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Bradycardia and Palpitations
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MedHelp Member's Question

Bradycardia and Palpitations

by kovacs, Mar 06, 2002 12:00AM




What could be the causes of near bradycardia. Pulse rate is always around 58-62 when at rest ( watching TV at the computor etc). Even standing or slow walking seem to take the pulse to only around 70-75. The reason I ask is that I started to notice palpitations around the same time as the lowered heart rate. I have always had palpitations (PAC's and PVC's) but not in the large volume as now (almost 1000 a day,mostly PACs with few PVCs). For many years before I would only have them occassionaly when tired, stressed etc, now they are at a steady rate.



I did start an extensive exercise/diet program ( no fads or drugs, just watching what I eat with lots of cardio) 4 months ago and lost over 30 lbs and was feeling better and stronger than I had in many years.

Went to have it checked out and all tests came back within normal limits except for mild hypertension for which atenolol was prescribed in low dose. It seemed that this drug lowered my pulse rate even lower to around 50 and I felt like a slug. I'm 53, otherwise in good health, have stopped almost all exercise for fear that we are missing something of a larger scale but the slow heart rate continues as do the palpitations.



Can you shed some light on what could have/is causing all this.

I've heard all kinds of answers- stretched the heart because of weight lifting, noise reaching the hearts pacemaker,heart not as flexible due to age, adrenalin excess, etc. It came and stayed out of the blue, granted I now feel and think about it all the time and the anxiety might be a factor but can't be the catch all. HELP



Doctor's Answer

by CCF-M.D.-CRC, Mar 11, 2002 12:00AM
Dear kovacs,

The most common cause of bradycardia (<60 bpm) in older persons is aging of the heart's electrical system.  Weight loss and an improved fitness level can also lower one's heartrate.  Of course beta-blockers also lower pulse rate.



A lower heart rate may actually allow more 'extra beats' to conduct through to the heart.  When the heart rate is higher these beats are suppressed by the intrinsic rhythm but when it drops down the beats can arise.  Beta-blockers usually work to counteract this increase.
Member Comments (17)

by BillyboyAA, Mar 06, 2002 12:00AM
I have a similar problem.  I have a resting rate of about 45-50 which my cardiologist says is great.  I feel tired, anxious, get alot of headaches, but he says this is from worrying about it so much, not from the bradycardia.  Right now it is about 47.  I do alot of cardio work at the gym.  Very healthy and in shape.  Is this possibly too slow.  Had a Holter and had a average rhythm of about 48 for the most part, except for being up and about.  I had about 140 "late beats" which I don't know what the hell they are, but every now and then, I feel extra long pauses.  I used a stopwatch to time some of them and most of them happen on an exhale.  The longest one I had on the Holter was 2.10 seconds.  He says this is fine as I have a slower heart rate.  And a very good vagal tone.  Also sinus arrhythmia, which is normal he says.  Could anyone who has the same symptoms please answer and try to help me.  I feel like I will need a pacemaker because of the pauses, they really scare me.  Can all of this be caused by anxiety/stress??  When I work out at the gym on the cardio machines, my pulse gets to about 100-120.  Anyone else with this problem, or is it a problem??  Thanx alot in advance.  

***@****

by pikamom, Mar 07, 2002 12:00AM
A slow heart rate is good, unless is like 30 or something. In a healthy active person it just means they are in good physical condition! Athletes have been known to have a pulse of 30. My grandma in her 90's on the other hand, very sedentary for years, needed a pacemaker for her pulse of 30.

by JR, Mar 07, 2002 12:00AM
as you know, good vagal tone (from the exercise) will cause a lowering of the heart rate of course, and from what ive gathered, people who are prone to PAC's, experience more when there heart rate falls. something to do with the heart resetting itself in between beats or something. some say that drugs to lover the heart rate can actually make PAC's worse while making PVC's better. but thats just what ive heard so it might be completely off base. might be something to investigate though....

by Richard_W, Mar 07, 2002 12:00AM
To: BillyboyAA
A lower heart rate is often very typical of a person in top physical conditioning.  Believe I have read that President Bush has a resting rate of 38 bpm.  As far as the pac/pvc situation that can be a real pain to deal with.  I would get a good diagnosis and possibly some medication to deal with it.  They are almost certainly benign.  However, I had quite a few myself (5000 in 24 hours) and eventually went into afib.  This has been successfully treated with Betapace and I seldom have any further problems.  My heart rate is normally in the high 40's while on the meds.

by pikamom, Mar 07, 2002 12:00AM
To: Kovacs
I can tell you are quite concerned with your heartbeats as this is the third question you've posted. From what I can gather, you've embarked on a fitness program and are doing well. Probably your heartrate has changed since you are rid of 30 pounds (that's alot of extra weight to carry around) and you're exercizing more. I'd say your heart is in good condition! It sounds like you had the tests and passed with flying colors. Try to put your mind at ease and think of something else. The more you think about your heartbeat the more aware of it you'll be. Don't take your pulse all the time, as that will just reinforce your awareness of it. I'm just talking from experience. Last year after my first time in the hospital and I was told how high my pulse was, I started taking it at the grocery store all the time. My resting rate was 120-140, and I too started exercizing more and lost 60 pounds. I'd take my pulse and think, O my god, it's 139! I felt every little twinge in my chest. I was given nitrostat for angina because my EKG showed my heart not getting enough oxygen, so when I got the chest pain I'd take a little pill under my tongue and think I could drop dead any minute. Now I finally had the catheterization and told my heart is normal although I probably have coronary artery spasm. The tachycardia is from an electrical problem and now I take cardizem instead of nitrostat. Finally my heartrate is under control and I don't get angina. I'm trying to forget about my pulse and haven't even taken it in the last month! I feel PVC's in my throat but know they are benign. I'm just trying to help put your mind to rest.

by kovacs, Mar 07, 2002 12:00AM
To: TerryLynn
Thanks for your reassurance.



I have become so disenchanted with many of the docs that have done all of my testing. They really can't answer or simply don't know the answers to many legitimate concerns that one has. Everyone who has palpitations knows that they are ABNORMAL but in the vast majority of cases benign. What this means to me at least is that there is a problem, causation is unknown but it is out there somewhere.



Just today I went in for a different stress test to further investigate the small possibility of a demonstratable cause/defect etc. They could not do the test because my blood pressure was 180/100. My pressure has always skyrocketed in any docs office and when I got home it never went higher than 140/92 and as low as 125/80 all depending on what I was doing. The only recommendation the docs have is to take meds and the pressure will drop and the palps will wane. What did happen: Pressure went to 105/60, palpitations were still there but very quiet and my pulse rate went from 60-62 to 46-56 and I felt like a slug.



Yes I am concerned but don't need to listen to my pulse as when I get palps, they let me know. Kinda like a hiccup in my chest