Low Heart Rate

[Vicmeister]

As I mentioned a few days ago, I've been waiting to hear from the Arrhythmia clinic. It's been 3 weeks and no phone call so I called today, got a voicemail. Hopefully I hear soon. Today I don't seem to have any energy and thought I would check my HR. I was shocked to see it was 43. Sure hope I don't go into AF. That's all I need. No wonder I have no energy. I think I may be a candidate for a pacemaker after all. But I had excellent advice from everyone and I will discuss all my options. I don't have any dizziness thank goodness but the low energy makes me very lazy and just not feeling myself. Feeling a bit down.😔

[wilsond]

HelloI sympathise as mine is kept at 50 / 55 but often dips down. Your low rate may be not 24/7.

Worth mentioning to your team, are you on any rate control meds ( bisoprolol, nevibrolol etc)

Are you under the care of a cardiologist or Electrophysiologist?

If so,highly recommend finding their Secretary, they're very efficient in my experience, they cut through the chaff. Example only recently on behalf of daughter in law,being messed about in the NHS ' system'.

One phone call from me,3 hours later,resolved.

Best wishes

[Vicmeister in reply to wilsond]

Hi Wilson

I will be seeing an EP at the arrhythmia clinic whenever I get an appointment. My heart rate is low a couple of times a day but not 24/7 and not everyday. Today it has been low for a couple of hours. Hence I guess my low energy. My resting heart rate averages around 58 BPM. As for rate control......I only take metoprolol when I have an AFIB event. And of course Eliquis. I will call again Monday. Thanks for responding.

[wilsond in reply to Vicmeister]

Best wishes. Resting 58 normally is acceptable, for us in the AF gang. Dipping down under 50 is not unusual but not welcome!Yes ,you will feel below par, as the engine is not supplying the petrol! Pace yourself according how you feel, try not to kick against it,ring in Monday and be politely persistent. Are you UK based? If so perhaps 111

[Vicmeister in reply to wilsond]

Hi Wilson. I am in Canada. I can be very persistent….lol. I will update. Keep well.

[opal11uk in reply to wilsond]

Totally agree, I always make 'friends' with the secretaries, it works!

[Ronnieboy]

My hr regularly dips down to 42 and never goes much above mid 50s,but I never seem to have any problems that I'm aware of .

[Vicmeister in reply to Ronnieboy]

You are lucky that you don't have any symptoms. 42 is pretty low. Keep well.

[Hidden in reply to Ronnieboy]

I am also in the span 42-52 (mostly about 46-48) bpm, permanently, but no problems at all. When I am in AF, my bpm is below 90. Slow running engine, lol!

[Vicmeister in reply to Hidden]

You are fortunate that you have no issues with a low HR. And oh how I wish that my AF was below 90. I take metoprolol as a PIP when in AF because my HR goes pretty fast. When in NSR my resting HR is in mid 50's and no real issues but I've noticed it dipping into the 40s and that is when I can feel the dip in energy. You are a rare animal....lol. Keep well.

[Ronnieboy in reply to Hidden]

To be honest I never seem to go into AF as far as I know ,when I did originally in 2009 the hr was 150,if I do some hard exercise it creeps up to 60ish.when I was younger I ran a few marathons whilst serving in the Royal signals,so maybe it's a legacy of that.

[Hidden in reply to Ronnieboy]

Hello, Ronnie! Nice to know that I am not alone with so slow HR! My resting HR was at 48, stable during my whole life. I was very keen to exercise where I was young, so my heart grew far over my body size (I am at 70-72 kg for decades). What I have noticed long ago, is that when under a heavy load, my HR would "spike" to 90, never over it, and then, after I would stop exercise I was doing, it would go down, to 48, within couple of seconds, with some unusual feeling in the chest (maybe transient irregularity of the pulse, like stumbling).

There are 2 reasons for such a slow resting (and general) HR.

Firstly, prolonged training, which was so correct, that it has not damaged the heart (between ourselves, damaging does happen pretty often if not careful enough). It might have been yours and my case. A prediction is that people with such, via exercise induced low HR, may live about 30% longer than the rest of the population. Good to know, lol!

As the second, people experience low resting HR when the HR control (regulation) gets out of order. In such cases, people may experience a lot of PVCs and, what is mostly unpleasant, pauses in the pulse (reported 5-7 sec to be the longest without fainting). At the present level of medical science, such patients usually get proposal for the pace-maker, what, according to my opinion, is not necessary in at least 50% of such cases.

Have a nice day, Ronnie!

Peter

[doodle68]

When not in a P-AF my heart rate was in the low 40s for a number of years and I felt ok, oh how I long for that low HR after months of crawling around breathless feeling I was running a never ending marathon with a HR in the 150 s (arrhythmia clinic unconcerned) while awaiting an ablation and now again following an ablation 9 days ago (I know early days but i am not optimistic) I am back in a breathless HR of 145 .

If you feel ok and not faint I would try not to worry.

[Vicmeister in reply to doodle68]

Hi doodle68. I do hope that the ablation works. It is early days. My concern with the low heart rate is having no energy. I'm just thankful that the low heart rate is not all day long. Be well.

[JOY2THEWORLD49]

Hi

Yes 43 is too low Day. My 24-heart monitor had me at average Night @ 47.

Diltiazem 120mg AM is my H/R Control.

Bisoprolol 2.5mg PM is my BP Control.

Have it checked out. It's how you feel. Jot everything down.

cheri JOY

[Vicmeister in reply to JOY2THEWORLD49]

43 is way too low especially with symptoms. You betcha I am writing everything down. Just glad that the low heart rate is not all the time. That would be horrid. But when it is I have no energy.

[Bigmark61]

I too get low heart rate below 50bpm usually at night when I go to bed and was low on energy I spoke to my consultant as I was getting worried about my appointment being missed as it had been 2 years since my last one. They did apologise but anyway after the chat they put me on Empagliflozin as she said it would help with my energy. Since using it it has improved some thankfully, I lost a few pound in weigh which can be a side effect. Take care 🖖🏼

[Vicmeister in reply to Bigmark61]

Thank you Bigmark61 for the info. Keep well.

[JOY2THEWORLD49 in reply to Bigmark61]

hi

interesting my DR LOCUM who has left the climic suggested just that med EMPAGLIFLOZIN.

BUT a barriers only funded for DIABETIC II amd MAORI patients.

Are you diabetic? joy

[Bigmark61 in reply to JOY2THEWORLD49]

No Joy but they discovered the connection to the medication and heart failure patients and it’s not long been allowed to be prescribed to patients with HF. Check it out if you can connect with this facebook page you can find out more about

facebook.com/pumpingmarvellous

Good luck 👍🏼

[JOY2THEWORLD49 in reply to Bigmark61]

HI

I READ ALL ABOUT IT. IT HAS A DIAURETIC IN IT.

I GO TO A NEW YOUNG MR CHAN ON 27 NOVEMBER AND I WILL ASK HIM.

ANY SIDE EFFECTS? IT WOULD BE AN ADDED MED. I HAVE SOME REGURGLITATION FROM THE RIGHT VENTRICLE AND DILATION ON LEFT SEEN BY THE EHO LAST MONTH.

CHERI JOY

[Bigmark61 in reply to JOY2THEWORLD49]

Joy the only side effect was losing a few pounds in weight as I’m not a diabetic it effect your blood sugars. Good luck with your appointment.

[JOY2THEWORLD49 in reply to Bigmark61]

hi

DR said it would affect my potassium which is 4.5. 5.0 is becoming toxic.

on a BMJ research re patient at 5.5 potassium another med was used to reduce his potassium.

This young Dr may be very uptodate with things.

I lost weight 6 kgs since MARCH this year. H/R WENT DOWN FROM. 88-96 dAY to 60s. But I NOW DRINK A2 milk and eat SOUR DOUGH.

CHERI JOY

[Ppiman]

Measured by my Apple Watch, I have days when I get a pulse range of 45-105 or similar but was told not to worry if it isn't causing me any health problems, which it doesn't seem to, although my energy levels are well down these days compared to recent years. I recall that you mentioned in a previous post that your Holter monitor test revealed a prolonged pause when you return to sinus rhythm after an AF episode and that this might need a permanent pacemaker to cure. I read a little around this and it seems an ablation can also be a way to improve this, in many cases better than a PM. Hopefully, it won't be long before you see your cardiologist and get this sorted once and for all since overlying all of your issues must be a lot of anxiety. That's always the case with me, at any rate, and I find it impossible to separate the effects of the two. In fact, I suspect, with me, anxiety is the worse of the two as it magnifies all else.

Steve

[Vicmeister in reply to Ppiman]

You're right about the anxiety. It definitely will make this worse. And I am a very anxious person. Yes there was a "conversion pause" when converting and I had lots of opinions on here pacemaker versus ablation. I have lots of questions for the EP. When my HR is low I have very low energy. Thankful it's not 24/7. Keep well.

[JOY2THEWORLD49 in reply to Ppiman]

HI STEVE

I GOT PAUSES WITH METOPROLOL. I WAS CHANGED TO BISOPROLOL. NO MORE PAUSES WITH THIS OR DILTIAZEM.

RESEARCH SAYS METOPROLOL SHOULD NOT BE USED WITH ASMATICS AND CERTAINLY NOT WITH AFERS.

BUT A PAUSE WOULD SLOW THE AVERAGE.

TAKE THE PAUSES OUT AND YOUR H/R WOULD RISE.

JOY

[Ppiman in reply to JOY2THEWORLD49]

Hi there, Joy. Luckily, I don't get pauses, only "missed" or "ectopic" beats that feel like "ripples" of palpitations. I think anyone with asthma will need to take extra care all round with beta blockers, especially if they are extra sensitive. It can;t be easy having AF and asthma.

How are you these days?

Steve.

[Swamps]

Good morning

I had afib with regular bouts after the initial episode waking after 2 hours in bed at 185BPM which stuck for four hours until medicated in hospital

I was put on beta blockers but with a naturally low HR already this was causing me problems with it going into the 30’s

I wore a pulse monitor and then presented the results to my GP who arranged for a consultation with a cardiologist! After numerous tests I had an ablation (now 10 years ago) I am and have been since no pacemaker, completely medication free and no afib or other heart issues since!

I asked the cardiologist what limitations there were on my participation in sports etc and he told me none, if I wanted I could complete an Ironman triathlon 🤣

Yes I consider myself fortunate but my point is don’t go straight for the pacemaker explore the other options first

Oh and the ablation takes about 3 months to fully take effect because it’s the resulting scar that forms on the heart that is the fix.

Post ablation I had regular readings of 28BPM at rest and for a while thought that they had broken me I used breathing excercises to bring it back up when the alarm went off

I now live a full and energetic life at 63, this year I cycled Lands end to John o Groats (950 miles) in 10 days for charity

I have done over 4000 miles cycling since February

I scuba dive, I am very active and up until retirement last year was an active police officer having only taken 2 weeks off for the ablation

Good luck hope this helps with your decision making. As I say I consider myself as very fortunate and happy to help others with what at the time seems like a weighty life affecting decision

[Vicmeister in reply to Swamps]

Good Morning. What a super positive post. Thank you for sharing your story. You're right about not jumping into getting a pacemaker. I am going to definitely weigh all my options. On my referral sheet to the arrhythmia clinic my cardiologist stated "pace maker vs ablation". That is just his opinion. I am going to ask EP lots of questions. I am not looking forward to something in my chest. Thanks again. So glad to hear you are doing so well. May it continue.

[Vonnegut]

Are you taking Bisoprolol? The lowest dose of that brought my heart rate down like that but only for three days as the pharmacist ( unlike the doctor) told me to let him know if I had any problems so I popped in to see him when I was feeling tired, he took my pulse and told me to stop taking it and the doc agreed! Nothing else was prescribed so I had to see an EP privately which is how I was prescribed Flecainide to take first as a PIP and now regularly. Good luck with finding what works for you soon!

[Vicmeister in reply to Vonnegut]

Hi there. I only take metoprolol when I have an AF attack. Otherwise I take no meds except for my anticoagulant (eliquis). So my HR is low naturally which is a worry but it's not all day. When it's low I have low energy. I am seeing an EP soon whenever I get an appointment and hopefully get this sorted. Thank you.

[Vonnegut in reply to Vicmeister]

Good luck. Hope you see the EP soon and find what works for you as we are all different.

[Vicmeister in reply to Vonnegut]

Thank you. I will update. Keep well.

[Vonnegut in reply to Vicmeister]

Thanks but sadly keeping well is out for me as I have chronic fatigue which is fairly debilitating but still alive and have my husband to care for me!

[Vicmeister in reply to Vonnegut]

Soooo sorry that you are feeling so poorly. Sending you a virtual hug.🤗 Glad that your hubby is there to care and help you.

[Vonnegut in reply to Vicmeister]

Thanks. He’s going off to do the shopping now and I’m resting up but at 79, I have outlived both of my parents and brain still in order - lovely dog - not sure what the thing is they have allocated me - leaves?

[Vicmeister in reply to Vonnegut]

Rest up Vonnegut. That's what I'm going to do on this rainy dreary day. My dog is my absolute pal. Her name is Sally and she is half golden and half border collie. Lots of hair everywhere!! She is so smart and loyal. I will put up with the hair because I love her so much. Take care and rest.

[Vonnegut in reply to Vicmeister]

Thank you- I thought I had already replied but it seems not so thanks again!

[Richie33]

Hello Vicmeister

I’m 78 and a male who has been treated for atrial flutter 4 years ago - no A Fib - have been athletic all my life and work out in gym as well as jog, walk, bike most days - my sleeping pulse rate all night long stays in the 30’s while my resting pulse rate awake stays in 40’s - when exercising my heart rate goes up over 120

My cardiologist says my current heart rates may have always been at those levels - exercise keeps me feeling very good - wish you the best with your own individual future

[Vicmeister in reply to Richie33]

Thank you Richie33. Glad to hear you are feeling good at those heart rates. When my HR is in the 40s I feel lazy and no energy. My resting HR is usually in mid 50s and I feel good at that rate. I am seeing my EP hopefully soon an get it all sorted. Keep well.

[Hidden]

My HR regularly goes below 45 - every night and sometimes during the day too. Actually just yesterday during the day I was sitting around and got the alert on my Apple watch to say it had gone below 45 for more than ten minutes. I'm not taking any medication that affects HR. I'm fairly fit and active.

My only point is that a HR in that range isn't necessarily going to make one feel unwell but we're all different of course.

[Vicmeister in reply to Hidden]

Thank you for responding. I agree that everyone is different. When my HR goes into the 40s, I have no energy and don't feel myself. I don't take any medication except as a PIP when having an Afib attack. I am seeing an EP soon so hopefully I can get this sorted.

[2learn]

Hi, have you had your heart scanned to see if any probs. I was told my low HR was a result of leaking mitral valve which needed fixing.

[Vicmeister in reply to 2learn]

Hi 2learn. Funny you should mention that. I do have a leaky mitral valve. I have asked if it could be causing my AF episodes. Answer was always no. BUT, when I see my EP (hopefully soon) I am definitely going to ask about the mitral valve and the slow HR. Thank you for suggesting the mitral valve. I wouldn't be concerned about the low HR if it weren't for the fact that I have no energy. Just glad that it doesn't stay low all day. That would be awful. Thanks again.

[2learn in reply to Vicmeister]

Hi, I had a number of scans over the yrs and was told that my heart was pumping well. However when they decided to do the valve repair they gave me a TOE internal scan and that revealed that my Ejection fraction rate (HR pumping rate) was only about 40% not what the scans had been saying that it was normal. So, after successful op I still needed a pacemaker, now 2yrs on my lastest scan says EFR up to 60% which is normal and PM stops my HR going below 60

[Vicmeister in reply to 2learn]

So the mitral valve wasn't the cause of the low HR? Sounds like the pacemaker corrected the low HR. Is that right?

[2learn in reply to Vicmeister]

My understanding is that because of a big leak, the heart was pumping agst less resistance so wasn't pumping efficiently hence the low EFR. The PM stops my HR going below 60. Other thing to check is sleep, do you sleep ok, cos sleep apnea can cause tiredness and lack of energy. good luck

[Vicmeister]

Thanks 2learn. I will update. Keep well.

[xr1450]

I had this same issue early this year. A few episodes of AF and also my heart rate plummeting to 37/38bpm and staying there for two or three hours at a time. I could not get to see anyone even after several frantic phone calls.

I figured that the beta blocker I take (nebivolol) is partly to reduce my heart rate so I made an executive decision of my own due to a horrible experience (heart probably stopped) and cut it by half from 5mg to 2.5mg. The slow heart rate stopped and I haven't had AF again since.

I am not saying you should do this I am only telling you what my experience was and how I dealt with it. When I eventual got to see my cardiologist he just said OK and left said to carry on as I was. I am due to see him again next month so we will see. Good luck and my advise is to INSIST you see someone.

[Vicmeister in reply to xr1450]

Hi there. Medications affect everyone sooooo differently. Good for you to think that the beta blocker might be the issue and to find out it was. It's amazing that you haven't had another AF episode as well. You are soooo lucky. My Af is awful. In my case I can't blame it on any medication because I only take metoprolol as a PIP when in Afib. Hopefully I will see the EP soon. Thanks and hope you are AF free forever. Have a super day.

[xr1450 in reply to xr1450]

Thanks.....I don't think for one minute my AF has permanently gone. it's been a problem for 15 years. I have Dilated cardiomyopathy and have had two ablations for the AF. I doubt very much that I have seen the last of it. But here's hoping. Good luck

[Vicmeister in reply to xr1450]

Well I hope you have seen the last of it. That would be the best. I would be happy if my Af episodes were less frequent. All the best to you.

[kocoach]

I just spoke to my cardiologist 2 weeks ago and told her my HR was like yours dropping down in the 40s and she told me not to be so concerned about the low HR. I didn't ask why not, so I am taking her advice and not worrying about it as much as I used to be. I've been seeing her for years now so I figure she knows better than I.

[Vicmeister in reply to kocoach]

Thanks kocoach. Your post made me feel better.

[Corrie12]

Hi mine goes down as low as 30 now it used to be 45 I'm waiting on ablation and a pacemaker. I've had many falls and now have hip issues due to falls from the heart rate when I was last in hospital with AF It was going from 230 bpm to 35 bpm hence I'm waiting on ablation and pacemaker. Still waiting I was last I'm hospital September.

[Vicmeister]

Hi! you’ve been through a lot. Thanks for sharing. I’m sure you will feel so much better after ablation and pacemaker. Keep us posted.

[credimus]

I was diagnosed with A/F in 2006. My HR has been or around 43 for the last two years. I have seen my cardiologist and have also been examined by a pacemaker consultant. I wore a monitor for a week after which it was decided that I carry on without a pacemaker. Energy wise I have good days and bad days but overall my quality if life us satisfactory if I keep my hopes modest.

[solarjdo69]

You could consider taking Hawthorne root/berry 500mg - 800mg once a day to start, increase to 2 /day if need be.

I take 800mg AM and 1 400mg PM b4 bed time. Increase the hearts beat strength and general heart improvement.

healthline.com/nutrition/ha...

Read the interactions / cautions just in case.

I take prescribed metropolol 2.5mg 1 / day and 240mg Diltiezem 1-2 times per day.

Sometimes I take only 1 diltiezem AM only.

[Vicmeister in reply to solarjdo69]

Thanks solarjdo69, I will give it a read.

[solarjdo69]

Here is one more helpful site.

draxe.com/nutrition/hawthor...

[Vicmeister]

Thank you very much.

[Denise-]

I was just the same. Average hr 43, went as low as 38 sometimes so tired and lethargic. Consultant took me off bisoprolol straight away. It's now around 55 and I feel much better