What is the treatment of choice for symptomatic bradycardia?

The treatment of choice for symptomatic bradycardia is atropine administration. Atropine is an anticholinergic medication that works by blocking the actions of the vagus nerve on the heart. This action increases heart rate by inhibiting parasympathetic stimulation, which is particularly valuable in cases where the heart rate is excessively low and the patient is exhibiting symptoms such as dizziness, fatigue, or hypotension.

When bradycardia is symptomatic, it signifies that the low heart rate is adversely affecting the patient’s hemodynamic status, leading to these symptoms. The rapid administration of atropine can help restore an adequate heart rate and improve perfusion to vital organs, thereby alleviating these symptoms.

Other treatment options like exercise therapy, while beneficial for overall cardiovascular conditioning, are not immediate solutions for symptomatic bradycardia. Cardioversion is used for certain types of tachyarrhythmias and is not appropriate for bradycardic patients. Beta-blockers, in contrast, would exacerbate bradycardia rather than provide a solution, as they also work to decrease heart rate. Thus, atropine is the most suitable choice for effectively managing symptomatic bradycardia in an acute setting.