This rhythm does not require treatment, unless it is causing symptoms, i.e. syncope, dizziness, tiredness and poor effort tolerance.
Sinus bradycardia <50 beats/minute or sinus arrest with slow escape rhythm, accompanied by hypotension, strongly suggest a treatable underlying cause such as:
» acute inferior myocardial infarct,
» hyperkalaemia, especially if wide QRS and/or peaked T waves,
» drugs, especially combination of verapamil and ß-blocker or digoxin,
» hypothermia, » hypoxia, or » hypothyroidism.
Treat the cause. Consider atropine if inferior infarct.
Refer all urgently to a cardiologist.