Is deep bradycardia always a sign of disease?

Question

Hello doctor,

Why is deep bradycardia (35 BPM) a disease for some people, while for others it is a sign of fitness and health? What makes the difference between deep bradycardia (35 BPM) being considered a disease and a sign of fitness?

Please advise.

Answer 1

Hello,

Welcome back to icliniq.com.

You raised a very good point. Cardiologists usually examine the ECG (electrocardiogram) and the patient's symptoms. If the ECG does not show any signs of conduction abnormalities and the patient is fit, healthy, and asymptomatic, it is reassuring, especially if they are an athlete. However, if the ECG indicates a conduction abnormality or delays, it raises concern, particularly if the patient experiences symptoms like lightheadedness, fainting, collapses, or exertional breathlessness. This situation warrants further investigation, and a pacemaker may be necessary if the condition persists after discontinuing all heart-slowing medications.

It is important to keep in mind that while a single ECG may confirm a conduction abnormality if present, it does not provide 100 percent certainty of exclusion, as the condition may be intermittent. For this reason, continuous cardiac monitoring is recommended for patients with symptoms that could indicate conduction abnormalities.

I hope this helps you.

Thank you.