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Heart Rate below 50 bpm

Harrythmia profile image
41 Replies

I’ve been on both BP & AF meds for some time now with my resting HR usually hovering in the 60’s BPM.

However now I’m finding that my smartwatch is regularly alerting me that my heart rate is dropping to below 50bpm for short periods of time. Sometimes reading as low as 44 or 45bpm. Not sure if this is anything to be concerned about given that it tends to happen when I’m usually seated and resting so perhaps a reading sub-50 would be considered normal. Does anyone taking BP and/or AF meds experience similar episodes of low HR ? Harry

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Harrythmia profile image
Harrythmia
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41 Replies
MummaSoap profile image
MummaSoap

Hi Harry

Sorry to hear what you’re going through, it must be unsettling for you.

I suppose the main question is, are you symptomatic when you have these low readings or would you be unaware if your watch wasn’t there to tell you?

Might be worth starting a log of the date/time/what you were doing/duration/any symptoms and taking it with you to your next appointment with your medical professional?

I know some athletes can have low resting heart rate readings like that so may not be cause for concern but without any medical training myself, I can’t speak for your specific situation.

Best wishes

Soap 🧼

Harrythmia profile image
Harrythmia in reply toMummaSoap

Thank you Soap. You are right with your suggestions. Harry

BenHall1 profile image
BenHall1

Hi there Harry,,

TBH, you've told us the problem and your concern but there is much more anybody would need to know before sensibly commenting.

So, to start with ........ it sounds like my own experience with Bisoprolol which I've taken for 13 years and with the exception of a short period of time when it was increased to 7.5 mg a day taken at night which made me feel like the Zombie from the Land of the Living Dead, I've taken it at 5 mg a day taken at night. I have returned to 5mg and am still on it. It is a Beta Blocker which holds my day time resting heart rate in the range of 64 to 67 bpm. Over night, my sleeping resting heart rate drops to around 52 to 55 bpm and occasionally drops as low as 46 bpm. Very occasionally it drops this low during the daytime when I'm seated or resting .... and I feel like crap. But not often. The other point that is interesting is that Bisoprolol in addition to having properties which control the heart rate, also has properties for controlling blood pressure. All that said I am on, and have been on for much longer than Bisoprolol, BP specific meds too ( and still am) such as Ramipril and Felodopine. So, the Ramipril and Felodopine are taken in the morning and act on my BP during the day when I'm up and at 'em, and the Bisoprolol works when I'm asleep at night. Thats the idea anyway - but - as I said very, very rarely during the day my HR drops low, low ! Frankly, I don't worry about it .... I'd be far, far more worried if despite being on my dose of Bisoprolol my heart rate galloped away higher than 100 bpm for any length of time. Then I'd darn well worry. Anyway, thats my little story.

So to give you a more sensible answer my questions are ......... 1) What HR meds are you on and what BP meds are you on 2) what is the dose of each and 3) what time of day do you take it/them. Also, you've told us what your HR is doing but what is your average blood pressure doing ? So, my BP ( which is varying all the time, all day, every day - which is normal for it in anybody) is currently averaging around 130/70 - BUT - bearing in mind, getting this low at the age 78 does need the medication I've told you about. I'm not an athlete, never have been, been sedentry for decades ... not bovvered!

Apart from all that I agree with MummaSoaps comments.

Cheers.

John

mav7 profile image
mav7

below 50bpm for short periods of time

For peace of mind, may want to discuss with your doctor who knows your history. Does the heart rate go back to normal after the short period ?

He may prescribe a holter monitor to verify the readings. And possibly change your dosage of medication.

jeanjeannie50 profile image
jeanjeannie50

Hi Harry

I would make your GP aware of the low rate your heart is dropping to and ask if you could reduce your beta blocker slightly.

Jean

ETHEL103 profile image
ETHEL103

Hi I posted a similar question a few weeks ago.My heart rate is also low and drops into the forties during sleep.Not worried about that as it is in the normal sleeping range however it is usually slow whilst I'm resting ie 45 to 55 and its then it seems to lurch into ectopic beats which are horrible and I feel every one like a miss firing engine.I have tried to contact my arrhythmia nurse but I've had no reply as of yet.Guess it's holiday time.I cannot take Bisoprolol or any beta blockers as my rate goes even lower.My replies on here were see your Gp which in a different world is the way to go but unfortunately it's very difficult as our surgery seems to be urgent appointments on the day by calling at 8.30.Very frustrating.Best wishes and you are not alone .

Ppiman profile image
Ppiman

Mine is similar, but I am taking 1.25mg bisoprolol. I was told that if it is without symptoms, it's fine. Your doctor is your guide.

Steve

Foxey2 profile image
Foxey2

My resting bpm is about 50bpm and drops to 40bpm when asleep, this has always been the case for me and is why I can’t take bisoprolol or anything like that. It’s probably worth checking out, but for some people a low bpm is completely normal and doesn’t cause any issues.

pottypete1 profile image
pottypete1

I was taken off Bisoprolol because of a slow heart rate.

My heart rate is still low when resting - circa 40-45. Saw my EP the other day he said no concern unless it falls below 40 consistently.

Pete

Ewloe profile image
Ewloe

I’ve had a few episodes of lower than my normal low heart rate. ( bisoprolol and ramipril). My usual is in the 50’s, sometimes it’s in the upper 40’s though and that’s when I’m aware of feeling wiped out and can’t think properly. I know at night it occasionally goes to about 38 consultants not concerned with the occasional night time bradycardia.

A few weeks ago I’d been walking, then sat down and didn’t get my lunch or drink anything as I couldn’t at the time. I was starting to feel wiped out and struggling to concentrate on a conversation that was going on. Until my watch alerted me. My heart rate had been under 40 for 10 minutes. I immediately left the room and ate and drank. I exercise quite regularly and I’ve lost a little weight recently even though I’m not overweight to begin with.

I’m putting the low pulse down to my not keeping my fluids up, being a bit lighter and that day I’d missed lunch. I’m finding if I don’t drink enough then that evening or following day I’m more likely to have a lower pulse. I’m really trying to keep my fluids up and eating a little bit more ( healthy stuff mostly).

Caradomben profile image
Caradomben

My heart rate was always between 45/50 on Flecainide 100mgs x twice a day and bisoprol 1.25mgs a day and I had no problems. I was told as long as it maintains blood pressure it’s ok.

However after breast surgery 5 weeks ago I have been in continuous AF and now my rate 80-.90s and on 5mgs bisoprolol and 100mgs Flecainide twice a day . Blood pressure very low . I am due to have a cardioversion on Friday. So fingers crossed . If you are worried go back see your GP for reassurance x

Harrythmia profile image
Harrythmia in reply toCaradomben

Thank you Caradomben. You are right, although this appears a common side effect, it’s still worth mentioning to GP for further checks

I wish you well with the cardioversion on Friday . I’m sure it will be successful.

Caradomben profile image
Caradomben in reply toHarrythmia

Thank you . I hope you get sorted too x

Thomas45 profile image
Thomas45

First question is, is the watch accurate? If you check your own pulse is the watch counting the same number, or when you're at the doctor's does your equipment and theirs agree on results?Second question, is how do you actually feel when your watch says your heart rate is low?

If you feel light headed then you better contact your medical centre so they can do some tests.

wilsond profile image
wilsond

Mine is usually 50 to 55,I'm on blood pressure tablets plus 1.25 mg bisoprolol. It does dip below 50 at times. My EP and GP don't seem concerned. Perhaps mention it to yours?

Best wishes

RichMert profile image
RichMert

Only thing I can add here is the subject of Ectopic Heart beats. Ectopic Heart beats are not picked up by your watch when it comes to a bpm count so, it may show up as low bpm even though you are still getting a weak beat inbetween. My recorder was dropping down to 35 bpm when every other beat was an Ectopic. Bisoprolol has corrected it but I am now dealing with the side effects which could be reduced circulation whilst exercising and tiredness.

Harrythmia profile image
Harrythmia in reply toRichMert

Thanks Richmert. Had thought about the possibility of ectopic heartbeats having a role. But will look into. Cheers

Richie33 profile image
Richie33

Hello Harry

I am 78 years old and do walk-run-bike of 10 to 15 miles per day plus 30 minutes in gym. I take 20 mg of Xarelto and 10 mg of Lisinopril daily. Exercise elevates my pulse rate to 150 . My resting pulse rate slows to low 40’s . My sleeping pulse rate stays in the 30’s . I feel healthy and excellent with an active lifestyle. I have been tested thoroughly and have no symptoms of heart illness

Richard

Harrythmia profile image
Harrythmia in reply toRichie33

Hi Richard They are amazing stats ! You are obviously very fit and healthy which is keeping any side effects of your drugs well at bay. I guess you’ve not led a sedentary life which has probably benefited you in your later years so well done. Harry

Richie33 profile image
Richie33 in reply toHarrythmia

Harry

Wishing you the very best in life ahead .

Richard

Harrythmia profile image
Harrythmia in reply toRichie33

Thank you Richard for your good wishes.

2learn profile image
2learn

Hi, You haven't said what you're on. Bisoprolol brings down HR and BP. My experience and what docs have told me is that low HR is fine for athletes and some other exceptional people, but for most people it can indicate a heart prob other than AFib. Have you had a heart scan , angiogram etc to see what's happening. I had to have pacemaker to stop mine going below 60

Harrythmia profile image
Harrythmia in reply to2learn

Hi 2Learn No no scans or routine checks done. I’m on 200mg a day Flecainide and 300mg a day Diltiazem. So pretty high daily dosage of both that might explain these side effects

2learn profile image
2learn in reply toHarrythmia

Think you should ask for a scan to check everything is ok

Rostom profile image
Rostom

I have been on Flecainide for c.25 years (no Bisoprolol etc.). My Fitbit constantly shows my resting hear rate as 41 - 45. I was wondering if this was OK as it was not within the normal parameters that one reads about. Every doctor I have mentioned this to was not the least bit concerned! I now don't worry and assume it is just the combination of Felcainide and me!

Harrythmia profile image
Harrythmia in reply toRostom

Thank you Rostom. That IS a relief to know I’m not the only one with this issue Harry

jayjay10000 profile image
jayjay10000

Hi Harrythmia. I also experience low heart rate when resting, eg watching TV, my heart rate is between 46 to 55 and when sleeping 40 to 45, I have told my Doctor more than one occasion. When my heart rate drops below 50 I start feeling light headed and faint. My legs feels like someone squeezing them and I start getting pins and needles in my feet, it's all to do with oxygen in the blood circulation. If you start getting any of these symptoms you need to go straight to ED( A&E ) but as I was told by the doctor at the hospital only your GP can make any changes to your medication.

Harrythmia profile image
Harrythmia in reply tojayjay10000

Thanks Jayjay. This whole experience would appear to be quite commonplace and probably an adverse effect of the medications we are all on. As you say, still worth getting it checked out in case there are other underlying issues as yet undetected Harry

LaceyLady profile image
LaceyLady

Bradycardia. I get this when sitting and more so at night. Medication was flecainide and Bisoprolol. I’d cut the Bisoprolol to 1/2 tablet but still got it. Anyway, ended up having a change of meds to Dronedarone 500mg x 2.

Still getting the low hr 🙄 Itsall very well drs telling you it’s ok, but in my book it’s not if it’s making you feel off and dizzy.

Why is it older people have so many falls???

My cardiologist mentioned a pacemaker 😳 No Way.

Hi Harry, may be worth while checking out the FibriCheck app.(medically certified by NHS). You can download the app onto a smartwatch, or phone.

You can register any number of readings. It records arrhythmias and ectopic beats. You get a detailed algorithm report, the algorithm also warns if you are tachy, Brady and or in AF.

Access to online medical experts. You can download and print the reports to take to your appointment.

My cardiologist was very impressed…

I swear by mine, and it keeps me sane…

Good luck.

Harrythmia profile image
Harrythmia in reply toFight-the-good-fight

Thank you so much for this. Will download it. Harry

JeanetteH profile image
JeanetteH

My resting heart rate is about 52 and lower during the night but i have a pacemaker that kicks in if it goes below 50 as they increased my betablockers recently

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Are you on any meds?

I have an avge H/R asleep of 47. No one is worried, probably always been my normal.

On Diltiazem CCB my Day Rest is 60s. Now.

cheers Joy. 74. (NZ)

kocoach profile image
kocoach

Hello Harry, woke up this morning and my HR was 43 usually around while relaxing it's 50ish. I don't like it that low and am seeing my EP on the 17th this month. I talked to his nurse a couple of weeks ago and expressed my concern and she said maybe a pace and ablate and I emphatically told her NO adjust my Med's instead, so we'll see what happens. My old GP told me his father in laws was 50BPM and wasn't too concerned about it. Who knows? Hope you get yours sorted out.

Dianabee profile image
Dianabee

hi my resting heart rate according to my fit bit is 38 bpm. I take bp medication and about 5 years ago I was on medication for af. Recently concerned as it was so low I asked my gp who said the Fitbit was not picking up the ectopic beats.

mcgavigan profile image
mcgavigan

Well don't wait till it gets to zero! Are you taking bisoprolol? And if so, how many grams. Bisoprolol is formulated to, among other things, lower your heart rate. Maybe your taking more than you need. Check with your doc. Personally I cold-turkeyed them and I improved quite dramatically. But check with your doc...

Harrythmia profile image
Harrythmia in reply tomcgavigan

No, not bisoprolol. Diltiazem and Flecainide. Diltiazem was increased by a third to help control PAF.

Lolabob123 profile image
Lolabob123

Hi Harry Ive been on Bisoprolol 5mg and my bpm was dropping to 40s my gp reduced it to 1.25 my rate has improved but since Ive hadmor breif episodes of slow af or paroxysmal af so I think Ineede to go back to gp

best of luck Stephen.

Harrythmia profile image
Harrythmia in reply toLolabob123

Hi Stephen. I’m sorry to hear of your flow AF. Sounds like with these meds that trying to fix one thing creates a problem elsewhere ! I suppose it’s a question of balancing the risks of putting up with a slow HR or more frequent episodes of AF. I think GP/cardiologist will advise on this Cheers Harry

Ronnieboy profile image
Ronnieboy

My hr is between a high of mid 50s and low of mid 40s,its been like this for years ,I feel fine . I havnt had an AF attack for years now ,and to be honest I just live my life and dont worry about things to much...

Harrythmia profile image
Harrythmia in reply toRonnieboy

Hi Ronnieboy. You’ve great a great outlook on it. The fact that your AF has stopped completely must be a great reassurance. Harry

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