Episodes of Bradycardia + Ectopics?

[Rhodog2612]

Hi everyone,

I posted on the forum previously regarding bradycardia which was continuing even after I reduced my Bisoprolol dose significantly. Unfortunately, around a month after stopping the Bisoprolol, the bradycardia still continues.

I have had 2 echocardiograms within the last 12 months, 24-hour ECGs, blood tests, standard ECG's at A&E and the GP, and have no underlying diagnosed heart conditions aside from ectopic beats which are currently at around 2& burden per day. I am a 29-year-old male in the UK weighing 86kg and 5ft 3 inches tall. I do not smoke or take drugs. I drink alcohol every weekend, and I don't get as much exercise as I probably should be due to work commitments.

All of my tests and scans have been normal aside from showing the ectopic beats and the bradycardia episodes, and the ultrasound said I have a "structure" in my heart which is likely a foetal remanent and is nothing to worry about. My daily blood pressure can be between 120/80 and 136/88.

To begin with, I was given Bisoprolol for ectopic beats, however this caused my heart rate to drop to the 40s at night and at times during the day. I was then told to stop this medication and I have been off it completely now for around a month with no withdrawal effects due to weaning off it extremely slowly, however I am still finding that when I'm sat down resting or when laid in bed, my heart rate is dropping to the mid 50s and high 40s, with the lowest readings being during sleep which I've been told is normal for when we are in deep sleep to have a heart rate between 40 and 50 for example.

Is it normal for someone my age to get such low heart rate readings during the day when resting?

Cardiologists and my GP seem to think there is nothing to worry about, but I can't help but see red flags when the NHS website says a normal heart rate should be between 60 and 100bpm, and mine is dropping to the 40s and 50s sometimes during the day?

I must say that I rarely get any side effects from the low heart rate such as dizziness or light headedness etc...

Any opinions would be great!

[bee2]

If you have no symptoms then it's seems ok. I have Bradycardia and heart rate has been as low as 32bpm I am in my 60's been in hospital several times for heart issues and tests and heart rate causes machines to beep all the time, but nobody seems worried 🤔

[wischo]

I have bradycardia for some time now although a lot older than you. My resting heartrate can drop as low as 42 bpm and my apple watch gives me an average of 48bpm. I am on 1.25mg of Bisoprolol for SVTs which is the minimum dose and my cardiologist is reluctant to stop it. I have quite a few Holtor monitors and there does not seem to be any concern although I do have a first degreee heart block. My cardiologist also told me that at some stage in the next 10 years we will be discussing a pacemaker although I feel it will be way before that long until it is brought up.

[BC-10]

Hi there,

I’ve been on bisoprolol for the last 18 years.

My personal experience has been that whenever I get a real bad run of ectopics - and I mean ONE every other regular beat - and sometimes TWO pvc’s in between before my heart goes back to regular sinus rhythm for ONE beat - it always coincides with low(ish) heart rates. It seems the lower your heart rate, the more there is a chance of an ectopic beat jumping in there while it has a chance. That’s my experience anyway.

Ectopics are such an enigma. Sometimes I will go for a whole year or more without hardly any. Then there are other times when I get so many I can hardly breathe properly.

Imo you don’t really have bradycardia in the strictest sense. ie - you do not have a defect or a iatrogenic reaction. By that I mean a medication causing it.

Also - imo and my own experience has been that bisoprolol rarely causes bradycardia. It is the best of the beta blockers for being heart selective only. It works specifically on your heart to suppress ectopic beats etc. and rarely causes any systemic issues. This is all my own experience of them - and I’ve been on most of the other drugs - propranolol, sotalol, atenolol, verapamil, diltiazem, ramipril, flecainide and then bisoprolol. The others all caused me to get a kind of acquired different heart rhythm and with the Flecainide I passed out from a Wide Complex Arrhythmia!

Relax and try not to worry too much. Best of health to you.

[CastorP77879402]

Hello BlossomsInSpring,Can you share with us what medication changes were made to get that result?

Thanks

[24623057]

can I ask what I mean when u say an “acquired different rhythm”. I’ve just been prescribed Diltiazem

60mg 3 times a day, modified release tablets for my ectopics, all of which are pvcs and my burden is 13 percent. So scared to take them and obviously don’t want another type of abnormal rhythm to start. Sorry for the long post

[Blueberrylover]

I am older than you but with the exact same problem, I am being fitted with a heart monitor next week, my heart rate goes from 42 to 95 bpm, before I was on Bisoprolol it would go from 42 to over 100, I have no symptoms but the worry is making my anxiety go through the roof, I will let you know how my monitor goes next week.

All the best Jan