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Sinus bradycardia indicates a heart rate slower than 60 beats per minute. Slow heart rhythm may be physiologically normal for some patients, while frequency <60/min may be inadequate for others.


  • Physiological sinus bradycardia (athletes and hard-working manual workers)
  • Increased vagus tonus
  • Reversible causes of bradycardia (hypovolemia, hypoxia, H ione acidosis, hypo/hyperkaliemia, hypoglycaemia, hypothermia, cardiac tamponade, trauma and the like)


  • Usually asymptomatic
  • Weakness, unconsciousness, presyncope and syncope (short term loss of consciousness).


  • ECG; heart rate below 60 beats per minute


  • Asymptomatic sinus bradycardia does not require treatment
  • Symptomatic bradycardia medication therapy (atropin drug of first choice)
  • Setting up a temporary pacemaker in patients who do not respond to medication therapy and those with serious signs of reduced organ perfusion.

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