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Bradycardia in children

Frank Zimmerman, MD
Section Editor
John K Triedman, MD
Deputy Editor
Carrie Armsby, MD, MPH


Bradycardia is defined as a heart rate below the normal range for age (table 1). Bradycardia is caused by intrinsic dysfunction or injury to the heart's conduction system or by extrinsic factors acting on a normal heart and its conduction system. Children who have bradycardia with poor perfusion or shock need immediate medical attention (algorithm 1). In patients with non-life-threatening symptoms, the management is dependent upon the severity of symptoms, the specific conduction defect, and whether there is underlying congenital heart disease (CHD).

The causes, evaluation, diagnosis, management, and outcome of bradycardia in children will be discussed here. Other forms of irregular heart rate in children and principles of pediatric advanced life support are discussed separately. (See "Irregular heart rate (arrhythmias) in children" and "Pediatric advanced life support (PALS)".)


The normal range for heart rate varies with age (table 1) [1]. Younger patients have higher heart rates that decrease to adult values by the late teenage years.

The threshold used to define bradycardia varies somewhat based upon the criteria used. For the purpose of this topic review, we consider bradycardia to be defined as a heart rate measured in the awake state that is below the normal range for age (table 1).

Alternate definitions are as follows:

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Literature review current through: Nov 2017. | This topic last updated: Sep 08, 2016.
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