Introduction

This rhythm does not require treatment, unless they are causing symptoms, i.e. syncope, dizziness, tiredness and poor effort tolerance. Sinus bradycardia < 50/minute or sinus arrest with slow escape rhythm, accompanied by hypotension, strongly suggests a treatable underlying cause:

• Acute inferior myocardial infarct

• Hyperkalaemia, especially if wide QRS and/or peaked T waves

• Drugs, especially combination of verapamil and ß –blocker or digoxin

• Hypothermia