Low resting HR

[Stinky1953]

I've noticed a few people mention they have a low resting heart rate, as do I (50-54).

Is this common among AF sufferers?

[Paulbounce]

I can only speak from personal experience Stinky.

First thing in the morning my HR is just what you mention at rest - lowest yet 46. As the day goes on it will go up and certainly does after eating a big meal - maybe 75 / 77.

I'll hit about 120 - 130 doing my daily walk / run but it soon drops to 65 ish then lower.

In afib I'm lucky to get a resting HR of 80 / 90.

Again this is just my personal view and take on the matter. I am delighted to see a reading of 55 at rest (for me personally). My heart has now had time to 'recover' from the time I was in afib when it was working overtime (145 BPM at one point).

I had my telephone follow up with my cardio about 3 weeks ago now. I told him the information I have posted above - he seemed happy enough about it.

Just one final thing - you wrote

"Is this common among AF sufferers"

No - I wouldn't say 50 - 55 is common if you were actually in afib - it tends to shoot up rather than down. I assume you mean when you are in sinus ?

However (again it's just my experience) I'm well happy with that rate when in NR.

Paul

[Stinky1953 in reply to Paulbounce]

Good morning Paul. I must apologize - I didn't explain myself properly. I was interested to know if people with naturally low HR's were perhaps more prone to AF.

I think you have partially answered the question for me in that people who exercise a lot and end up with a low HR also tend to get AF.

I on the other hand have never exercised excessively, apart from when I was in the army, but I've always had a low HR.

When I'm in AF, as I have been for the last 7 weeks, my HR seldom drops below 100 even on 10mg Bisoprolol.

Tim

[Hidden in reply to Stinky1953]

I can be in AF with an HR of 70! HR usually in 40/50s. Have reduced Nebivolol to 1.5 but no effect.

[MarkS]

I think there are a couple of reasons for low HR when not in AF.

The first is that those with low HR's tend to be very fit and those who exercise a lot have a higher chance of getting AF. Hence there are a lot of cyclists on this forum who train (excessively?) hard and have low HR's.

Secondly, AFers often take beta blockers to lower their HR when in AF, but which which are also notorious for lowering HR too much when not in AF.

I used to exercise hard, which I think prompted my AF, and I also took a range of beta blockers including the ghastly sotalol, which combined reduced my HR to the 40's when not in AF. Now I've moderated exercise, had an ablation and dumped the beta blockers, my HR is around 65 which I'm happy with.

[Stinky1953 in reply to MarkS]

Good morning Mark. I was interested to know if people like myself with a naturally low HR were perhaps more prone to getting AF. Apart from when I was briefly in the army I have never exercised excessively but have always had a HR in the low 50's.

Beta blockers will take my HR into the low 40's but have little effect when I'm in AF as I have been for the last 7 weeks. Even on 10 mg Bisoprolol my HR seldom drops below 100.

Tim.

[DevonHubby1]

Wife is on 3.75mg Bisoprolol. Suffers from PAF but no serious attack since one hospitalised her a year ago. Her resting BPM is in the high 40s. We have assumed this low rate was due to the meds.

[Stinky1953 in reply to DevonHubby1]

Good morning. Bisoprolol is almost certainly the reason for your wife's low HR. I cannot tolerate Bisoprolol when not in AF - it makes my HR way too low and a feel as though I'm wading through treacle all day.

I was interested to know if people with a naturally low HR are perhaps more prone to AF

Tim

[Hidden]

Mine is generally about 55 but I am on 1.25mg of nebivolol and 150 mg of flecainde a day, it was usually lower 60s when not in AF up to nearly 200 when in it, I suspect the higher the dose the lower it goes, mine goes too low if i take anymore beta blocker. Nebivolol is the easiest to tolerate some of the others are awful.

Andy

[doodle68 in reply to Hidden]

Hi Andy I take nebivolol daily and when in P-AF I take an extra dose (5 mg) as a PIP to help to keep my HR down .

When asked to try increasing my daily dose to help to prevent the increase in episodes I was worried doing so when not in AF would lower my HR too much but strangely it didn't change, however I didn't feel great and became more breathless .

[Stinky1953 in reply to Hidden]

Good morning. Andy I was interested to know if people like myself with a naturally low HR were perhaps more prone to AF.

I've never heard of Nebivolol before but good to hear it's easier to tolerate. Will ask my doctor about it. Thank you.

Tim

[Hidden in reply to Stinky1953]

Hi Tim

Yes give it a try I was previously on bisoprolol which I think knocked it too low and also affects sleep I understand, I think nebivolol is more expensive and the NHS as we would expect goes for the cheapest option, my HR has never really been much over 60 but I have always exercised although I've moderated how much I push myself now due to AF, never max out anymore, mind you at 54 I think my high intensity workout days are over. Moderation but consistent best for AF I think and I rarely get attacks now.

Andy

[Stinky1953 in reply to Hidden]

Thank you Andy. I will ask my EP.

[doodle68]

Hello Stinky 😊 I have a low resting heart rate (48-58) and even during exercise struggle to raise it very much. This is due to taking beta blockers (nebivolol) which also lower my blood pressure.

It is not a problem for my and my doctor also says it is not a problem as long as I don't feel dizzy.

[secondtry]

I don't think for the majority of us AF sufferers there is any one cause (excepting some people like athletes overtraining), more a combination of bad lifestyle habits coupled with individual physical circumstances. MyHR is similar to yours and Paulbounce and I think it increases the chances of an AF episode but not a trigger in itself. I always recall a medic saying that when the main beat gets low it is a chance for the 'little drummers' to take over. To combat this I try to do regular exercise of some sort throughout the day and increase my motivation to improve other lifestyle habits to compensate.

[Stinky1953 in reply to secondtry]

Interestingly before my latest bout of AF started I had been doing more exercise than I had for years. It started with using a turbo trainer in lock down and then to riding my new bike. Since being in persistent AF I've not been able to exercise at all. All very frustrating.

[S11m]

AF usually causes increased heart rate, but some of have bradycardia AF, with low heart rate.

I have always had a low heart rate - I had postural hypotension when I was a teenager.

I was an endurance athlete - in 1995 I cycled 760 miles in 90 hours )Paris-Brest-Paris).

Before I had three cardioversions, two catheter ablations and two pacemakers, I was in "permanent" AF, and at night my pulse was getting down the 35, and my SPO2 to 75! (When I was fit, a resting heart rate of 30 was OK.)

[Stinky1953 in reply to S11m]

That's very interesting and 760 miles in 90 hours is very impressive.

It's interesting also that you had a slow HR even as a teenager. Perhaps there is a link between a naturally slow HR and AF.

[Physalis]

I think that people with normally higher heart rates can cope with medications which, say, bring their normal hr down from, say, 80 to 70. They don't have the same problems as a lot of people on here who are not happy to have it brought down from 60 to 50 or 50 to 40. Doctors don't seem to take this into account.

[Stinky1953 in reply to Physalis]

I agree totally. It astounds me that doctors prescribe beta blockers so willingly to those of us with a slow resting HR.

[VioletG]

I have had a slow resting heart rate for 20 years. My diagnosis is Sinus Node Dysfunction. Typical rate at rest is 45, but can dip into the 30’s whilst sleeping. It goes up to 100 with exercise. For many years I had no concerns and felt fine. I was just told that probably there was a pacemaker in my future sometime. But a year ago I saw an EP, who told me that people with slow hearts are at higher risk for developing Afib. I hadn’t known that, and sure enough, two months later I had my first episode of afib. So now have additional diagnosis of Paroxysmal Afib. Had six episodes. EP says all rate and rhythm medications not good for those with already slow hearts, so I had an ablation last December. I am having a second ablation next week to correct AFlutter which developed since the first ablation. I do believe my slow heart contributed to developing Afib.

[Stinky1953 in reply to VioletG]

Thanks Violet that's very interesting. None of the EP's I've seen have told me that but I will certainly ask the next time I see one. From the answers I'm getting it seems there is a link between a slow resting HR and an increased chance of developing AF

[Magson]

I have always had a fairly low testing HR . Around 50 bpm . My Cardiologist thought it was good to give me 1.25 mg of Bisopropol . Turns out it wasn't and it took my resting HR down to 40. It increased the frequency of my A F episodes which mostly occurred at 2.00 am. There were quite a few side effects with Bisopropol but that is another story. Stopped it after two years. Slow heart rate brings on AF? The jury's out.

[Stinky1953 in reply to Magson]

I get exactly the same problem with Bisoprolol if taken when not in AF. However now I'm in persistent AF and taking 10mg a day it doesn't seem to make any difference. Perhaps time to try a different beta blocker.

[Zozzy]

I have a fairly normal resting heart rate (58-64): it tends towards the low end when I'm in better shape/the day after exercise. I'm not on any meds and it's always been around that level pre-, during and post-AF (ablation in 2017).

My max heart rate has always been quite high (over 200 when pushing to the limit) - and even now (I no longer push that hard since the ablation) it doesn't take too much to push it over 180. The doctors' view: relative to my physiology my heart is a little smaller than average, so it beats a little faster when pushed.

During AF it would touch 225 on a gentle jog (and I was exhausted) and when I was on bisoprolol it would drop into the 40s (and I was always tired).

Steve

[Coco51]

I have had a low resting heart rate - bradycardia - all my life 48bpm typically. I am not a great exerciser though I have always been active. It's due to first degree heart block and a long PR interval. It never really bothered me tbh.

Since developing AF and taking Flecainide and Bisoprolol it's been down as low as 36 bpm at night, which bothered the EP. So I was strongly recommended a back up pacemaker to work only when the heartrate drops. I had one fitted in January and it works OK. Although the follow up checks have been postponed for Covid.🙄

I have a friend who also has bradycardia and she too has AF. Another friend, a former Olympic saleswoman- superfit- also has AF. I think, in answer to your question, there may well be some connection. (Maybe the AF is trying to compensate for the low rate? Probably something more technical...) Anyway VioletG 's EP in her post above seems to think so.

[Stinky1953 in reply to Coco51]

Thank you.

[LindaDaisy]

My natural heart rate is quite low. I am not energetic at all. When I had my ICD put in, it was also set up to pace me if I drop below 60. Technicians tell me I’m now paced about 75% of the time. Two reasons for setting the pacing

1. My underlying condition (LVNC) is the reason for my medications. My blood pressure and heart rate are low. Pacing was a way for them to give medication to support my heart While not letting my heart rate go too low.

2. My EP thought that when my heart rate dropped too low it triggered my AF. I definitely have less episodes of PAF now compared to before I had the ICD put in. When AF does occur I can often related it back to a possible trigger but not always.

[etlmadd]

I had a low heart rate all my life around 45, I exercised regularly , walking and gym, eat healthy but now have permanent AF, hated being on Bisopropol so weaned myself off it and now just take Edoxiban. Interesting to think there might be a link between low heart rate and AF

[Hidden]

My heart rate is often in the 40s and goes up to 50s or above when I feel well enough to get out for a walk which I haven't recently- it might have to do with age- I've 76 - but it's why I had to stop taking the daily 1.25mg bisoprolol after three days- goodness knows what that did to my heart rate but it exhausted me!