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Bradycardia how low is too low

Heart Rhythm Conditions | Last Active: Jun 20 4:27pm | Replies (48)

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Well, as you've all showed, there's bradycardia and there's bradycardia, brought on by a myriad of causes. Some bradycardia is physiologic and may represent normal cardiac function in some individuals, other bradycardia may be pathologic and cause physiological havoc and lousy quality of life in the poor schmucks inflicted with this ( ask me how I know this). To sort all this out, guidelines to differentiate among the causes of bradycardia( and tachycardia in applicable cases) and determination of appropriate treatment methods have been put forth to aid diagnosticians in their best treatment of patients with these conditions. I don't think anyone would be happy just to throw pacemakers/CRT/defibrillators at everyone who visits a cardiologist with a complaint of bradycardia!

The table shown in this link ( Merck Manual) summarizes the 2019/2021 American College of Cardiology, American Heart Association, and the Heart Rhythm Society Guidelines for pacemaker placement.
https://www.msdmanuals.com/professional/multimedia/table/indications-for-permanent-pacemakers
And here's a second article that basically covers take home points in those guidelines:
https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2021/08/31/18/37/2021-esc-guidelines-on-cardiac-pacing-esc-2021

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Replies to "Well, as you've all showed, there's bradycardia and there's bradycardia, brought on by a myriad of..."

@marybird Very interesting. I was very fit in my past and an average resting heart rate of around 43 was normal.

It’s been many years since I’ve been that fit. My average resting heart rate moved to around 55 - 60.

Suddenly last year my average resting heart rate at times dropped as low as 35 and averaged 44. I’m walking daily with my young dogs for a hour and a half but certainly no elite athlete any more!!

I’ve had numerous tests including an MRI and a 48 hour Holter monitor. No apparent reason for the very low results 🤷‍♀️

The cardiologist says not to worry but just keep an eye on my smart watch monitoring and how I feel. So that’s what I’m doing. No pace maker for me!