If you experience any of the following symptoms, such as frequent fatigue, weakness, lethargy, feeling uncomfortable with your heartbeat, dizziness, blackness or even fainting, you may have a slow heartbeat and should see a cardiologist. What is a normal heart and how does it function? A normal human heart is usually the size of your fist and beats rhythmically in your chest to deliver blood throughout your body. The rhythmic beating of the heart is controlled by the conduction system of the heart, which is responsible for controlling the rate of the heartbeat. The normal human heart beats 60-100 times per minute in a quiet state. If the heart’s conduction system is diseased or aging, it can cause a slow heartbeat. A slow heartbeat is not a complex disease and can usually be detected by a normal body ECG or 24-hour ambulatory ECG. There are two common causes of slow heartbeat: one is a medical condition called “sick sinus node syndrome”, or sick sinus, which is caused by a problem with the sinus node, which is responsible for the heart’s rhythmic instructions. Sometimes the sinus node sends out only 30 heartbeat commands a minute, sometimes no commands for a few seconds, and sometimes no response for 5-6 seconds. In this case, the blood is not sent out properly and the resulting lack of blood supply to the brain leads to dizziness, blackness or confusion and even loss of consciousness. Another type of AV block is caused by AV block. AV block disease is caused by the malfunction of the AV node and/or conduction bundle, resulting in the sinus node commands not reaching the ventricles and the ventricles beating slower than the atria, and this slower ventricular beating cannot meet the needs of our whole body blood supply, thus causing symptoms such as dizziness, weakness, easy fatigue, and in severe cases, loss of consciousness and even life-threatening. So how do you treat a slow heartbeat? Slow heartbeat is usually treated with medication and pacemaker therapy. Medication, such as atropine or isoproterenol, can increase the heart rate. In addition, some people are not sensitive to drug therapy, and drug therapy itself may have side effects, often causing new arrhythmias or other adverse effects, so it is not suitable for long-term treatment. Pacemaker therapy is the most effective treatment for tachycardia, as confirmed by numerous clinical studies. The pacemaker has been around for nearly 50 years and is now a very sophisticated medical device. It actually consists of two parts: one is the pacemaker implanted in the body, which contains the battery and the circuitry, and is actually a small battery-powered computer. The other part is the electrode lead, which reaches the heart via a vein and connects the pacemaker to the heart and is responsible for transmitting the pacemaker pulses to the heart and the heartbeat activity to the pacemaker. When the pacemaker senses that the patient’s heartbeat is normal, it is on standby and does not release electrical impulses to the heart, thus maintaining the heart’s normal rhythm, eliminating or reducing symptoms, and improving quality of life. or alleviate symptoms, improve quality of life, and prolong the patient’s life. Some studies suggest that the survival rate of patients with pacemaker implantation is significantly better than that of patients without pacemaker implantation, approaching that of the normal population. Is the pacemaker implantation procedure painful? What are the risks? Some people may be concerned that the procedure is painful or risky, but in fact pacemaker implantation is a simple and safe procedure. In the first step, the surgeon usually makes a small incision in the skin just below the collarbone and places an electrode lead through a vein into the heart. In the second step, a small pacemaker (usually the size of an ordinary watch) is placed under the skin in the lower part of the incision and the lead is attached to it. In the final step, the incision is closed and sutured. The procedure requires only local anesthesia and usually takes only 1 to 2 hours to complete, and the patient is usually discharged about a week after the procedure. When a pacemaker is implanted, patients generally feel better about themselves than they did before the implantation and are able to not only perform normal work, school and activities, but also resume some of the lifestyles they had previously given up because of their slow heartbeat. Usually there are several types of pacemakers. Initially, pacemakers were only able to maintain the minimum frequency of the heart to safeguard the patient’s life, but with the continuous development of science, there are now dual-chamber pacemakers with frequency-adaptive function, which can issue the number of heartbeats corresponding to your different activities and work in a way that is almost close to the activity of a normal heart. In fact, some patients with pacemakers with frequency adaptation can participate in more strenuous sports such as long-distance running and hiking.