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Bradycardia is a low heart rate and often occurs in people who are very fit, such as athletes. However, it may also occur because of an underlying condition such as a heart problem or an underactive thyroid gland.

Bradycardia means that your heart beats very slowly. For most people, that heart rate is between 60 and 100 beats per minute (bpm) when resting.

A low heart rate (fewer than 60 bpm) may sometimes be normal and can be a sign of being very fit. Top athletes may have a pulse rate of fewer than 40 bpm. This normal slow heartbeat doesn't cause any problems and does not need any treatment. Bradycardia may also occur in older endurance athletes and may then need treatment with a pacemaker.

However, sometimes bradycardia is caused by an underlying medical condition and does cause symptoms. Bradycardia may be a sign of a problem with the heart's electrical system. It means that the heart's natural pacemaker isn't working right or that the electrical pathways of the heart are disrupted. In severe forms of bradycardia, the heart beats so slowly that it doesn't pump enough blood to meet the body's needs. This can cause symptoms and can be life-threatening.

Bradycardia may not cause any symptoms. However, bradycardia may cause you to feel:

There are many possible causes. Bradycardia may be normal, especially in young very fit people. Otherwise the possible causes include:

The treatment depends on the underlying cause and the symptoms. If the bradycardia isn't causing any symptoms there is no need for any treatment unless treatment is needed for the underlying cause of the bradycardia.

If damage to the heart's electrical system causes your heart to beat too slowly, you may need to have a pacemaker. A pacemaker is a device placed under your skin that helps correct the low heart rate. People who have a pacemaker can lead normal, active lives; however, this will also depend on the underlying condition.

If another medical problem, such as hypothyroidism or an imbalance of salts (electrolytes), is causing a low heart rate then treating the cause will often cure the bradycardia.

If a medicine is causing your heart to beat too slowly, your doctor may lower the dose of the medicine or change it to a different medicine.

Always obtain emergency help (in the UK, call 999) if you, or someone near you, have collapsed or if you have symptoms of a heart attack, such as severe chest pain or severe shortness of breath.

Also seek emergency help if your heart rate is slower than usual and you feel like you might pass out, or if you notice increased shortness of breath.

For most people, bradycardia will not cause any complications. Any complications will depend on the underlying cause of the slow heart rate.

If severe bradycardia isn't treated, it can lead to serious problems. These may include sudden collapse, fits (seizures) or even death.

Bradycardia can be caused by heart disease, so healthy lifestyle advice is very important. This includes healthy eating, not smoking, reducing body weight (if overweight) and taking regular exercise. See the separate leaflet called Cardiovascular Disease (Atheroma) for more details.

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