Arrhythmia Alliance

Slow BPM no symptoms

A few weeks back I noticed that my pulse was beating rather slow and at that time also significantly irregular. However, otherwise I felt breathlessness or chest pains, no dizziness apart from maybe feeling a little lightheaded once for a few seconds. Even after a short session on the cv machines in the hotel gym I was ok apart from maybe feeling a little fatigued and generally not as fit as I have been.

Athough maybe not as irregular, my resting bpm has remained slow : between low 40s and low 50s but still no real symptoms apart from maybe an understandable increased feeling of anxiety. As you do, I went to GP to get checked out and saw a practice nurse who gave me ECG which she said showed slow pulse with some unevenness and slight irregularity in beat. I was referred that day to the hospital's ambulatory care department where I was given a second ECG and examination this time by the doctor. He said that although my pulse was slow it was sinus rhythm, he also referred me for echocardiogram and 24hr ECG Holter test.

It was a three week wait for this to happen and was completed a few days ago. I understand now once again I have a few weeks to wait for either the cardiac consultant or my own GP to discuss the results.

Naturally, I am becoming increasingly anxious as time goes on but coping quite well, mainly due to the fact that that I have not experienced any of the adverse symptoms, other than a general feeling of lack of fitness when doing exhertive activities, and some occasional discomfort which I am putting down to an ever encroaching state of anxiety

I am wondering if there is a problem with my slow bpm or whether this could be just normal for me. I understand that some athletic people can have a reduced bpm, but I would not call myself an athlete.

Has anyone out there experienced anything similar and what was the outcome?

6 Replies

Hi Buccine. My resting heart rate tends to be in the 40s and 50s and I'm not an athlete either! My sister is the same so that is not necessarily a problem. I have recently been diagnosed with Paroxysmal Atrial Fibrillation and it took a 7 day monitor to catch the symptoms. Nothing showed up on an ECG or echocardiogram. I hope you get your results soon as there is nothing more stressful than a long wait.


Hi Buccine,

slow beat may come from genetical reason as well. In this case your heart might be stronger alike as athletes and you cant feel nothing. I have both background (former waterpolo player and genetic enlargement of my heart) and I never can feel my aFib. Simply the stronger heart can compensate the loss of atrial function. Even during afib episode I have only 70-80 bpm (without afib 50-60 bpm).

Your cardiologist, did the best. Echocardiogram is the best for seeing wether your heart is enlarged or not.

All the best:


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Hi folks, I just thought I would give you an update.

Things have moved on somewhat. I received my results and had my meeting with consultant cardiologist. She was fabulous and explained it all and answered all of my questions. Although echocardiogram results showed my actual heart to be healthy and functioning normally, it turned out I do have Bradycardia caused by Sick Sinus Syndrome. Disappointing news I guess but at least I had a diagnosis and went a long way to relieving my anxiety.

However, although slow pulse she did say I had sinus rhythm bpm (45 to 50) and at that time no heart block. She told me that best treatment would possibly be a pacemaker. However, as I was showing few symptoms at this time, I was to go away, stop worrying and checking pulses etc and see how I get along. She arranged to see me again in three months and to contact her through her secretary if I had any concerns or worsening symptoms showed themselves.

For a few weeks I felt fine, but sure enough things changed, in fact I would say suddenly changed. I wished to start running again, but I had no tolerance to exercise. I felt within a particular week that I fell off a cliff and began to experience the classic symptoms, breathlessness, light headedness, headaches, jaw pain, fatigue and poor sleep. Even standing up and initial movements brought on some symptoms. My pulse had slowed to 34 to 40bpm, although I didn't have blackouts.

As advised I contacted my GP and the secretary of the cardio consultant. I was concerned about the dramatic change and onset of symptoms and the fact that I had made plans to holiday abroad in a few weeks. The consultant phoned me back personally and confirmed that a pacemaker is now advised. It was explained that the sudden onset of worsening symptoms was due to the fact that my condition of Sick Sinus Syndrome had changed and heart block had developed. A pre op assessment was arranged that very morning and two days later I was in the hospital having the pacemaker implanted.

A lot is said about the NHS in the UK, but in this case they were outstanding. They responded quickly and things were soon rearranged to accommodate me. On the day I was surrounded with caring professional staff, the resources were impressive and the implant operation went smoothly (2 lead pacemaker). I was home the same day.

Although a little sore and bruised as expected, I felt the improvement straight away. My heart rate has returned to a steady 60 bpm and so far no symptoms. I feel obviously disappointed that I had developed this condition but now very happy that things feel good and I will now go away on holiday in few weeks without worry and anxiety.

I am only 57 which I understand is relatively young for this condition. The cause, as they say may never be known. I am diabetic (type 2) and was diagnosed over 20 years ago which may have contributed to the early onset of my Bradycardia. Also, just less than a year ago, I suffered a rather nasty flu-like virus which was accompanied by high fever and left me with slight loss of peripheral vision in my left eye...a possible suspect? With the benefit of hindsight, I believe this is when the first signs of fatigue and exercise intolerance began to show themselves. I guess I must accept the fact that I will never know for certain.

I seem to have written quite an update, however if it may indicate any similarities to anyone it would be good to know, and if my experience reassures others I am glad. As for me, I can only say that a pacemaker is a premier treatment and in my case I could not have been dealt with any better by the NHS and a fabulous consultant. Hopefully, my life can get back to being as normal as possible and I wonder where I would have been if these amazing devices were not around.

Good luck everyone,



Hi Buccine! I am glad you have got yourself sorted out and have had good results from NHS treatment! I wish I could say the same! I have bradycardia pulse rate of 40bpm.and I get runs of svt when it goes up to 180bpm. I am constantly tired and have painful pvcs as well but my useless doctors have just told me to live with it which is a complete copout on their part! I get really frustrated and depressed and some days can't function hardly at all !! Best wishes to you !


Hi art195,

Get second opinion and insist, you are entitled.

No one should suffer with such symptoms.

Good luck

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Thanks Buccine!


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