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Arrhythmia Alliance
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Sudden very slow heart beat when sitting down

Hi all,

I am a 27 year old, and have been diagnosed with anxiety, due to my dizziness, occasional chest and arm pain, and basically feeling bad really frequently. While I believe a lot of my issues could be mentally related, I am unsure if it is the whole story. The anxiety was diagnosed after blood tests, echo, ECG and holter earlier this year were all fine.

However, I became increasingly aware of my heart rate. I've noticed that my resting heart rate can go to low 50's, while when doing normal activities such as walking etc. it is usually in 100-110s. Do you have any comments on this?

Additionally, using my chest strap I have recorded the following exercise (I am confident it is correct, since I checked with my blood pressure monitor which recognises irregular beats): I start measuring my heart rate while sitting, then suddenly get up and after 5 seconds I suddenly sit down again. As expected the heart rate goes up after standing up, but there is a really irregularly slow beat when I sit down, after which my rate adjusts to what it was. I am attaching a picture ( i stood up when there is a small spike up, while I sat down when there is a huge surge down).

Could you please tell me if this is worrisome, and should I request additional investigation by cardiologist?

Thank you so much.

7 Replies

Hi, If you feel something is wrong, you should be more consequent. Go to your gp tell him you had pre-syncope/syncope episode/s , irregular HR ect. Few months ago I had similar issues because ecg, 24h holter didnt show any signs of the heart problem I decided bypass GP next time. I was consequent and showed my problem when I had heart problem episode. I went to the nearest (and good) hospital, I said I passed out (what was true) and they admitted me within 45min to the cardiology ward. They made lot of tests, ecg at this time showed bradycardia 37-42 in escape Rythm. Since that time I was under investigation - holter 48/72hr showed pauses during a day , but it were paroxysmal events. They made more tests and results were answered for all questions:

Heart Rate 37-90 during a day (37-45 rest - mostly juction/escape rythm, up to 90 during work and exercises) .

25-40 during night

Paroxysmal sinus exit block ( random time - pauses 3 - 6 sec)

Paroxysmal Atrial Fibrilation

At the end was given diagnosis:

Sick Sinus Syndrom

Chronotrphy incompetence

AV block 1deg evolving to higher 2nd and 3rd degree

Long QT/QTc

One decision - dual pacemaker

Implanted in June this year. Everything was ok for 3 months until symptoms returned. I knew its problem with PM.

I received a letter regarding repossitioning/replacement of the top lead and date was for Nov .

Last week, during periodic appointment my cardiologist decided to make urgent surgery becaue I was slowed down to 20bpm and twice passed out in docs room.

I am 43 (no smoke, no drink alco, no drugs) and all docs say I was to young for PM but symptomatic symptoms said something different.

In my case I had few possible sources:

380v electric shock in the past, throat angina (not heart), not cured flu.

As you see, short term holter does not register paroxysmal events which can appear next hour after removing electrodes. Sometimes there is used loop recorder implanted under the skin. It can be there for 2years and record all in loop but you can trigger permanent event record when you feel its happened.

I Hope its only electrolytes imbalance or anxiety. Beginings are hard because GP's are like firewall in long process.

Take care and be consequent


1 like

Thanks Dariusz,

This is really a nice reply. I have already requested an appointment with cardiologist, so we will go through holter monitoring once again.

I am very sorry for your troubles, and hope you stay well. I also thought a bit of posting these kind of stuff online, and concluded that it doesn't make sense. I mean, this is arythmia forum, so doubt there will be much people who had problems but turned out well here. They will probably forget it. I will try to follow up with my diagnosis, and development, but there is a higher probability I will forget if everything goes well :). So, it seems to me as a really pessimistic thing to do, given that fact that I know so little about heart.

Nevertheless, I find your asnwer very helpful. Perhaps if I get an episode severe enough before appointment, I might go to hospital immediately.

Thanks again!


Tnx, My advice - try demand holter at least 48hrs , even longer if possible. May I ask you a question, did your issues appear spontanously (randomly) without any external triggers such physical stress, anxiety ect. Or its permanent state i.ex in the morning, or when you did not eat breakfast, dinner ect. ? What is your blood presure in rest . When you seat and you have normal BP, try check it 3min after standing. It can not drop to much. Check your symptoms in relation to hypotension effect during stress test



Hello Dariusz,

Sorry - I have just seen this. Anyhow, I think my blood pressure is on the low side but OK. When I am lying down and resting it is 100/60. It goes up to 110/70 when standing up mostly.

Anyhow, I am just wearing holter. I got it for 24 hours. I am experiencing some chest pain, so that is good, as it should be representative.

Thank again.



Hello Zlaja, your BP is low but still acceptable. The pain in a chest is not good sign but it depends what type. Of course its good when some symptoms appear during tests but not danger for life. I will wait for some news from you

Kind Regards



Hi did u find out anything from test because have the same problem with a sharp drop in heart rate when insit down


What did you find was your diagnosis?


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