Management of symptomatic bradycardia

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An overview of the management of symptomatic bradycardias

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Management of symptomatic bradycardia

  1. 1. Management of Symptomatic Bradycardia Dr Atit M Ghoda
  2. 2. Definition • By definition, bradycardia is a heart rate of <60 beats per minute. • When it produces symptoms in a patient, it is called symptomatic bradycardia
  3. 3. Initial Management Remember the mnemonic AEIOUY • A = Assess(ABCDE) • E = ECG (Get an ECG) • I = IV line • O = Oxygen and Spo2 monitoring • U = You go and get help • Y = Why did this happen (cause)
  4. 4. Is it accompanied by adverse features? Adverse features include • Features of Shock • Myocardial Ischemia • Syncope • Heart Failure
  5. 5. Adverse or Symptomatic? • Remember and understand that it is important to distinguish between a bradycardic patient that has adverse symptoms and a patient who is just symptomatic but has features like dizziness, or a funny feeling in the chest.
  6. 6. Patient with Adverse features • Needs to be treated promptly. • Atropine is the drug of choice • Dose= 500mcg iv • A maximum of 3mg can be given at 3-5min intervals • So, a maximum of 6 doses can be given
  7. 7. Patient doesnt respond to Atropine Different options available like Drugs: Isoprenaline Adrenaline OR Arrange for Transcutaneous pacing
  8. 8. • Call a specialist for arranging Transvenous Pacing
  9. 9. • In certain situations, administration of certain drugs can be tried before pacing. • Eg. Using digoxin specific antibody fragments in cases of digoxin toxicity
  10. 10. •THANK YOU

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