What is the initial treatment for symptomatic bradycardia in ACLS?

What is the initial treatment for symptomatic bradycardia in ACLS?

• A. Epinephrine infusion
• B. External pacing
• C. Dopamine infusion
• D. Atropine

Answer: (D)

Treating symptomatic bradycardia in ACLS begins with removing excessive vagal influence on the heart. Atropine blocks muscarinic receptors, which reduces parasympathetic braking of the SA node and AV node, letting automaticity and conduction increase. This rapid, direct action often restores a faster, more reliable heart rate and improves perfusion, making atropine the preferred first-line choice. It’s given as an IV bolus of 0.5 mg, repeatable every 3–5 minutes up to a total of 3 mg. If atropine doesn’t produce an adequate response or the rhythm suggests a high-grade AV block, escalation to pacing or infusions of dopamine or epinephrine is used to support heart rate and blood pressure.

Treating symptomatic bradycardia in ACLS begins with removing excessive vagal influence on the heart. Atropine blocks muscarinic receptors, which reduces parasympathetic braking of the SA node and AV node, letting automaticity and conduction increase. This rapid, direct action often restores a faster, more reliable heart rate and improves perfusion, making atropine the preferred first-line choice. It’s given as an IV bolus of 0.5 mg, repeatable every 3–5 minutes up to a total of 3 mg. If atropine doesn’t produce an adequate response or the rhythm suggests a high-grade AV block, escalation to pacing or infusions of dopamine or epinephrine is used to support heart rate and blood pressure.