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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.
An abnormal sinus bradycardia that is persistent is most often caused by intrinsic sinus node disease â disease within the sinus node itself. Usually, sinus node disease is due to a type of fibrosis (scarring) within the sinus node, which is a common manifestation of aging.