I have had a low HR all my life, about 45bpm and I am not and have not been an athlete. I think it is genetic. I have now developed paroxysmal AFib and HR shoots up to 130 and stays there for several hours and then reverts to 40 or below. My Apple Watch tells me that the time in which my HR is below 40 is steadily increasing. In February this year it was never below 40 and now it is often below 40 for up to 5 hours. There has been a steady linear increase in the time HR is below 40 which correlates with the time in AFib which has also been steadily increasing. Has anyone else got a heart like mine and how was it treated. I am currently on flecainide Pip ( sotalol did not work). I am thinking ablation or pacemaker. Any advice would be gratefully received.
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I'm not an expert but suspect a PM may well help. It sounds like your AF may be bradycardia related so maintaining a rate of 60 or better could well stop this. Best discuss with your cardiologist.
Thanks for your response. I will certainly discuss with my cardiologist and also try to get a 2nd opinion. It is curious. Is the bradycardia causing the AFib or the AFib causing the increase in bradycardia?
My Dad had a low HR due to AV Node block if I remember and he was fitted a PM, but lately he has been blacking out for several seconds and then he comes to in AF ( about 100BPM) This then causes confusion the next day. He has dementia whereby he has no short term memory now, but the confusion is different.
His PM only keeps his HR to 60BPM,but it is always irregular as the PM just puts a beat here and there. When he has these attacks his BP drops as well.
I think he is having a pause like you were having Bob and comes round when the PM catches up and as it certainly having an effect on his dementia.
I think his low HR could be the cause as he has a mixed dementia 50% vascular.
He his in a home and the nurse practioner wanted to stop his Bisoprolol last week to improve his postural hypotension and change to Amlodipine but I objected as I think he needs the beta blocker for his AF control, The cardiologist at the hospital agreed with me
He his 90 years old so not much they can do to help
I HAD A STROKE WITH AF RAPID AND PERSISTENT IN 2019 BUT DURING MY STAY IN HOSPITAL A CAROTID ARTERIES CHECK found the scanner checking my shadow on thyroid so Papillary Cancer was biopsied and diagnosed.
Apart from the rapid H/Rate of 186 avg Day on Metoprolol and pauses at night 47avg bpm on a 24hr Heart Monitor, Bisoprolol was 156 and not much better at conytolling my heart beat.
My normal Night Heart Neat was always been low - cold shoulders and feet at night.
? why. No one can tell me.
For 2yrs 6 mths I've been on CCB Diltiazem 120mg AM which controls heart beat at 60s day. BB Bisoprolol 2.5mg PM which controls my BP.
Diltiazem has an anti-arrhymic affect and because heart STRUCTURE is abnormal I cannot have cardioversion, ablation or anti-arrhymic med like flec....
You need an ECHO, ECG, a 24hr Heart Monitor urgently. Only then will the specialist see what is going on.
I also run at a lower body temperature of 36.5.
Now BP is 120-132. / 69-79.
Many ablations through scarring have lowered heart rates too low and yours is already low.
I was lightheaded at 51 during the day so do you have symptoms at such a low heart rate?
See what the Heart Specialist says.
I guess that you don't know when the AF happens for a pill in the pocket?
It's a wonder you have not called the Ambulance. I was scared that mine might go lower than 51 but it didn't and Diltiazem or Bisoprolol does not interfere t go lower than 47bpm at night.
Thanks for sending me the booklet. Do you have a detailed booklet on Sick sinus syndrome or brady-tachycardia. The main question is: Is the bradycardia causing the AFib, or is the AFib causing the decrease in HR and the prolonged time with a rate below 40? I think the answer to this question would determine whether ablation or a PM would be the answer. But how to find out?
Hey Sam, you might need to have a look at this brochure. It looks like it had an issue likely when being pdf’d and it makes for hard reading when the spacing has gone haywire.
A heart rate going below 40bpm is generally not viewed as good and generally leads to needing a pacemaker, but your circumstance where you've had a low rate all your life may be different. How do you feel when your rate goes very low?
Have you received any medical advice? I'm guessing you have as you have been prescribed medication.
Quite often when the heart rate goes low people can lose consciousness.
I hope that someone who has experienced what you have will come on the forum and tell you their story.
Thanks for your reponse. I feel fine even when my HR goes very low. I cannot tell it is low and have never fainted of had any symptoms. I am very active and swim everyday, even with a low heart rate. If I did not have my apple watch I would not even know. So the low heart rate doesn't give me any problems. It is the AFib which is causing the problems.
I have never heard of AF causing bradycardia but I have often heard of bradycardia ‘allowing’ AF. It would be interesting to know the answer to your question so please report if you find it.
That is a good question, LowT. I don't know what my ejection fraction is. My Fractional shortening is 50%. Normal range is >25% and there is apparently a correlation between FS and EF, but I cannot find what it is.
I am a very fit 77.
I take flecainide, xarelto and magnesium, Vit D3 and K an coenzyme Q10.
Have you spoken to your GP or Cardiologist about your recent change in symptoms, it would probably be wise to ring and do so.I've answered at this point because you mentioned the supplements you are taking.
I don't know if you are aware but both Magnesium and Coenzyme Q10 lower heart rate and can cause an increase in low heart rate ( bradycardia) particularly at night , and hypotension , especially if they are used by people whom are on drugs used to control aFib which reduce heart rate or blood pressure. They also increase your risk of bruising and cause a longer bleeding time for those on antiplatelet or anticoagulant medications.
They may not cause a noticeable interaction initially but as your aFib or other cardiovascular conditions change over time , or become managed , at this point the use of supplements can have a more negative effect , even if they were fine for you for some time.
Interactions can occur slowly over time and can eventually, in some cases, become a potential trigger for cardiac arrhythmias, even if the doses of your medications and supplements are spaced four hours apart as is often recommended.
It might be an idea to consider coming off your supplements and seeing if the symptoms and low heart rate improves which could take 4-6 weeks to show a steady pattern.
I would have thought that if you inform your Cardiologist about taking certain supplements they would suggest coming off them and possibly changing doses of certain medications to see if that would improve the situation before making the final decision about whether you required a pacemaker, so it could be worth jumping the gun on that so you could prove that the supplements weren't a factor at the initial appointment.
Toxic levels of Magnesium can slow heart rate. People who have poor kidney function should be aware of this. Usually extra Mg is just passed through kidneys.
You are certainly asking a lot of pertinent questions - more than my cardiologist! My HRvariability daily reading from Apple watch is mean 52 with a range of 31-86 when not in AFib (109 readings since Feb 2nd 2024.) I have put all the measurements in a graph and there is absolutely no trend - perfect straight line. The variability during Afib is 173 (159-254), also no trend.
Thyroid function TSH is 1.94mIU/L (right in the middle of the normal range.
I take magnesium bisglycinate 375mg twice a day.
I don't take a potassium supplement. My potassium level was 4.5mmol/L in february this year and 3.9mmol/L in june. Slightly on the low side normal is >4mmol/L. Should I be taking a potassium supplement. My cardiologist didn't think it was abnormal.
Eternally grateful for any advice.
Are you medically trained.? I was a research pharmacist.
⁶Hi pteridomania. I have AF permanent. Had a pm implanted 3 years ago. Im going to to our hospital tomorrow to have my pm adjusted as i am having a really bad time. Cant excersise at all. Walk downtown hr goes up to around 140. Im 82 yo so thats probably why im getting a sore chest and back ,breathing and fatigue probsso perpetually hunting for place to sit and rest. Im an ex life time athlete. While im at the hospital i will be given a homemonitor to take home ,its a biotronik messenger. Aparently it picks up a lot of info including ECG from the PM. Theres also a diary feature for patient input.Does anyone have experience of this.Im thinking im not fat away from being given AV node ablation or AV node isolation.
Sorry to hear about your problems. They sound a lot worse than mine. Hope they manage to find out more information from the biotronic messnger so they can put you on the right track.
I find the WATCH HRV one year trend display most useful rather than manually creating a graph
Have you had a loop recorder done?
Have you been diagnosed with sick sinus syndrome?
I use 200 mg elemental Mg from MgCitrate TID. No GI issue. How much elemental Mg are you getting per tablet?
I also take KCl 20 meq TID My K runs low to mid normal at that dose.
Do you have sleep apnea?
I use O2 ring nighty so have close monitoring if any AFib occurs during sleep. Also tracks O2 sat nicely. Takes less than a minute and provides nice comprehensive morning report.
No I haven't had a loop recorder but will be getting a Holter in the next couple of weeks.
I don't have sleep apnoea.
The Apple watch is pretty good a catching all the AFib episodes.
However the trend on the apple watch for HR variability, gives a very false impression, as it obviously records HRV when in AFib (very high) and when not in Afib and lumps it all together, so you cannot see the real trend. I prefer to follow the trend when not in AFib and separate out the trend when in AFib. This gives a better picture.
Forget all the watches, i just use an oxymeter, but dont need to really as most with AF know anyway when AF beginning. Just my own experience of PAF. Also you may have permanent AF, i have the intermittent type once a month at present.
Well i must have a good one because mine is very accurate, i have also got one of the BP monitors the Drs. use and it reads exactly the same h.rate, as i check both when in AF. Who told you oxymeters wont give accuracy during AF. mine literally goes up and down as my h.rate increased and lowers all through the episode, in fact i leave it on my finger most times, but try not to get obsessed with it.
Flec.. itself is a risky med. It has been known to make aF worse.
I understand that it wont bring heart rate down as its roll is to even out the irregularity of your heart beat.
Whereas CCB Diltiazem does both with me. Brings down my Heart Rate Beat and does the smoothing of the irregularity all at once. Taking it early AM Dr feels it is 'wearing off' towards late afternoon so does not interfere with the 47bpm at night.
I take the the 120mg CD. Diltiazem.
Yes some meds contain potassium and at 5 you should be watching this element closely.
Your TSH is OK but T3 and total T4 need to be checked as well. Thyroglubin serum is a marker for cancer of the thyroid. T3 can be raised by 2-4 Brazil nuts daily to increase selemium and also beef liver and sardines.
I don't do any supplements except for B12. I was found delicient in 2010. I take 1,000ug sublingual SOLGAR 100 nuggets. I take 1 on 3 days week. You should be at 700-800 level for us oldies.
This is separate blood test from your 3 mthly normal tests.
thanks for your response. I don't think diltiazam is right for me, as it is usually used for angina and high blood pressure which I do not have. I will look into checking T2 and T3.
I had to ask my cardiologist to test the TSH, as he would not normally do it. I am not happy with my cardiologist and have seeing a different one in September.
I have no other symptoms. I have no angina pain, flutters or palpations.
They do say with persistent AF as there is no stopping or starting AF symptoms once controlled disappear.
You say you do not have high blood pressure in your last post but the time previous you say that you do!???
I guess you will sort it out your fatigue and tiredness. It could be the Bisoprolol like it was for me with Metoprolol when I could not exert myself. If I did very little I had to lie down and would go to sleep.
BBs do that as there function is to block Adrenalin.
CCBs block calcium.
Ace block something else.
Instead of looking at meds and discounting them as "you don't have .... this or that" be open to trying each group separately under your cardiologist.
Thyroid problems are connected with AF. But cardiologists know about hearts and very little about thyroid problems.
You mean T3 and T4. (Not T2)
All the best. It was a private Cardiologist who tried me on Diltiazen. My BP wasn't overly hypertensive.
I was diagnosed with paroxysmal Afib in 2010. I was put on Amiodarone which I could not tolerate. I was then prescribed Sotalol which did help maintain sinus rhythm, but by early 2014 my heart rate frequently became extremely low (30s)
I was immediately referred for a pacemaker and it has eliminated the lows. My cardiologist felt that the pacemaker was a necessity because I was “at risk of sudden cardiac death” (his words) My pacemaker rate is 70
I agree with Bob that the pacemaker may help but that is just from my personal experience
Amiodorone not a nice drug, and it stays in your system for ages and counteracts with some other drugs too, my husband was on it but in the end had to come off as became quite ill it did its job but at a cost. he has COPD heart failure and AF,
I have PAF, and get by with PIP bisoprolol.
I always look up drugs they prescribe to know exactly what we are putting into our bodies.
Just wondering if your AF episodes are at night or anytime.
My PAF is always at night and my cardio thinks it's triggered by low HR, I have naturally low HR, not as low as yours. My cardio says it's the low HR that gives ectopics more opportunity come between the beats and disturb it triggering PAF ... see Sanjay Gupta about vagal type PAF ...
As Jean says if you're not fainting or feeling bad when the heart is very low then it may not be as big a problem as it sounds, however you obviously do need to know and ideally your cardio should be able to answer your questions.
My AFib is always when I am resting, never when I am moving about exercising or swimming.
My low HR does not cause me any problems at all, in fact I would not know I had it if I did not have an Apple Watch. So I am reluctant to have a pacemaker, unless it also cures the AFib. It is only the Afib which is a problem for me.
Hi, Your case could have been written by myself, i.e. h.r. around 48 in my case sometimes 50, always been the same and no athlete either, i have PAF, when i get an attack my h.rate though goes slightly higher than yours around 140, i take 2 bisoprolol stragiht away and it took last week 2 and half hours to come back to near normal, i get attacks areound one a month now, but my Cardio at Aberdeen Royal Infirmary is adament until and if cases of AF become permanent he will not use intervention apart from the meds, he tells me that i am no where near pacemaker with symptoms like your own, or ablations or all the other things they attempt, some cases successful some not. All i can tell you is what my Cardiologist believes, so i trust him and he is good, i am seeing him again soon, but one thing i want cleared up with him, is, is is safe to just sit and wait out the AF until it returns to normal, as one GP told me 15 mins in AF and need A & E. but that may have been before i was put on Bisoprolol.
Speak to your Cardio, but i wouldnt worry i am in the same boat, and my Cardio isnt worried.
Just a response to your 'sit it out and wait'.My EP told me that because I am medicated and on antibiotics anticoagulant that I can sit it out and wait as they would only monitor me in hospital. I have/had paroxysmal afib and my episodes would last for 36 hours!
I had an ablation in March this year so hoping that had knocked it on the head (well at least for now anyway)
Good to hear that I am not alone in the world and good to hear that you can trust your cardiologist. Mine sees me as a number, - "another old lady with Afib, here are your pills, nothing to do about it, just old age, come back in 6 months". I'm going to a different cardiologist in September.
Good to hear that your Afib is under control. Hopefully mine will be soon. Good luck
“Another old lady with Afib” sounds like a very familiar reaction from Drs 🤦🏻♀️
My late husband had the same heart problems as me and we both saw the same Cardiologist yet he was treated with far more urgency and respect, I used to get the typical pat on the head, off you go dear 😡
Well to be honest with how the NHS is now, we are lucky to even see a Cardiologist, i had to wait months before first appointment, he happens to be a nice man though, i emailed him / his secretary first, on one or two problems i was having with very low BP since i had an EKG by his department, and he has brought forward my appointment by 3 months to see him. Maybe he takes a bit more interest as knows i am carer to my husband who is 80, COPD. Heart Failure and AF, and so much more, without me it would cost the services more as he would need care, maybe i am just being cynical, but who knows. as i say upto now he has been good. Awful getting old isnt it seems like yesterday i was 18.
So many on here are talking such too much technology, I believe in talking to my Cardiologist, i have an oxymeter home here, and this all the technology one has to have to see if one is in AF, but due respect, most with AF know it anyway. Good luck, and dont worry, my response below, details, i have exactly the same as you have.
Well even if wearing one of the high tech watches, same thing. but as long as we are all on anti coagulants best thing to avoid blood clots causing real problems, I personally dont think i hve had one during the night, i think if so the irratic heart would wake me, yes i have an oxymeter, but to be honest i dont need it for the AF i know when am in AF. I use mine mainly for my oxy levels.
I'm not taking anticoagulants because of genuine intracranial bleed concerns, so if my AF burden is actually greater than I think because of unknown AF events while asleep, I want to know about it, mainly to reconsider my anticoagulation decision. Not just presume AF would wake me, which seems to me extremely optimistic. After all, as I am able to sleep after an AF event is detected, it's only logical to assume AF could also start (and finish) while I'm asleep.
Anyway this is my situation, and I'm not offering advice to anyone else. But I genuinely would like an accurate nighttime way to monitor my AF, and hoping you might have a solution for this I have missed (your no device solution). Even the REACT-AF trial is using Apple watches to monitor AF events, including at night.
WEll i dont know you medical issues in detail re: brain bleeds, but all i do know is my Cardiologist told me the thing all with AF should be taking are Anti coagulants, this is our front defence or a good part of it against a stroke. So even if you are having AF during sleep be it night or day, you are at risk of stroke, but i am sure you know this, for myself i would lessen the odds and take the meds, that is the one thing i dread in having AF and that is a stroke, i am carer for my husband, we would be up queer steet without a doubt. but we all have to weigh up the pros and cons.
Hi there. I am busy reading through all of these 'technical' replies and to be frank they are just going over my head which, in turn, puts me off of replying to the original question and telling my story and treatments.
I know what you mean, best we dont even try to understand we are not consultants in the field of Cardiology after all, we can all read up but understanding it fully we need to be medically trained. Just be happy if you have a good Cardiologist. Good Luck.
Don't be put off please. everyone's experiences are really helpful to read and you story could be exactly the same as another reader whom is worried about their symptoms so they feel braver to talk too.We have plenty of people with lots of experience and research to give more technical answers but reading the real life experience and tips from everyone is invaluable to us all.
Like you, I have a generally slow heart with periods of bradycardia, sometimes below 40bpm. Also, before my ablation for fast atrial flutter (155bpm) in 2019, I was given digoxin, which often took the rate to below 40bpm. Since then my average rate seem to have slowed further. I now take 1.25mg bisoprolol tp try to clam my ectopic beats and AF but it does little, and increasing to 2.5mg did no more than cause yet more bradycardia. I have just been prescribed flecainide. I have only taken a single dose, which worked well, but gave me very heavy and worrying heartbeats.
I think, in the end, an ablation will be the best way for both of us. Mine is planned but there is a long waiting list, up to 12 months, in the UK. I also have a left bundle branch block, which seems to add to my symptoms.
Overall, I think the real measure of what to do depends upon the level of symptoms, how well they are coped with, and whether what is happening is putting the heart under strain and long-term risk of failure. A recent MRI I gad suggested mine hadn't changed in the nearly 5 years since the first scan and this left me wondering whether to just live with the condition? An elderly friend, now 90, has done just that, with his permanent AF.
My own AF used to be much more occasional in frequency, but much faster in rate, as around 140-180+bpm. Of late it is more frequent, perhaps every two weeks, yet now at a slower rate, settling at around 85-140bpm. It is, as a result, much less uncomfortable than it used to be. Thanks to the MRI scan, I am managing to control the anxiety it creates, too, leaving me wondering just how big a part fear has played in the past.
So, summing up: symptomatology and prognosis would likely guide my choice of treatment. In your case, only if the bradycardia is symptomatic would you need a PM, I should think. If beta blockers were helpful to you in reducing symptoms and improving heart health, the a PM would allow a higher dose of these to be administered. I think, if I were you, on balance (if overly symptomatic), I would see how the flecainide goes, and try the ablation.
I've a very low heart rate ..as low as 43 and never higher than about 58 ,never had any problems with it, it's never irregular so I don't worry about it,OK I get tired but I'm knocking on a bit.Im diagnosed with AF this past 15 years but never have problems with it,that's my experience.
I have slow normal BP and resting heart rate figures.
My BP is usually around the 10-120 / 70-80 mark with a pulse rate of anywhere from 50 -70 beats per minute. I also have AF.
Other than my daily cholesterol tablet, half a blood pressure tablet per day (ever since a small heart attack in 2020) and the anticoagulant Eliquis, I'm on no AF meds. I've had a cardioversion and a pulsed ablation and both failed to return me to normal sinus rhythm.
I have a heart rhythm problem but the medics have no idea what caused it or how to best treat it. But as my readings / stats etc do drop quite low at times, a pacemaker seems to be somewhere in my future as they are geared mainly towards low heart rates / rhythms than the galloping horses type of AF / heart rates.
I’ve had bradycardia and low blood pressure for many years (I was keen on exercise but definitely no athlete) . No symptoms at all so the various cardiologists I saw for my PAF weren’t concerned. My resting heart rate is around 41 - 45 on beta blockers without them was around 48 dropping to 38 in my sleep. I was diagnosed with paroxysmal AF in 2019. It seemed to be when resting my AF would kick in and I suspected it was due to my heart rate dropping further when resting. Initially I would present at A&E (as instructed) with each AF episode. Each visit the A&E docs would increase my bisoprolol prescription but I noticed the higher the dose the more frequent my AF episodes, convincing me that my low heart rate was responsible. Sick sinus syndrome was also mentioned by one cardiologist but I heard nothing more about that.
I then saw an EP who didn’t mention sick sinus syndrome (and I forgot to ask 🙄 but assume he would’ve seen it from the 7 day holter if it was there). I’ve since been prescribed an unrelated medication which increases my heart rate by about 10bpm as a side effect. This combined with EP prescription of soltalol seems to have reduced my episodes but who knows how long for. My EP has suggested an ablation if my episodes increase again. I have a suspicion I may end up with a pace maker too.
Yes exactly - I have a low resting HR and ,my understanding is that beta blockers / calcium blockers are counterproductive, slowing the heart even more so that ectopics can confuse and trigger PAF -my cardio explained this a few months ago.
For some reason the hospital cardios didn't take my night time vagal type PAF and low resting HR into account when they prescribed Verapamil - after 10 days I was on my knees and taken off it. I'm fortunate that my monthly PAF episodes are shorter now, I just have PIP Flecainide and Edoxaban.
In relation to the experience of PAF, an echo technician pointed out that when the resting HR is low people tend to feel PAF more when it bounces to 150 or more. So Pteridomania if your heart goes from under 40 to 200 that's a big jump and it must feel horrible ...
We're told it's not dangerous but it can feel very dangerous!
Yes! I do wonder how I’d be without beta blockers, if I’d have fewer episodes but not brave enough to suggest or try it. My AF used to dance around up to 160bpm but on beta blockers it doesn’t go much higher than around 100 so I don’t worry about damage to my heart so stay at home and ride it out - usually around 15 hours (I am very symptomatic though unfortunately).
Hi there. My lowest HR has been 38 and highest has been 183bpm. Short history. Diagnosed in 2020 - Cardioversion then but didn't solve my problem. Prescribed Bisoprolol/Sotalol initially then in 2021 after coming off of Sotalol before Ablation my HR shot up to 183bpm and was admitted day before my ablation admitted for Ablation. Unsuccessful and kept in overnight and HR shot back up to 175bpm and every time I moved out of bed to go to toilet off it would go again so administered Amiodarone through IV. Spent 24 hours in CCU whilst they monitored me then kept in total for 10 days. Discharged in Tachycardia then another Cardioversion - this time it worked for 3 months but it was a great feeling to feel 'normal' again for that short period. My HR still varies and it is very uncomfortable when it goes over 54bpm and below 48 then I get dizzy spells when standing up. Follow up with Cardiologist and he has said that there are no more medications and to let him know when I want the Pacemaker and he will arrange it. Most days I have episodes of AFib/skipped beats - some very long ones and they make you feel awful but I am not ready for the Pacemaker just yet. Still try to have normal life and adjust to everything and go daily walks but my heart tells me to take a 'day off' and I listen to it. Don't know if this has given you any reassurance in your condition and everyone copes in their own way but I hope you get some answers soon. Take care.
Hi, my heart rate was always around 50 and I exercised regularly so I thought it was a result of that. However it turned out I had a badly leaking heart valve. So I needed open heart surgery to repair it and then my hear rate stayed low so needed a pacemaker. My advice would be make sure you've had your heart thoroughly checked to see if there is any underlying cause.
My story was very similar. Always had a low heart rate. Annual ecg always noted bradycardia. Then I developed afib with high heart rate..termed Brady-Tachy . After several scary episodes my doctors convinced me that to treat it without risking going dangerously low a pace maker was the answer. Have had it over four years and it was an excellent solution. It also is a constant monitor of what’s happening in my heart and I rarely think about the fact that I have a PM.
Thanks. Sorry about delay. Have been missing in action with another health issue . I have a two lead cardiac pacemaker from Abbot. It activates when my heart rate goes below 55. And yes it did help with my afib and aflutter over the past 4 years , but a couple really long aflutter episodes, and a desire to reduce the medication I take, has convinced me to undergo ablation at a premiere Boston hospital where Ill have a PFAblation in a few weeks. Fingers crossed on outcome.
My heart rate was 38 and I have paradoximal af I had a pacemaker fitted 12 years ago when I was 51 now it crnt go lower than 60 and its helped alot I'm on flecanide pip and I take 50 mg twice a day as I'm waiting now for catheter ablation but I must say the pacemaker has helped for the last 12 years any thing else you need to know just ask
I had a pacemaker fitted a year ago because after an Afib episode my heart rate would plummet to 32bpm and I would feel terrible, it would gradually increase over a few hours.
My heart rate was always erratic and Afib episodes every month or so.
Since having the Pm fitted I have only had one episode in a year, which I am very pleased about and also very surprised! I didn’t expect it to have such a beneficial effect on my Afib and am so glad to have had it done, I was also offered an ablation which I declined and hopefully won’t need one.
I have had the same problem with the slow heart rate and cardiologists have talked about a PM. When I went for my second ablation and my rate dropped to 30 whilst was under the general anesthetic I was listed for one and the issue was with the sinus node not working properly . This was triggering my AF but I will be soon be able to take medication to control it.
First of all the clinical decisions should be made by your cardiologist/EP with your approval.
Tachycardia is the more common manifestation with Afib ( mine was about 130bpm when I was diagnosed). That said my resting heartrate was about 50bpm, but I was a runner, so when I got Afib it was a shock..I was used to a lower heartrate.
I am now in NSR following a cardioversion in February as a previous ablation did not work. Straight after the cardioversion my heart rate went back to about 50bpm, but its is often lower, ie, similar to yours, in the 40's.
This started to worry me, but I had no symptoms and felt fine. My beta blockers which I were on were reduced to the lowest possible dose. I have had a Halter monitor test and an echo since the cardioversion, all which would show my bradycardia, but nothing has been said. I will be due another review soon, but as I have no symptoms and can do everything I don't think they are too concerned...They are more concerned about tachycardia in my view. As for fitting a pacemaker the that is a decision which would be made by the cardiologist and yourself...Don't know if they would think it is needed.
Pacemakers are fitted in Afib, but often for control of tachycardia in permanent Afib when they have given up trying to control rhythm and they cant control the heart rate either. They ablate the SA node which destroys the trigger, so it will cure the tachycardia but it means you will have a permanent pacemaker...Hope this helps, and you get sorted. All the best!
Hello Pterdomania; My resting HR is 47 BPM and when I have an AFIB episode it goes up to 135 BPM. I thought I was going to pass out when I saw it went down to 39 once, but that was because I was in shock that it went that low. My EP said if I don't have any symptoms to not worry about it, (easy for him to say). I used to live in the ER due to my AFIB and numerous Drs. telling me to ride it out even when my HR was 200, I was told as long as I was on an anticoagulant to not worry as it usually converted to NSR in 24 hrs. My last visit with the EP last month he said I would eventually have to have a pacemaker of which I said NO Way. I used to be an athlete and very active until I reached 54 years of age, I am now 78 "with one foot on a banana peel and the other foot in the grave" but still going strong. I have had AFIB for close to 35 years now and am currently taking Amiodarone 200mg daily for about 4-5 years for my AFIB. I kind of like the low HR as I can rest a lot better. The only thing I say is to listen to what your cardiologist/EP says and don't ever hesitate to tell them what is on your mind concerning your fears. If they have the experience they will know how you feel and it will help them in putting a treatment plan together for you. I pray everything will work out for you. Have a Blessed Day. Hope this helps in some way.
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afib and chest infection 
Afib isn't a disease,it's a malady 
Afib on Sotalol
AFIB ATTACK 
Bradycardia, sleep apnea and now AFib
