In the case of ACLS and EMS services, we will use the terms bradycardia and bradyarrhythmia interchangeably to refer to both slow sinus and non-sinus rhythms. The algorithm for bradycardias with a pulse does not require distinguishing between these two types of rhythms. The fact that the patient is symptomatic is enough to begin treatment. 

The provider must consider three factors:

• The patient has bradycardia
• The patient has symptoms or signs caused by bradycardia
• The patient is stable or unstable