Pacemakers
A pacemaker is a small device placed under the skin below the collarbone that stops the heart from beating too slowly.
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Conditions · Dubai
Bradycardia: a slow heart rate
Bradycardia means a slow heart rate, usually below 60 beats a minute at rest. It is often normal in fit people and during sleep. It matters when it causes dizziness, fainting, tiredness or breathlessness, or when tests show a risky type of heart block. Dr Shady Habboush assesses slow heart rhythms at Saudi German Hospital Dubai.
Dr Shady HabboushConsultant Interventional Cardiology · Saudi German Hospital Dubai2 min read3 sourcesMedically reviewed against ESC and NHS guidance
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Signs worth a check
- Dizziness, light-headedness or near-fainting
- Fainting (syncope), especially without warning
- Tiredness or breathlessness on effort that is new
- A slow pulse found on a smartwatch, ECG or check-up, with or without symptoms
Risks and alternatives
Not every slow heart rate needs a pacemaker. Treatment is guided by symptoms, the type of rhythm problem and its cause, and is explained with its benefits and risks before any decision.
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How it is assessed
- 01
History and examination, including a review of medicines that slow the heart, such as beta-blockers.
- 02
An ECG, and blood tests such as thyroid function and potassium.
- 03
Rhythm monitoring for one day or longer (Holter), or a longer-term monitor if symptoms are infrequent.
- 04
Sometimes an exercise test, to see whether the heart rate rises normally with effort.
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Treatment options
If a medicine or another treatable cause is responsible, treating that cause may be enough.
If the slow rhythm causes symptoms and has no reversible cause, a pacemaker is usually recommended; a leadless pacemaker suits some people.
A slow heart rate without symptoms, in a fit person, often needs no treatment.
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Questions about this
Is a heart rate of 50 dangerous?
Not necessarily. Many fit people have a resting rate of 50 or lower. It matters if you have symptoms or if an ECG shows heart block.
When do I need a pacemaker for a slow heart rate?
When the slow rhythm causes symptoms such as dizziness, fainting or tiredness and there is no reversible cause, or when tests show a high-risk type of heart block.
Can medicines cause a slow heart rate?
Yes. Beta-blockers, some calcium channel blockers, digoxin and some other medicines can. Do not stop a medicine without speaking to your doctor.
Can my smartwatch detect bradycardia?
It can show a low heart rate, which is a reason to get an ECG. It cannot diagnose the type of rhythm problem on its own.
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Related guides
Leadless pacemakers
A leadless pacemaker is a self-contained pacemaker about the size of a large vitamin capsule that is placed inside the heart through a vein in the leg.
Read the guidePalpitations
Palpitations are an awareness of your own heartbeat: racing, fluttering, skipping or pounding.
Read the guideSources
Medical facts on this page follow the sources below.
- NHS: Arrhythmia
- NHS: Heart block
- 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J 2021
Medically reviewed against ESC and NHS guidance · Updated October 2026. General information, not medical advice.
Location and booking
Book a consultation
Appointments are made through Saudi German Hospital Dubai, Hessa Street, Al Barsha 3. Consultations in Arabic, English and German.
- Address
- Hessa Street, Al Barsha 3, Dubai
- Languages
- Arabic, English, German
Chest pain right now? Do not wait for an appointment. Call 998 or go to the nearest emergency department.