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Sinus bradycardia can be the result of many things including good physical fitness, medications, and some forms of heart block. Sinus refers to the sinus node, the heart's natural pacemaker which creates the normal regular heartbeat.
Bradycardia often starts in the sinus node. A slow heart rate may occur because the sinus node: 1  Discharges electrical impulses at a slower than normal rate. 2  Pauses or fails to discharge at a regular rate. 3  Discharges an electrical impulse that's blocked before causing the atria to contract.