Materiały źródłowe

• #1 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  Bradycardia, a condition characterized by an abnormally slow heart rate, poses significant challenges in terms of diagnosis and treatment. While it is a concern world-wide, low- and middle-income countries (LMICs) face substantial barriers in accessing appropriate bradycardia therapy. […] The cost of devices, limited number of implanting physicians, geographical isolation from major hospitals, and lack of education and awareness are major obstacles in delivering pacemaker therapy to patients in LMICs who meet the treatment guidelines. […] The prevalence of bradycardia globally varies from 0.5% to 2.0% in the general population. […] However, there are fewer studies on AV block and SND incidence compared to other heart arrhythmias like atrial fibrillation (AF), and this is especially true in lower-income countries where data on the incidence of bradycardia becomes even more sparse.

• #2 Bradycardia | Diagnosis & Disease Information – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/bradycardia/

  Bradycardia is common. The estimated worldwide prevalence of bradycardia is 0.5% to 2.0%. In the United States, sinus bradycardia is the most common type, with an estimated prevalence of approximately 1 case in every 1000 persons. Although bradycardia can occur at any age, due to the slowing of intercellular cardiac conduction with normal aging and disease progression, it is more common in patients age 65 years and older. […] A range of physiological, pathological, and pharmacological factors are associated with the development of bradycardia. Many organizations define bradycardia as an adult heart rate of fewer than 60 bpm, but the American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) guidelines on bradycardia and cardiac conduction delay use a lower cutoff point of fewer than 50 bpm because in population-based studies many healthy individuals were found to have a normal resting heart rate of 50 to 60 bpm.

• #3 Bradycardia | Diagnosis & Disease Information – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/bradycardia/

  Bradycardia is common. The estimated worldwide prevalence of bradycardia is 0.5% to 2.0%. In the United States, sinus bradycardia is the most common type, with an estimated prevalence of approximately 1 case in every 1000 persons. Although bradycardia can occur at any age, due to the slowing of intercellular cardiac conduction with normal aging and disease progression, it is more common in patients age 65 years and older. […] A range of physiological, pathological, and pharmacological factors are associated with the development of bradycardia. Many organizations define bradycardia as an adult heart rate of fewer than 60 bpm, but the American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) guidelines on bradycardia and cardiac conduction delay use a lower cutoff point of fewer than 50 bpm because in population-based studies many healthy individuals were found to have a normal resting heart rate of 50 to 60 bpm.

• #4 Bradycardia – Wikipedia

  https://en.wikipedia.org/wiki/Bradycardia

  In clinical practice, elderly people over age 65 and young athletes of both sexes may have sinus bradycardia. […] The US Centers for Disease Control and Prevention reported in 2011 that 15.2% of adult males and 6.9% of adult females had clinically defined bradycardia (a resting pulse rate below 60 BPM).

• #5 Bradycardia | Diagnosis & Disease Information – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/bradycardia/

  Bradycardia is common. The estimated worldwide prevalence of bradycardia is 0.5% to 2.0%. In the United States, sinus bradycardia is the most common type, with an estimated prevalence of approximately 1 case in every 1000 persons. Although bradycardia can occur at any age, due to the slowing of intercellular cardiac conduction with normal aging and disease progression, it is more common in patients age 65 years and older. […] A range of physiological, pathological, and pharmacological factors are associated with the development of bradycardia. Many organizations define bradycardia as an adult heart rate of fewer than 60 bpm, but the American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) guidelines on bradycardia and cardiac conduction delay use a lower cutoff point of fewer than 50 bpm because in population-based studies many healthy individuals were found to have a normal resting heart rate of 50 to 60 bpm.

• #6 Bradycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17841-bradycardia

  Bradycardia can happen to people of any age and background but is more common in adults over 65. It’s less common in younger adults and children because your heart rate naturally slows down as you get older. The exception is when it happens because of certain conditions you’re born with (genetic or otherwise). […] Bradycardia is a common condition among people in certain age groups and with certain circumstances. Its most common in the following: […] People over 65. This condition causes symptoms in about 1 in every 600 adults over age 65. That means there are over half a million adults over 65 with symptoms of this condition. However, the number of people with bradycardia but no symptoms is probably much higher. Bradycardia is especially common in older adults when theyre asleep. […] Bradycardia is an arrhythmia (abnormal heart rhythm) because it is slower than the typical rate. The normal heart rate range for adults is between 60 and 100 beats per minute. […] For people who do have symptoms or problems because of bradycardia, youre more likely to have a good outcome with early diagnosis and treatment. Delays in treatment, especially when bradycardia happens because of certain conditions, usually increase your risk of complications or death.

• #7 Diagnosing Bradycardia | NYU Langone Health

  https://nyulangone.org/conditions/bradycardia/diagnosis

  Bradycardia is often discovered during a routine physical exam, before symptoms become noticeable. […] The risk of bradycardia increases with age. People who have had a heart attack or have received a diagnosis of coronary artery disease have a greater chance of developing the condition. […] Our experts may also recommend an electrocardiogram, exercise stress test, echocardiogram, tilt table test, or surveillance monitoring. […] Your doctor may ask you to wear a Holter device or ambulatory telemetry device to monitor your hearts activity during your normal daily activities. […] Data from the device are sent to the Heart Rhythm Centers device clinic, where our experts review the results and use the information, in conjunction with your doctor, to help determine the best treatment for you.

• #8 Bradycardia | Diagnosis & Disease Information – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/bradycardia/

  Bradycardia is common. The estimated worldwide prevalence of bradycardia is 0.5% to 2.0%. In the United States, sinus bradycardia is the most common type, with an estimated prevalence of approximately 1 case in every 1000 persons. Although bradycardia can occur at any age, due to the slowing of intercellular cardiac conduction with normal aging and disease progression, it is more common in patients age 65 years and older. […] A range of physiological, pathological, and pharmacological factors are associated with the development of bradycardia. Many organizations define bradycardia as an adult heart rate of fewer than 60 bpm, but the American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) guidelines on bradycardia and cardiac conduction delay use a lower cutoff point of fewer than 50 bpm because in population-based studies many healthy individuals were found to have a normal resting heart rate of 50 to 60 bpm.

• #9 Bradycardia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Bradycardia_epidemiology_and_demographics

  Bradycardia is mostly the result of sinus node dysfunction found in one in 600 individuals over 65 years of age. […] The incidence of bradycardia is approximately 1 in 600 individuals worldwide. […] The prevalence of unexplained sinus bradycardia (SB) is approximately 400 per 100,000 individuals worldwide. […] Bradycardia is more common in older patients, over the age of 65 years. […] There is no racial predilection to bradycardia. […] Bradycardia affects men and women equally.

• #10 Sinus Bradycardia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/29047

  In clinical practice, adults over the age of 65 and young athletes of both sexes are commonly known to present with sinus bradycardia. One in 600 adults over 65 has sinus node dysfunction, but more research needs to be done to collect epidemiologic data within the United States and globally for patients with sinus bradycardia. […] Sinus bradycardia has many intrinsic and extrinsic etiologies.

• #11 Bradycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17841-bradycardia

  Bradycardia can happen to people of any age and background but is more common in adults over 65. It’s less common in younger adults and children because your heart rate naturally slows down as you get older. The exception is when it happens because of certain conditions you’re born with (genetic or otherwise). […] Bradycardia is a common condition among people in certain age groups and with certain circumstances. Its most common in the following: […] People over 65. This condition causes symptoms in about 1 in every 600 adults over age 65. That means there are over half a million adults over 65 with symptoms of this condition. However, the number of people with bradycardia but no symptoms is probably much higher. Bradycardia is especially common in older adults when theyre asleep. […] Bradycardia is an arrhythmia (abnormal heart rhythm) because it is slower than the typical rate. The normal heart rate range for adults is between 60 and 100 beats per minute. […] For people who do have symptoms or problems because of bradycardia, youre more likely to have a good outcome with early diagnosis and treatment. Delays in treatment, especially when bradycardia happens because of certain conditions, usually increase your risk of complications or death.

• #12 Bradycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17841-bradycardia

  Bradycardia can happen to people of any age and background but is more common in adults over 65. It’s less common in younger adults and children because your heart rate naturally slows down as you get older. The exception is when it happens because of certain conditions you’re born with (genetic or otherwise). […] Bradycardia is a common condition among people in certain age groups and with certain circumstances. Its most common in the following: […] People over 65. This condition causes symptoms in about 1 in every 600 adults over age 65. That means there are over half a million adults over 65 with symptoms of this condition. However, the number of people with bradycardia but no symptoms is probably much higher. Bradycardia is especially common in older adults when theyre asleep. […] Bradycardia is an arrhythmia (abnormal heart rhythm) because it is slower than the typical rate. The normal heart rate range for adults is between 60 and 100 beats per minute. […] For people who do have symptoms or problems because of bradycardia, youre more likely to have a good outcome with early diagnosis and treatment. Delays in treatment, especially when bradycardia happens because of certain conditions, usually increase your risk of complications or death.

• #13 Bradycardia – Wikipedia

  https://en.wikipedia.org/wiki/Bradycardia

  In clinical practice, elderly people over age 65 and young athletes of both sexes may have sinus bradycardia. […] The US Centers for Disease Control and Prevention reported in 2011 that 15.2% of adult males and 6.9% of adult females had clinically defined bradycardia (a resting pulse rate below 60 BPM).

• #14 Sinus Bradycardia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493201/

  In clinical practice, adults over the age of 65 and young athletes of both sexes are commonly known to present with sinus bradycardia. One in 600 adults over 65 has sinus node dysfunction, but more research needs to be done to collect epidemiologic data within the United States and globally for patients with sinus bradycardia. […] Sinus bradycardia is a common occurrence in sick sinus syndrome. In this disorder, there is dysfunction of the SA node. The condition is most common in elderly patients with concomitant heart disease.

• #15 Sinus Bradycardia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/760220-overview

  In a retrospective review (2011-2022) of 77 Turkish children diagnosed with sinus node dysfunction, Sahin et al noted the most common rhythm disturbances were age-incompatible bradycardia and pauses. A little over three quarters of the children had structural heart disease, of which 61% were congenital (most frequent: transposition of the great arteries, atrial septal defect, atrioventricular septal defect, left atrial isomerism). […] In a multicenter observational study (2002-2023) comprising resting ECG data from 6125 adult male Brazilian soccer players of White (n = 2496), Black (n = 1625), and mixed-race (n = 2004) ethnicities, Ferrari et al noted that 97% of the ECGs were normal, with 50.1% showing sinus bradycardia, in which the mean PR interval was higher in Black players than the other two groups.

• #16 Pediatric Sinus Bradycardia

  https://pedemmorsels.com/pediatric-sinus-bradycardia/

  Sinus Bradycardia is almost never due to a primary cardiac issue in children. […] Kids with benign sinus bradycardia are asymptomatic and have benign clinical courses. […] So, while the overall clinical course of Pediatric Sinus Bradycardia is benign and reassuring, take the opportunity to consider other entities, particularly eating disorders. […] Bradycardia is defined as a heart rate less than the lower limit of normal for a child’s age, and the most common cause is sinus bradycardia. […] Sinus bradycardia is probably the most common thing in paeds that we are asked to review on the ward, and a frequent (incidental) finding in ED.

• #17 Pediatric Sinus Bradycardia

  https://pedemmorsels.com/pediatric-sinus-bradycardia/

  Sinus Bradycardia is almost never due to a primary cardiac issue in children. […] Kids with benign sinus bradycardia are asymptomatic and have benign clinical courses. […] So, while the overall clinical course of Pediatric Sinus Bradycardia is benign and reassuring, take the opportunity to consider other entities, particularly eating disorders. […] Bradycardia is defined as a heart rate less than the lower limit of normal for a child’s age, and the most common cause is sinus bradycardia. […] Sinus bradycardia is probably the most common thing in paeds that we are asked to review on the ward, and a frequent (incidental) finding in ED.

• #18 Sinus Bradycardia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/760220-overview

  In a retrospective review (2011-2022) of 77 Turkish children diagnosed with sinus node dysfunction, Sahin et al noted the most common rhythm disturbances were age-incompatible bradycardia and pauses. A little over three quarters of the children had structural heart disease, of which 61% were congenital (most frequent: transposition of the great arteries, atrial septal defect, atrioventricular septal defect, left atrial isomerism). […] In a multicenter observational study (2002-2023) comprising resting ECG data from 6125 adult male Brazilian soccer players of White (n = 2496), Black (n = 1625), and mixed-race (n = 2004) ethnicities, Ferrari et al noted that 97% of the ECGs were normal, with 50.1% showing sinus bradycardia, in which the mean PR interval was higher in Black players than the other two groups.

• #19 Bradycardia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Bradycardia_epidemiology_and_demographics

  Bradycardia is mostly the result of sinus node dysfunction found in one in 600 individuals over 65 years of age. […] The incidence of bradycardia is approximately 1 in 600 individuals worldwide. […] The prevalence of unexplained sinus bradycardia (SB) is approximately 400 per 100,000 individuals worldwide. […] Bradycardia is more common in older patients, over the age of 65 years. […] There is no racial predilection to bradycardia. […] Bradycardia affects men and women equally.

• #20 Bradycardia – Wikipedia

  https://en.wikipedia.org/wiki/Bradycardia

  In clinical practice, elderly people over age 65 and young athletes of both sexes may have sinus bradycardia. […] The US Centers for Disease Control and Prevention reported in 2011 that 15.2% of adult males and 6.9% of adult females had clinically defined bradycardia (a resting pulse rate below 60 BPM).

• #21 Bradycardia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Bradycardia_epidemiology_and_demographics

  Bradycardia is mostly the result of sinus node dysfunction found in one in 600 individuals over 65 years of age. […] The incidence of bradycardia is approximately 1 in 600 individuals worldwide. […] The prevalence of unexplained sinus bradycardia (SB) is approximately 400 per 100,000 individuals worldwide. […] Bradycardia is more common in older patients, over the age of 65 years. […] There is no racial predilection to bradycardia. […] Bradycardia affects men and women equally.

• #22 Sinus Bradycardia: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/760220-overview

  In a retrospective review (2011-2022) of 77 Turkish children diagnosed with sinus node dysfunction, Sahin et al noted the most common rhythm disturbances were age-incompatible bradycardia and pauses. A little over three quarters of the children had structural heart disease, of which 61% were congenital (most frequent: transposition of the great arteries, atrial septal defect, atrioventricular septal defect, left atrial isomerism). […] In a multicenter observational study (2002-2023) comprising resting ECG data from 6125 adult male Brazilian soccer players of White (n = 2496), Black (n = 1625), and mixed-race (n = 2004) ethnicities, Ferrari et al noted that 97% of the ECGs were normal, with 50.1% showing sinus bradycardia, in which the mean PR interval was higher in Black players than the other two groups.

• #23 Sinus Node Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0800/p179.html

  Sinus node dysfunction may occur at any age; however, increasing age is the most significant risk factor with the highest disease prevalence in patients 70 to 89 years of age. The incidence of sinus node dysfunction is 0.8 per 1,000 person-years and is expected to double by 2060 due to the aging population. Conditions associated with advanced age such as hypertension, chronic kidney disease, diabetes mellitus, and coronary heart disease are overlapping risk factors and potential causes of sinus node dysfunction. […] Bradycardia-tachycardia syndrome occurs in approximately 50% of patients with sinus node dysfunction and increases the risk of stroke and death. […] A diagnosis of sinus node dysfunction requires direct correlation of observed bradyarrhythmia with symptoms of end-organ hypoperfusion.

• #24 Sinus node dysfunction – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/sinus-node-dysfunction/

  Incidence: 0.8 per 1000 person-years. […] Mean age: 68 years (although can occur at any age). […] Risk factors: Coronary artery disease, Hypertension, Diabetes mellitus, Obesity, Right bundle branch block. […] Epidemiological data refers to the US, unless otherwise specified.

• #25 Sick Sinus Syndrome

  https://mobile.fpnotebook.com/CV/EKG/SckSnsSyndrm.htm

  Incidence: 0.8 per 1000 person years […] Prevalence: 1 in 600 cardiac patients over age 65 years […] Peaks at ages 70 to 89 years old […] Mean age: 68 years old (median 74 years old) […] Prevalence: 0.5 to 1.5% of patients annually, ultimately affecting 50% of Sick Sinus Syndrome patients.

• #26 Sinus Node Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0800/p179.html

  Sinus node dysfunction may occur at any age; however, increasing age is the most significant risk factor with the highest disease prevalence in patients 70 to 89 years of age. The incidence of sinus node dysfunction is 0.8 per 1,000 person-years and is expected to double by 2060 due to the aging population. Conditions associated with advanced age such as hypertension, chronic kidney disease, diabetes mellitus, and coronary heart disease are overlapping risk factors and potential causes of sinus node dysfunction. […] Bradycardia-tachycardia syndrome occurs in approximately 50% of patients with sinus node dysfunction and increases the risk of stroke and death. […] A diagnosis of sinus node dysfunction requires direct correlation of observed bradyarrhythmia with symptoms of end-organ hypoperfusion.

• #27 Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-024-81983-x

  Patients with diabetes mellitus (DM) and chronic kidney disease (CKD) exhibit an elevated risk for cardiac arrhythmias, such as bradycardia, which may potentially lead to sudden cardiac death (SCD). […] Our analysis revealed a significant increase in bradycardia frequency during periods of lowest relative glucose, particularly between 06:00-09:00 and 12:00-15:00. […] Our findings not only highlight the strong correlation between relative glucose levels, heart rate parameters, and bradycardia onset but also emphasize the need for a more personalized definition of hypoglycemia to understand its relationship with bradyarrhythmias in high-risk DM and CKD patient populations. […] Bradycardia, characterized by heart rates falling below a defined threshold, represents one of the prevalent types of cardiac arrhythmias.

• #28 Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-024-81983-x

  Patients with diabetes mellitus (DM) and chronic kidney disease (CKD) exhibit an elevated risk for cardiac arrhythmias, such as bradycardia, which may potentially lead to sudden cardiac death (SCD). […] Our analysis revealed a significant increase in bradycardia frequency during periods of lowest relative glucose, particularly between 06:00-09:00 and 12:00-15:00. […] Our findings not only highlight the strong correlation between relative glucose levels, heart rate parameters, and bradycardia onset but also emphasize the need for a more personalized definition of hypoglycemia to understand its relationship with bradyarrhythmias in high-risk DM and CKD patient populations. […] Bradycardia, characterized by heart rates falling below a defined threshold, represents one of the prevalent types of cardiac arrhythmias.

• #29 Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-024-81983-x

  Patients with diabetes mellitus (DM) and chronic kidney disease (CKD) exhibit an elevated risk for cardiac arrhythmias, such as bradycardia, which may potentially lead to sudden cardiac death (SCD). […] Our analysis revealed a significant increase in bradycardia frequency during periods of lowest relative glucose, particularly between 06:00-09:00 and 12:00-15:00. […] Our findings not only highlight the strong correlation between relative glucose levels, heart rate parameters, and bradycardia onset but also emphasize the need for a more personalized definition of hypoglycemia to understand its relationship with bradyarrhythmias in high-risk DM and CKD patient populations. […] Bradycardia, characterized by heart rates falling below a defined threshold, represents one of the prevalent types of cardiac arrhythmias.

• #30 Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-024-81983-x

  Our findings indicate, for the first time, that the threshold for bradycardias associated with hypo- and hyperglycemia is related to individual relative glucose levels. […] We also examined the expression of time-domain, frequency-domain, and nonlinear HRV features during the bradycardia events. […] Our results underscore the significance of implementing a personalized glucose monitoring approach for individuals with diabetes and CKD.

• #31 Sinus Node Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0800/p179.html

  Sinus node dysfunction may occur at any age; however, increasing age is the most significant risk factor with the highest disease prevalence in patients 70 to 89 years of age. The incidence of sinus node dysfunction is 0.8 per 1,000 person-years and is expected to double by 2060 due to the aging population. Conditions associated with advanced age such as hypertension, chronic kidney disease, diabetes mellitus, and coronary heart disease are overlapping risk factors and potential causes of sinus node dysfunction. […] Bradycardia-tachycardia syndrome occurs in approximately 50% of patients with sinus node dysfunction and increases the risk of stroke and death. […] A diagnosis of sinus node dysfunction requires direct correlation of observed bradyarrhythmia with symptoms of end-organ hypoperfusion.

• #32 Sick Sinus Syndrome: A Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0515/p691.html

  Sick sinus syndrome usually occurs in older adults, but it can affect persons of all ages. One in 600 cardiac patients older than 65 years has this syndrome. In one study of patients older than 21 years with sick sinus syndrome, the median age was 74 years. Men and women are affected equally. […] The diagnosis of sick sinus syndrome requires correlating symptoms of end-organ hypoperfusion with the presence of bradyarrhythmia observed on cardiac monitoring. If short-term monitoring is nondiagnostic, prolonged cardiac monitoring should be considered. Permanent pacemaker placement is recommended only in patients with symptomatic sick sinus syndrome and documented bradycardia. […] More than 50 percent of patients with sick sinus syndrome develop tachy-brady syndrome with atrial fibrillation or flutter as the tachyarrhythmia, leading to an increased risk of embolic stroke.

• #33 Bradycardia in Recent Heart Transplant: Will the Microscope Illuminate the True Answer? | Methodist DeBakey Cardiovascular J

  https://journal.houstonmethodist.org/articles/10.14797/PREM9909

  According to the most recent International Society for Heart and Lung Transplantation (ISHLT) guidelines, the current standard of care for all adult orthotopic heart transplant (OHT) recipients is to undergo periodic endomyocardial biopsy (EMB) 6 to 12 months postoperatively for surveillance of heart transplant rejection or at any point if there is a clinical suspicion for rejection. After this time, periodic EMB surveillance every 4 to 6 months is recommended for heart transplant recipients at higher risk for late acute rejection. Beyond a period of 5 years post heart transplantation, the routine use of EMB is optional depending on clinical judgment and the risk of late allograft rejection. […] Although EMB is the ISHLTs method of choice for primary assessment and surveillance when transplant rejection occurs, its utility in detecting rejection is restricted when sampling and reporting issues arise and can thus lower the sensitivity for accurate diagnosis.

• #34 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  In many developing countries, heart block is the main cause of bradycardia, with SND accounting for only 5% of cases in some LMICs. […] These infectious diseases can directly affect the heart’s electrical conduction system, leading to bradycardia. […] While data is lacking on the incidence of bradycardia for many LMICs, there is available data on the rate of pacemaker implantation in many parts of the world. […] The treatment of conduction disorders and the use of device therapy require specialized physician training, a supportive healthcare workforce, and access to cutting-edge technology, which are often not readily available in LMICs. […] Several factors contribute to the limited access to bradycardia care in LMICs. These include underdeveloped healthcare infrastructure, lack of resources, high cost associated with procedures, a shortage of physicians trained in implanting devices, and low levels of patient awareness.

• #35 Relative Bradycardia in Patients with Mild-to-Moderate Coronavirus Disease, Japan – Volume 26, Number 10—October 2020 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/26/10/20-2648_article

  Relative bradycardia was a common characteristic for 54 patients with PCR-confirmed mild-to-moderate coronavirus disease in Japan. […] Relative bradycardia is a characteristic physical finding in some intracellular bacterial infections, viral infections, and noninfectious diseases. […] In summary, relative bradycardia was a characteristic clinical finding in patients who had mild-to-moderate COVID-19 in Japan. This clinical sign could help clinicians diagnose COVID-19.

• #36 Automated Medical Care: Bradycardia Detection and Cardiac Monitoring of Preterm Infants

  https://www.mdpi.com/1648-9144/57/11/1199

  Bradycardia is defined as a cardiac event, where the heart rate slows to less than 100 bpm for at least two beats in duration. […] The preterm state is a vulnerable state, highly related to sudden infant death syndrome (SIDS), due in part to apnea and sleep disorders, calling for special sleep practice to ensure an infant’s safety. […] Respiratory pauses (called apnea-bradycardia episodes), associated with heart rhythm disorders, are stated as being common to preterm infants. […] Recent studies have shown that persons infected with the COVID-19 disease are frequently reported to develop cardiovascular symptoms and cardiac arrhythmias. An automatic surveillance system (both for neonates and adults) has a practical medical application. […] The algorithm can be personalized, following the neonate’s cardiac rhythm changes. […] The bradycardia events annotated by physicians were correctly detected.

• #37 Automated Medical Care: Bradycardia Detection and Cardiac Monitoring of Preterm Infants

  https://www.mdpi.com/1648-9144/57/11/1199

  Bradycardia is defined as a cardiac event, where the heart rate slows to less than 100 bpm for at least two beats in duration. […] The preterm state is a vulnerable state, highly related to sudden infant death syndrome (SIDS), due in part to apnea and sleep disorders, calling for special sleep practice to ensure an infant’s safety. […] Respiratory pauses (called apnea-bradycardia episodes), associated with heart rhythm disorders, are stated as being common to preterm infants. […] Recent studies have shown that persons infected with the COVID-19 disease are frequently reported to develop cardiovascular symptoms and cardiac arrhythmias. An automatic surveillance system (both for neonates and adults) has a practical medical application. […] The algorithm can be personalized, following the neonate’s cardiac rhythm changes. […] The bradycardia events annotated by physicians were correctly detected.

• #38 Consensus Guidelines for Management of Apnea of Prematurity – UCSF Pediatrics

  https://medconnection.ucsfbenioffchildrens.org/apnea-guidelines

  Epidemiology […] Incidence inversely proportional to gestational age […] 100% = 28wks […] 85% 30wks […] 20% 34wks […] Natural history […] Severe events resolve first, isolated bradycardia events resolve last […] 92% resolve by 37wks […] 98% resolve by 40wks […] Persistent events beyond full term corrected gestational age (40wks CGA) are common in infants born @ 28wks GA […] 6-22% of infants born at 24-28wks GA, proportionate to GA […] Eventual cessation of events […] Virtually no extreme events 43wks CGA […] […] […] Lorch SA et al; Epidemiology of apnea and bradycardia resolution in premature infants. Pediatrics. 2011 Aug;128(2):e366-73

• #39 Consensus Guidelines for Management of Apnea of Prematurity – UCSF Pediatrics

  https://medconnection.ucsfbenioffchildrens.org/apnea-guidelines

  Epidemiology […] Incidence inversely proportional to gestational age […] 100% = 28wks […] 85% 30wks […] 20% 34wks […] Natural history […] Severe events resolve first, isolated bradycardia events resolve last […] 92% resolve by 37wks […] 98% resolve by 40wks […] Persistent events beyond full term corrected gestational age (40wks CGA) are common in infants born @ 28wks GA […] 6-22% of infants born at 24-28wks GA, proportionate to GA […] Eventual cessation of events […] Virtually no extreme events 43wks CGA […] […] […] Lorch SA et al; Epidemiology of apnea and bradycardia resolution in premature infants. Pediatrics. 2011 Aug;128(2):e366-73

• #40 Diagnosing Bradycardia | NYU Langone Health

  https://nyulangone.org/conditions/bradycardia/diagnosis

  Bradycardia is often discovered during a routine physical exam, before symptoms become noticeable. […] The risk of bradycardia increases with age. People who have had a heart attack or have received a diagnosis of coronary artery disease have a greater chance of developing the condition. […] Our experts may also recommend an electrocardiogram, exercise stress test, echocardiogram, tilt table test, or surveillance monitoring. […] Your doctor may ask you to wear a Holter device or ambulatory telemetry device to monitor your hearts activity during your normal daily activities. […] Data from the device are sent to the Heart Rhythm Centers device clinic, where our experts review the results and use the information, in conjunction with your doctor, to help determine the best treatment for you.

• #41 Sick Sinus Syndrome: A Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0515/p691.html

  Sick sinus syndrome usually occurs in older adults, but it can affect persons of all ages. One in 600 cardiac patients older than 65 years has this syndrome. In one study of patients older than 21 years with sick sinus syndrome, the median age was 74 years. Men and women are affected equally. […] The diagnosis of sick sinus syndrome requires correlating symptoms of end-organ hypoperfusion with the presence of bradyarrhythmia observed on cardiac monitoring. If short-term monitoring is nondiagnostic, prolonged cardiac monitoring should be considered. Permanent pacemaker placement is recommended only in patients with symptomatic sick sinus syndrome and documented bradycardia. […] More than 50 percent of patients with sick sinus syndrome develop tachy-brady syndrome with atrial fibrillation or flutter as the tachyarrhythmia, leading to an increased risk of embolic stroke.

• #42 Sinus Node Dysfunction | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0800/p179.html

  Sinus node dysfunction may occur at any age; however, increasing age is the most significant risk factor with the highest disease prevalence in patients 70 to 89 years of age. The incidence of sinus node dysfunction is 0.8 per 1,000 person-years and is expected to double by 2060 due to the aging population. Conditions associated with advanced age such as hypertension, chronic kidney disease, diabetes mellitus, and coronary heart disease are overlapping risk factors and potential causes of sinus node dysfunction. […] Bradycardia-tachycardia syndrome occurs in approximately 50% of patients with sinus node dysfunction and increases the risk of stroke and death. […] A diagnosis of sinus node dysfunction requires direct correlation of observed bradyarrhythmia with symptoms of end-organ hypoperfusion.

• #43 Diagnosing Bradycardia | NYU Langone Health

  https://nyulangone.org/conditions/bradycardia/diagnosis

  Bradycardia is often discovered during a routine physical exam, before symptoms become noticeable. […] The risk of bradycardia increases with age. People who have had a heart attack or have received a diagnosis of coronary artery disease have a greater chance of developing the condition. […] Our experts may also recommend an electrocardiogram, exercise stress test, echocardiogram, tilt table test, or surveillance monitoring. […] Your doctor may ask you to wear a Holter device or ambulatory telemetry device to monitor your hearts activity during your normal daily activities. […] Data from the device are sent to the Heart Rhythm Centers device clinic, where our experts review the results and use the information, in conjunction with your doctor, to help determine the best treatment for you.

• #44 Diagnosing Bradycardia | NYU Langone Health

  https://nyulangone.org/conditions/bradycardia/diagnosis

  Bradycardia is often discovered during a routine physical exam, before symptoms become noticeable. […] The risk of bradycardia increases with age. People who have had a heart attack or have received a diagnosis of coronary artery disease have a greater chance of developing the condition. […] Our experts may also recommend an electrocardiogram, exercise stress test, echocardiogram, tilt table test, or surveillance monitoring. […] Your doctor may ask you to wear a Holter device or ambulatory telemetry device to monitor your hearts activity during your normal daily activities. […] Data from the device are sent to the Heart Rhythm Centers device clinic, where our experts review the results and use the information, in conjunction with your doctor, to help determine the best treatment for you.

• #45 ACC/AHA/HRS Release Updated Bradycardia Diagnosis and Management Guidelines – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/news/acc-aha-hrs-release-updated-bradycardia-diagnosis-and-management-guidelines/

  The American College of Cardiology, the American Heart Association, and the Heart Rhythm Society have released a guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. […] The guideline also includes recommendations on post-procedure surveillance and pacemaker implantation since conduction abnormalities are common after transcatheter aortic valve replacement. […] Post-procedure surveillance is recommended after transcatheter aortic valve replacement due to conduction system abnormalities.

• #46 ACC/AHA/HRS Release Updated Bradycardia Diagnosis and Management Guidelines – Clinical Advisor

  https://www.clinicaladvisor.com/news/acc-aha-hrs-release-updated-bradycardia-diagnosis-and-management-guidelines/

  The American College of Cardiology, the American Heart Association and the Heart Rhythm Society have released a guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. […] The guideline also includes recommendations on post-procedure surveillance and pacemaker implantation since conduction abnormalities are common after transcatheter aortic valve replacement. […] Post-procedure surveillance is recommended after transcatheter aortic valve replacement due to conduction system abnormalities.

• #47 Societies Publish New Guidance for the Treatment of Slow, Irregular Heartbeats – HRS

  https://www.hrsonline.org/news/societies-publish-new-guidance-treatment-slow-irregular-heartbeats/

  The American College of Cardiology, the American Heart Association and the Heart Rhythm Society today released a guideline for the evaluation and treatment of patients with bradycardia, or a slow heartbeat, and cardiac conduction disorders. […] Bradycardia is generally classified into three categories: sinus node dysfunction, atrioventricular (AV) block, and conduction disorders. […] Bradycardia and conduction abnormalities are more often seen in elderly patients. […] The guideline includes recommendations on post-procedure surveillance and pacemaker implantation. […] Yet, according to the authors, there are still knowledge gaps in understanding how to manage bradycardia, especially the evolving role of and developing technology for pacing. […] Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice.

• #48 Automated Medical Care: Bradycardia Detection and Cardiac Monitoring of Preterm Infants

  https://www.mdpi.com/1648-9144/57/11/1199

  Bradycardia is defined as a cardiac event, where the heart rate slows to less than 100 bpm for at least two beats in duration. […] The preterm state is a vulnerable state, highly related to sudden infant death syndrome (SIDS), due in part to apnea and sleep disorders, calling for special sleep practice to ensure an infant’s safety. […] Respiratory pauses (called apnea-bradycardia episodes), associated with heart rhythm disorders, are stated as being common to preterm infants. […] Recent studies have shown that persons infected with the COVID-19 disease are frequently reported to develop cardiovascular symptoms and cardiac arrhythmias. An automatic surveillance system (both for neonates and adults) has a practical medical application. […] The algorithm can be personalized, following the neonate’s cardiac rhythm changes. […] The bradycardia events annotated by physicians were correctly detected.

• #49 Bradycardia in Recent Heart Transplant: Will the Microscope Illuminate the True Answer? | Methodist DeBakey Cardiovascular J

  https://journal.houstonmethodist.org/articles/10.14797/PREM9909

  While the use of EMB, donor-specific antibodies (DSAs), and gene expression profiling (GEP) are in the ISHLT guidelines for the care of heart transplant recipients, incorporation of DD-cfDNA and MMDx are new and not yet included. […] The utility of artificial intelligence when used by cardiac care teams should be evaluated further. […] Tools such as MMDx, a system that uses machine learning to compare gene expression to a given data set, can assist in managing transplant rejection. […] Further studies should be considered involving cellular rejection in heart transplants and the role MMDx and other machine-learning technologies can have when compared to the current gold standard. This could play a vital role in supplementing or replacing the information provided by EMB. […] The use of machine-learning tools like MMDx proved to be invaluable in the case of our patient, who had no evidence rejection on EMB. With the information these resources provide, cardiac care teams can effectively impact the management trajectory of transplant patients with complications. Transplant standards should reflect the increased utility of these tools to ensure providers have more guidance when suspecting rejection when biopsy shows otherwise.

• #50 Bradycardia in Recent Heart Transplant: Will the Microscope Illuminate the True Answer? | Methodist DeBakey Cardiovascular J

  https://journal.houstonmethodist.org/articles/10.14797/PREM9909

  While the use of EMB, donor-specific antibodies (DSAs), and gene expression profiling (GEP) are in the ISHLT guidelines for the care of heart transplant recipients, incorporation of DD-cfDNA and MMDx are new and not yet included. […] The utility of artificial intelligence when used by cardiac care teams should be evaluated further. […] Tools such as MMDx, a system that uses machine learning to compare gene expression to a given data set, can assist in managing transplant rejection. […] Further studies should be considered involving cellular rejection in heart transplants and the role MMDx and other machine-learning technologies can have when compared to the current gold standard. This could play a vital role in supplementing or replacing the information provided by EMB. […] The use of machine-learning tools like MMDx proved to be invaluable in the case of our patient, who had no evidence rejection on EMB. With the information these resources provide, cardiac care teams can effectively impact the management trajectory of transplant patients with complications. Transplant standards should reflect the increased utility of these tools to ensure providers have more guidance when suspecting rejection when biopsy shows otherwise.

• #51 FDA Drug Safety Communication: Revised recommendations for cardiovascular monitoring and use of multiple sclerosis drug Gilenya (fingolimod) | FDA

  https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-revised-recommendations-cardiovascular-monitoring-and-use-multiple

  FDA continues to recommend that all patients starting Gilenya be monitored for signs of a slow heart rate (bradycardia) for at least 6 hours after the first dose. […] In addition, FDA is now also recommending that the time of cardiovascular monitoring be extended past 6 hours in patients who are at higher risk for or who may not tolerate bradycardia. […] FDA concluded that it would be prudent to extend the monitoring period beyond 6 hours in patients who experience a heart rate of less than 45 beats per minute in the first 6 hours, or in those who had their lowest heart rate at 6 hours post-dose, as further bradycardia is still possible after 6 hours. […] FDA also reviewed postmarket data reported for Gilenya, including other deaths from apparent cardiovascular origin or of unknown origin.

• #52 Ictal bradycardia and asystole associated with intractable epilepsy: a case series – The British Journal of Cardiology

  https://bjcardio.co.uk/2010/09/ictal-bradycardia-and-asystole-associated-with-intractable-epilepsy-a-case-series/

  Ictal bradycardia/asystole is a poorly recognised cause of collapse late in the course of a typical complex partial seizure. Its recognition is important as it might potentially lead to sudden unexpected death in epilepsy (SUDEP). […] It is important to identify ictal bradycardia as a potential harbinger of lethal rhythms, such as asystole, as this may be one important mechanism leading to sudden unexpected death in epilepsy (SUDEP). […] The scarcity of epilepsy monitoring facilities means that ictal asystole will probably remain under-recognised. […] Intuitively, we postulate that early diagnosis and treatment of ictal asystole in patients with refractory epilepsy could prevent SUDEP. […] It is also apparent that there needs to be an increase in the number of epilepsy monitoring beds.

• #53 Differential Diagnosis of Bradycardia

  https://ddxof.com/bradycardia/

  Epidemiology7 […] Analysis of 277 patients presenting to the emergency department with compromising bradycardia. […] Symptoms […] Syncope (33%) […] Dizziness (22%) […] Angina (17%) […] Dyspnea/Heart Failure (11%) […] ECG […] High-grade AV block (48%) […] Sinus bradycardia (17%) […] Sinus arrest (15%) […] Slow atrial fibrillation (14%) […] Cause […] Primary (49%) […] Drug (21%) […] Ischemia/Infarction (14%) […] Pacemaker failure (6%) […] Intoxication (6%) […] Electrolyte disorder (4%)

• #54 Differential Diagnosis of Bradycardia

  https://ddxof.com/bradycardia/

  Epidemiology7 […] Analysis of 277 patients presenting to the emergency department with compromising bradycardia. […] Symptoms […] Syncope (33%) […] Dizziness (22%) […] Angina (17%) […] Dyspnea/Heart Failure (11%) […] ECG […] High-grade AV block (48%) […] Sinus bradycardia (17%) […] Sinus arrest (15%) […] Slow atrial fibrillation (14%) […] Cause […] Primary (49%) […] Drug (21%) […] Ischemia/Infarction (14%) […] Pacemaker failure (6%) […] Intoxication (6%) […] Electrolyte disorder (4%)

• #55 Differential Diagnosis of Bradycardia

  https://ddxof.com/bradycardia/

  Epidemiology7 […] Analysis of 277 patients presenting to the emergency department with compromising bradycardia. […] Symptoms […] Syncope (33%) […] Dizziness (22%) […] Angina (17%) […] Dyspnea/Heart Failure (11%) […] ECG […] High-grade AV block (48%) […] Sinus bradycardia (17%) […] Sinus arrest (15%) […] Slow atrial fibrillation (14%) […] Cause […] Primary (49%) […] Drug (21%) […] Ischemia/Infarction (14%) […] Pacemaker failure (6%) […] Intoxication (6%) […] Electrolyte disorder (4%)

• #56 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  Bradycardia, a condition characterized by an abnormally slow heart rate, poses significant challenges in terms of diagnosis and treatment. While it is a concern world-wide, low- and middle-income countries (LMICs) face substantial barriers in accessing appropriate bradycardia therapy. […] The cost of devices, limited number of implanting physicians, geographical isolation from major hospitals, and lack of education and awareness are major obstacles in delivering pacemaker therapy to patients in LMICs who meet the treatment guidelines. […] The prevalence of bradycardia globally varies from 0.5% to 2.0% in the general population. […] However, there are fewer studies on AV block and SND incidence compared to other heart arrhythmias like atrial fibrillation (AF), and this is especially true in lower-income countries where data on the incidence of bradycardia becomes even more sparse.

• #57 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  In many developing countries, heart block is the main cause of bradycardia, with SND accounting for only 5% of cases in some LMICs. […] These infectious diseases can directly affect the heart’s electrical conduction system, leading to bradycardia. […] While data is lacking on the incidence of bradycardia for many LMICs, there is available data on the rate of pacemaker implantation in many parts of the world. […] The treatment of conduction disorders and the use of device therapy require specialized physician training, a supportive healthcare workforce, and access to cutting-edge technology, which are often not readily available in LMICs. […] Several factors contribute to the limited access to bradycardia care in LMICs. These include underdeveloped healthcare infrastructure, lack of resources, high cost associated with procedures, a shortage of physicians trained in implanting devices, and low levels of patient awareness.

• #58 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  In many developing countries, heart block is the main cause of bradycardia, with SND accounting for only 5% of cases in some LMICs. […] These infectious diseases can directly affect the heart’s electrical conduction system, leading to bradycardia. […] While data is lacking on the incidence of bradycardia for many LMICs, there is available data on the rate of pacemaker implantation in many parts of the world. […] The treatment of conduction disorders and the use of device therapy require specialized physician training, a supportive healthcare workforce, and access to cutting-edge technology, which are often not readily available in LMICs. […] Several factors contribute to the limited access to bradycardia care in LMICs. These include underdeveloped healthcare infrastructure, lack of resources, high cost associated with procedures, a shortage of physicians trained in implanting devices, and low levels of patient awareness.

• #59 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  The scarcity of specialized cardiac centres and skilled healthcare professionals further exacerbates the challenges in providing care for bradycardia and other conduction disorders. […] Access to necessary healthcare services is hindered by financial barriers, even in regions where hospitals and trained physicians are available. […] In addition to the low number of implanting facilities and the price deterrent of pacemaker implants, there is also limited public awareness about cardiovascular diseases, including bradycardia, in LMICs. […] A shortage of trained healthcare professionals, particularly specialized cardiologists and EPs, hampers access to bradycardia therapy. […] Many regions within developing countries face geographical isolation from healthcare facilities, which are usually located in major cities. […] Limited research and data collection on cardiovascular diseases in LMICs hinders evidence-based interventions. […] Without accurate data, advocating for resources and policies to address bradycardia care becomes challenging.

• #60 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  The scarcity of specialized cardiac centres and skilled healthcare professionals further exacerbates the challenges in providing care for bradycardia and other conduction disorders. […] Access to necessary healthcare services is hindered by financial barriers, even in regions where hospitals and trained physicians are available. […] In addition to the low number of implanting facilities and the price deterrent of pacemaker implants, there is also limited public awareness about cardiovascular diseases, including bradycardia, in LMICs. […] A shortage of trained healthcare professionals, particularly specialized cardiologists and EPs, hampers access to bradycardia therapy. […] Many regions within developing countries face geographical isolation from healthcare facilities, which are usually located in major cities. […] Limited research and data collection on cardiovascular diseases in LMICs hinders evidence-based interventions. […] Without accurate data, advocating for resources and policies to address bradycardia care becomes challenging.

• #61 Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10689927/

  The scarcity of specialized cardiac centres and skilled healthcare professionals further exacerbates the challenges in providing care for bradycardia and other conduction disorders. […] Access to necessary healthcare services is hindered by financial barriers, even in regions where hospitals and trained physicians are available. […] In addition to the low number of implanting facilities and the price deterrent of pacemaker implants, there is also limited public awareness about cardiovascular diseases, including bradycardia, in LMICs. […] A shortage of trained healthcare professionals, particularly specialized cardiologists and EPs, hampers access to bradycardia therapy. […] Many regions within developing countries face geographical isolation from healthcare facilities, which are usually located in major cities. […] Limited research and data collection on cardiovascular diseases in LMICs hinders evidence-based interventions. […] Without accurate data, advocating for resources and policies to address bradycardia care becomes challenging.

• #62 Societies Publish New Guidance for the Treatment of Slow, Irregular Heartbeats – HRS

  https://www.hrsonline.org/news/societies-publish-new-guidance-treatment-slow-irregular-heartbeats/

  The American College of Cardiology, the American Heart Association and the Heart Rhythm Society today released a guideline for the evaluation and treatment of patients with bradycardia, or a slow heartbeat, and cardiac conduction disorders. […] Bradycardia is generally classified into three categories: sinus node dysfunction, atrioventricular (AV) block, and conduction disorders. […] Bradycardia and conduction abnormalities are more often seen in elderly patients. […] The guideline includes recommendations on post-procedure surveillance and pacemaker implantation. […] Yet, according to the authors, there are still knowledge gaps in understanding how to manage bradycardia, especially the evolving role of and developing technology for pacing. […] Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice.

• #63 Societies Publish New Guidance for the Treatment of Slow, Irregular Heartbeats – HRS

  https://www.hrsonline.org/news/societies-publish-new-guidance-treatment-slow-irregular-heartbeats/

  The American College of Cardiology, the American Heart Association and the Heart Rhythm Society today released a guideline for the evaluation and treatment of patients with bradycardia, or a slow heartbeat, and cardiac conduction disorders. […] Bradycardia is generally classified into three categories: sinus node dysfunction, atrioventricular (AV) block, and conduction disorders. […] Bradycardia and conduction abnormalities are more often seen in elderly patients. […] The guideline includes recommendations on post-procedure surveillance and pacemaker implantation. […] Yet, according to the authors, there are still knowledge gaps in understanding how to manage bradycardia, especially the evolving role of and developing technology for pacing. […] Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice.

• #64 Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-024-81983-x

  Our findings indicate, for the first time, that the threshold for bradycardias associated with hypo- and hyperglycemia is related to individual relative glucose levels. […] We also examined the expression of time-domain, frequency-domain, and nonlinear HRV features during the bradycardia events. […] Our results underscore the significance of implementing a personalized glucose monitoring approach for individuals with diabetes and CKD.

• #65 Ictal bradycardia and asystole associated with intractable epilepsy: a case series – The British Journal of Cardiology

  https://bjcardio.co.uk/2010/09/ictal-bradycardia-and-asystole-associated-with-intractable-epilepsy-a-case-series/

  Ictal bradycardia/asystole is a poorly recognised cause of collapse late in the course of a typical complex partial seizure. Its recognition is important as it might potentially lead to sudden unexpected death in epilepsy (SUDEP). […] It is important to identify ictal bradycardia as a potential harbinger of lethal rhythms, such as asystole, as this may be one important mechanism leading to sudden unexpected death in epilepsy (SUDEP). […] The scarcity of epilepsy monitoring facilities means that ictal asystole will probably remain under-recognised. […] Intuitively, we postulate that early diagnosis and treatment of ictal asystole in patients with refractory epilepsy could prevent SUDEP. […] It is also apparent that there needs to be an increase in the number of epilepsy monitoring beds.

• #66 Bradycardia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17841-bradycardia

  Bradycardia can happen to people of any age and background but is more common in adults over 65. It’s less common in younger adults and children because your heart rate naturally slows down as you get older. The exception is when it happens because of certain conditions you’re born with (genetic or otherwise). […] Bradycardia is a common condition among people in certain age groups and with certain circumstances. Its most common in the following: […] People over 65. This condition causes symptoms in about 1 in every 600 adults over age 65. That means there are over half a million adults over 65 with symptoms of this condition. However, the number of people with bradycardia but no symptoms is probably much higher. Bradycardia is especially common in older adults when theyre asleep. […] Bradycardia is an arrhythmia (abnormal heart rhythm) because it is slower than the typical rate. The normal heart rate range for adults is between 60 and 100 beats per minute. […] For people who do have symptoms or problems because of bradycardia, youre more likely to have a good outcome with early diagnosis and treatment. Delays in treatment, especially when bradycardia happens because of certain conditions, usually increase your risk of complications or death.

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