Bradycardia

Question 1

The management of bradycardia depends on the presence/absence of…? (2)

Answer 1

“Adverse signs”

Risk of asystole

Question 2

What are the adverse features in bradycardia which indicate need for treatment? (4)

Answer 2

Signs of shock (systolic BP less than 90, clinical signs)
Syncope
Myocardial ischaemia
Signs of heart failure

Question 3

Which features indicate risk of asystole?

Answer 3

Complete heart block with broad QRS
Recent asystole
Mobitz II
Ventricular pause more than 3 seconds

Question 4

How bradycardia + adverse signs be managed?

Answer 4

Atropine

Question 5

How should bradycardia + risk of asystole be managed? What if there is a delay in provision of this? (3)

Answer 5

Transvenous pacing

Atropine
Adrenaline infusion
Transcutaneous pacing