Rosh Emergency Medicine Practice Test 2025 – 400 Free Practice Questions to Pass the Exam

The treatment of choice for symptomatic bradycardia is atropine. Atropine works by blocking the action of the vagus nerve, which decreases parasympathetic tone and increases heart rate. This anticholinergic mechanism is particularly effective in cases where bradycardia is associated with a high vagal tone, such as in certain types of heart blocks or in the setting of symptomatic bradyarrhythmias.

When a patient presents with symptomatic bradycardia—manifesting as dizziness, weakness, fatigue, or hypotension—prompt administration of atropine can help to quickly raise the heart rate and alleviate symptoms. While pacing may be employed in certain situations, especially in cases where atropine is ineffective or in high-degree heart blocks, it is not the first-line treatment unless the bradycardia is severe or persistent and the patient is unstable.

Defibrillation is indicated for life-threatening arrhythmias, such as ventricular fibrillation or pulseless ventricular tachycardia, rather than for bradycardia. Amiodarone is an antiarrhythmic medication used primarily for tachyarrhythmias, not bradycardia, and thus is not appropriate as a treatment for this condition.