If symptomatic, standard ACLS guidelines for symptomatic bradycardia to include
Atropine 0.5mg IV q3-5min PRN total dose of 3mg
Transcutaneous pacing, followed by transvenous pacing
Dopamine IV consider for low BP 3mcg/kg/minute titrate up to 20 mcg/kg/minute
Dobutamine IV consider for heart failure at 5mcg/kg/minute titrate up to 20mcg/kg/minute if needed for HR and BP augmentation
Treat underlying etiology
Avoid AV nodal<unk> ing agents (e.g. β-blockers)
Atropine 0.5mg IV q3-5min PRN total dose of 3mg
Transcutaneous pacing, followed by transvenous pacing
Dopamine IV consider for low BP 3mcg/kg/minute titrate up to 20 mcg/kg/minute
Dobutamine IV consider for heart failure at 5mcg/kg/minute titrate up to 20mcg/kg/minute if needed for HR and BP augmentation
Trifascicular Block
Differential includes ischemic events, electrolyte abnormalities, and medication overdoses in addition to rheumatologic conditions[1][2]
Digital block
Anterior MI
Cervical spine clearance
Rheumatic fever
Nerve and regional blocks 
Myocarditis