Heart Rate

I am reading different things on here about HRs and it has me wondering - but I don't about what yet. After I had my ablation in February I was kept over night in the hospital. And of course I was being monitored. And every time I would approach a deep sleep I would be startled awake by the audible alarm because my HR dropped to 42. That didn't seem to alarm anyone but me. Fast forward five weeks and SVT episodes return and I am put on Toprol and put on a 24/7 heart monitor for a week. The cardiologist reports that my HR during that period was from a low of 35 to a high of 59. Again this did not seem to alarm anyone but me. I am 60 years old and not athletic and about 25 to 30 pounds overweight but otherwise relatively healthy. Should those rates be alarming? I guess a follow up question to that would be: if I do get a PM in October, will the higher rate (assuming the low setting would be higher than 35) prevent me from getting a good night's sleep?

8 Comments

what is alarming?

by Tracey_E - 2013-07-29 09:07:03

If anything, a normal rate should help you get a good nights sleep. They can set the lower limit wherever. 60 is standard but many feel good at 50. It can be changed if where they put it to start isn't ideal.

Under 60 is labeled bradycardia and considered slow. Most people do ok with rates in the 50's. Some people do ok with rates in the 40's but most feel better with a higher rate. Under 40, imo, should be paced even if there are no symptoms.

I'm not a professional so take my opinion with a grain of salt, but 2 things would have me opting for the pm. It's not life or death, it's not urgent, but it surprises me the dr isn't pushing for the pm sooner rather than later because imo you are clearly a candidate.

One, 35 while asleep is not good. Even if you don't have symptoms and don't feel the dips, it's hard on your organs when your hr gets that low.

Also, not getting over 59. If you walk up the stairs or go for a walk or any exertion at all, your rate should go up substantially more than it is. A higher rate on exertion would give you more energy, and also not be so hard on your body. Our hr goes up with activity because our body needs more oxygen. If the toprol is holding your rate down, every time you exert you are stressing your body.

They probably weren't worried in the hospital because you were monitored and you were fresh out of an ablation. It's common for things to level out on their own over the next days or weeks. But now? I can't see why they aren't scheduling surgery unless perhaps the toprol is temporary. Is it working for the svt?

Additional info

by rfassett - 2013-07-29 10:07:02

Hi TracyE and thanks for responding. The Toprol suppressed the SVT for awhile. But I had real issues with the Toprol causing serious memory issues. And then the SVTs busted through the Toprol. So at my last appointment two weeks ago, I was put on cardizem. I have not had the memory issues but the SVTs are busting through the cardizem on nearly a daily basis with one being clocked three days ago at 240bpm. I am scheduled for another ablation in October which will most likely result with a PM implanted.

Similar situation

by kmom - 2013-07-29 11:07:54

I am currently on propafenone for a-flutter about 3 months post ablation. It seems to be doing its job but heart rate keeps dipping into the 40's and 50's sometimes at night per my finger monitor its down into even the high 30's although it doesn't stay. (Before he even did the ablation or i started any meds after the holter he said my heart at times was having 3 sec pauses of asystole -- dont know if iam still doing that). Dr has talked about a pm for me because he's afraid that the meds will make it go too low. Already sometimes I am lightheaded and don't feel that great sometimes. But Iam coping It beats the afib/flutter for sure. I know ablation is a good alternative to meds and would of course I would have it done again if necessary but since dr thinks its on my right side of heart that he can't get to because I had surgery many years ago for an ASD and there's a patch there that he doesn't want to poke thru. The surgery was too many years ago to obtain any records unfortunately. Good luck to you keep us posted as to your outcome.

kmom

by IAN MC - 2013-07-30 08:07:33

I do prefer your new name !

Like you I had an ablation for atrial flutter ( successful fortunately ) and at the time the cardiologist identified that I too had been having cardiac pauses . It seems to me that these are 2 different conditions which need different approaches :-

- flutter , which ablation cured for me, and propafenone is controlling for you BUT the drop in HR combined with your pre-existing pauses may limit the dosages that you can be given

- the cardiac pauses cannot be treated by drugs and if they get worse you will need a PM ; I believe that, even if you had a successful right side ablation for the flutter, you would still be left with the pauses . Is that your understanding of your situation ?

Best Wishes

Ian

Ian MC

by kmom - 2013-07-30 10:07:05

Yes, that is my understanding. I need to make a follow up appt with the dr. since I haven't seen him since I started the meds 2 weeks ago. I was supposed to have cardioversion the next day but when I got to hospital I was back in rhythm (thank goodness) and was sent home. we really don't know which side is the culprit however he suspects the right side cause there were some issues that he found during the ablation proceedure but they didn't last long so he didn't worry about it. when my symptoms cropped up again he was pretty confident he took care of the left side (side he could get to) thus suspects the right side is what's giving me fits. I'm pretty sure I will have to take the medicine probably for life. Last time I saw the dr. (2 weeks ago) we seriously talked about the possibility of a PM (which actually at this point doesn't sound all that bad given my pauses and low HR's right now--but as I've posted before does anyone know how low is too low--40's 50's is that ok?? I've had some lightheadedness as well but that could very well be just a side effect from the meds it's kind of funny that both the meds i'm taking have those side effects listed and I also had those symptoms BEFORE i started the meds ha--how do you know? haha my body doesn't do well taking meds (and of course I'd rather not) but in this case I don't think I have much of a choice

sinus pauses

by kmom - 2013-07-30 11:07:45

Just to make myself clear--i forgot to mention--that the sinus pauses i was talking about ONLY happen at night when i'm sleeping. (showed up in a holter monitor test) however the low heart rates in the 40's and 50's do happen while i'm awake

low rates

by kmom - 2013-08-05 11:08:05

another question--could the slower heart rates 40's 50's and an occasional high 30's (only at night) be the reason I feel so crappy during the day?? sometimes I notice that my HR will dip into the high 40's and 50's during the day at rest (don't know what it's doing other times) but I'm beginning to feel so tired sometimes. (if needed) would a PM help with that?? I'm beginning to feel like an 80 year old weighing 500 lbs ha (i'm only 53 and weigh 213 which is way too much but last year I didn't feel like this)--I know the meds are probably part of this (Rhythmal and Pradaxa--both saying they have side effects of tiredness, lightheadedness etc) I just want to start feeling better again. Thanks

tired

by Tracey_E - 2013-08-10 11:08:45

Yes, a low rate during the day and lower rates at night will make you tired. Or it could be side effects of the meds, though they say that gets better after 4-6 weeks. For me, it was more like 4-6 months until I was less tired.

You know you're wired when...

You can feel your fingers and toes again.

Member Quotes

You'll come to peace with it in time.