Final answer:
Sinus bradycardia treatment begins with atropine administration, and, if necessary, can escalate to pacing or dopamine/epinephrine, with a pacemaker as a longer-term solution for serious cases. Identifying and treating the underlying cause is also vital.
Step-by-step explanation:
The first line treatment for symptomatic sinus bradycardia involves identifying the underlying cause and addressing it promptly. If the bradycardia is causing significant symptoms that suggest the heart is not providing sufficient oxygenated blood to the tissues, immediate treatment is required. For acute management, intravenous atropine is the first line medication. If atropine is ineffective and the patient is hemodynamically unstable, additional interventions like transcutaneous pacing or the administration of dopamine or epinephrine may be necessary.
Inherent causes of bradycardia such as abnormalities in the SA or AV node may require the installation of a pacemaker if the condition is serious. External factors causing bradycardia can include conditions like thyroid pathologies, metabolic or electrolyte imbalances, and over-prescription of beta blocker medications. In these cases, correcting the external cause is crucial, and might involve adjusting medication levels or treating the metabolic disorder.