Bradycardia In Children: Advice For Parents

Health & Medical Articles

Bradycardia (slow heart rate) is a common condition that affects thousands of Americans. To supply oxygen to the body, a healthy heart will beat 60 to 100 times per minute, but if you have bradycardia, this rate slows to less than 60 beats per minute. While doctors more commonly associate the problem with adults, bradycardia also affects children, so it's important that parents understand the risks that a slow heart rate can present. Learn more about the symptoms of bradycardia, and find out about the steps you may need to take to keep your child heart-healthy.


Bradycardia occurs when something interferes with the electrical impulses that normally control the way your heart pumps. Several things can cause this interference, including:

  • A problem with the sinoatrial (SA) node (which doctors commonly call sinus bradycardia)
  • Problems with the conduction pathways of the heart
  • Problems with metabolism (such as hypothyroidism)
  • Heart damage (from heart attack or heart disease)
  • A congenital (from birth) heart defect
  • Certain medications
  • Infection of the heart tissue (myocarditis)

Around 35 percent of all child sufferers have sinus bradycardia. The incidence in athletes (physiologic bradycardia) is generally higher, due to their training. Sinus bradycardia generally occurs as a result of something outside the heart, particularly in infants and babies. For example, gastric reflux and sleep apnea can stimulate a nerve called the vagus nerve, which temporarily slows down the heart rate.


In mild cases, your son or daughter may not show any symptoms of bradycardia. The severity of symptoms can vary significantly. For example, if your child has a heart block (disruption of crucial electrical signals), the symptoms can range from first-degree (the signals slow down slightly) to third-degree (the signals stop completely).

A diagnosis of bradycardia largely depends on the child's heart rate during a 12-lead ECG examination. Guidelines for children are:

  • 0-3 years – less than 100 bpm
  • 3-9 years – less than 60 bpm
  • 9-16 years – less than 50 bpm

Children with physiologic bradycardia don't normally show any symptoms, and parents shouldn't become concerned. That aside, pathologic bradycardia can lead to extreme fatigue and can prevent children exercising. Kids may also suffer from chest pains, dizziness and fainting. Many younger children with the condition also suffer from recurrent nightmares.


Your child's doctor may carry out an electrocardiogram (ECG or EKG) to test your child's pulse rate. The ECG is a simple, painless test where the doctor attaches leads from a special machine to your child and reads the signals that come from your son or daughter's heart. Some doctors carry out this test in their own surgery, but if they don't have the right equipment, they may refer your child to a cardiologist.

A doctor may also recommend blood tests to look for any underlying health problems. If he or she suspects that your child has sleep apnea, your doctor may also recommend sleep monitoring tests.

Treatment options

Physiologic sinus bradycardia is generally a healthy finding and does not normally need any treatment. If your child has secondary or pathologic bradycardia, your doctor will generally attempt to treat the underlying problem.            

Treatment will vary according to the underlying cause. For example, if a prescription medicine causes the slow heart rate, your doctor may change the dose or recommend a different drug.

If your child has a congenital heart defect that a doctor cannot treat, you may need to consider a pacemaker. A pacemaker is a small, battery-operated device that a cardiologist will surgically implant. The device monitors your child's heart rate and generates electrical impulses to keep up the desired heart rate.

Pacemaker technology continues to improve. Although doctors don't normally recommend this treatment in children, pacemaker use is increasing. If your child needs a pacemaker, he or she will normally have a device for life, so cardiologists must consider several unique factors. For example, it's vital that a surgeon carefully chooses the implantation site. If the surgeon subsequently needs to move the device to another place, the chances of optimal performance can decrease.

Bradycardia is a relatively common heart condition that often doesn't cause problems for children. Talk to your cardiology specialist to understand more about the best treatment option for your child.


11 December 2014

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