The heart rate at rest usually fluctuates between 60 and 100/min, depending on the size of the heart and the individual training condition. In particularly well-trained people, heart rates below 50/min are more the rule.
Puls messen bei einer Bradykardie

Physiologic slow heart beat

If heart rates at rest are below 60/min even without endurance exercise, this is called bradycardia. This is by no means a cause for concern, but should be clarified and treated - especially if it is accompanied by complaints such as unusual fatigue, dizziness, fainting spells or shortness of breath during everyday exertion. Clinical examination, ECG, long-term ECG, stress test, cardiac ultrasound and laboratory tests help to confirm the diagnosis of bradycardia and identify possible causes. Occasionally, sleep medicine examinations or tilt table examinations are indicated for certain forms of bradycardic arrhythmia.

There are many ways to classify bradycardic arrhythmias. We prefer a pragmatic and practical approach:

Reversible ("reversible") causes. These include

- Side effects of medications (sleeping pills, opioids, antidepressants and antipsychotics, blood pressure medications and antiarrhythmic medications)

- Disturbances of the electrolyte ("blood salt") balance

- Inflammatory diseases (rheumatoid arthritis, lupus)

- Sleep-related breathing disorders (sleep apnoea syndrome). Irreversible causes

- Degenerative diseases of the cardiac muscle and conduction system

- Genetic diseases of cardiac ion channels

- Storage diseases of the heart

- Disease of the heart muscle and impaired blood supply to the heart

- Atrial flutter (Brady-Tachy syndrome)

If symptoms are present, often only the implantation of a pacemaker is helpful in the long term.

Bradycardia is a medical diagnosis, which is made by a doctor. In the meantime, however, everyday technical devices - such as an Apple Watch - can also provide the such as an Apple Watch - can provide initial indications of a cardiac arrhythmia.

Do you have a finding and would like a second opinion or are you not sure whether you have bradycardia? One of our specialists will be happy to take the time for a consultation. 

+41 44 999 18 88 Contact request

Conduction disorders

These slow arrhythmias also often have a degenerative cause. The symptoms are similar to those of sinus node disease: dizziness, fainting spells (syncope), shortness of breath during physical exertion. If the diagnosis is confirmed, pacemaker implantation can also make a symptom-free life possible in this case.

The classification of conduction disorders into AV block I-III degrees, bifascicular (two conduction pathways affected) or trifascicular (three conduction pathways disturbed), supra- or infrahisary (above or below the His bundle) is medically and prognostically important. Especially in older patients, a pragmatic symptom- and cause-related approach is helpful.

If symptoms are present, often only the implantation of a pacemaker is helpful in the long term.