Bradycardia has been defined historically as a heart rate below 60 beats/minute (bpm). However, many healthy individuals have a resting heart rate below this and some groups (such as endurance athletes) may have a resting heart rate of less than 30 bpm. For this reason, a strict lower limit is probably not useful and clinicians should use the presence of symptoms as a guide to whether bradycardia warrants further investigation. The key role of the GP is in differentiating patients with pathological bradycardia, who need further investigation or referral, from those with physiological bradycardia who do not.
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