Female, mid 50's, 5'4", 112 lbs. Have been running for 5 years - about 20 miles per week. Prior to starting the running program I changed my eating habits to an extremely low fat (but balanced) diet, (which I maintain) and lost over 60 lbs. I suffer from insomnia - awakening about 4 AM - so I get only about 5-6 hours sleep. About two years ago I was told I had very low resting pulse rate - about 42, but no symptoms. This was then attributed to my running.
Two weeks ago, while hearing some gory news, I fainted - with no warning signs. I was taken to the hospital, and because of the low pulse rate, was monitored for 30 hours. During this time, although I did not feel any symptoms of lightheadedness, I was told my pulse rate twice got down to 28, with other instances in the 30's. A thallium stress test was done with normal results. I have since had an echo - also normal. I sometimes feel very enervated - kind of "not in the moment", and I fall asleep inappropriately - like in a theater - but NOT as though I'm going to faint. The dimemna: When I was discharged from the hospital I was told I needed a pacemaker. I sought a second opinion, and this doctor concurred. However, after the echo, and when I reiterated that I did not feel like I was going to faint, he issued an event monitor, which I am to wear for a month. I'm really not sure when to activate it - since I don't feel in danger of fainting. One more thing: I MAY have passed out once before, about a year ago - only I can't be sure whether this was "passing out", or "falling asleep".
What should I do? Other than the risk of accident if a syncope occurs, are there other risks of living with bradycardia? Particularly, absent syncope, with very low pulse rate, is the brain in some chronic oxygen deficit?