Bradycardia is the condition where the heart beats at a rate that is considered abnormal for a child. Though bradycardia should be thoroughly examined, this isn’t always a point for concern. When bradycardia becomes symptomatic and compromises cardiovascular function, providers are expected to act on the condition. It is reflective of poor blood pressure, encouraging shock, altered mental status, and/or poor tissue perfusion. Low blood pressure, chest discomfort, abnormal rhythm, shortness of breath, lightheadedness, confusion, syncope, and/or pulmonary edema/congestion are among the symptoms of symptomatic bradycardia. This condition usually becomes symptomatic when it is a new change in the person’s physical well-being.
- Slow rate with normal rhythm
First Degree AV Block
- PR interval is longer than 0.20 seconds
Type I Second Degree AV Block (Mobitz I/Wenckebach)
- Interval of the PR increases in length until QRS complex is dropped
Type II Second Degree AV Block (Mobitz II)
- PR interval is the same length until intermittently dropped QRS complex is dropped
Third Degree AV Block (Complete)
- PR and QRS are not coordinated with each other
- It is of utmost importance to regulate adequate perfusion, which means there must be a proper amount of blood coursing through the body when treating symptomatic bradycardia
- Increasing the heart rate is not a primary concern of treatment; treatment should instead be focused on resolving symptoms and other signs.
- Cardiac Arrest Protocol should be performed as soon as the person’s pulse drops.
- There are reversible causes of bradycardia in children and infants which should be investigated and treated whenever applicable
- Less than 0.1 mg of atropine may aggravate bradycardia, leading to paradoxical bradycardia