The need for a pacemaker with a heart rate of 40 beats per minute should be patient-specific; patients with bradycardia in the awake state with dizziness and weakness need one. A heart rate of 40 beats per minute should first be assessed in what state the heart rate is, so an ambulatory electrocardiogram is recommended to find out the extent of bradycardia in the patient over a 24-hour period and to determine whether there are any symptoms associated with bradycardia. If the heart rate is at night during sleep, there are no symptoms, and there is no other serious arrhythmia, regular observation is recommended, and a pacemaker is not needed for the time being. If the heart rate is 40 beats per minute in the waking state, accompanied by symptoms such as weakness after activity, dizziness, chest tightness, etc., it is considered that the symptoms are related to bradycardia, and there is an indication for pacemaker installation. Or, if the patient has no discomfort but is accompanied by prolonged sinus arrest or severe arrhythmia, with the risk of fainting, shock, sudden death, etc., pacemaker installation is recommended. Patients with bradycardia should go to the hospital in time and be treated under the guidance of a doctor.