Drops in Blood pressure with Low Heart Rate

Hi friends,
My DDD pacemaker settings were changed about 3 months (post atrial flutter ablation) ago and they changed my Heart Rate from 60 down to 50 bpm. I have noticed that when am sitting still and my HR is under 60 that I get lightheaded and BP will drop. My BP has been taken by different people and drops Below 100/ - It seems to be increasing and becoming more annyoying - Could this be from my pacemaker or simply vasovagal and just live with it?

A holter test was done and showed no arrhythmia.
Anyone else have any symptoms when they lowered your heart rate.

2 Comments

BP + low HR

by Vai - 2012-02-28 01:02:25

Hi
Low HR do not, as a general rule, correlate with low BP (at least that was I was told).

My experience:-.
With BP med, my BP is controlled in a normal range of 110/85. That is my most comfortable BP rate. At times, the BP fell to 97/75 but I did not really feel any worse for it although I must say I realized it enough to check my BP.

My Pm is re-set to 55 bpm, down from initial implant setting of 60 bpm.

The combined BP & HR setting probably has some influence on how you feel. During a routine PM interrogation, the tech reset my PM to 50 bpm (my BP at that time was about 100/80), I felt woozy after just a few seconds. The tech advised my minimum setting is 55 bpm although he prefers to stay at 60 bpm.

I gathered that BP is not affected when HR is lowered but my experience tells me both should not be kept low by meds (BP) and HR (PM setting) at the same time.

Hope this makes sense and helpful.

Medications?

by jenny97 - 2012-02-29 10:02:54

Are you on any beta blockers? They can lower your blood pressure significantly. If so, you might want to discuss the possibility of switching or lowering the dose with your doctor.

Why did they lower the PM heart rate? What are the ramifications if they increase the hr back to 60? It seems like that might be the easiest fix and definitely something to consider, even if it is vasovagal in nature.

If that is the case, there are some other options you might discuss with your doctor: increased sodium intake (Mayo told me to start with 4-6 grams of sodium per day), increased fluid intake (particularly water and sports drinks with electrolytes), exercise (lower body especially - strengthening the legs can help keep the blood circulating to the heart more efficiently). There may also be some settings on your pm, like rate drop response, that could be employed to minimize the episodes.

Good luck!

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