Is deep bradycardia always a sign of disease?

Hi,

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You raised a very good point. Cardiologists usually look at the ECG (electrocardiogram) and the patient's symptoms. If the ECG does not show any features of conduction abnormalities and the patient is fit, healthy, and has no symptoms, then it is reassuring especially if they are athletes. However, if the ECG shows a conduction abnormality or delays then it is of concern and if the patient has symptoms of lightheadedness, fainting, collapses, or exertional breathlessness, then it is of concern and needs more investigations and possible pacemakers if the condition persists after stopping all heart slowing medications. You need to bear in mind that a single ECG could confirm a conduction abnormality if present, but does not 100 % exclude as the condition could be intermittent, This is why a period of continuous cardiac monitoring is recommended for patients who have symptoms that could be related to conduction abnormalities.