Bradycardia and Afib

[Calypso76]

Hi everyone, I believe I posted here about my low heart rate before, but now I would like to know if anyone is being treated for it. The last time I spoke to my cardiologist, I told him about my low heart rate, especially in the morning when I feel lightheaded and can barely walk. He said he was going to give me a 24-hour monitor to see how low my pulse goes, but he never did. My level of functioning is about 50% what it used to be. Thanks for your help.

[Jalia]

Get on to your cardiologists secretary and ask when you are going to get the monitor!

[Fifille in reply to Jalia]

I would go straight to a&e, get them to assess you.

[Jalia in reply to Fifille]

I wouldn't have thought that this fits the criteria of Accident & Emergency

[Fifille in reply to Jalia]

Neither did I for several months but ended up being admitted with brachycardia with very low heart rate.Had pacemaker fitted almost immediately. Was told should have had an ecg when low rate was detected a year before.

[Jalia in reply to Fifille]

Fair enough! Very low rate does warrant a 'trip'.

[Calypso76 in reply to Jalia]

That's what I'm going to do. Thanks!

[Lezzers]

My husband has bradycardia amongst other things. Do you know how low your HR is going?

[Calypso76 in reply to Lezzers]

It's usually in the 40s, but strangely enough this morning it was 51. Pretty good for me.

[Redactrice]

My cardiology team says that the important thing is how you feel -- if you're lightheaded, can barely walk and are functioning at 50%, that's not good enough.

Are you taking any drugs? Beta blockers in particular can slow you right down. Bradycardia (normal resting heart in the 40s) used to be normal for me when I was younger and fitter. Now I'm at the low end of normal (resting rate 50-60 in NSR) and drop into bradycardia (low 40s) quite predictably according to how high a dose of beta blocker I take. I try to avoid this by cutting down on metoprolol as soon as I stay in rhythm for 24hrs. My cardiologist agreed that this is sensible.

Definitely chase this up with your cardiologist and get that monitor.

[Calypso76 in reply to Redactrice]

Thanks Redactrice, I'm not on anything except statin and a blood thinner. My cardiologist said I don't need a PM and I as yet have not received the monitor. I guess I'll just have to wait on my next appt in 3 months to take it up with him.

[Harryl]

I had a HR of between 30 and 40 falling sometimes when I was asleep to the 20s. Know this because I had a 48 hour monitoring device. Never felt ill, dizzy or sick but did feel breathless from time to time . After the monitoring results it was agreed that I needed a Pacemaker and this was fitted in September where the HR was increased to 60. Now been signed off and I'm back in the gym after many years and feeling progressively better. The whole process from diagnosis to having the PM fitted was approx 2 months . I'm 72 male and have had AF since my THB back in 2020 albeit its never given me any concern probably because the HR was quite low. Hope this helps

[Parkhome in reply to Harryl]

hi, I'm in newcross hospital at the moment, they say they are going to fit a pacemaker, my heart rate is low, but they said I'd got ventricular bigeminy.

I have got a bicuspid valve with moderate stenosis & slight regurgitation, also dialation of the aorta. I just woulderd how you felt after you had your pacemaker fitted,

I'm starting to get a bit worried.

[Harryl in reply to Parkhome]

HI Parkhome. I feel perfectly OK after the fitting of the Pacemaker. I dont know if its worth stating that whilst I've been told I have AF I've never experienced the downsides condition i.e never felt my heart was racing or felt I had missed a heartbeat etc. Interestingly enough when I was chatting to a consultant pre-op she stated that around 85% of the population have AF

[Jalia in reply to Harryl]

I wouldn't hsve said 85% of population have AF! Possibly refers to older age range.

[Harryl in reply to Jalia]

Just telling you what was I was told Jalia by a Consultant. There was no mention of Age parameters

[Jalia in reply to Harryl]

Something wrong there! GPs would be treating nearly all their patients as this would be detected very easily with pulse check

[Calypso76 in reply to Harryl]

Thanks, Harry. My HR has never dropped into the 30s that I know of. It's usually in the 40s.

[Desertflowerchild]

Yes, I have afib and low heart rate - or had. My heart would drop into the mid 40s every night and 30s when I had been doing a lot of physical training (or after a long episode of afib w tachycardia). I had an ablation on Oct 2, 2024 and right now my average low is 50-51 about 6 bpm higher than before. I don't know whether my resting heart rate will drop back down in a few months or whether this will be my new normal. The only treatment I am aware of for low heart rate is a pacemaker.

[Calypso76 in reply to Desertflowerchild]

Was the ablation to bring you back to normal rhythm? And you don't have a pacemaker? I'm new to all this so forgive me if I'm asking the wrong questions.

[Desertflowerchild in reply to Calypso76]

Instead of going the medication route for paroxysmal atrial fibrillation, I had a pulsed field catheter ablation procedure to try to stop or reduce episodes. Before the procedure, my burden of atrial fibrillation was about 3%, and with the ablation, I am hoping it will be 0% or very close to 0% for at least a few years.

Low heart rate has been my normal for decades and has never caused me any negative symptoms.

There was no problem with my low heart rate until atrial fibrillation entered the picture. With atrial fibrillation, my low heart rate limits the medications I could take for atrial fibrillation because most of the medications decrease the heart rate and with my already low rate, I don't have much margin. So, if, in the future, I need to take medications for afib, then my doctors would first want to have a pacemaker inserted that would take over were the medications to drop my heart rate too low.

That's my understanding and, regarding the medications, there has been some disagreement between the several specialists I have consulted. But 3 out of the 4 thought medications would be unsafe for me.

[Calypso76 in reply to Desertflowerchild]

There was no problem with my low heart rate until atrial fibrillation entered the picture. This is true for me as well. And I suspect (I could be wrong) the blood thinner drops my HR even lower because I was able to function pretty normally before I started taking them. I don't understand why my cardiologist thinks I don't need a pacemaker. Thanks for your input.

[abcom in reply to Desertflowerchild]

Hi, is the ablation working for low heartbeats too? Until July, my tachycardia was going up to @ 200 heartbeats. Something happened in July-August and since then I have heartbeats drop, followed up by fast heartbeats for a short time. Probably the heart is trying to compensate the lack of oxygen. I thought that the ablation is only for fast heartbeats. Is it working?

[Desertflowerchild in reply to abcom]

My ablation was to stop atrial fibrillation and the EP also hit an area that was causing flutter. Ablation, to my knowledge, is not used to correct low heart rate.

My resting heart rate is slightly elevated compared to before my ablation -- I don't know why or whether this is temporary or a good, neutral or bad indication.

[abcom in reply to Desertflowerchild]

Thank you for message, I understand you were well informed about the procedure in your case. I was recommended for ablation about 4 years ago but for some reason I preferred to stay on medication, only as needed. Following a chest pain event in mid-July my tachycardia changed and I still have no response to these symptoms. The first picture is the old one, the second one is about a month ago. I am trying to understand what is going on and if ablation would help now.

Old ECG

[Ennasti]

Low heart rates are pretty common, especially if you’re on meds. The issue is symptoms. If you’re passing out with a low heart rate they’ll look at it more closely. They usually won’t worry about low rates at rest or sleep. A fast rate does more damage than a low rate so they will choose low over high

Here’s my low heart rate warnings for the past couple of weeks. My watch will alert me if it drops lower than 50 for more than 10 minutes. You’ll notice they’re all during the day. I have no symptoms though and it’s been like this for about 4 years. I’ve had readings in the 30s on monitors and my doctors are aware of this - they’re mainly from my heart pausing. The actual reason for a low heart rate is another thing your doctor is taking into his assessment.

I get lots of one off measurements of less than 40 or the low 40s )and lots f very high one off measurements too!) but it means nothing and is often the Watch not reading properly or it’s tried to measure at the time my heart is having a few ectopics.

I will have a pacemaker in the future as I do also suffer from AF, tachy and I have a left bundle branch block.

Screen shot of app show low hr alerts

[Calypso76 in reply to Ennasti]

Thanks for your input, Ennasti! I have had low heart rate for as long as I can remember. I also have a murmur, which never seemed to bother my primary doctor. He always said it was nothing to worry about, then they changed me to another doctor who insisted I must see a cardiologist who put me on a monitor and came up with the A-fib diagnosis. So now I'm on a blood thinner and my doctor says I don't need a pacemaker. But thank God, I don't pass out.

[Ennasti in reply to Calypso76]

Yes, I had a low heart rate for many years prior to meds but to think it may have been from being very fit. I recall about 25 years ago I was donating blood and the nurse said if my heart rate was 1 point lower they wouldn’t be able to take my donation. I have no idea how low it was as I did’t think to ask. I just thought it was odd as I thought it signalled fitness. 😆

Now it’s definitely the meds though as my cardiac function isn’t favourable to too much exercise!