ACLS: Bradycardia

Revision as of 20:31, 29 October 2013 by Mceledon83 (talk | contribs)


  • Only intervene if pt is symptomatic (hypotension, AMS, chest pain, pulm edema)


  1. Sinus node dysfunction
    1. Sinus bradycardia
    2. Sinus arrest
    3. Tachy-brady syndrome (sick sinus)
    4. Chronotropic incompetence
  2. AV node dysfunction
    1. 1st degree AV block
    2. 2nd degree AV block Mobitz I/Wenckebach
    3. 2nd degree AV block Mobitz II
    4. 3rd degree AV block (complete heart block)


  • Transcutaneous pacing
  • Chronotropes
  • Atropine
    • Can be used as temporizing measure (while awaiting pacing and/or chronotropes)
    • Use cautiously in pts w/ ongoing ischemia (tachycardia may worsen ischemia)
    • 0.5mg q3-5min
  • Transvenous pacing
    • Required if transcutaneous pacing + chronotropes is ineffective

See Also