Bradycardia how low is too low

@labexperiment
No syncope to cope with🙏

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

@rbusch1944

I have bradycardia. At 75 I started getting a bit dizzy when working out. My heart rate dropped to 31 and I was admitted to the hospital. I had a pacemaker put in (Medtronic). I will be 79 tomorrow. I strength train 3 X a week and do Zumba 2X a week. I would ask your doctor if that would be advised for you.

The procedure was simple. People have different levels of discomfort in recovery. When I returned to the gym I was afraid to do anything. But taking it slowly, I have returned to my previous activity level.

I too could lose some weight as I have bad knees. It's tough 🙁 Need to add brisk walking to my schedule.

This has been my experience. Hope it helps.

@mbixler
Thanks, I've been wondering when my EP would mention the pacemaker. He says "not worried about high '40s". My main issue is energy, alertness, and not getting dizzy. I'm thinking of another ablation to get off of amiodarone, which seems to lower heart rate.

@neilgr777 Do you take any meds to control your Afib? I was placed on Flecainide with very good results. They decreased the dosage of it when the bradycardia started - it didn’t cause it, as I has a “ sick sinus diagnosis “ - and it still controlled the Afib. Just a thought.

Mine goes as low as 29 in morning today was a good morning with a 43 irregular pulse walked 2 miles watered did laundry finally at 62. This is a regular morning for me

Interesting to read y'all. My problem is more the other way so I take BP meds including a beta blocker and sometimes I feel it works too well and wondered how low is too low.

If it gets under 60 I take note. When it gets under 50, in my case I'm concerned, especially because I think it only does that when I've got an accidental big dose from my meds - I highly suspect their quality control is not what it should be. But no real symptoms as such.

I tend to have a cup of tea and do some light exercise if and when I catch it too low, and have delayed or skipped my next pill.

@glenc That does seem very low. I'm surprised you function so well. It must be that your heart is otherwise in really good condition, strong contractions, just a lot of time between them. It also suggests that your valves are closing off backflow well, and that your ejection fraction is pretty robust. Good for you!

@gloaming Have a leaking valve and a couple other problems but told heart is strong but it does cause a headache.

@glenc Okay, so between the one regurgitating valve and your slow beats, it does put you at some risk. If you can move about well, walk up an incline for several minutes, and not get badly out of breath, you're probably okay for now. In my case, with years of activity and competitive running, my HR rises to 110-116 BPM when walking briskly...for my age. :_D