THERAPEUTIC MANAGEMENT OF SYMPTOMATIC BRADYCARDIAS: STABILIZATION PROTOCOLS AND ADVANCED LIFE SUPPORT

Abstract

Symptomatic bradycardias constitute a potentially serious clinical condition in the emergency setting, requiring early recognition and immediate intervention to prevent hemodynamic instability and adverse outcomes. In this context, the present study aimed to synthesize recent evidence on the therapeutic management of these arrhythmias, with emphasis on stabilization protocols and advanced life support. This is a narrative literature review conducted in the PubMed database, encompassing publications from the last five years, in English and Portuguese, that addressed diagnosis, pathophysiological mechanisms, and therapeutic strategies, including reports of drug toxicity. The findings showed that the diagnosis depends on the correlation between clinical manifestations, such as syncope or hypotension, and electrocardiographic changes, such as sinus bradycardia and atrioventricular blocks. In addition, an increase in the incidence of cases associated with the use of drugs, including antivirals, chemotherapeutic agents, and corticosteroids, whose mechanisms involve alterations in cardiac electrical conduction and modulation of ion channels, was observed. It is noteworthy that intravenous atropine remains the first-line therapy in emergency management, while discontinuation of the causative agent and continuous cardiac monitoring for the minimum recommended period are fundamental for reversing the condition and preventing recurrences. In conclusion, effective management of symptomatic bradycardias requires an integrated approach, detailed etiological investigation, and rigorous application of Advanced Life Support protocols, with systematic electrocardiographic monitoring being an indispensable measure for patient safety.