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Patient
64-year-old man, hypertensive treated with amlodipine; control surface ECG; asymptomatic patient;
Trace
Atrial sinus activity (positive P waves in leads I, II, V5, V6 and negative in aVR); sinus bradycardia with rate of 45 bpm, normal PR, narrow QRS;
Exergue
The presence of a moderate sinus bradycardia is not pathological per se. The implantation of a pacemaker in this setting is justified only in the presence of symptoms.
This patient has a sinus bradycardia corresponding to a heart rate lower than 50 or 60 bpm (depending on definitions) at rest. The difference between physiological and pathological bradycardia may be difficult to determine.