Bradycardia - normal ECG, Echo and bloods. What could be causing it!?

[JadeH92]

A bit long so sorry in advance but can anyone help!

About 16 month's ago I was put on propranolol after having a 24 hour tape which showed ectopics. I have taken between 40mg - 120mg daily mainly 80mg (one in the morning and one in the evening). I didn't notice much improvement with my palpitations (ectopics) but because I was told my 24 hour tape was fine I just tried to put it to the back of my mind.

Fast forward to about 5 weeks ago, I had noticed my palpitations had changed from what felt like a missing beat to also adding in a fluttery feeling too. I had Covid at the time so thought it could just do to with being unwell and didn't think anything of it. However, when checking my oxygen levels I noticed my heart rate was in the late 40s - mid 50s. I monitored this for a week and with no change spoke to my GP who requested a 72 hour tape and bloods. I had an ECG done which was fine at the time HR was 61.

On the final day of my 72 hour tape, when I work (I work at a Hospital), I felt really dizzy, lightheaded, sick and had chest pain. So I went to A&E and was diagnosed with Bradycardia caused by the propranolol. I was advised to stop this immediately. I had an ECG which was fine and they attached me to a monitor and my HR was sitting around 47 - 50. They checked the bloods I had done a week earlier and this was fine, they also repeated bloods and these were also all okay. They believed that once my propranolol was out of my system I should be okay. However, advised for an echo and referral to Cardiology urgently as an outpatient.

I've had my echo and the results are all fine. So I am still waiting for the 72 hour tape results and appointment with Cardiology.

I am in my early 30s, I am a bit over weight but I am healthy. I have lost over 2 stone intentionally over the past few months and am continuing to be healthy and exercise at least 3 times a week.

I really hoped that stopping the propranolol ( over a week ago now) would help but I am still having both types of palpitations, as well as episodes of bradycardia but then also at times when doing simple tasks like walking up the stairs episodes of tachycardia. I am really happy that so far all my tests are coming back normal but what is causing it and will it go away!?

Thanks for reading and thanks in advance for any advice!

[Tos92]

Sorry to hear about your experience Jade.

I’ve had a similar experience with a betablocker which I’ve recently started, however, it is a Bystolic. As soon as I noticed my heart rate was dropping to the 40’s, I decreased my dosage which has made a difference to my bradycardia. I use mine to treat a fast heart rate/tachycardia.

I’m surprised that they took you off Propranolol completely and did not replace it with something else as you still have the existing issue of the ectopics/heart palpitations. What dosage of Propranolol were you on? Is there any chance you could go on a lower dose like I have done with mine?

Usually, ectopics are harmless. My tachycardia is treated as I have a myocardial bridge and my specialist does not want to take the risk. If your tests have come back normal and you still don’t know the cause for yours, maybe have a look at whether your lifestyle is contributing towards it. I see that you have lost weight which is a great achievement. I have found that outside of physique, stress and a lack of sleep can cause a spike in my heart rate too. Like yourself, simple tasks such as housework, walking, changing etc can also spike my heart rate.

Do go back to your GP and see if they can provide an alternative for you.

Good luck.

Tos

[Summertimeflowers]

Hi. Going through similar at the mo checked BP one morning because I had a Doctors appointment pulse coming up 38 and I had irregular heartbeat so at appointment told her this (not what appointment was made for ) sent that day for ECG and put in blood thinners 2 days later she rang me to say stop tablets and ECG was fine just showing etopic beats refered for 24 hour ECG not had results yet next week iv got echocardiogram. All blood tests ok still keep getting low pulse just waiting for tests to come back and then appointment with cardiologist 🤷‍♀️ please let me know how you get on kinds regards 🌻

[Sambobs17]

hi Jade92 - I’m sorry your going through this, I’m on the same path as you. I’ve had these ectopics off and on for years but not lasted long whereas at the the moment I’m going into my sixth week with them seen by GP twice bloods normal ecg normal - but it got worse all the symptoms you describe so my husband insisted I went to A&E ecg showed sinus rhythm but lots of ectopics the doctor wasn’t worried but said I needed a heart monitor for 24/48 hours and an echo - I had this done in 2021 it was found I had LVDD only mild but I need to know it’s stayed that way apparently usually caused by hypertension (tick that box) and age I’m 68F - I’ve since received an appointment for heart monitor for next week it has seemed like the longest five weeks since I received the letter with the appointment, I know that’s not long but when you feel rubbish you want answers. I too take an anti arrhythmic tablet Sotolol very small dose originally prescribed for SVT now I’m like you pulse goes low along with the ectopics - please let us know how you go on I do hope it’s sorted for you very soon I can only say I’m with you on this one take care - I also take amlodipine for BP 😊xx