Norms for Heart Rate - and body mass index

I understand that normal pulse rate is between 60 and 100 bpm.
However I have also read that there is an apparent 3:1 relation
between resting heart rate and body mass index.  I am 50+, diagnosed with bradycardia, one syncope episode, with usual resting rate around 40 - but going down to low 30's even high 20's at times.  My BMI is a tad below 20 - so even based on this BMI my heart rate is low.  My question(s): (1) Given that the norms apparently are based on average BMI of around 24 - is my heart rate as far from the norm as it would appear on the surface?  (2) Were the "norms" standardized for women or only based on men's averages?    (3)  With the event monitor, I have documented some incidents of low 30's pulse rate where I felt enervated, extremely fatigue.  (I do not ever feel on the verge of fainting.)  So this appears to correlate bradycardia with symptoms.  However, is it not possible that at other times my rate goes down to the low 30's WITH NO symptoms?  What does the event monitor really prove?   I am so grateful to you, and to this forum.

[Cleveland Clinic, MD]

Dear Wen,
I have never heard to the BMI to HR ratio but I suppose in general it makes sense that the higher your BMI (more out of shape) the higher your resting heart rate.  I don't think this ratio applies in your case.  Low heart rates and syncope are a Class I indication for a pacemaker and were you my patient I would recommend getting a pacer as soon as possible.  Event monitors are useful in correlating heart rate and symptoms, which may include fatigue.  Occasionally if someone is at rest a low heart rate may be asymptomatic but even in this case if the heart rate dips below 30 it is a Class II indication for a pacemaker.

[wen]

Thanks for your help.  Now my doctor has strongly recommended pacing, so I've given up fighting it.  I hate the idea of someone programming me!

[Cleveland Clinic, MD]

I understanding you hesitance but I think you will feel much better with a pacemaker. Let us know how things turn out.