Having bradycardia (say "bray-dee-KAR-dee-uh") means that your child's heart beats slower than normal. The normal heart rate (pulse) for children and teens varies with age:

• Newborn: 120 to 160 bpm (beats per minute)
• Infant: 110 to 150 bpm
• 1 to 3 years: 90 to 130 bpm
• 4 to 6 years: 80 to 120 bpm
• 7 to 11 years: 70 to 110 bpm
• 12 years and older: 60 to 100 bpm

These are general ranges. Your child's heart rate can be a little higher or lower and still be normal. Heart rate also changes with activity and sleep.

For some children, bradycardia is normal if it doesn't cause symptoms or problems.

But in other children, it's a sign of a problem with the heart's electrical system. It means that the heart's natural pacemaker isn't working right or that the electrical pathways of the heart are disrupted. Sometimes, the heart beats so slowly that it doesn't pump enough blood to meet the body's needs. This can cause symptoms, such as feeling dizzy or weak. In some cases, it can be life-threatening.

Bradycardia can be caused by many things. Examples include:

• Problems with the structure of the heart.
• Physical activity. For example, kids who are very athletic may have a slower heart rate.
• Diseases that damage the heart's electrical system. These include infections.
• Conditions that can slow electrical impulses through the heart. Examples include having a low thyroid level (hypothyroidism) or having an electrolyte imbalance, such as too much potassium in the blood.
• Many types of medicines. Examples include heart medicines, seizure medicines, and opioid pain medicines.

Bradycardia can cause an irregular heartbeat. It can also make it harder for the heart to pump blood to the body. This may cause symptoms such as:

• Tiredness (fatigue), weakness, and loss of ability to exercise.
• Poor feeding in infants.
• Confusion.
• Shortness of breath.
• Dizziness or fainting.
• Chest pain.
• Swelling in the legs and feet.

Some children with bradycardia have no symptoms.

A doctor may take your child’s pulse, do a physical exam, ask questions about their health, and do an electrocardiogram (EKG or ECG). An EKG measures the electrical signals that control heart rhythm.

Bradycardia often comes and goes, so a standard EKG done in the doctor's office may not find it. An EKG can find bradycardia only if your child has it during the test. Your child may need to wear or carry a device called a portable, or ambulatory, electrocardiogram. Examples include a Holter monitor and a cardiac event monitor. Your child might use it for a day or more. It records your child’s heart rhythm while they go about their daily routine.

Your child may have other tests to find out if another problem is causing their slow heart rate.

Treatment of bradycardia depends on the cause. It also depends on the type your child has and how bad the symptoms are. If your child needs treatment, your options may include:

• Treatment of the underlying cause, if the cause can be fixed. For instance, if a medicine is causing the slow heartbeat, then stopping the medicine (under the doctor’s guidance) may correct the problem.
• Medicines. Medicines may be used to treat conditions that cause bradycardia. Some medicines can also be used for a short time to increase the heart rate. They are generally given through an I.V. (intravenous) line, so they aren't long-term solutions.
• Pacemaker. A small pacemaker is placed under the skin (usually in the chest) and connected to the heart. The device tracks your child’s heartbeat. When the heart beats too slowly, the device sends electrical impulses to keep the heart beating at the right pace.
• Temporary pacemaker. This device may be connected to the heart using wires guided through a blood vessel in your child's neck or leg to the heart. It's sometimes done using special pads placed on the chest. This treatment may be used in an emergency, as a bridge to permanent pacing, when pacing is needed only for a short time. It also may be done for more study of a child’s condition.

• If there are no symptoms, your child can usually continue all normal activities, including sports and exercise. A slow heart rate without symptoms is often normal, especially in active or athletic children.
• If your child has symptoms, have your child stop the activity and rest. Contact the doctor before allowing your child to return to sports or exercise.
• Work with the doctor on any lifestyle changes your child may need. These might mean changing your child’s diet and starting an exercise program.
• Follow the doctor's instructions about any medicines your child is taking. Do not stop or change any medicine without talking to the doctor first.

Call 911anytime you think your child may need emergency care. For example, call if your child:

• Has chest pain.
• Has chest pain that spreads to the shoulder, arm, neck, or back.
• Has trouble breathing.
• Has a slow heartbeat with dizziness or lightheadedness.
• Faints or loses consciousness.

Contact your doctor now or seek immediate medical care if your child:

• Has occasional weakness.
• Feels dizzy or lightheaded.
• Has unusual trouble exercising.