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Sinus Bradycardia
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Sinus Bradycardia

My history, I'm a 26 year old male, run 20+miles a week, with a resting rate of low 30's-40's, that rises approiately with acitivity. I also deal with bouts of anxiety and panic disorder. I recently had a panic attack that led me to the ER, where they found nothing and I asked my doctor for yet another event monitor. Since the panic attack I have been a nervous reck and feel lightheaded, dizzy, tired, and feel lots of palps all day. On one event strip I sent while lying down I felt a palp and the strip showed a rate of 25, after many years of my doctor telling me I may need a pacemaker sometime in the future, he wants to now because one or two strips showed some rates of 25 or 29. Also, I've never passed out. My questions are.

1. What is your interpetation, could these rates of 25 be a random event that was finally caught because I've asked for so many tests.
2. I'm now worried my heart will either stop, or begin to beat consistently at 25 and I will not get enough oxygen to my brain and die. How likely of a scenario is this, does ones heart work this way.
3. Are there other 26 year olds out there that are otherwise perfectly healthy that have a pacemaker, or have rates this low.
4. My doctor's main concern seems to be I could pass out while driving and kill myself or someone else, does this seem like the worst case scenario
5. Things for me were great for the past year, does it seem realistic that all of sudden things with my heart that much worse, or I'm just dealing with another bout of panic.

This site is great and you people are wonderful. Thank
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Hi TKellyvt,

Cases like this can be tough.  It is common for physically fit young people to have low heart rates, especially at night or when resting.  It is important to know if there anything structurally (by echocardiography) or electrically (EKG, holter, event monitor, tilt-table testing, EP study) wrong with your heart.

1. What is your interpetation, could these rates of 25 be a random event that was finally caught because I've asked for so many tests.

With out seeing the actually rhythm strip, I cannon interpret the results.  It is important to know where in the heart your beats originate from and for this we look at the morphology or configuration of the complexes.  Narrow complex beats are not very concerning and suggest you have increased vagal (parasympathetic) tone.  If you have wide complex beats, this may suggest a form of heart block or nothing at all.  It also depends on how long your rates stays at 25 bpm.  If it is only for a few seconds and you don't have symptoms, again, this is not a big deal.  If you are walking, running, or otherwise active and your heart rate slows to 25, this suggests a problem.

2. I'm now worried my heart will either stop, or begin to beat consistently at 25 and I will not get enough oxygen to my brain and die. How likely of a scenario is this, does ones heart work this way.


If your EKG is normal, your echo is normal, and your event monitor shows narrow complexes at a rate of 25, you shouldn't worry about your heart stopping.  It may be worth seeing a cardiologist to interpret the strips and help put your mind at ease.

3. Are there other 26 year olds out there that are otherwise perfectly healthy that have a pacemaker, or have rates this low.

Yes there are young people with pacemakers, admittedly, not many.  There are many young people with anxiety disorders that feel like they are going to pass out and have palpitations.  You should not feel alone.

4. My doctor's main concern seems to be I could pass out while driving and kill myself or someone else, does this seem like the worst case scenario

You mentioned that your heart rate slowed while you were lying down.  Unless you have passed out and haven't mentioned it, I don't think there is a reason to believe that you will while you are active.  All this said, I have not seen your rhythm strip.  There may be a piece of information I am missing.

5. Things for me were great for the past year, does it seem realistic that all of sudden things with my heart that much worse, or I'm just dealing with another bout of panic.

Is it possible something is worse, yes.  Is it likely, no.  You are likely dealing with another bout of panic attacks.  Panic attacks can make you feel like you are going pace, get dizzy, etc.

Good luck working through these issues.  This is a common concern I see in clinic, so don't feel alone.  If you haven't seen a cardiologist yet,  you may want to simply for reassurance.



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