This rhythm does not require treatment, unless they are causing symptoms, i.e. syncope, dizziness, tiredness and poor effort tolerance.
Sinus bradycardia < 50/minute or sinus arrest with slow escape rhythm, accompanied by hypotension, strongly suggests a treatable underlying cause:
- Acute inferior myocardial infarct
- Hyperkalaemia, especially if wide QRS and/or peaked T waves
- Drugs, especially combination of verapamil and ß –blocker or digoxin
- Hypothermia
- Hypoxia
Treat the cause. Consider atropine if inferior infarct.
Sinus arrest
- Refer all to a cardiologist specialist.
