Slow heart rate

[RaisinBran]

I have been diagnosed with bradycardia. One electrophysiologist wants me to have a pacemaker and another (for a second opinion) says I don't need one. I function very well during the day, have a good night's sleep and am not fatigued. The slow heart rate started when a holter monitor was put on me in 2015 and they discovered it then. I had it immediately checked out at the best heart hospital in this country and was told at the time that I was fine and did not have to do anything about it. My resting heart rate is in the high 30s. Can anyone comment on this? I am seeing a third electrophysiologist in Boston at the end of December to try and have this resolved. Thanks

[PMRpro Ambassador]

I have a pacemaker. I was having bradys following tachycardic atrial fibrillation episodes and occasional long pauses of up to 7 seconds which eventually resulted in a collapse and hitting my head on a radiator, The bruising was quite spectacular!

I wasn't allowed out of hospital until the pacemaker was inserted because of the risk of collapse in a dangerous situation - at the top of stairs for example. I didn't have any hesitation agreeing - and rightly so in my opinion given what happened to a close friend 3 years ago. He came out of the bathroom and had a dizzy spell which caused him to fall headfirst down the adjacent stairs. He suffered an unstable fracture of the C3/4 vertebrae and has been paraplegic since. He has some use of his hands, enough to use a computer and drink a beer if someone straps it in his hand. But otherwise he requires care 24/7.

You can't know when your current level of bradycardia will go even lower - brains don't do well without a good oxygen supply. It will be interesting to hear what the third opinion says.

[RaisinBran in reply to PMRpro]

Thank you Pro! I haven't had any dizzy spells yet-fortunately. Since my 5 bypasses in 2000, I have been exercising daily (7 days a week) which may be why I have a low resting heart rate at around 38. No AFIB even after wearing an event heart monitor for 30 days. Thanks for your input. I really do not want a pacemaker--I am very active and lift heavy objects daily.

[PMRpro Ambassador in reply to RaisinBran]

No - that sort of level is low even for professional athletes and I doubt you are that good!!

My pacemaker doesn't stop me doing anything - it is only the first few weeks after surgery you have to be careful just like after any surgery.

rbhh-specialistcare.co.uk/n...

[RaisinBran in reply to PMRpro]

Thank you

[Eiadio in reply to RaisinBran]

Dear RaisinBran,

I’ve had a low HR (50) since my teens and ran most days.

Early 2023 my HR changed to 30bpm and in August was diagnosed with atrial fluttter.

I was running throughout the 30bpm but began to notice some ankle swelling and evening sleepiness.

I’ve just had cardioversion and PPM fitted 3 weeks ago and feel totally renergised. I’m walking but not running yet but can’t wait…… it’ll be the best Christmas gift 🙂

You’ve not had AF or your medics would be more concerned.

82 and still exercising daily….. ‘chapeau’ I’m still a young boy compared

[RaisinBran in reply to Eiadio]

That was very helpful! Thank you and keep running Partner.

[Grammy80]

I was diagnosed with bradycardia back in 2020 which would also be reflected in my BP. In spite of a few other issues including asthma my oxygen is OK. I don't exercise anywhere near how much you do.. much more sedentary.

I was born and raised Massachusetts not far from Boston and have often relied on them or the Mayo Clinic. Pro, as always, certainly makes some excellent points. I do have a friend now residing in North Carolina who has had a pacemaker for 9 years and just celebrated her 92nd birthday~!

I had been scheduled for a thyroid surgery which I have cancelled because of other issues but it reveals my basic philosophy. If I really, really need it....let's do it...but let's be sure I need it.

It is my humble opinion that due to pressure from insurance companies in the States and paying so little on claims made by hospitals and Doctor's there are often unnecessary procedures done. Arm yourself with knowledge....which you obviously do~! My best💞

[RaisinBran in reply to Grammy80]

Makes very good sense! Thank you Grammy80

[pink123floyd]

I too have sinus bracadia only found after i collasped in town with my daughter not at low as your,s 53 is my normal spot same thing with 2 different doctors need pacemaker ,no you dont , so never bothered to go back that was back in 1996 .dont exert myself just pace thing out . Take care and hope 3rd time lucky you get some answer,s.x

[Hidden]

Did you have a look at the Mayo Clinic website under bradycardia and particularly Heart Block. If your pulse is permanently sub 40 then your ticker has to pump extra hard to keep your circulation going, which may not be good for you long term. Did you uave an echo to check on this? Is an electrophysiologist a cardiologist if not perhaps such an opinion would clarify things for you.

[RaisinBran in reply to Hidden]

Yes, an Electro guy is a cardiologist and specifically deals with cardiac arrhythmias. That is what is confusing me. Both opinions are from Electro guys, and only occur nocturnally, never while I am awake.

[Hidden]

Perhaps your problem is in the ' difficult to decide what's best category' hence differing opinions?

[RaisinBran in reply to Hidden]

yes

[Hidden]

??Go with the physician who is most thorough and gives you a clear risk:benefit explanation. Best of luck.

[RaisinBran in reply to Hidden]

Ty

[pmr_nikola]

When you say that you exercise, how long and how intense? You are correct that exercise will lower HR. Almost all endurance athletes have very low resting HR. When I was in top fitness (for me) and training for triathlons I had HR in mid to high 30s. Now I am somewhere in low to mid 40's. I still exercise 4-5 hrs/week at mid to high intensity. Never had any issue with heart although last cardio appointment/test was 7-8 years ago I feel I am still fine. BP is on the low side, usually about 110/60 range.

Did you always have low HR or just recently?