1. < Heart Rhythm Conditions

I have Bradacardia - when do I need a pacemaker?

Posted by joseph9 @joseph9, May 21 12:24am

Hi I am 74 and have always had a low heart rate 50-60s.
I had cataract surgery in August 2024 and while being prepped the nurse saw my HR was 33. Dr gave me something and I made an appointment with a cardiologist. I wore a heart monitor for 2 weeks. After reviewing the results the Dr
Said although my avg HR was low he did not prescribe a pacemaker or drug as my avg heart rate was above the range .
He said the medical board modified the requirement for a pacemaker as too many were being prescribed.
I believe he said my avg HR was low 40
I was supposed to have an appointment in March but the Dr called and said I didn’t need to come in since everything was ok. I have an Oximeter -HR monitor
My heartbeat is usually 45-55 but will suddenly drop to 30 or lower and then move back to 40’s all with in a minute.
I excercise regularly and my HR goes to 60’s but drops down rather quickly to 50’s.
Earlier this evening my heart rate went from 50 down to 26-27 for about a minute then I got up and rate goes up to 45-50
I took a video of the device to document
I haven’t had a problem with dizziness
Only occasionally
I play golf 4 times a week
7 handicap
Hoping I’m still ok
Should I talk to Dr about a pacemaker or is their an alternative
Thanks
Joseph

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joseph9 | @joseph9 | 6 days ago
In reply to @bettycll "I had an episode of nearly passing out. That is when I learned that my heart..." + (show)
@bettycll

I had an episode of nearly passing out. That is when I learned that my heart rate was in the 30's. I then did have a cardiac monitor for a month. When things did not improve and I passed out for several minutes (fortunately, my son caught me), I was given a pacemaker. The EP said that it would happen again, probably for longer and I may have to be resuscitated and no one around to catch me. That easily convinced me to want the pacemaker. So, I agree with marybird that having a syncope episode with the low heart rate would meet the guidelines for a pacemaker.

Jump to this post

Hi
Good you got the pacemaker before you had a major problem with no support on hand to assist.
My heart rate drops to 30’s but no problems at this time.
I monitor with a finger o2 and hr device and confirm with a BP and Hr monitor.
If I get other symptoms I’ll get back with Dr and see if a pacemaker is an option.
Take care

REPLY
carylw | @carylw | 5 days ago

Like yourself, I have always had a low heart rate ......possibly due to all the sporting activities in my younger days. First tachycardia episode lasted 5 hours. Alone and unable to move as I was in a semi paralytic but 'thumping' state. Has occurred 1000's of times since along with continued total exhaustion. Was 24/7 for several months but could not ablate due to other rhythms. Fast forward 2.5 years - diagnosed with tachycardia/bradycardia syndrome. Several months ago I began collapsing and blacking out due to very low B/P. That is when a dual chamber pacemaker was inserted. The only real downside has been the fact diltiazem was prescribed over and above my usual 250mg bisoprolol daily (the sole medication I had been taking). Currently trying to resolve chronic constipation, but it's wonderful to actually almost 'function' again. So........when to get a pacemaker? When you begin collapsing, but preferably earlier.

REPLY
joseph9 | @joseph9 | 5 days ago

I now have a BP monitor that logs my readings to my phone
For week ending 5/28 BP avg was 121/69
Heart rate was low of 42 and high of 53
Plan on 3 times a day
And I check my oximeter pulse device occasionally
I feel better about my situation

REPLY
1 reply
carylw | @carylw | 5 days ago
In reply to @joseph9 "I now have a BP monitor that logs my readings to my phone For week ending..." + (show)
@joseph9

I now have a BP monitor that logs my readings to my phone
For week ending 5/28 BP avg was 121/69
Heart rate was low of 42 and high of 53
Plan on 3 times a day
And I check my oximeter pulse device occasionally
I feel better about my situation

Jump to this post

Good to hear you are feeling more comfortable with your situation.

REPLY
joseph9 | @joseph9 | 4 days ago

Yes, good to have data to document my status
So any changes from my new ‘norm’ I can be aware of and make decisions.
Thanks

REPLY
mwmc777 | @mwmc777 | 4 days ago
In reply to @bettycll "I had an episode of nearly passing out. That is when I learned that my heart..." + (show)
@bettycll

I had an episode of nearly passing out. That is when I learned that my heart rate was in the 30's. I then did have a cardiac monitor for a month. When things did not improve and I passed out for several minutes (fortunately, my son caught me), I was given a pacemaker. The EP said that it would happen again, probably for longer and I may have to be resuscitated and no one around to catch me. That easily convinced me to want the pacemaker. So, I agree with marybird that having a syncope episode with the low heart rate would meet the guidelines for a pacemaker.

Jump to this post

Have had a Pacemaker since May 2023. It keeps my heart rate from dropping below 60. I also try to practice deep breathing as I find myself holding my breath often. But I also have Afib and have had several Cardioversons, 1 Ablation and on Sotalol and Eliquis! Glad to see you have an EP Cardiologist on your team also.

REPLY
1 reply
joseph9 | @joseph9 | 4 days ago
In reply to @mwmc777 "Have had a Pacemaker since May 2023. It keeps my heart rate from dropping below 60...." + (show)
@mwmc777

Have had a Pacemaker since May 2023. It keeps my heart rate from dropping below 60. I also try to practice deep breathing as I find myself holding my breath often. But I also have Afib and have had several Cardioversons, 1 Ablation and on Sotalol and Eliquis! Glad to see you have an EP Cardiologist on your team also.

Jump to this post

Good to hear you are cognizant of the importance of proper breathing.
Especially you should always breathe through and exhale through the nose.
New to me as I was probably more of a mouth breather,
With my low heart rate I figured I need to get more air in my blood.
Fortunately about the time my heart rate problems I heard a podcast with James Nestor who wrote a book “Breath” about the science of breathing .
Perfect timing for me to find this book .
I’m working on making sure that my breathing maximizes oxygen in my bloodstream to minimize any lightheaded feelings.
Take care👌

REPLY
caroline58 | @caroline58 | 4 days ago

You should not be as low as below 40 which is usually the lowest limit for a pacemaker. Below 30 is absolutely not good but a dangerous situation for you.
Good you film it, keep doing it and demand visits and show more occasions where you are lower than 40 and say that you want, yes demand a pacemaker! I have worked as a nurse in emergency care and in cardiac wards in intensive care. In my country we have the right to a second opinion with another doctor but also to change the Health Center and hospital if we are dissatisfied, can you call and ask if you can get an appointment with another cardiologist?

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milkmaid | @milkmaid | 3 days ago

Signs and symptoms along with low heart rate usually is a determining factor. I am assuming no meds are being taken that could drop heart rate. Also, any over the counter supplements such as foxglove, which is same as digoxin in pill form.

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