Low Heart Rate - post AF procedure

2 years ago I had a procedure where they created scar tissue in my heart to block stray electrical current and slow down my hearts AFib problem. I have been in normal sinus rythm for 2 years. Unfortunately I just came from a routine test after feeling a little dizzy and lightheaded. My heart rate was in the low 40's. The doctor has ordered a holter monitor for 24 hrs and a nuke test. He suggested that I see my EP and discuss varying options. He mentioned the word pacemaker...I'm 40 years old, have started working out 5 days a wekk (5 weeks ago), have lost 30 pds, currently weigh 274...Has anyone ever heard a procedure for chronic AFIb (high hr) and then find out that they have an abnormally slow rate? if so, what are the options here..I don't like the sound of the word pacemaker...Am I in any current danger? Any sites out there (besides this great one) that may discuss this problem further). Thanks

[va_tony]

Your current symptoms probably have nothing to do with your previous afib ablation. Technically, a heart rate of 50 or below is called bradycardia.  Here are a few sites that discuss the condition.  Of course, you can find more by simply googling bradycardia:

http://en.wikipedia.org/wiki/Bradycardia

http://www.emedicine.com/emerg/topic534.htm

http://www.mayoclinic.org/bradycardia/

The usual way one treats "symptomatic" bradycardia is with a pacemaker. Bradycardia is usually not life threatening... but it can affect the quality of life, especially if you feel weak and dizzy all the time.  On the other hand, it may be that the low heart rate is somehow associated with your recent weight loss and strenuous workouts. You mentioned your heart rate was 40 while you were dizzy.  How is it normally.  When I use to run a lot, my heart rate would dip into the 50's and 40's but I felt fine. The key point with heart rate is how you feel normally.  Many atheletes have heart rates  in the low 40s and feel perfectly normal. If you just had the one dizzy episode, you may not have a serious problem.  What did your ekg at the doctor's office say? Any mention of heart block?

Anyway, I wouldn't worry too much at this point.  You seem to be in good hands. After the EP does some tests, s/he will be able to assess your condition better.  The pacemaker was a worst case scenareo.  Even then, getting a pacemaker for bradycardia is no big deal and won't restrict your lifestyle.  I know guys who have pacemakers and are active runners and atheletes. Also, the tests may show nothing unusual.

While it's great to lose weight and start an exercise program, one should always start slowly-- just a pound or two a week and gradually build indurance during exercise as well. Perhaps you over did it.

Regards

Tony

[Bigblueh20]

Tony, thanks for the feedback. I have felt dizzy a few times in the last few weeks, but I attributed it to the exercise and diet. When I went to the doctor and had the EKG performed my heart rate was low...I had no clue. I went in feeling healthy as could be and left feeling miserable. My resting heart rate is around 42-45 bpm. (I've only started to check it since yesterday - i found out about this glitch yesterday!!)

I exercised today and was able to get my heart rate up to around 78-80% of my MHR - based on 220-40 *.85. The doctor told me to keep exercising. I assume it can't hurt.

The funny thing is the last time I had a heart issue (chronic Atrial Fib) - I was always in AF. When we went back and looked at my records/physicals I had chronic AF for at least 2 years (a very lucky guy - the doctors were amazed taht I did not have a blood clot). You can imagine how fast I switched my primary physician - he didn't pick it up. Once again, I had no clue anything was wrong with me...I was training pretty hard...

A

[Bigblueh20]

Thanks for the encouragement. Really don't like the sound of Pacemaker, but so be it. Amazingly when I had the ablation I felt like a new man. Had more energy than one can imagine. The doctor mentioned that if they can solve this low HR problem I may have even more energy....I like the sound of that! Thanks for the feedback. Jim

Went and had my holter hooked up this morning...will know the results in a few days. I have the Nucleur ST on Thursday - should have a better picture by the end of the week!!!

THAANKS

[Donna-lee]

My husband is the other way got bradycardia and a pacer then developed AF so now is due to undergo an ablation. The pacer doesnt bother him at all and the insertion was a very straightforward op. In fact last week when it was being tested the tech turned it off his own pacing was 29 bpm so I'm glad he has this technology. I wish you well with your case. Regards Donna

[mariop]

Actually there are two places that could be of help to you but the Medhelp Police doesn't allow posting of links.

If you know how to google try pacemakerclub for one and afibbers for the other.

[Bigblueh20]

Tony, thanks for all of the good feedback. You seem to be very familiar with the different heart issues - I hope not from experience. I have a question for you...Would you consider a pacemaker if you had the following scenario going on....You were 40, relatively healthy, exercise 45 minutes 5-6 days per week. Healthy, robust heart with a poor electrical/conductive system.Was able to get your HR up in the 150 range during exercise yet had a normal resting heart rate (basically throughout the day when sitting down) at around 45bpm. Heart drops in the mid-30 range when sleeping...couple of skips and pauses thrown in there as well...At the same time have had 2 abalations in 2 years for Atrial fib..seem to be in normal synus rhythm now...last time was in NSR for 2 years and it suddenly converted back....Would you consider a pacemaker...Some days I have nasty dizzy spells (not that often), I always get a bit lightheaded when I get up too quick...beyond that just a slow heart rate....

Also, with a slow heart rate..do you think i need to stay on Cumadin (coumadin) (in your opinion). If I were to have a Pacemaker installed would I still need to take Cumadin (coumadin) (in your opinion)...