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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).
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).