Bradycardia

Patients should be instructed to monitor heart rate and symptoms. It may be helpful for the patient to keep a symptom diary to record heart rate and blood pressure when symptomatic. Asymptomatic patients with bradycardia may monitor themselves as outpatients and notify their doctors only when they develop cardinal symptoms, such as dizziness, syncope, or exercise intolerance, or symptoms suggestive of congestive heart failure, so that therapy may be planned accordingly. For symptomatic patients who may require a pacemaker, shared decision making between the patient and provider should be performed in order to discuss the relative risks and benefits of pacemaker placement, and ensure that a pacemaker will be congruent with the patient's goals of care, values, and preferences. For patients with a pacemaker, scheduled follow-up care is needed. Patients must check the pacemaker pocket site for bleeding and infection and notify their doctor immediately if these occur. Batteries may last between 5 and 10 years.