Bradycardia and Palpitations

[kovacs]

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

[CCF-M.D.-CRC]

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.

[BillyboyAA]

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.  
***@****

[pikamom]

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.

[JR]

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....

[Richard_W]

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.

[pikamom]

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.

[kovacs]

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 every minute of every hour of every day for about a 1000 per day.

They are perhaps the most bothersome thing I have ever had to date and I also realize that its just the tip of the iceberg . I know that others have vastly more severe conditions and I feel badly for them.

After my retirement, life became more sedentary and for a few short years I let the weight pile on and decided to get back into pre-retirement shape which was a lifelong state I used to keep myself in. Then the palps started along with a lowering of pulse rate and so on.

I have never been a cry baby but this thing baffles me. In the past 5 weeks I have stopped exercising and even have altered my diet to see if that was the cause. No change.

So I search for answers within medical literature, alternate medicines/treatments, various doctors input and opinions while trudging on.

Again I thank everyone for their input, reassurance, suggestions and caring attitudes. All of it is greatly appreciated.

Anyone can feel free to email me at: ***@****

[Richard_W]

If I were you I would get a copy of your medical record from all of your doctors and read it.  In it you should find a lot of information and you can research the internet and other sources for a further understanding.  If you haven't already had an echo you should get this and get such information as your ejection fraction and dimensions of your heart.  Long term high blood pressure can definitely damage the heart muscle.  My wife's cardiologist used to like to get the blood pressure to about 100/50 to reduce the burden on the heart.  He maintained he could get anyone's blood pressure down.

[PmkNJ40yoM]

I am posting this here as it seems an appropriate thread to do so. I am a 40-year old Male. I have been obese since childhood. I have had bouts of PVC's since I was 22. The past 2 years I have found myself in the ER 4 times when the PVC's had gotten really bad. Doctors prescribed Metoprolol (lopressor) 100mg twice daily and that seemed to help. I also take hydrochlorthyazide 10mg daily. Now for the unusual part of my problem. Each time I have undertaken a weight loss program, after I have lost about 35 > 40 pounds my PVC's return with a vengance. The weird part is that they only occur when I am sitting down or laying down. I can be sitting at my desk and they will start and run on continuously until I can not stand it any more and then I will stand up and walk around the room and instantly they stop. It is to the point that everyone in the office knows when I am having the problem when I start walking around my desk.

Some days it gets so frustrating that I will leave the building and walk around the city (I work in Philadelphia). I do not experience any PVC's (at least they are not noticable) when I am walking. After My walk I can be sure of several hours of relief, but like clockwork the darn things will start up again.

It gets very depressing once this happens to me and many times before I have gone back to eating and gained all my weight back. Ironically, the PVC's will go away again once I have gained the weight back. I am determined not to fall back this time and continue on my weight-loss program, but I am at my wits end some times. It is discouraging that I feel I am doing the right things yet the PVC's come back. I have stayed up until 3:00 and 4:00 o'clock in the morning just cleaing my apartment and doing things cause as long as I am moving I feel fine. Once I try to relax, BAM it starts up.

Thanks for letting me vent here. I have been following these threads for a while and have found some relief in knowing that there are so many other people experiencing similar problems like myself and I am not nuts. Of course i have had continuous runs of those bad-boys the whole time I have been typing this. I think I will go for a walk!!!  :>)

[kovacs]

Hey, someone I can relate to. I was not overweight all my life but had few PVC's/PAC's all my life. At around 50 I let my weight get the better of me and ballooned to 268lbs ( had always been in good shape around 205-215}. So by 53 I was goodnfat. We decided to enbark on a strict diet and exercise program (no drugs or fads, lots of cardio and some weights) and as things went well for months, at about 30-35lbs of loss the palps began. Absolutely worse when sitting or reclining by the TV, escalating after meals but right before falling asleep they would get less in number. I was having close to 1000 skips a day and theorized it had something to do with the weight loss and slower resting heart rate. The docs did not share my thoughts and prescribed 25mg of atenolol. My blood pressure was high but again, I thought it was high because of the constant anxiety over the palps. I stopped the diet and was seriously thinking of regaining the weight but my stubborness prevailed and I continued with the diet but modified the heavy workouts to ones more leisurely. No change in the palps yet but I hope that they will self regulate in the near future even though the cardio doc and most fellow skipper don't feel they will resolve. I hope they are wrong as I know we can live with them but boy are they bothersome.

Good luck to you, keep up the walking and diet as even with the palps we will be much healthier for it.

We live in Southwest Florida so exercising is very fashionable here. Email me anytime at: ***@****

PS: I also had many palps sitting here typing this response but I try to ignore them the best I can.

Frank

[kovacs]

Thanks for writing, I kinda figured that the doc blew me off cause I'm searching for answers they nor my docs seem to have.

As for the atenolol, I started on it when my blood pressure shot up to 180/100 before another stress test (just 2 days ago). The doc conducting the test would not do it unless my pressure is much lower. During and after excercise my pressure is usually the best at 130/80 but the doc didn't want to hear of it.

The good news is that the meds take the pressure to 110/65 and my pulse to 45-55 but the palps are still there even more in number but much less in force.

Today I got pissed about feeling like a slug so out came my bike and I went on a 10 mile ride at a decent clip (40 minutes) and could'nt get my heart rate over 100. I did notice that the palps were non existent for about the first 30 minutes and for the last 10, I had maybe 4-5. Within precisely 2 minutes the pulse was about 58 and the palps were back.

I know that 1000 a day is not that bad but still I wonder how long before they go to 3000, 10,000 and 25,000. Perhaps never but perhaps tomorrow. I don't dwell on it but from all I've read and what the docs say, once they begin they usually ( in most people) don't go away. Am I wrong? I sure hope so.

Anyhow thanks for your encouragement, you've gone through a lot and I'm the cherry on the block. Hope someday to report good things. Everybody wants to go to heaven but nobody wants to die.

Its always good to hear from you.

Frank

[Westies]

My blood pressure is not very high. I am 57 and overweight. My problem is my heartrate, in the past few years, in the 90's and 100's. If I do anything much at all it goes up higher. If I go to the beach and take photographs (our business) it goes to 135 and stays there for three days.
At night it goes high sometimes.
None of my Dr.s have addressed this issue.One was going to, but put me on Paxil because he thought my sweating episodes were from anxiety. I was on it a month...I went off of it during the next month and then had Myoclonic seizures and tardive from it.
So, I hope someone out there has an answer. I was going to be put on a month long Holter, but was not.
I am on Toprol XL and Diovan. I am told I have COPD and ashtma. Could this be why my heartrate goes so high?

[GinBreadMan]

I am 33 years old and was diagnosed with cardiomyopathy. It was diagnosed because I was constantly having palpitations. I was put on beta-blockers and at first they didnt work then the palpitations stopped for about 3 weeks and know they are back I only have about 100 a day but at my highpoint I was getting about 2000 a day. Is it normal for these to go and come back again and what can I do besides going crazy. Any help would be great.

[panicky1]

Here's my addition to what's already been said:  a few years ago I started feeling skipped beats, mostly in the throat area, and reported them to M.D.  She said it's no big deal, forget about it.  I did so, but as I approached age 50 they became more frequent and strong and annoying.  I began to panic every time I experienced one or several in a row.  (I'd had a resting heart rate of 96 for years but no one ever said that was too high and BP had always been normal.

Since age 45 or so, I've also had weird feelings, like anxiety/panic, feeling of dizziness, out of body type feelings, ringing in the ears, oddball stabbing chest pains on occasion -- you name it.  

One day, after a frightening series of extra strong, rapid "palpitations" and thinking I would pass out, I drove myself to the doc's office and, since my regular doc was out, another one in the office took an EKG immediately and said the heart rate was by then (45 minutes after the incident) very fast, but normal (at that moment).  

I ended up seeing an electrophysiologist (heart rhythm specialist) who did his own EKG, listened to my heart from every angle, read the results of an "event monitor" that I wore almost daily for three weeks, read my file, etc.  His diagnosis was: there is an arrythmia, but that it "appears to be benign."  He suggested I avoid stress, continue on .25 mg. Atenolol daily IF I WANTED TO, and it would be OK to continue low dose Xanax which I had started taking.

I must tell you, this combo works fairly well, but it's not perfect.  Every bizarre pain or blip starts another round of worry.  I'm 53 and about 15-20 pounds overweight now so figure I'm a prime candidate for heart attack :)

Best advice I can give to anyone with similar symptoms is to avoid stress, GET ENOUGH SLEEP (this makes a huge difference), and try not to even THINK about heart problems.  This is difficult because subconsciously the worry is always there.

My BP is around 120/80 in the doc's office now (used to be a bit higher before Atenolol), but at drugstore test sites it's MUCH lower.  Pulse is now quite low -- from around 50 up to around 72.  Actually, this is fine.  I was told by the pharmacist when first taking Atenolol that if BP dropped below 50 I should "just get up and move around!"  I just love a comedian!

My total cholesterol runs around 220 - 240, but HDL has always been over 70.  While drinking a few glasses of red wine per week my HDL was, get this, over 90!  I stopped drinking it a couple of years ago because it can increase heart rate and cause palps, but I'm back on it to see if I can raise the HDL up to the 80's/90's again, or if it's a bit lower because I am pretty well past "the change."  The doc wants to do a cholesterol test again in six months to see if this red-wine drinking really raises the "good" HDL.  Glad to have a partner in crime!  (Primary doc is female, same age as me, so we get along well).

For you other middle-aged ladies out there, Menopause can be the time when all of this starts up, hormones are going crazy for a number of years, and HRT can help, if you want it.  I don't.

Whatever your age or gender, worry about these heart symptoms, especially if doctors tell you it's nothing of great concern, is just causing more trouble.  Worry in itself is a huge culprit.  Best advice is DON'T WORRY SO MUCH!!!!!  I know, I know, easier said than done...

[andrew21w]

I also have skipped heart beats every now and then.it is extremely bothersome and causes a great deal of panic.i've always been quite panicky these past few years,so this just adds fuel to the fire.every little ache or pain makes me worry,and i start to self diagnose myself.i've been to several doctors who ran tons of tests,all of which were normal.my biggest worries are about my heart.i worry that i'll have a heart attack or that my heart will just stop beating.this worry has interfered with my life.i have no reason to worry since heart problems are not in my family.i am also only 27 years old.i'm  embarrasses by this because i know there are people out there with real health problems.i just can't seem to get past this.

[SunNStarz]

Hi Andrew,
I just read everyones post but yours hit home because we sound exactly alike.
Im female and 29, I dont smoke either but am under some stress.
I also have skipped heart beats every now and then.
It is really, extremely bothersome and every time my mind wanders "am i having a heart attack","do i have heart disease"

This has interfered with my life too, Im always stopping and checking my pulse also.

I have been to a cardiologist but he couldnt run stress tests because im paralyzed from an accident 12yrs ago which worries me because ive had no cardiovascular exercise in those 12yrs.

Heart problems are not in my family either.

its driving me crazy, paranoia and i too, can't seem to get past this.

If you or anyone would like to email me you can at:
***@****

Take Care,
Stacie

[andrew21w]

hi stacie,you do sound like me.sometimes i'll be fine and not worrying,and then i'll have a skipped heartbeat.that's all it takes,my mind wanders,i get very anxious and sometimes panic.it depresses me to feel like this all the time.i never used to have these prob.the anxiety is more scary than the skipped heartbeats,but that's what triggers the anxiety these days.
   have u had any tests done to see what is going on with your skipped heart beats?i've had several done and they were all normal,but still i worry.
   i'll tell u what my docs told me:skipped heartbeats are,in most cases not serious.in fact alot more people than u think get them,athletes,etc.and they are really nothing to worry about.at the most
they are just simply annoying.
   thanks for the reply,it helps to know i'm not alone.let me know how you're doing,and take care

[Ted55]

A related discussion, palpitaions was started.