Low Heart Rate

[Harrythmia]

thanks to everyone who responded to my post. I am grateful for your comments and support. It is defined going to be worth raising with GP although this might involve a referral back to specialist who originally prescribed my heart meds. From what everyone’s experiences seem to suggest there are a myriad of reasons why some of us suffer with these episodes of bradycardia which may or may not be anything to worry about not least medication side effects, lifestyle and of course that curse of old age that creeps up on us ! Thanks again.

Incidentally, is it the general practice for patients who are on permanent heart rate controlling drugs to have regular checks and scans maybe even every two or five years to rule out any adverse effect or damage they may be having on the rest of the body? With BP medication most of us probably get regular blood tests to check on liver & kidney function etc . But the only time I seem to get an ECG or EKG on my “heart health” is when I have to go to A&E for a prolonged AF attack. I’m assuming most of us just keep taking these heart rate controlling drugs every day without a fuss even if they feel fine?

[BenHall1]

Re your last para ........ yes, normal for me, and I'd get real worried if there was any change to this practice. Annually for bog standard bloods and every 2 years for Echocardiogram. Apart from that I just keep scoffing my HR control meds even when I feel fine .... which is all the time. no AF now for at least 18 months, maybe closer to 4 years, just can't remember when now.

John

[Harrythmia in reply to BenHall1]

Really John ? EKG every 2 years as a routine call up ? That’s very reassuring for you. Not everyone has this level of EP monitoring probably certainly not on the nhs

[Karendeena in reply to Harrythmia]

I have only had 1 echo and that's just after I was diagnosed 3 years ago. I have had a couple of ECG but that's by my GP when having an afib episode

[bantam12]

I don’t get regular checks, scans or ecg’s, nothing other than yearly pacemaker check.

I don’t even have a cardiologist anymore, despite still having issues which my GP won’t get involved with so would have to be referred back as a new patient which is hopeless with waiting lists.

[Harrythmia in reply to bantam12]

Thanks bantam12 I agree. Unless it’s an emergency you have to re-enter the sausage machine of the nhs to get checked out.

[Janey1955]

Same here

[Ppiman]

The cardiologist I saw did write in his report that I should have an echo heart scan every year or two, but nothing has happened since then, in 2020. I keep thinking that I should mention it to my GP but that haunting let sleeping dogs lie mentality keeps me from doing that.

Steve

[Harrythmia in reply to Ppiman]

Hi Ppman. If the cardiologist advised you have scan annually or every two years then I would follow that advice. Your GP had the report on file so can see the recommendation for him/her self and arrange it.

[Ppiman in reply to Harrythmia]

I'll take your advice and ask him. Thanks.

Steve

[wilsond]

I have an annual ECG ,as I have a bicuspid aortic valve. I did have to remind them this year,as I noticed I wasn't called last year.( I was too focused on my upcoming ablation then to notice!)Quickly arranged,had 6 week wait and its on Thursday!

Also ,yes take tablets whether I feel I need them or not.

[Harrythmia in reply to wilsond]

Good luck with the ablation on Thursday wilsond. Yes, I agree, tablets are prescribed for a reason !

[wilsond in reply to Harrythmia]

Ah Sorry,didn't make myself clear. 8 had my ablation in June 2022,this Thursday is for Echo cardiographer and Holter monitor for my bicuspid aortic valve. It has only 2 flaps instead of 3,less efficient. Best wishes

[2learn]

Hi, I have NHS annual checks and a GP surgery that will do ECGs if I think I'm in Afib and refer if I am. If you have bradycardia you need to find out what maybe causing this and your consultant should arrange tests etc.

[Harrythmia in reply to 2learn]

Hi again 2Learn. You are right of course. Sudden changes like this need to be investigated but it’s not always possible for patients to have a direct line of comms with a cardiologist. For most of us our first port of call is the GP who may or may not decide to refer you.

[wilsond in reply to Harrythmia]

If you ever do get to see a cardiologist or even better an Electrophysiologist, I have always found that their Secretaries are the power behind the throne, very efficient and helpful.

[Deejay62]

I have an echo and ecg if I end up in a&e or sometimes my Gp might request one. They usually forward the results to my cardiologist. I have a CRT-D device fitted so they see what they need to see from that and that result if forwarded to EP if there’s anything that’s not good. My AF is persistent or permanent as stated in some reports. I don’t even feel it. I’m seeing my cardiologist every 9 months in person. It was 6 monthly in person and 6 monthly via phone. And my device checks are the same 6 monthly in clinic and 6 monthly monitor check.

[Harrythmia in reply to Deejay62]

Sounds like you’re being well monitored Deejay. You’re in good hands with your permanent AF

[JOY2THEWORLD49 in reply to Harrythmia]

Hi

44-45 H/R Day Resting is too low.

Starting off on Diltiazem 180mg I dropped to 51. Too low.

Diltiazem 120mg is fine for me. Was 88-96 then a year later 60s.

Get GP to try lesser dose.

NZ doesn't worry about the rhythm (flecainide)as much as over 100 H/R. You cant have an operation with over.

cheers Joy. 74. (NZ)

[Harrythmia in reply to JOY2THEWORLD49]

Thank you Joy. I will see what GP says to that suggestion about lowering Diltiazem.

[JOY2THEWORLD49]

Hi

Time on med can change.

I double check 4 x times month.

Last november and 11 months after introduction to CCB Diltiazem 120mg.

My H/R Day had changed from 88-96 to 60s! I feel improved with my exertion.

Always 47avg at night.

It is better to keep monitoring.

cheri JOY. 74. (NZ)

[Harrythmia in reply to JOY2THEWORLD49]

Hi Joy from NW. my Diltiazem went up from 200mg to 300mg pd but that was 2 yrs ago. so I’m not sure if it’s the Diltiazem, irbesartan or Flecainide or even a combination that may be having this effect on low HR. Don’t think my resting HR ever went down to 43-44 in the last 2 years. So will be asking GP

[JOY2THEWORLD49 in reply to Harrythmia]

Hi

It points to Diltiazem dose. With me 180mg activated H/R down 105 in 2 hours!

Maximum dose is 360 and the private H/Specialist said in his report thzt I could up as maximum dose 360mg!

But even 180g was too much.

I settled down with 120mg AM and Bisoprolol 2.5mg PM for BP.

That's a mighty big increase from 200-300mg. It is a powerful drug.

I lost 5kg and could be the reason my H/R fell. I tried just Bisoprolol but that was not right.

Check it out with Specialist.

On 180mg I was lightheaded and hated that.

cheers JOY

[Nerja2012]

Harrythmia. I've had PAF for seven years now, only seen a cardiologist once. I take Apixaban and low dose Bisoprolol, I never ever get called in for checkups or blood tests. As I've just had a pre op assessment which was fine I guess I'm OK. My GPs next to useless, I get all my help and info off this wonderfull forum .

[Harrythmia in reply to Nerja2012]

Hi Nerja. Yes, I’ve had PAF a bit longer (9 years.). It’s got gradually worse which in turn involved taking a higher daily dose of flecainide. It doesn’t resolve the issue as we all find, but helps me better manage it. On yours specific point, I think that generally speaking, once you’re prescribed the right meds which “do the job” and also “agree with you”, you might get one or two follow-up checks. But after it may well be left to the individual to manage. That seems to be my experience.

In my case there’s been a deviation from the “norm” over the past 9 years in respect of my resting HR dropping suddenly for periods so the general consensus from this forum seems to be to either accept this change as nothing serious to worry about OR get checked out by the GP who may want to refer you.

I am following the latter route and am prepared to wait my time for an appointment. I’m not treating it as serious or urgent atm. I certainly have no intention of attending A&E about this for a scan unless absolutely essential. It’s hard to advise others what to do as we all know. I think it’s a personal choice and whatever gives peace of mind at the end of the day. Cheers Harry

[JOY2THEWORLD49 in reply to Nerja2012]

Hi

GPs are against changing meds given by specialists. They only put doses up or down.

They don't want the responsibility.

You should have at least 6 mthly blood tests. I have 3 monthly as stroke with AF and found to have Papillary cancer THyroid in 2019.

chers JOY. 74. (NZ)

[Nerja2012]

Harrythmia. I'm lucky in that my PAF hasn't changed at all ,episodes months apart so I guess as you say if the meds and lifestyle seem to work then there's no need for checkups but in your case it wouldn't hurt ,peace of mind is priceless. Keep well .