Clinical profile and early in-hospital outcomes of bradyarrhythmias: A prospective observational study from a tertiary care centre in North India

Background: Bradyarrhythmias constitute an important cause of hemodynamic instability, recurrent syncope, and sudden cardiac events, especially in aging population. Regional data from the Indian subcontinent, particularly from Kashmir, remain limited despite rising device implantation rates. Objectives: To describe the demographic patterns, clinical presentation, electrocardiography (ECG) characteristics, pacing strategies, and short-term outcomes of patients presenting with bradyarrhythmias at a tertiary cardiac center in Kashmir. Methodology: A prospective observational study was conducted over 2 years and included 723 adult patients presenting with clinically significant bradyarrhythmias. Data collected included demographics, comorbidities, presenting symptoms, ECG findings, device therapy, and in-hospital outcomes. As the study was descriptive in nature, inferential statistical testing was not performed. Results: The majority were older adults, with a slight male predominance. Complete heart block (≈58%) emerged as the most frequent bradyarrhythmia, followed by sick sinus syndrome (≈12%), second-degree atrioventricular (AV) block (≈11%), and bifascicular/trifascicular blocks. Syncope and presyncope were the most common symptoms. Dual-chamber pacing was used in approximately three-fourths of patients and single-chamber pacing in nearly one-fifth. Procedural complications were infrequent and mostly minor. In-hospital mortality was low and confined to those with significant comorbidities or advanced conduction disease. Conclusion: Bradyarrhythmias remain a major clinical burden in Kashmir, dominated by advanced AV block. Timely diagnosis and appropriate pacemaker implantation, primarily dual-chamber systems, yield excellent short-term outcomes. Strengthening referral pathways and early recognition at peripheral centers may further reduce morbidity.