ABSTRACT
The need to treat bradycardias is dictated primarily by the clinical Presentation of the patient [1]. Bradycardia may bean incidental finding in asymptornatic patients [2]. On the other hand, bradycardia may present with haemodynamic instability and loss of consciousness [3]. Out of the bradycardic rhythms to be encountered in these patients, high grade atrioventricular-block represents a significant portion [4]. Compromising bradycardia requires an effective diagnostic and therapeutic approach [1]. The goal of initial management is stabilization by increase of the ventricular rate by both pharmacological and non-pharmacological interventions, sometimes even cardiopulmonary resuscitation is required [5]. A careful clinical workup for potential causes, including ischacmic and non-ischaemic aetiologies, is crucial for successful management [6]. There are only a few reports available on the management and outcome of patients presenting with compromising bradycardia to the emergency department [ED] [1]. This study include 210 consecutive patients, with compromising bradycardia, admitted to the emergency department of National Heart Institute [tertiary Care hospital] within eight month period, 107 patients [51%] females, 103 patients [49%] males, whose age ranged from 25 to 89 years. The aim of this study is to report the incidence, symptoms, presenting rhythm, underlying mechanism, management, and outcome of patients presenting with compromising bradycardia to the emergency department and to assess the incidence of patients in need for temporary and permanent pacing. All patients were subjected to full history taking, general and local cardiac examination, resting 12-leads ECG and routine laboratory investigation