Bradyarrhythmias are frequently encountered in primary care; they comprise various rhythm disturbances including sinoatrial node and atrioventricular conduction disorders. Clinical presentation varies from a wide range of symptomatic presentations including dizziness, syncope, dyspnoea, fatigue and heart failure symptoms to the asymptomatic, incidental finding. Diagnosing patients correctly including a symptom–rhythm correlation is important, especially as some carry a risk of sudden death. In this article we will discuss disease states, diagnosis, referral and an essential guide to cardiac pacemakers, the primary lifelong treatment option for selected patients without reversible causes.
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