'Mild' Bradycardia Taken Seriously?

low HR

by SamanthaS - 2019-08-28 17:49:13

This is the excuse I heard from all my doctors after the pacemaker was placed and the EP stood there at the bottom of my bed and said, "you've experienced dizziness for years and no one ever thought to check your heart?"  You need to find another doctor before you crash while you are driving a car.  Insist on seeing an electrophysiologist.  It's crazy for you to have to deal with an emergency like I did when you already pretty much know what's going on!  Good luck!

low HR

by islandgirl - 2019-08-28 22:20:40

Ask for a holter monitor to wear for 30 days.  In the meantime, I would probably consider seeing an electrophysiologist.  If a dr isn't willing to listen and work with you, switch to somebody else.

low HR

by Bhamster - 2019-08-29 07:12:40

I would also ask for a holter monitor. I'm 62, and have always been athletic active, but aslo experienced the "slow thinking". In 2015, the episodes seemed to worsen and one morning I passed out. My vitals were still considered normal, but as a precaution I went to see a cardiologist. And wore a holter monitor which revealed consistent episodes of low 30's with 6-8 second gaps. Shortly thereafter, I was no longer feeling fine 24/7 and proceeded with the pm implant.   

Been there

by Gotrhythm - 2019-08-29 13:29:35

Don't go back to the cardiologist you saw yesterday. That doctor has already make up his mind and it's not likely you can change it.

Have you consulted an EP, a cardiologist who specializes in rhythm disorders?

If you have already consulted several cardiolgists and/or an EP, then you need to be seen at a major teaching hospital where there is a good cardiology department, even if you have to travel. They have more experience with unusual conditions and are more likely to think outside the box. 

Remember this: doctors can't treat what they can't see. So ask for a Holter monitor test. You know at least some of the things that will bring on the slow HR. While the test is going on, do all of them. Do everything you know to bring on your symptoms when you are at the doctor's office. Also, consider getting a personal ECG device like Kardia Mobile that would allow you to record cardiac activitity when you are having symptoms and give you some real data to show to the doctor.

One more thing. Don't go alone. You need an advocate, someone to be a second pair of ears. Someone who won't let you be brushed off.

I have great sympathy for you. Now that I have a pacemaker and know what a steady heartbeat feels like, I can see that I needed one at your age. When I look back, I see that what I did wrong was I never passed out.

Bradycardia

by PacedNRunning - 2019-08-29 20:38:19

I’ve been bradycardic for years. 50’s prior to becoming a runner but always athletic. After running I hover in the 40’s day and 30’s at night. I have mild symptoms and was told no treatment until I have more symptoms. That was 15 years ago. I always told docs my HR doesn’t match my activity level. I run but im not a hard core runner. Maybe 11-15 miles a week at the most. But if you run more and run a lot perhaps cut back on the running. If you’ve had a holter monitor for 1 weeks and all is good it has to be something else. Pacemakers seems like an easy fix which it is but it comes with a whole set of things people don’t think about for the future. I’ve seen many get pacemakers thinking it was bc their HR is low and feels no different than the did prepacer I took a medication recently called gabapentin and it increased my resting HR from 45 to 65. If I had gotten a pacemaker for Brady and saw this medication fixed it , I would be Pissed. Ask about meds or raise your HR other than a pacemaker. My doctor was very careful before giving me a pacemaker. Don’t keep searching until you find a “yes” doctor. Find one that knows what they are doing and knows when to place when and when not too. 50’s HeArt rate for someone who runs isn’t unusual. I know you want answers but I would try other methods first. Maybe you need more sleep. Diet? Etc. 

Thanks...and about that EP

by Bret1968 - 2019-08-29 20:50:27

THANKS everyone for your comments. This round (differentiating from 3 years ago) my GP sent me first to an EP and we did a 24-hour Holter. My rhythm is rock-solid steady (just too slow)...but steady is all the EP cared about so he was blow-off #1 about a month ago. He tried to tell me that my 'tired' symptoms were most likely due to sleep apnea, like apnea can explain a 15 point drop in resting heart rate over the course of a week. I told him I always wake up feeling more tired than when I went to bed. So you'd think the Holter showing a sleeping pulse of 41 would be a strong point toward doing something - nope, 'that's not uncommon, particularly among runners'. 

I swore off exercise to let things reset - you know, get my pulse back to the upper 50s where I feel bad, but not horrible. It's working, but I've had several weeks of fairly wicked orthostatic hypotension that messed me up even more, so I called the practice and got in to see a different cardiologist through their 'rapid access' clinic...and was blown off by him this week. Just read his notes from my visit. He's 'reasonably certain that your thinking problems are not associated with your heart.' 

Of course I couldn't demonstrate the orthostatic hypotension considering how stressed I was. My pulse and BP were both 20 pts higher than normal. He was only interested in 'what he sees', my heavily-documented numbers be-damned. 

On the bright side, I've got an appointment in a month with the cardiologist I saw 3 years ago. When I pressed him on doing something to help me clear my head then, he said "all I could do is give you a pacemaker." I shied away from it at the time. I should have said 'sign me up' and not dealt with this lousy summer. Hoping he's still more open minded than his colleagues.

Is there a medical term for 'low grade yet symptomatic bradycardia' that I haven't found or any documentation of folks with heartrates in the 50s being helped by PMs?

THANKS again!

Bret

THANKS Tiffsterty

by Bret1968 - 2019-08-29 20:57:15

I'll ask about 'non-permament' alterations before diving in...

Sleep Apnea is Life Threatening!

by KonaLawrence - 2019-08-30 03:31:02

Hi Bret,
You describe what may be symptoms of Sleep Apnea. It doesn't necessarily lower your heart rate or even affect it. It lowers the oxygenation of your blood. Over the course of months & years Sleep Apnea and decreased oxygen in the blood causes brain fuzziness, excessive tiredness and long-term organ damage. It significantly elevates your risk of heart attack, dementia, stroke and early death. It's no joke. I'm an athlete, I have Afib and Bradycardia and yes I have a pacemaker. But my heart rate was low like yours and it was no big deal. Only after I had fainted a couple times and wore a Holter monitor for a couple weeks did I have data that I also had 3-5 second pauses, i.e. my heart stopped for 3-5 seconds! Only the fainting (syncope) and 3+ second pauses meant I needed a pacemaker. Heart Rate in the 40s day-time and 30s night-time was no big deal.

On the other hand I had no measurable symptoms of Sleep Apnea, except that I usually got up to go to the bathroom 5-6 times every night. Oh well, it's just because I'm an older guy. Right? Wrong! It's called Nocturia and it is a symptom of Sleep Apnea. Other symptoms are daytime tiredness and brain fuzziness. A healthy person has a blood oxygenation level of 95+% all the time, day & night. Below 90% is a concern. Below 85% causes problems. Below 80% is very serious. I finally did a one night sleep study, after denying I had anything wrong for years, and found my night time blood oxygenation was 74%!!!!! I had severe Sleep Apnea! Now I use a CPAP machine and sleep much better. I only get up for the bathroom once a night. My thinking is clearer, I have more energy and I'm never sleepy during the day. If your doc even hinted at having a sleep study, please do it! It might solve some or all of your problems. If it comes back negative, it at lease eliminates Sleep Apnea as a contributing issue.
​Good Luck, Lawrence

Check oxygen level a

by marylandpm - 2019-08-31 04:49:48

 Why don’t you use a bevice you put on your finger to check your oxygen level. Drugstores sell them.  Also the new CPAC machines have a lot of information stored on them that you can access yourself.

. 

Blood oxygen level

by AgentX86 - 2019-08-31 10:17:31

You can buy recording pulse-ox meters that will make a 24hr recording of your blood O2 levels.  Of course they're "not for medical use" (wink, wink) but they'll give you a good idea of where you stand.

<https://www.amazon.com/CONTEC-CMS50F-oximeter-monitor-software/dp/B0796QYM8R/ref=sr_1_12?keywords=CMS-50E&qid=1566180426&s=gateway&sr=8-12>