Algorithm for the diagnosis and management of sinus bradycardia

ECG: electrocardiogram; ETT: exercise tolerance test; TSH: thyroid stimulating hormone; IV: intravenous; MI: myocardial infarction; HR: heart rate; ILR: implantable loop recorder; SSS: sick sinus syndrome; PPM: permanent pacemaker.
* If atropine is ineffective, IV infusion of dopamine (2 to 10 mcg/kg/minute) or epinephrine (2 to 10 mcg/minute) may also be considered prior to temporary pacing.