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The preferred treatment for symptomatic bradycardia in children is transcutaneous external cardiac pacing. This approach is often used in emergency situations where a child exhibits signs of significant bradycardia, such as altered mental status, poor perfusion, or hypotension.

Transcutaneous pacing involves using surface electrodes to deliver electrical impulses to the heart, effectively prompting it to beat at an appropriate rate. It is a recommended intervention, especially when the bradycardia is symptomatic or when the child is hemodynamically unstable.

While atropine can also be used for bradycardia, it is generally not the first-line intervention in emergency settings for symptomatic cases. Adenosine is primarily used for certain types of supraventricular tachycardia rather than bradycardia, and lidocaine is an antiarrhythmic that is used for ventricular arrhythmias rather than for the treatment of bradycardia. Hence, transcutaneous external cardiac pacing is the most effective and immediate method for addressing symptomatic bradycardia in a pediatric patient.