Diagnostic Code 7009 · 38 CFR §4.104
Bradycardia is an abnormally slow heart rate, typically below 60 beats per minute, that causes symptoms such as fatigue, dizziness, shortness of breath, or fainting. In veterans, bradycardia commonly develops as a side effect of medications like beta-blockers prescribed for other service-connected conditions, or from cardiac conduction system damage sustained during service. The condition can also result from sick sinus syndrome, heart block, or autonomic dysfunction related to traumatic brain injury. Many veterans with bradycardia require permanent pacemaker implantation, which changes how the VA evaluates the condition. The VA rates symptomatic bradycardia based on exercise capacity measured in metabolic equivalents (METs) and the presence of cardiac symptoms like dyspnea, fatigue, angina, or syncope.
| Rating | Criteria |
|---|---|
| 100% | |
| 60% | |
| 30% | |
| 10% |
Electrocardiogram (ECG/EKG) documenting the slow heart rate and any conduction abnormalities. Holter monitor or event monitor recordings showing bradycardia episodes and their frequency. Exercise stress test with METs estimation — this is the primary measurement for rating purposes. Echocardiogram showing any structural changes or ejection fraction measurements. Medical records documenting symptoms like syncope, presyncope, fatigue, and exercise intolerance. If bradycardia is medication-induced, records showing the service-connected condition requiring the medication and the prescription history. Pacemaker implantation records if applicable.