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Low pulse rate after bypass surgery
I had bypass surgery in 11/2006 & blockages of 85, 90, 95 &100%. Surgeon said that @ my age of 72 yrs I was lucky to be living & only because my heart grew its own bypass over the years  I was still alive. I had no obvious symptoms prior to surgery other than a slight pressure in the chest when wheeling a loaded wheelbarrow up a steep hill. Prior to this for (14) years I lived in NM @ 6000 ft evaluation, did 20 min.weight & cycle exercise, walked in the mtns daily besides swimming laps laps regularly. My Internist's EKG'S never found any problems & I never had any shortness of breath or dizziness. Right after surgery they had a problem with my heart rate being very slow (30-40 bpm) & put me on a temporary pacemaker.
Neither the surgeon or cardiologist could explain the problem after numerous tests during my (11) day stay. I still have a heart rate of 40/50 bpm but on a tread mill I reached a pulse rate of 131.I still have no signs of shortness of breath or dizziness. My Internist is pushing for me to get a pacemaker & the cardiologist says we can wait until I have outward  symptoms. My question is, & haven't found it addressed anywhere, is could there be less of a need for the heart to beat @ 60-100 bpm because of natural bypass it grew before surgery. It would appear that there would a considerable reduction in the resistance of the vascular system. I am currently 79 yrs old. Any insight you can give me in regard to this problem would be greatly appreciated.    Thanks!  Al.  
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I've had two open-heart surgeries for valve replacement (there've been no coronary artery problems).  Since the second surgery, I have generally had a pulse rate in the 40's immediately upon awakening in the morning -- before I stir in bed.  During the daytime, when I'm alert and upright but not exercising, it's in the mid-50's to the low 60's.  I haven't taken my pulse rate during exercise, so I don't know about that.  

In any case, my resting pulse is lower than it was before I had the two valve surgeries.  It used to be in the low 70's when I was awake and calm.  I assume I have had some damage to the conduction pathways, which I understand sometimes happens with OHS, especially multiple OHS.  But no one has ever said anything to me about getting a pacemaker.  In fact, for many years, I was on a beta blocker -- by prescription, of course -- that kept my heart rate almost as low as yours is now.  I took myself off of the beta blocker because of side effects of lethargy and weight gain.  After getting off of the beta blocker, my heart rate did increase a bit, up to what it is now.  My heart rate is still not what it was prior to my two surgeries, but I do feel better with a slightly higher heart rate than when I was on the beta blocker.  

I don't know about your heart having less of a need to beat faster because of natural bypass.  I kind of doubt it, but I'm not an expert.  What I would suggest is that if you have symptoms secondary to a slow heart rate, than tell your cardiologist about the symptoms, and perhaps the two of you should revisit the pacemaker issue.  Or if you are on a beta blocker, perhaps your cardiologist can adjust that medication to let your heart rate come up a little.  Personally, I would rather reduce my dosage of the beta blocker than get a pacemaker.  But if I ever do truly need a pacemaker, I guess I will get one.

If you are feeling fine, perhaps it is appropriate to leave well enough alone.  I would let the internist's opinions be his business.  You have a cardiologist to handle the cardiology.  My internist sometimes has opinions about my cardiology care, and if I don't wish to do what the internist recommends, I respectfully ignore him.  The only doctor who I do have to deal with about cardiology decisions is my cardiologist.  
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