FOR APPs & PRIMARY CARE CLINICIANS
Bradycardia & heart block — Quick reference
First steps, urgent findings, referral guidance, and handoff essentials.
First steps
Review EKG/conduction pattern, symptoms, drugs, and reversible causes. Match intermittent symptoms to rhythm monitoring when appropriate.
Recognize the urgent patient
Symptomatic major pauses, advanced AV block, syncope with concerning conduction disease, or instability needs urgent monitored assessment.
When to refer
Refer suspected significant conduction disease or symptomatic bradycardia to cardiology/EP for pacing assessment.
What to send with the referral
EKGs and strips; symptom timing; medication list; relevant electrolytes/thyroid tests; previous monitor results.
Avoid this pitfall
A single heart-rate value does not decide pacing. Certain advanced blocks need treatment even without obvious symptoms.
Reviewed October 11, 2026. This quick reference summarizes the linked guide; use the full guide for context and clinical references.