Bradycardia - Differential Diagnosis Framework and Management

Narrow Complex Bradycardia:

 • Regular: Sinus Bradycardia, AFib w/ AV Block, Atrial Tachy w/ AV Block, Junctional Escape

 • Irregular: Sinus Arrhythmia, Sinus Arrest, AFib w/ Slow Vent Rate, AFib w/ Variable AV Block, Mobitz I AV Block, Mobitz II AV Block

Wide Complex Bradycardia:

 • Regular: Regular SVT WI Wide QRS, Ventricular Escape

 • Irregular: Irregular SVT w/ Wide QRS, Mobitz II AV Block

Unstable Bradycardia Management:

1) PADS ON!!

2) Prepare for transcutaneous pacing

3) Depending on degree of instability and availability of resources:

  • Give atropine, ±

  • Bolus epinephrine & start infusion if successful, vs.

  • Start dopamine as substitute to epinephrine

4) Page Cardiology consultant

5) Address H's and T's



Sophia Hayes MD @Sophia_Hayes_MD



#Bradycardia #Differential #Diagnosis #Management #cardiology #criticalcare