 15 outpatient and diagnostic centres, providing the latest tests and treatments depending on your needs.
Quick access to tests: We'll confirm an appointment with a bradycardia heart rhythm specialist within 24 hours of you getting in touch. You'll receive results within 48 hours of any diagnostic tests for peace of mind.
Comprehensive treatment options: We provide every aspect of arrhythmia care. If your bradycardia requires treatment, you'll be recommended the most effective options for your condition.

What is bradycardia?

Bradycardia (pronounced brad-e-KAHR-dee-uh) is the medical term used for a heart rate which is lower than normal. Where a normal resting heart rate for adults is typically between 60 and 100 BPM, a bradycardia heart rhythm is below 60 BPM.

Some people, such as athletes who are very fit, have a naturally low heart rate but don't experience any symptoms or need treatment.

However, sometimes bradycardia is the result of a problem with the electrical impulses in your heart which prevents it from pumping enough blood around your body. This can lead to symptoms including tiredness, dizziness, shortness of breath or palpitations, requiring swift diagnosis and treatment as available through our private network.

Bradycardia vs tachycardia

Bradycardia is a type of arrhythmia, a category of conditions that involve an abnormal heart rhythm. Tachycardia is the opposite type, describing an abnormally fast heart rate.

How to check your own heartbeat

If you think your heart rate may be unusually slow, you can take your own pulse by:

Sitting for around five minutes so your heart is at its resting rate
Placing two fingers gently on the inside of your other wrist
Once you feel your pulse, counting the number of beats in 30 seconds
Multiplying this number by two to calculate your beats per minute

If the number is below 60, you may have bradycardia.

Types of bradycardia (bradyarrhythmias)

There are several types of bradycardia and not all of them are dangerous. Although your doctor may diagnose bradycardia if you have a resting heart rate below 60 beats per minute, this doesn't necessarily mean you need any treatment.

For most people, there are times when your heart beats slower without any cause for concern (for example, when you’re relaxed or asleep). However, bradycardia sometimes has an underlying cause which requires treatment.

Your cardiologist will carry out a full assessment to diagnose which type of bradycardia you have. The most common include:

Sinus bradycardia: Most common in older adults and athletes, some people with sinus bradycardia don't have any symptoms. It occurs when the sinus node (your heart's natural pacemaker) doesn't work properly, resulting in a slow heartbeat. It’s also commonly seen in people on some types of heart medication, particularly beta-blockers.

When sinus bradycardia does cause symptoms, it’s known as sick sinus syndrome, a common type of cardiac arrhythmia in which the heart rate can alternate between very fast (tachycardia) and very slow (bradycardia).

Heart block (also known as atrioventricular/AV block): Occurs when electrical impulses through the heart are blocked, causing it to beat more slowly or with an irregular rhythm. It’s common in older people as the heart ages or after a heart attack.

Other types of bradycardia include:

Junctional bradycardia: Usually caused by an absence of the electrical impulse from the sinus node. As a result, the heartbeat is generated by a different part of your heart, the AV (atrioventricular) node, and is slower than normal. Commonly seen in young people and often normal, it can cause symptoms and need treatment if persistent, particularly in older people.

Rest assured we see more cases than any other private provider, from common to complex. If you’re diagnosed with one of these types or another arrhythmia, we offer the best available care to improve your condition.

Causes of bradycardia

Bradycardia can be caused by many factors including:

Damage to the heart tissue from heart disease, a heart attack or complications from heart surgery
Congenital heart defects (heart problems which are present at birth)
Myocarditis (inflammation of the heart tissue)
An underactive thyroid gland (hypothyroidism)
A chemical imbalance in the blood
Sleep apnoea, a condition which causes repeated pauses in breathing during sleep
Other rare medical conditions including rheumatic fever, lupus and Lyme disease
Certain medications such as beta-blockers, or drugs to treat other heart rhythm disorders

Bradycardia risk factors

Bradycardia is sometimes caused by congenital heart problems which can't be avoided, as well as being more common in people over the age of 65. Other factors which increase your risk of developing heart disease also increase the risk of a bradycardia heart rhythm, including:

High blood pressure
Being very overweight
Smoking
Drinking too much alcohol
Taking illegal drugs
Stress and anxiety
Not getting enough physical activity (though high levels of athleticism can also cause bradycardia)

If you’re worried about your personal risk or want to know more, we can help you understand and manage it effectively through our private diagnostics network.

Blood tests

Several blood conditions can lead to heart rhythm problems, including bradycardia. You may be recommended to undergo blood tests to check factors including:

Electrolyte levels, including calcium, potassium and magnesium
Thyroid hormone levels
Troponin, a protein found your heart muscle’s cells which can leak into your blood as a result of heart damage
Toxic substances, such as prescription or recreational drugs

How is bradycardia diagnosed?

If your GP suspects you may have bradycardia, they'll refer you to a cardiologist for further diagnostic tests. You can also book an appointment with our GP service or one of our heart rhythm specialist cardiologists directly for same-day appointments and swift results.

Use the arrows below to learn about the tests.

Electrocardiogram (ECG)

This test measures the electrical activity of your heart to diagnose bradycardia and other types of abnormal heart rhythms.

During an ECG, sensors containing electrodes are attached to your chest with sticky pads. These sensors are connected to a computer which reads the electrical activity of your heart. It's a painless procedure which usually takes only a few minutes to complete.

If your bradycardia arrhythmia symptoms are triggered by exercise, your cardiologist may also carry out an exercise ECG – also known as a cardiac stress test (or exercise stress test). This records your heart rhythm while you're using a treadmill.

Ambulatory electrocardiogram (ECG)

This is a mobile ECG which you wear on your body for a period of time, usually between 24 hours and 14 days as recommended by your consultant. It works the same way as an electrocardiogram.

Some monitors have electrodes attached to your chest with sticky pads, called Holters, and these are connected to a small monitor which you wear around your neck. During the monitoring period, you’ll need to keep the device on at all times and avoid getting it wet (although it’s easy to remove when you want to have a bath or shower).

The modern version of this monitor is a Zio patch, a smaller, more discreet and convenient device designed for the same purpose. Zio’s do not have cables or wires and you can get these wet in a shower, but not submerged in a bath. They’re much easier to wear than Holters and can be worn for 1-2 weeks easily, providing much more information to your consultant.

You’ll be asked to keep a diary of your symptoms whilst you’re wearing the monitor. They’re used to evaluate transient heart rhythm changes which aren’t picked up on simple ECGs.

Echocardiogram

This is an ultrasound scan which is used to assess your heart chambers, valves and blood flow to identify potential underlying conditions and complications, and judge whether you need treatment.

During the procedure (which uses the same technology as a pregnancy ultrasound), you'll be asked to lie on your back and side whilst the consultant applies a special gel to your chest and moves an ultrasound probe over the area. This type of scan uses sound waves and echoes to create a moving image of your heart.

It's painless and usually takes around 20-30 minutes to complete.

Tilt-table test

If you experience dizzy spells or fainting, this test can be used to check if they're related to a slow heart rate. Like a cardiac stress test, it's designed to see how you respond to certain triggers such as changes in body position in a controlled environment.

During the test, you'll lie on a bed which is slowly tilted to a 60-degree angle, with a consultant monitoring your heart rate and any symptoms it causes for up to 45 minutes. A drug called GTN will be sprayed under your tongue and you may feel dizzy, lightheaded or lose consciousness during the test.

Blood tests

Several blood conditions can lead to heart rhythm problems, including bradycardia. You may be recommended to undergo blood tests to check factors including:

Electrolyte levels, including calcium, potassium and magnesium
Thyroid hormone levels
Troponin, a protein found your heart muscle’s cells which can leak into your blood as a result of heart damage
Toxic substances, such as prescription or recreational drugs

Electrocardiogram (ECG)

This test measures the electrical activity of your heart to diagnose bradycardia and other types of abnormal heart rhythms.

Ambulatory electrocardiogram (ECG)

This is a mobile ECG which you wear on your body for a period of time, usually between 24 hours and 14 days as recommended by your consultant. It works the same way as an electrocardiogram.

You’ll be asked to keep a diary of your symptoms whilst you’re wearing the monitor. They’re used to evaluate transient heart rhythm changes which aren’t picked up on simple ECGs.

Echocardiogram

This is an ultrasound scan which is used to assess your heart chambers, valves and blood flow to identify potential underlying conditions and complications, and judge whether you need treatment.

It's painless and usually takes around 20-30 minutes to complete.

Tilt-table test

Blood tests

Several blood conditions can lead to heart rhythm problems, including bradycardia. You may be recommended to undergo blood tests to check factors including:

Electrolyte levels, including calcium, potassium and magnesium
Thyroid hormone levels
Troponin, a protein found your heart muscle’s cells which can leak into your blood as a result of heart damage
Toxic substances, such as prescription or recreational drugs

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Get rapid access to accurate diagnostic tests

We have the most comprehensive diagnostics network in the UK and have provided over 75,000 ECGs and over 62,000 echocardiograms in the last three years alone, ensuring you the highest possible accuracy. If you have a slow heart rate or other symptoms, you can have an appointment confirmed within 24 hours and receive results within 48 hours of any tests you require.

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Bradycardia treatment options

There are various treatments for a low heart rate including monitoring, medication management, pacemakers and ablations. If you're diagnosed with bradycardia, your treatment will depend on the cause and severity of your condition as recommended by your consultant.

It may involve stopping or changing certain medications or making changes to your lifestyle. If your bradycardia is related to an underlying condition such as hypothyroidism (an underactive thyroid) or congenital heart disease, your treatment will usually focus on managing that condition.

If you don't have any symptoms or your condition is mild or infrequent, you may be recommended monitoring rather than immediate bradycardia arrhythmia treatment. Your cardiologist will work with you to determine the most effective treatment options – all of which are available through our private cardiac network.

Monitoring and/or lifestyle changes

For mild or symptom-free bradycardia, especially in young, healthy individuals, reassurance may be all that’s necessary. Sometimes regular check-ups may be suggested to monitor symptoms over a longer period of time.

Sometimes certain activities can trigger or worsen symptoms, meaning simple lifestyle changes such as staying hydrated could help improve your condition.

Medication management for bradycardia

Some medications such as beta-blockers and those used for other heart conditions can cause bradycardia, so it's important to let your consultant know about anything you're taking. They may recommend changing the dose or type of medication if it's found to be causing your slow heart rate.

In emergencies, you may also be given medication for a low heart rate intravenously to improve how your heart functions, such as atropine or isprenaline.

Bradycardia surgery (pacemaker)

In some cases, especially if the cause of your bradycardia is a problem with the heart's electrical system, you may need to have a pacemaker fitted.

A pacemaker is a small electrical device which is fitted under the skin, typically through a surgical procedure at the left shoulder. This device then monitors your heart's rhythm and sends tiny electrical impulses to restore your heart rate to normal. At HCA we also offer patients the new leadless pacemakers. These are miniaturised pacemakers that are implanted through a tube in the leg.

Your doctor will recommend the best type of pacemaker for you.

The most effective bradycardia treatment for you

If your bradycardia requires treatment, our specialists will recommend the most effective options for you. We treat more cases than any other private provider, including 885 pacemakers fitted between 2021 and 2023. This scale and experience help us ensure the best possible outcome for every individual.

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Can you prevent bradycardia?

In many cases, bradycardia isn't preventable. But there may be steps you can take to reduce your risk. Leading a healthy lifestyle is one way to prevent bradycardia (as well as other symptoms of heart disease). Ways to improve your heart health include:

Getting regular exercise
Maintaining a healthy weight
Eating a healthy diet which is rich in fibre, fruit and vegetables and low in salt, sugar and saturated fats
Giving up smoking
Drinking alcohol in moderation
Reducing your blood cholesterol level
Managing your blood pressure
Managing stress and anxiety

If appropriate, our consultants will advise on the most relevant and impactful lifestyle changes for you.

Possible bradycardia complications

If left undiagnosed or without treatment, severe bradycardia can lead to complications including:

See a cardiologist about bradycardia

Our electrophysiologists specialise in the diagnosis, treatment and management of bradycardia and other heart rhythm disorders. You can rest assured that you will receive the very highest level of care from our expert cardiology teams.

Use our consultant finder to view their profiles, expertise and experience, and book an appointment directly. Alternatively, we can quickly connect you with the right specialist for your symptoms or diagnosis when you request an appointment.

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Paying for your private bradycardia treatment

There are several different options available for paying for your care. In some cases, your bradycardia arrhythmia treatment may be covered by private medical insurance. Speak to your insurer about your cover and whether any conditions apply.

You can also choose to pay privately, using your preferred payment method. We will provide you with a clear and transparent quote for your treatment so that you're not surprised by any hidden costs or additional charges.

How to pay for your treatment