I recently had a Holter test for breathlessness and low energy levels. My Holter results registered a heart rate of 35-110. My AF is controlled by heart rate control drugs. The doctor has assured me that this result is nothing to be concerned about and is acceptable. I will see the cardiologist in October. Is this okay ? (Just asking )
Heart rate.: I recently had a Holter... - Atrial Fibrillati...
Heart rate.
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PhyllisK
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I would say that I personally think that your heart rate going down to 35 is unacceptable. Difficult to know what to do because if you reduced your medication dose the high heart rate would increase. Are you aware when your heart rate goes down to 35? For instance do you feel faint, breathless or very tired?
GP's are often jack of all trades and master of none, though some specialise in things like diabetes, skin complaints etc. It's quite a big decision regarding what to do next for you and I'm guessing that your doctor feels it would be better for your more experienced heart consultant to decide the next step.
If you don't want to wait until October, then why not ring his secretary and let her know that you will be willing to take an earlier appointment if someone should cancel theirs.
Jean
Agree that 35 bpm is a concern. 110 isn't worryingly high, especially if you were active - even just doing household chores
I find that my energy ebbs away dramatically when my pulse drops but recovers just as easily ! I know it is mild in comparison to full blown AF and the doctor is totally underwhelmed. I guess that’s good but I am now breathless at the drop of a hat. I think Jean might say , “ don’t drop the hat”.
I get breathless
I had a average of 96 peak 115 in my last test
The doctor wasn’t concerned with the number when it went to 1115 he said if it’s constant 110 he would be , mine was never under 55 so I don’t know about the low number
Hi Jean, it is good to see that you continue to support the AF group. I think over the winter my breathlessness has increased and I cannot walk very far. I take the dog around the park but now. I have become weak and need to go from bench to bench. I appreciate that at my age (I am 81-going on 45) it could be coincidental but I didn’t want to go down without a fight. Hence my badgering the doctor. As always any replies to my posts are full of common sense but! also reassuring . Thanks.
I think that the breathlessness is a concern, regardless of your age. Especially if it is new as a symptom. For me, that would be an indicator that something needs attention. I suspect your GP doesn't know what to do with the holter information. I agree with Jean about calling the medical secretary. Do you ever feel faint with it all? Let them know if so.
I agree re breathlessness should be checked out as that was the first question my cardiologist asked recently when I discussed new HR patterns. The question I struggle with (probably just me) what level of breathlessness is relevant eg at 70yo going up 2 flights of stairs and feeling it, may or may not be relevant 🤔.
Anything that's new and uncomfortable might be relevant. Sometimes it's fluid retention if you have persistent AF (that can be addressed with diuretics), or it might be you'd benefit from a pacemaker. Lots of people have them here and I'd definitely go for one if needed in the future.
Thanks Singwell, that helps and a pacemaker is a possible for the future but my cardiologist's opinion was not yet...he didn't explain further!
I get spells of bradycardia down into the low 40s. I don’t feel breathless with it, luckily but I am sure that is possible.
As your specialist has suggested one eventually, previously, was the PM to address the low rate? That would explain your GP’s response. I tend to hold GPs in high regard, myself, but I might have been lucky!
Another option is a “Pace & Ablate” procedure, which several people here have spoken highly of.
Shortness of breath might be from chestiness of various causes. My friend gets it from mild COPD for example. Has your GP not investigated it before? I think he or she should.
Steve
You need to add more detail before anyone could say it was good or bad. My holters show a range from roughly 32 to up to 180 but my heart might only beat four beats at a rate of 32 beats per minute or 4 beats in a row at 180 beats per minute. It also depends on when it happens. Are you awake and moving when it beats at the low rate? Was the high rate still sinus rythym. So many questions need answers before anyone could even vaguely guess at it being good or bad.
My advice is to listen to your doctor. They’ve obviously reviewed and have it in perspective and if they’re saying it’s ok, then trust that it is ok.
You are correct thank you. I guess feeling unwell makes one lose perspective. I guess my loss of energy leaves me frustrated. Stay safe.
I know exactly how you feel. I’m now concentrating on ensuring I’m as fit and active as I can be - even though that means only regular walks and some light resistance exercises but it makes me feel good that I’m doing something. It even helps a little with the fatigue. There’s not much else I can do - it’s all in the hands of my doctors and I trust them to do their part. I’m doing my part at the same time. Hang in there. We all go through ups and downs so you’re in the company of people who understand.
The low reading was probably recorded when you are asleep and can be a normal finding and the 110bpm is not concerning when you have afib controlled or otherwise. As you know afib and the associated treatment can leave you feeling tired with low energy. If your GP has no concern then why waste your time worrying about it you are fine. Wait until you see your cardiologist and no doubt he will have a plan of action to make you feel better and improve things for you. I wish you all the best as this afib is a right pain to live with.
I wouldn’t……
You wouldn’t what? Sorry but I have no idea what you’re saying.
I wouldn’t trust my doctors 100% , if their treatment wasn’t improving my condition I’d get further advice. But I take your point that we should do our bit, very important.
The rate of 35 is not good and with this low rate at night I had to call out paramedics as I felt so bad. My GP was not worried at all but I just could not function. I was on the lowest dose of Bisoprolol at the time and eventually had to come off as this was what was causing my rate to go so low. Tried other calcium channel blockers and rate/rhythm control medications and various mixes for about a year maybe less. Would be OK for about 3 - 5 weeks on them and then would get breathless and fatigued again and rate go too low when resting. In the end they took me off them completely as they made me feel worse than the AF and I am just on anticoagulants. I now have permanent low rate AF and my resting rate is in the mid 50's and rarely go over 130 and only when exercising and gardening.
I haven’t felt unwell enough to call the paramedics but the doctor has decreased one of my tablets and thinks the cardiologist might consider even more. It’s interesting to know that you are experiencing the same symptoms. Thank you for sharing.
Yes best to get reviewed by your cardio or EP. Medication and/or dosage are likely to need adjusting as you go along.
35 is low and considered Bradycardia
I have to agree with Ennasti, it is how the doctor interpreted the reading but, I can feel rotten. Thanks for your comment, it is very informative.
When my heart rated dipped that low I was fitted with a pacemaker and I am now paced at 60 miles and hour x
we’re all different and what is deemed to be acceptable by the doctors for one person may not be acceptable for another. My ecg monitor showed a mainly night time bradycardia only on occasions and for a short time of 38. The cardiologist is happy with this as I’m asymptomatic with it. I’ve an Apple Watch and it’s set to alert me if my pulse goes under 40 for a period of time ( I don’t wear it at night), it’s done so once but I’d not drunk enough and my lunch was late after a walk. I soon remedied that and all was well.
Like you my arrhythmias are kept in check by rate control drugs as they want to avoid anti arrhythmic drugs with the muscle damage I’ve got.
Speak with cardiologist and see.
My mother has sick sinus syndrome and heart rate can suddenly go from her ‘af normal’ of around 80 to then goto 150 and then drop to 40 in seconds. She refused a pacemaker and intervention but your gp can’t report 35 bpm as normal! I agree with other comments on here. Hope yr soon sorted. Take care 🦊x
My GP is ok with the results and I am seeing the cardiologist in October. I can only respect their expertise. AF is such a rotten condition. 😌
My heart rate can go as low as 32bpm but it doesn't stay that way, in a nuclear test the fastest it went was 72bpm before I had chest pain etc and test was stopped. I have had Tachy/Bradycardia put on hospital notes. But my cardiologist like your GP doesn't think it's cause for concern yet. I am on no meds as like others above they caused my heart rate to drop.
My pulse drops as low as 42 during the night (as per my watch) and my EP was not concerned about this either.But, as an aside, I've been feeling very tired for the past few weeks, to the point of falling asleep the minute my backside hits a chair, and at a thyroid appt with my endocrinologist, discovered my vitamin D levels had dropped dramatically since my last blood test 4 months ago.
May be worth you asking for a blood test to see if there is another reason for your fatigue. I'd just assumed heart, as I'm waiting for a valve repair but, may have been down to Vit D.
I can sympathise with you and your tiredness. I have had the full amount of blood tests that cover every aspect of my constitution and there are no concerns. The doctor suggested I take a supplement of Vit D as a precaution. Thank you for your advice. Stay safe.
Hi
And have your B12 (single different test) to be above 600 is you are over 65.
Thyroid levels normal TSH 0.6 - 4.2
T3 above 3.9. (Eat 2-4 Brazil Nuts perday, add sardines and Beef Liver. I had to raise mine. 3.4 too low Dr said
T4 total to 22.
Tiredness I would get thyroglubin serum level.
and thyroglobin antibodies
Nothing worse than fatigue or tiredness but the breathlessness could be leaking valve which comes from not getting your blood around your body in good time and even. Mitral Valve?
Take care,
Joy. 75. (NZ)
My thyroid levels are normal. My B12 is supplemented and fine.
And I am nowhere near 65!
Same situation with the Vit D happened to me..low HR, it took almost3 weeks taking a daily supplement for symptoms to gradually disappear. We did find out my arrhythmia med dose was too high in the process..
Thank you for taking the time to reply. Hopefully decreasing my medication dosage may help with restoring my heartbeat levels. Stay safe.
My heart rate has been a low resting rate for a couple of years so that isn't Vit D related at this point.😊
hola ducky! HR usually in the 55-60 range but dipped into low 40's. became concerned, got my meds lowered but still had same symptoms.. found out my D was low..took supplements and symptoms went away.. my cardiologist swears that it wasn't the Vit D that was causing the low HR.... i'm just glad it back to normal 😀
A bit like my old cardiologist who swore that the anticoagulants were not the cause of heavy monthlies, even though I'd not had a problem prior 😁.My resting rate is between 42 and 52, lower end when sleeping and has been since a cardioversion 2 years ago. The low Vit D idls in past 4 months 😁.
Glad you're feeling tickety boo now. 😊
I would 35 is an issue but not 110, trying speaking to your doctor again, mine used to drop to 40 and I felt awful
Hi
The Holter Neck Heart Monitor result should have given you an average Day and Night. I suspect 35 was at night.
I got a 47bpm AVG Night (so fluctation os some sort. ) Never worried me even though I wil get to the loo sometimes. Drinking cocoa at late evening.
Day 110 when you are exerting yourself is low. Perhaps you don't exert yourself much.
The Drs/Specialists and Anaesthetist want you to be below 100 at rest. They won't do an operation unless it is a must like my Thyroidectomy and had a rapid heart rate as I was not controlled ny Metoprolol. I had 2 anaesthetists and 2 Drs in the operating theatre.
It is how you feel.
At night you are sleeping.. How do you feel if you need to get up?
How do you feel during the day. Obviously under control and under 100.
Discharged after Thyroidectomy 5 days later with 135 Heart Rate should have been questioned to change or introduce new meds which would work to pull down my heart rate.
That happened a year later when I insisted on a heart specialist as I had NO FOLLOWUP after my Embolic Stroke. In 2021 under a specialist the h/monitor shoed 186bpm Day and 47avg Night. I was fatigued, tired, and Metopolol gave me pauses at night.
Changed to Bisoprolol and monitored 156 Day and 47 Night I was left. Still uncontrolled but no breathlessness or pauses.
Referred to a private specialist after 11mths. He introduced CCB Calcium Channel Blocker , on 180mg Diltiazem and some Bisoprolol tt went down to 51 in 2 hours and stopped there.
After discussion with our Heathline and NZ Heart Foundation I was guided.
Take 120mg Diltiazen CD AM
Take 2.5mg Bisoprolol PM
So both heart rate and BP are controlled.
I've been on this regime for 2. years 6 months.
Now Day heart rate 60s. I lost 5-6kgs.
120-135 /. 69-79. Night Heart Rate stays at 47bpm avge.
I'm forever grateful to the Heart Specialist. I will go back to him if I need to.
What are you taking for Rate Control?
BBs didn't work for me. Something had to do it drastically.
cherio JOY. 75. (NZ)
Wow! thank you for taking the time to respond to my post in such detail. I am taking 240 mg of Diltiazem reduced from 360mg. I am also taking 5mg Nebivolol. This is under review. Thank you again for sharing your experience with me.
Hi
I looked up your Nebivolol. NOT available in NZ.
Apparently called a "novel" new beta blocker which is more tolerated than others but it works on Systolic hypertention when only the Systolic is singled to be high.
Interestingly both Diastolic and Systollic were high but more so systollic. although functioning well and pressure I have a soft systollic heart murmur diagnosed in 2022.
As your specialist should know Diltiazem should not be given if you have abnormality in your ower Chambers.
Also I hope you take Doltiazem at AM and separate Nebivlol at PM. The NZ Heart Foundation said that was imperative. As they work differently.
Maybe that's the trouble. And may be only 120mg Diltiazem is reqired. Like me. The report said (before I started Diltiazem that I could have up to 360 when he gave me 180 (Half dose). As you can see 180mg was too much, lightheaded - couldn't drive. No way!
As your Nebivolol is controlling your hypertension (I hope as you don't state what is happening with that, your Diltiazem could be lowered down to 120mg. Difference was 88-96 Day at first from 51 and then I dropped weight to arrive at 60s. Then late afternoon it evens out to arrive at my 47bpm at night.
I wonder why NZ my home doesn't fund Nebivolol. But then they drped the 30 and 60mg Diltiazem just before I started on it.
Drs tend to up and u your meds until the Specialist changes it or twinks it or a new med.
I can tell you that I wouldn't be happy with 30s or low 40s. 47bpm avg I am Ok with. I've always had cold shoulders at night.
Alot of folks have had ablatios and we are not one of them. Hoorah. No burning/freezing of our heart which causes scarring.
cheri JOY.
Hi
Ha I read New Zealand doesn't fund MODERN MEDICINES.
We are finance strapped to a budget.
Last month after National said they would fund a number of cancer meds but 7 months after have not, voters weren't happy so take National to task. Voters won and very slowly they Pharmac are being funded to cover tese meds.
But we have always ill patients who on these drugs live a little longer and we have drugs like Nebivolol which make a difference in controlling their Systollic level only. It is a delemma.
I am under the surgeon after I was ? diagnosed with THyroid Papillary Camcer 4 days in hospital. Arrangements for the biopsy was from diect the hospital.
Are you in the UK?
Cheri JOY
Not surprised you have the low rate then. 240 Diltiazem dropped my resting rate to the 50s and I couldn’t function on that. My normal resting rate on 180mg is about 65 but I can notice if it drops to 50 as it occasionally does. I have spikes up to 125 but I generally don’t notice them!
I am seeing the cardiologist in October and I guess my medication will be reviewed. Up until February I took 120 mg Diltiazem three times a day=. 360mg daily. But it is only this few months that I have felt so whacked! Fingers crossed. Stay safe. x
Hello, agree best info is from ones consultant, but Drs. of course have a good bit of idea as AF is very common for us, and most GP's encouner it regularly. HR of 35 to 110 is acceptable, my own goes down to high 40's as alwys had low HR. but lower now on a half beta blocker daily, Anyones HR increases and decreases throughout the day, when walking say with my dog mine can go up to 125 - 130 ish easily, it is how hearts operate even the fittest ones. Many people have h.r. is 30's and if it doesnt cause faintness etc, it will rise and fall as their days progress with whatever one is doing.
I was concerned about low HR, but was assured unless i felt light headed and near fainting, then no worries, I suppose the o nly time to worry is if it stays there when moving faster. In general all us with AF have one of the most common conditions, everyone is different. my Cardio tells me he does not do invasive procedures like a lot of people on here have done, until the condition is worse and warrants the procedures.
Stay calm, if you are that concerned, try and get earlier appt. with hospital, but i wouldnt worry if i were in your shoes, it is concerning i know as i ws there the same concerns, until speaking to heart specialist i am looked aft er by at hospital. Good Luck👍
I love this AF group. You have put my mind at rest thank you.
hi, when you say heart rate drugs do you mean beta blockers eg bisoprolol. If so this reduces your heart rate and when you take it may be a factor. so, if you take it on a morn ing and your HR goes down afterwards you could ask GP about taking it at night.
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