Anyone else have a Resting Heart Rate of 50 bpm?

Hi, I have had PAF for 10 years but only very occaisionally get full blown episodes i.e. about twice a year. The current treatment is "pill in pocket" 100mg Flecainide and 2.5mg bisoprolol if I get an episode. Also take 75mg aspirin daily. Recently, I visited a different cardiologist and had an ECG and an echocardiogram and he said that he was concerned about my heart rate which was slow at 50 bpm. He said if I get an episode do not take the bisopropol as this could slow my heart rate down too much. I am due to go for more tests, a treadmill stress ECG to try to determine whether the slow heart rate is a problem. Also have been feeling very tired.

Does anyone else suffer the odd episode of AF but also has a slow heart rate?

Reading other posts it looks as if I should be on anti-coagulants. I am 69 so my CHAD/VASC score is 1 but shortly to be 70 when my score goes up to 2.

Cheers! Lofty

21 Replies

  • Hi. I was diagnosed 2 years go with PAF and have a CHADS/VACS2 score of 2. I am 66 years old. My resting heartbeat is usually around 48. I think this is probably because I am taking Bisoprolol and Losartan although it has always been on the low side. I also take 75mg Asprin.

  • My heart rate is medicated to be around 55 to 65. Occasionally it goes down to 50/52. As you are having tests it will show if it is an issue for you. Anticoagulation, please no aspirin for stroke risk as far as AF is concerned. Not sure if you need aspirin for another heart condition which is useful in some cases but a no no for AF stroke protection.

    Get yourself prescribed an anticoagulant as a priority. I was changed to one at age 60. Better safe than sorry.


  • You really MUST be anti coagulated as soon as possible. Aspirin is about as useful as a chocolate fire-guard for stroke prevention in AF so get sorted please. There is a recent post about a poor chap who took it on himself to stop taking warfarin as he only occasionally had events and within two weeks was fighting for his life after a massive stroke. There are still far too many doctors who think aspirin is useful. It has uses in other heart conditions and many people take both . Try to see an EP for the best advice and treatment.


  • My GP reflected BobD's comment. "You are 65 with PAF, why aren't you on an anticoag??" Now on Apixaban

  • Yes, I used to have a slow heart rate - low to mid forties. My GP halved my atenolol dose because of it, and also because I had cold feet. My resting heart rate was subsequently between 45 and 55, but since an ablation six weeks ago the heartbeat has been about 70 which seems very unfamiliar. It is slowing down a bit. I was quite happy with it slower - no problems at all.

  • Mine is usually around the mid 40's, a few years back my dose of Bisopropol was increased from 1.25 to 2.5 and this caused my pulse to drop to mid 30's. Hubby had to call 999 one day as I was disoriented and incomprehensible and he thought I had had a stroke. After a night in hospital they said it was probably a migraine attack, which I thought was rubbish as I have never suffered with that or lack of Oxygen to the brain due to low pulse,this was after they had discounted a TIA, which was all very reassuring not. I was put back on 1.25mg and had an MRI scan which was fine.

  • My RHR is about 43 (38 is the lowest I've seen), but it hasn't dropped since I went on the meds last year. Exercising is different, the meds have lowered my HR by about 12bpm. I'm on 100mg Flecainide and 120mg Diltiazem, and after the A&E gave me 5mg of Bisoprolol on top of that I was almost passing out walking home from the bus!

  • I have a slow RHR and only took bisoprolol for 4 days as pulse dropped too low!

  • I wish I knew what my resting heart rate was before A F . I never took any notice before getting crook and then It was of in an ambulance and I have been on pills ever since.My heart rate regularly goes below 50 at rest and anything below 45 makes me feel quite ill. I have been taken off one medication and it has improved slightly. I wish my cardio cared about me going below 50. He seems to think it's better to be slow in rhythm than fast in AF.I was put in hospital for the night a couple of months ago to see just how low my heart rate was going but the monitor I was on had an alarm that went off every time my heart rate droped below 47 .the only thing I learnt was that my heart rate always drops below 47 when I fall asleep and that you can't sleep with alarm in your ear.

  • I had a pacemaker fitted cos my resting pulse dropped below 30. Was told AF won't kill you but a very slow pulse will. Before all this started my pulse was 50 and I was fine


  • Pulse currently around 50, but previously in the low 40s when I was fitter. I feel completely fine with HR in the 40s.

    I was recently in the hospital (for a completely unrelated incident) and HR hovered around 37bpm. I still felt fine, but the docs and nurses were on tenterhooks!

  • I've been fine at 38 bpm.

  • I've been in NSR now since October last year, following a cardioversion. Saw my cardio last week for a check up (the first since the cardioversion). My pulse rate was and still is, around 50bpm. I suggested to him that maybe I should reduce or come off my 5mg Bisop dose, as I felt I didn't want to slow down any more. He didn't agree and was happy with the pulse rate. Instead, he took me off one of my hypertension drugs. So I guess , all the while you feel OK, a slow heart beat is acceptable. It all strikes me as so........experimental, sometimes!!

  • I suppose a slow HR is acceptable it one can function all right. I am similar to you, I have PAF, 68 years old and had a HR of 50bpm. With a HR of 50 I had trouble breathing at night, all my extremities were very cold and during the day I had zero energy. For me it was just not enough cardio output. Fortunately for me I have a pacemaker. After 13 months of trying I finally convinced my cardiologist to raise my resting HR from 50 to 60. I am breathing a lot easier and have more energy. I really feel that you should be on a anticoagulant and maybe try and see a EP.

  • My resting heart rate is 48 some times and 58 other times, it was recorded at 38bpm through night on tape,a couple of times. When I was at my fittest it was cardiologist said it wouldn't concern him if I was as fit as Linford Christie !but I,m not !

  • The NHS have told me that I'm "superfit", but according to the tables published by the American College of Sports Medicine I am in the bottom 10% of the population.

  • I have always had a low heart rate. My first trip to the hospital with what I came to know to be AF, I was given a beta blocker, not sure which one, and my heart rate went to 30. The hospital staff were a bit excited - gave me nitro and then two shots of morphine. These did nothing. I felt ok and probably after the effects of the drug wore off, my heart rate went back to my usual 60 or so. After lots of tests and a new slate of drugs, my heart rate would go into the low 40's to high 30's and then I would often go into AF. So after about 5 weeks of this, I went off all the drugs since none of the doctors knew what was happening and after about 6 weeks my heart rate went back to its usual 60 or so. Even when I exercise, my heart rate stays under 100. I have not had AF since. 'Someone on this forum posted this link It might be an idea to show this to your doctor.

  • Thanks to all the replies to my original post re. slow heart rate. The main point I have gathered is that I must come off 75mg aspirin and be on either warferin or one of the new anti-coagulants. Which would you go for? I am aware of the pros and cons of each - the main worry about the new anti-coags would seem to be that there is currently no antidote, so I would have to be careful with the chain saw! LOL

    Cheers! Lofty

  • If you put Wafarin v new anticoagulants in the search box you should find a very long thread re the pro and cons.

    Personally, after reading so many posts re peoples' problems with stabilizing their INR and as we travel so much so I don't have the flexibility to work to the NHS's fixed schedules I take Dabigatran (Pradaxa). Suits me fine and I had no problem getting the scripts from my GP. Not everyone on this forum seems to be so fortunate so you may not have a choice if your GP surgery has a policy of not prescribing the NOAC's because of cost (supposedly).

    Summarising the responses:- concensus seemed to be wafarin and it's use is well documented and researched and therefor no surprises. For many people whose INR stabalizes quickly and doesn't vary it seems to be a good choice. There is an antidote VITK for warfarin but there are also hospital procedures to reverse the effect of the NOAC's and there is an antidote in the pipeline. Bleeding issue was not a consideration for me. NOAC's have very short half life so are very predictable and they don't have the interactions with foods which warfarin does. You don't need the constant blood tests, however some feel safer having them as they find it reassuring to be told that they are adequately protected from stroke whereas for others its' all too inconvenient and imprecise.

    So you will get a variety of responses and I guess you need to make up your own mind - download the leaflets from the AFA site and read all you can about the latest studies on their efficacy.

  • Are you exercising regularly? A resting HR of 50 is normal for sports people.

  • Interesting to hear about the alternatives to warfarin. Like many of you, my GP wouldn't prescribe it because of the lack of antidote. I have a resting HR of 50 and I'm 57. Prior to the AF taking over my life, I ran a lot an trained quite hard. Now I run a bit and walk a lot. I've read that after ablation, your resting HR tends to be higher than before.

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