A LITTLE CONFUSED: Just got back from... - Atrial Fibrillati...

Atrial Fibrillation Support

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A LITTLE CONFUSED

kocoach profile image
43 Replies

Just got back from the VA emergency room where I was told to go immediately by the VA nurse advice hotline. Fell asleep in my computer chair and when I awoke I put my oximeter on my finger and it showed a reading for heart rate of 37 but after a couple of blips went right up to normal which is around 54. I've never seen it that low before so I called the hotline. When I got to the ER they did an EKG, drew blood and took me to a bed where they took a chest x-ray and hooked me up to monitors. The Dr. came in and we talked, I told him I was on amiodarone and lisinopril and a few others. He looked at the vitals on the monitors and said they weren't bad but wait for the results of the x-ray and blood tests. After about an hour he came in and said everything was normal and that amiodarone was lowering my heart rate to 37 at rest, and he told me that the HR goes up and down during the day and to only take twice a day; in the morning and at night before bed and that it was better to have my heart rate low as it's not working so hard, and as long as I wasn't having any adverse symptoms he wasn't alarmed or concerned and discharged me and said not to worry. Has anyone else had any similar advice from your Dr.s? I always thought a low heart rate wasn't too good; but this Dr. seemed very knowledgeable.

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kocoach
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43 Replies
CDreamer profile image
CDreamer

Hi - what is normal for one person can cause symptoms for others. Your ‘normal’ of 54 is still below what most people would consider within normal range for a resting rate which is 60-100. Many atheletes will have much lower resting rates which are ‘normal’ for them - you don’t seemed to have been worried with a rate of 54 so I’m guessing that is normal for you.

A one off reading of 37 is low but it seems to have not stayed there for long so I would be very worried if it hadn’t come back up very quickly but not too concerned if it was just a blip. Good that you got checked out so if it happens again or you get symptoms of breathlessness when resting or feel lightheaded and dizzy - call your hotline straight away.

kocoach profile image
kocoach in reply to CDreamer

Thank You CDreamer, that what the ER Dr. said as well. I was an athelete at one time but that was a very long time ago. Just worried me seeing it that low for first time and it concerned the Hotline as well. Dr. also said if I wasn't taking amiodarone my HR would more than likely be really high. Had afib since 1995 but never seen heart rate this low. Have a Blessed day

jeanjeannie50 profile image
jeanjeannie50

I bought myself an oximeter recently, it was one that is supposedly used by St Johns and wasn't cheap. I can honestly say it's brought total misery into my life. If you don't have one, please don't get. Mine has an alarm for high or low heart rate and low oxygen levels. Well, they're always going off, just about every time I put it on my finger. It's a miracle I'm still alive, fortunately I just don't trust them!

Jean

Gumbie_Cat profile image
Gumbie_Cat in reply to jeanjeannie50

I rarely use the one that I bought. It always seems to give a low reading. I was at the GP, and he put one of these on my finger. I gasped at the low reading, and he said ‘what do you mean, it’s 98%. (I was, of course, reading it upside down….)

jeanjeannie50 profile image
jeanjeannie50 in reply to Gumbie_Cat

That made me laugh. The numbers on mine face me. x

Desanthony profile image
Desanthony in reply to jeanjeannie50

I bought a cheap one years ago and it seems really good - I couldn't cope with one with alarms on though. We often compare it to the one used at the surgery - or used to before Covid and the one they use at our pharmacy and it is still giving similar readings to those used by the professionals so happy with it - even if the back of it is broken so now the batteries occassionally fall out. It's been really useful to be able to ring the surgery and give them readings when my wife has been ill with asthma.

jeanjeannie50 profile image
jeanjeannie50 in reply to Desanthony

I had no idea it had alarms, bought it from a shop. If online, I think I would have rejected it, or perhaps at that time may have thought what a good idea - not realising how frequently it was going to go off.

Desanthony profile image
Desanthony in reply to jeanjeannie50

I think ours came from Lidl. If we have an odd reading we often take another straight away - same as we do with the BP Monitor. Pleased to say never had a very low reading.

kocoach profile image
kocoach in reply to Gumbie_Cat

Same here Gumbie_Cat at the emergency room hooked up on their monitors spo was 97 and heart rate 54 but at home spo was 92-94.. What good are these things if they're so inaccurate? The main things to be concerned about is not the numbers but the symptoms you're having. I learned a lot last night.

kocoach profile image
kocoach in reply to jeanjeannie50

Hi jean, I'm like but I bought not one but two of these which was fda and medical use approved and they are not accurate as I found out last night at the ER. Mine read 92-94 while their's was a steady 97. The Dr. told me it's the symptoms to be more concerned about not the readings. Have a great day.

jeanjeannie50 profile image
jeanjeannie50 in reply to kocoach

That's re-assured me, thank you.

baba profile image
baba in reply to jeanjeannie50

They don't give accurate heart rate when in Atrial Fibrillation.

jeanjeannie50 profile image
jeanjeannie50 in reply to baba

I'm in AF all the time, so have wasted my money.

baba profile image
baba in reply to jeanjeannie50

I think it should still give an accurate oxygen saturation reading but I’m no expert.

jeanjeannie50 profile image
jeanjeannie50 in reply to baba

Sadly, mine doesn't. Not unless mine really does go down to 89 at times. I suppose could still be because of the Pneumonia and covid I've had. I don't want to think about it anymore, have given up with using it. The alarm on it going off stresses me.

Hilianna profile image
Hilianna in reply to jeanjeannie50

How do you manage if you are in AF all the time? My AF visits me for about 4 - 5 hours or so and I feel pretty awful during that time. The AF has been more frequent recently and harder to concentrate on whatever I am doing. I also get lesser bouts of it where the heart rate stays lower but still shoots up and down. I register figures of between thirty odd (not very often, usually in the forties) and the hundred and sixties. Do you sit/lie down or try to keep going? I have had it for 4 years. Sometimes my legs feel very weak and standing is very difficult. Thanks.

jeanjeannie50 profile image
jeanjeannie50 in reply to Hilianna

I think you have to judge by how you're feeling. At times in the past my heart rate would go up and down and it would wear me out. Whenever I can I carry on as normal. Sitting thinking about what's going on only makes the situation worse. With some attacks you can do nothing else other than sit, but try to distract your mind by reading or watching tv, a good friend coming round for a chat is a great remedy too.

Jean

Cha275rL profile image
Cha275rL in reply to jeanjeannie50

I thought about getting one Jean, but def won’t now. That would make me totally paranoid, and I’m bad enough as it is lol. Are you feeling better now? I don’t comment much but do read it on here, and was sorry to hear how ill you were.

jeanjeannie50 profile image
jeanjeannie50 in reply to Cha275rL

No don't waste your money. I have a chest x-ray this week, plus an echocardiogram. Feel so much better now thank you.

baba profile image
baba in reply to jeanjeannie50

Glad you are being checked out, I hope all will be well.

C66t profile image
C66t in reply to jeanjeannie50

good luck with the check up. You have had a rotten time. I take my hat off to you esp eith the blasted afib.😇🥰

DawnTX profile image
DawnTX in reply to jeanjeannie50

I bought one also but I realize if it’s not on your finger a certain way the reading can be off. I did not spend a lot for mine but what I do is check it along with the one at my doctors when I am there to make sure they are the same numbers. I only take it to her three times a day. So far it’s been right on the money. Just like all machines so to speak you can’t live by what they say. Things go wrong with them. And just like blood sugar yes it could fluctuate within minutes and according to what you’re doing.

dedeottie profile image
dedeottie in reply to jeanjeannie50

if you have cold hands they don’t work! I have Reynauds disease and have to warm my hands on a hot water bottle before using. I recently went to the doctor with post covid chest infection and he spent 20 mins warming my hands until he could get a proper reading. He said he couldn’t let me leave the surgery with a reading as low as it was. By the time my hands were warm my reading was 99! X

jeanjeannie50 profile image
jeanjeannie50 in reply to dedeottie

That's interesting, yes my hands can often be cold. I'll put some thermal gloves on and give it another try..

Palpman profile image
Palpman

For many of us a heart rate in the 50's or even 40's is quite normal.

When mine dropped to 37 I took a Kardia reading. It showed no P waves so I concluded that it might be an AV Node junctional pulse.

kocoach profile image
kocoach in reply to Palpman

Thank You Palpman, I'll have to do some research on p waves and AV node junctional pulse.

beardy_chris profile image
beardy_chris

My cardiologist says "Don't worry about the numbers, how do you feel?" - and that applies to pulse, BP, SpO2 etc. He said that, if the numbers change rapidly, it /might/ be worth investigation but don't get fixated on them.

For example, your pulse rate will go up if you get a virus (e.g. a cold, not necessarily covid) as your body fights it off - all completely normal.

Buffafly profile image
Buffafly in reply to beardy_chris

I only use monitors (kardia, oximeter and peak flow meter) if I feel symptoms. I have a watch which shows that my HR fluctuates wildly during 24 hours. If I do suddenly feel ‘off’ I make a note of the time and look later to see if my HR was showing unusually high or low at that time. At that point I often notice that my HR spiked at 115 at some other time and I didn’t notice a thing.

Auriculaire profile image
Auriculaire in reply to Buffafly

I've stopped using my Kardia altogether. I know when I'm afib and seeing the high heart rate increased my anxiety and made my symptoms worse . Since stopping I have had some shorter episodes - they were always about 12 hours before.

Gillybean123 profile image
Gillybean123 in reply to Auriculaire

I have just sent a new blood pressure machine back. It kept scaring me as well. And I have taken my watch off. As you say we know when we are in AF. I just count it on my wrist. X

Gillybean123 profile image
Gillybean123

hi there, bit scary for you. How long have you been on the Amiodarone. I am 72 and am contemplating going on it. Was on it 13 years ago without any adverse effects but concerned about going on it again. We have to put our trust in the Doctors. But there is always a bit of doubt. My pulse went down to 40 a few weeks ago. I thought Oh *** jumped up and started moving then it was normal rate again. Hope you are feeling ok now.

Budken profile image
Budken

I was originally diagnosed with Paroxysmal Afib in 2011 in Florida. My Cardiologist ( the attending Cardiologist at the Emergency Room ) resisted the plan to convert me by shock. He instead put me on a 50mg dose of Flecainide, twice daily. The afib stopped within twenty minutes. He also put me on 25 mg of Metoprolol once a day. I asked why, and he said " it helps the Flec, work better ". I often noticed that upon waking up, my HR was only between 40 and 45 BPM. I asked about this, and he said, " this is what we want, we do not want you to go back into afib". A few years later, a different State and a different Cardiologist. I had occasional outbreaks of Afib that would last a few hours. The Doc in Florida had raised my Flecainide to 100 mg twice daily. The Doc, thought it was the Metoprolol and said the other Doc should never have put me on that. He said it was that, combined with the Flecainide that was causing my problems. I was also having intermittent PVC's. Weaning off the stuff was scary. My heart was jumping all over the place. I thought surely I was going to die. Five years later, I am living in Germany. I have not had a single outbreak of Afib since I stopped the Metoprolol, and very few PVC's. However my Cardiologist here, has said she does not like the slow Heart Rate. She thinks it is too slow. She wants to reduce my dosage of Flecainide, which was raised to 100mg twice daily, five years ago. Once again I am nervous. It seems each Cardiologist has their own idea of how this should be treated. In your case I think your Cardiologist probably knows best. However it is never harmful, to get a second opinion, from someone else.

ozziebob profile image
ozziebob

I just wanted to add that I am happy with my oximeter. To avoid potential quality control issues with cheaper Chinese made devices, I bought a slightly more expensive German made oximeter. Clever those Germans. No whistles and alerts though.

The one time I was able to compare my device to an oximeter at my Surgery, both showed the same 98%.

I bought it originally because I was waking with headaches and I was concerned I might have had low oxygen saturation during sleep. I have always experienced the occasional sudden forced inhalation as I wake or drift off in a relaxed state. Fortunately saturation was not the problem, but I always check my saturation whenever I'm feeling "off", and also usually just before bed to reassure myself all is well.

I really just wanted to say that oximeters are not without value to some of us.

baba profile image
baba in reply to ozziebob

I agree. I wouldn't use it to check my heart rate, now in permanent AF. But would check oxygen saturation if feeling breathlessness or had chest infection.

Qzwxecrv profile image
Qzwxecrv

Mine is lows 30s when I’m sleeping and mid 40s at rest during the day. My cardiologist said if there are no symptoms nothing to worry about.

kocoach profile image
kocoach in reply to Qzwxecrv

Exactly what mine said.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

37!

I was scared at 51 H/R when I had been 186 and 156 on other drugs BBs but the CCB Calcium Channel Blocker 180mg Diltiazem reduced me 105 at rest within 2 hours.

We settled on 120mg Diltiazem am and 2.5mg Bisoprolol night.

123/72. 77-88 H/R

Slow H/R comes with problems of dizziness on waking and getting up. You don't want any pauses!

I would have been delighted for Dr to put me on 24 hour heart monitor.

You have had an eCHO of heart I hope.

You have AF?

Dosage of your meds? Your age?

cheers JOY. 73. (NZ)

kocoach profile image
kocoach in reply to JOY2THEWORLD49

Hi JOY, yes 37, even just yesterday it dropped for a second to 34, lowest I've ever seen it but went right back up immediately and finally converted back to 54bpm after four hours. Dr. say's I have paroxismal afib and that is the hardest to find where the problem is as it keeps going in and out of afib at random. Yes had all the tests and was told all normal (who knows)? I was told better low than high as long as not having any adverse symptoms ( dizziness, fainting, shortness of breath, blurred vision, chest pain, trouble breathing etc.) I'm 76 years young on amidarone switched from Tikosyn before it was even approved for afib treatment (on trial study) so we'll just see where this goes. Thank You for reply and have a Blessed Day.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to kocoach

Hi

I couldn't operate with such a low H/R day. I dont notice at night.

Some talk about 'internal bleeding".

On anti-co.agulants we could be bleeding somewhere inside.

I was light headed on 51. I would not drive.

It happened on the new introduced drug Diltiazem CCB.

It was arranged to drop it to 120mg from 180mg (half dose0.

Otherwise it could be dehydration or weight loss.

My rapid persistent H/R is now under control.

cheers JOY

kocoach profile image
kocoach in reply to JOY2THEWORLD49

I was on diltiazem as a PIP when I went into afib but it caused my heart rate to go very low so I spoke with Dr. and I'm off of it now for quite some time but HR still goes low once in awhile. I would monitor your HR when on diltiazem just to see that it doesn't go very low.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to kocoach

Hi

I've been on reduced dose 120mg. I have got it under 100.

Even with low BP 115/70. my H/R can be a problem of going up to 103.

I need Diltiazem to lower the H/R day.

I am aware if heart rhymn comes normal itself which it can do with Papillary Thyroid Cancer removed, I would need to discontinue it.

No longer lower doses of under 120mg are available!

I'm resting after 2 teeth filled alongside each other. Last Wed but still had pain so checked in with Dr yesterday - must have an infection. Antibiotics are working thank goodness.

3-4pm next dose.

Honestly Diltiazem worked within 2 hours! Scary stuff when it took me at rest from 120's to 51.

Cheri. JOY

Elfiejean profile image
Elfiejean

My heartrate used to drop to 32 when I was sleeping. Had a week long monitor on. They put a pacemaker in me. I take 100mg of Amioderone daily. I believe everyone needs an evaluation and treatment based on their history and condition. Doubt that one treatment fits all. My awake pulse was in the 40"s. Told them this on many occasions. One day it finally bothered them. Go figure.

kocoach profile image
kocoach in reply to Elfiejean

Hi Elfijean, just yesterday during afib my HR dropped for a second to 34bpm but shot up right away and climbed back up to 136 then to 111 then to 99 it was all over the place but finally after four hours converted back to normal 54 bpm. My primary care Dr. called and sent an email to my EP and said they needed to either change dose of amiodarone or put me on a different medication. Like you say "go figure".

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