Slow Heart Rate Concerns

[Run2Win]

I'm a 26, 4 years ago Family doc said I had a low pulse, but was not worried. Since then I've have seen an EP and due to my anxiety issues have had numerous tests(Holter, Echo, event monitor). All came back conferming sinus brady, anywhere from 30's-40's. I'm a runner, 25 miles a week, but my doc says I have sick sinus. I recently requested an event monitor after a panic attack, and based on a strip showing a rate of 25 my doc now wants to put a pacemaker(previous low was 30). My echo is normal, and monitor strips just show sinus brady, pac's, dropped beats, pauses, and skips. Also I have never passed out. I have noticed by wearing my polar heart monitor that there are times when my watch shows 27, 28, 29. Might hangout there for awhile, but I usually stand up and it goes up. Sometimes it can hangout in low 30's for awhile(15-30 minutes, but mostly my resting pulse is 35-44). Symptons for me are tough, since anxiet and heart symptons are similar.

1. How concerning is this. I mean how long can my rate stay that way before I pass out or lose consciousnes and die.

2. Would venture to guess that if I never worked out my resting heart rate would still be low, but proably stay in 50's or 60's.

3. How possible that I just have high vagal tone, and my conditioning just exaserbates the low pulse.

4. Does this sound like a life threatning heart problem. Who is to say that my heart rate won't stay at 25 or drop even lower, or worse stop completely.

5. Do you think I really need a pacemaker, if not, what is the likely hood I will need one in the future.

Thanks.

[Cleveland Clinic]

run2win,

Your heart rate is most likely related to your conditioning.

1. How concerning is this. I mean how long can my rate stay that way before I pass out or lose consciousnes and die.

The symptoms of slow heart are generally not passing out, especially with an established bradycardia. While your heart rhythm is slow, I would like to know what rate it was over time and if the rate of 25 was an error from the way the monitor recorded your overall rate. Still the implantation of a pacemaker without symptoms might meet with some debate, especially if your heart rate reponds to exercise appropriately (yuo are able to exercise aggressivley from the way it sounds)

2. Would venture to guess that if I never worked out my resting heart rate would still be low, but proably stay in 50's or 60's.

Dont know, depends on what your rhythm is. Your condition does play a factor though.

3. How possible that I just have high vagal tone, and my conditioning just exaserbates the low pulse.

The vagal tone is a result of your conditioning.

4. Does this sound like a life threatning heart problem. Who is to say that my heart rate won't stay at 25 or drop even lower, or worse stop completely.

Your heart has a back up rhythm if needed. I venture to guess that most of this is due to conditioning.

5. Do you think I really need a pacemaker, if not, what is the likely hood I will need one in the future.

Impossible to tell. But with a complete lack of symptoms, I would want to be sure you had intrinsic conduction disease contributing to your heart rate before moving in that direstion.

Anxiety is often confused with chest pain. Bradycardia symptoms are usually fatigue and feelings of passing out.  You are young and otherwise healthy, before proceeding with an invasive procedure like a pacemaker, I would get a second opinion to be sure that I was comfortable with the descision if needed.  

hope this is a start

[Dr. Erik]

That is a pretty low heart rate, although, unless you are tired all the time and have no energy then I think that you're not in any immediate danger. With your heart rate dipping into the mid 20's, though, it may be a cause for concern if it drops any lower. Get a second opinion before you do anything. Good Luck.


Erik

[netrox]

25 bpm and no symptoms? Wow, that's amazing. Good thing you don't have symptoms though. Does the rate increase when you move around?

-jeff

[gcleland01]

Please talk to your doctors. I pray everyday for a women who lies in a coma, and may never recover b/c She fell into a cardiac arrest while exercising. For weeks before this she had several fainting episodes and all her doctors could comment on was that she had an abnormally low pulse rate, but They told her she had no worries b/c she was in "olympic caliber shape". 6 weeks later she almost died when her heart stopped while working out. it has been a year and she is severely brain damaged, she cant communicate and will always need 24 hour care. I dont mean to scare you, but this can be very serious and should be fully investigated by your physicians. some doctors think if you are young and in good shape that you cant have heart problems, but that is just not true.

[tkellyvt]

I'm not sure why you would post a comment like that to someone with an anxiety disorder. I know quite a bit about arrythmias and your friends cardia arrest probably had nothing to do with her slow pulse. I would imagine there was something else wrong with her heart besides a slow pulse. People do not have cardiac arrest and go into a coma because of a slow pulse alone. I would like to know what her medical history was. I think you should show more discretion before posting comments like that, it was an irresponible thing of you to do.