Sinus Bradycardia with pause episodes

[HuskyHendrix]

Are 1.5 sec sinus pauses serious?

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I would think this might translate to a heart rate of 40. Can you explain the context of this finding? Has the cardio you saw yesterday told you about this? Or is it recorded on your monitor? Are you on any medication which could contribute to this? What is your cardiac history?

[HuskyHendrix]

I take 50 mg. of losartan postassium for high blood pressure. Resting heart rate is generally around 51-56. Recorded a strip on my I-watch and had intermittent pauses of about 1.25 to 1.5 secs. Watch diagnosed it as a-fib, but heart rate never got above 65. Thanks Oyster

[Hidden in reply to HuskyHendrix]

I haven’t read that losartan potassium causes bradycardia or heart block at normal doses. But anything is possible and I would run that by your cardio. You don’t seem very happy with him, why not get a second opinion?

[Buffafly in reply to HuskyHendrix]

Ectopics?

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From your post yesterday, it sounds like the main issue here is whether you need a permanent pacemaker. In this context, the short duration of sinus arrest may be of secondary importance. Does your cardio suspect sick sinus syndrome?

The symptoms the cardio will be most concerned about in relation to a PM I imagine, would be dizzy spells, feeling faint and blacking out, related to fall in cardiac output as it affects your brain.

Did you check about driving? This could be a big issue legally and insurance wise, until this is sorted out. Any doubts and you should not be driving until you have clarified this with the cardio in my opinion.

Only your cardiologist can advise you. I am not a doctor.

[pablojack]

Don't wish to confuse your issue but I have a similar persistent pause for 3 years and now a resting heart rate of around 46bpm.( immediately following cardioversion for atrial flutter) No symptoms at all even with short term use of bisoprolol taking bpm to 40. Either at rest or with fairly intense exercise.( beta blockers lower resting and maximum heart rate) However, as suggested, you may have something else going on. In my case , later diagnosis of dilated cardiomyopathy, which may or may not be connected to my bradycardia. Low heart rate and the pauses you describe do not in themselves cause cardiomyopathy or anything else I am aware of, but again, in my specific case, probably too much of a coincidence to be entirely unconnected, since my cardiomyopathy is deemed idiopathic. Yours seems much more likely to be a sinus issue though a heart rate of 51/56 is not particularly low. ( athletes have much lower resting heart rates) My message would be that the pause and the bpm is only significant if you have other symptoms or issues. If I only had the bpm and pause issues , and these were stable, then I would not be overly concerned.

However, you need to work with your cardiologist on your specific case and be somewhat persistent in seeking answers. if you develop symptoms, or your resting heart rate continue to drop, then indeed you may be a candidate for a pacemaker but this is more to do with the symptoms rather than the heart rate itself. Similarly with the driving issue.

[HuskyHendrix]

Thanks for your comments, Oyster. I have always had a resting heart rate of 48 to 54, as I do 50-60 mins of cardio 5-6 days a week and have run marathons. Had a stress echo a month ago and showed no signs of arterial stenosis or valve incompetence. Stress ECG showed possible v-fib during recovery; which is why primary care MD recommended an ambulatory monitor for 30 days. Had pause episodes while sleeping, but apparently experienced a single 5 sec pause while awake. Curiously, cardiologist told me to be aware of any symptoms, monitor my heart using the Apple I-watch and see him again in six weeks. Noticed a few 1-1.5 sec pauses, no symptoms, but somewhat predisposed to paranoia. Think I need both a new cardio and primary care physician.