Bradycardia and Stress test

  I have always (since I was about 20) had a low resting pulse rate -
  sometimes as low as 45 bpm. No specific symptoms, except lethargy.
  I am now 51. Had a (routine) stress test in January. Brady protocol.
  Reached level four, 11 mins and 40 secs on the treadmill before automatic
  shutoff due to reaching my target heart rate (179 bpd if I remember
  correctly).
  During the resting period after the stress test, the attending physician
  told me (later) that I had had a 'right bundle block',which lasted for
  15 mins. The cardiogram subsequently returned to normal. There were no
  symptomes, except the physician had asked me to lie down, and when I tried
   to get up after a few minutes, I was dizzy. And very thirsty.
  I was recommended a thallium test, and that I see a cardiologist, who
  asked me to forego the thallium test and have an angiogram instead,
  as the thallium test would not provide ay additional information.
  I plan to have this within the next two weeks - around Mar 23.
   My questions are:
  1) is there any non invasive procedure that would serve the same purpose?
  2) can my bradycardia and the right bundle block I had be connected?
  3) is the (small?) risk of an angiogram/ angioplasty justified, in your view?
  Background: strong family history of heart disease and depression;
  high cholesterol level (242, Dec 98 and 216 Jan 99) and high LDL/HDL ratio, both since
  (hopefully) corrected.

[CCF CARDIO MD APS]

_
Dear Salman,
1. The thallium is the non-invasive procedure, and most cardiologists would not
choose the invasive one (catheterization) unless they really felt that it would
provide the most useful information.  So, is there a non-invasive alternative to
cardiac catheterization?  The answer is no.
2. Since the heart rate and the bundle branches are both a part of the electrical
system of the heart, yes the two in your case can be related.
3. Although this forum is designed for informational purposes only and not
opinions, GIVEN your significant cardiac risk factors (high cholesterol and family history)
it would be wise for you to decide that the small risk of catheterization (with or
without angioplasty) is significantly smaller than the risk of not getting to the bottom of things,
i.e. finding out if you have any coronary blockages with a cath.  Remember, the decision is yours, and
know that everyone going in to any procedure with even the smallest of risks has every right to be anxious.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.