BradyCardia New Diagnosis

[Tash213]

Hi there,

I am an aerobic and fitness instructor amongst other jobs, and also work out myself in the gym on a weekly basis.

Approx 6 months - 1 year ago I began getting palpatations randomly but they didnt start to bother me too much until about 6 months ago.

Just after this time I was sent for blood tests for determining gluten intolerance and coeliac disease.

I had read up on the internet that an irregular heart beat was a symtom of coeliac so thought this would calm down when i changed my diet. I am awaiting on an endescope to determine if i am coeliac as blood tests were unclear.

However, my doctor also noticed an irregular heartbeat on checking one day and advised an ECG. This came back perfect but as i was still experiencing palpatations I was sent for a 24 hr monitor box.

I was given the results this week and was very shocked and upset!

My doctor has described to me that during the tape they found 4 x bradycardia occur. My sleep heart rate was around 45-47bpm and as the tape was on whilst i took an aerobic class there were times when it showed up to 120bpm.

My palpatations are so inconsistent. They feel like a missed beat and it can be quite a scary sensation as if your heart is stopping!

I can go days without experiencing one, or I can have days where they seem to last 2-4 hours. Almost always when im at home just chilling out.

The doctor was almost adament that I will have to have a pacemaker to which i am terrified at the thought. He was also a little surprised that I hadnt been fainting of feeling like i was going to.

From memory, I just feel a little weak/er when i have them but I dont feel particularly lightheaded or anything. More just a horrible sensation.

I am not especially tired compared to the norm either as I do physical activity almost every day as part of my job.

I am now scared and thinking of my heart beat constantly incase i have a palpatation now knowing how dangerous they can be :(

I am being referred to a cardio ologist now for futher advice and treatment.

Any advice or suggestions welcome as to any other alternative medicine, so as to avoid as much as possible having a pacemaker. I am 39 years old.

Thank you so much for listening and any comments in advance.

Kind regards

[Mom2four85]

Tash213 I would be very cautious of them giving you a no driving order, once you have that order it is such a pain! ugh - you can possibly drive, but in alot of states like FL, if you have the order and have an accident etc your insurance co can drop you or they do not have to pay for anything (check with your local DoT).

I am trying my hardest to get my NCS (neurocardiogenic syncope) reversed so I can drive :P  Doctors are very reluctant to take that order away once a doctor gives it...I was 42 when I got mine - it's no pleasant thing to have to wait on others to take you to the store for every little need you have.  My poor husband has had to be my chaffeur to every dr's appt or checkup meds etc for over a year, and it gets old.

I've also had shortness of breath with palpitations; dizziness & lightheaded and don't always pass out - normally I only pass out once or twice a year.

Did your doctor talk to you about meds to help treat the palpitations - since you get  mini palpatations, more often than not you get winded straight away you need to escalate to a cardiologist and EP, now you're talking symptomatic and that needs to be looked into.  The cardiologist will hopefully do a full workup, if not ask - 24 hr holter, ekg's of their own, bloodwork, stress test, echo and they may have something else they want to do.  Although, if yours are sporadic, they may have to do a 30 day monitor to catch what's going on.

[Tash213]

Hi there,

Thanks for your comments.

So what symptoms did you have then that you didnt faint either?
I had to inform my work nurse today and she made same comment about me maybe having to give up driving! As i work 3 jobs and al over the place a few times a day I need my car for everything so would pretty much be out of work!! :(

Tash

[Mom2four85]

Chicky2001; yes OSA can be a risk and a major contributor to pvc's and other arrythmia's.  

My cardiologist sent me to have a sleep study after my tests came back abnormal, before I had surgery.  I was 1 point from the severe OSA category but I rarely ever snored.  Having the ablation and my PM/ICD implanted helped alot because my HR will not go below 40 now sleeping.  I can't tolerate the cpap, so I'm just dealing with the days I wake up with headaches or can tell I didn't sleep well.

The only problem there may be with you already have a PM is unless they turn it off or lower the rates, you may not get an accurate reading - ask your dr how this works.

If you have OSA there are many treatments out there and if you cant tolerate the cpap ask about them.

[chicky2001]

I just got a pacer and two ablations and my EP told me afterwards I have a very bad sleep apnea.  She said I have to go for a sleep study.  I never knew I had this problem.  I was shocked.  It seems during the procedures, they had to tell me to breath all the time under the conscious sedation so they wouldn't end up having to tube me.  Ever heard of this??

I hope I am not headed for another problem FGS.  

[chicky2001]

Have you seen an EP?  That is a cardiologist that deals with the electrical part of the heart.  Don't do anything until you see one.  They are the ones who will implant a pacer if needed.  You would certainly need an EP study before it can be determined  you need a pacer.  I just had a pacer put in Friday.  If you needed one, they are not so bad.  I've only had one for three days, but my heartbeat is normal and I feel much better for sure.  I never fainted either, but felt like I might.  

Good luck.

[Mom2four85]

Another thing to think of is once you have a pacemaker implanted it would be a major deal to take it back out.  The PM surgery itself isn't that bad, a day or two in the hospital and  leaves a 3-5" scar and can cause some complications if the leads aren't right.  

For alot of people pm's are a great thing and help them, but not all.  I'm one of the ones I question my pm/icd - I've had nothing but problems with my leads and now 1 year after I'm looking at lead failure and may have to have that major surgery to have them replaced.  

Bradycardia, Tachycardia and even palpitations in a normally structural heart is usually ok and mainly a nuisance - many of us live with these things and just learn to cope around them.   I've had my HR in the 30's (and tanked to 0) Tachycardia sitting in the dr's office at 125 the entire time, or 180-200 when I'm walking, also had 50,000 pvc's, PAC's, SVT, NSVT,  tachy, brady...my boring list goes on and on lol

Please get a full cardio workup and check your heart out, if it's not broke, dont fix it :P  get a 2nd or even 3rd opinion if you have to before doing something that may alter your life.

[Tash213]

Thank you so much Lisa, Bromley and Cindy for your comments and your time in replying to me.

I think for me, it is more the fact that my GP is usually so very good and im sure he wouldnt want to scare me for any other reason than he thinks hes telling it to me straight!

He mentioned that whilst my resting heart rate was 45-47bpm, in the mornings when i first wake it races up to 60-70 for a short while then settles. I can feel this happening, although i have no other symptoms and i guess this is possible normal when youve been sedentary at such low rate and then rush around ready for work!??!

My heart rate when exercising usually in the gym can go up to 132bpm. On the 24 tape I was only teaching an intermediate dance class hence it showed around 120bpm highest.

For me the fear is having another palpatation as I know the sensation is not nice, plus i now know how bad the effects are when they occur and what it could mean.

I will keep you posted on seeing the Cardio-ologist and fingers crossed as it is so random when I am receiving these palpatations they may decide to leave things for now.

Thank you so much again for all your kind works.

Regards

Tash

[cindy707]

First off i wouldn't jump the gun here...i think the most important thing to me that you said was that your doc is going to refer you to a cardio doc.  I would definately wait for confirmation before you take this leap.  The other thing to consider is that apparently you are in great physical shape and you may want to bear in mind that Lance Armstrongs resting pulse rate is 36-38 on an average .  When people are in tip top shape, work out, eat right, refrain from all of the bad stuff it is normal for them to have a very low pulse rate especially to me if you are not having any other symtoms with the slow rate.  As far as the irregular heart rate goes...again you need confirmation from a heart doc not a general doc.  Personally no matter how good a G.P doc is to me that doc should have allowed a heart expert in ordering the Holter monitor, in attempting to diagnose anything that is going on with you without the appropriate tests which is what they have done....a general practioner is just that...general medicine....a heart doc deals ONLY with the heart....it may very well be normal for you to have a pulse rate in the mid to upper 40's because of your conditioning...and it was very very wrong for that doc to just toss it out there to you that you need a pacemaker...wrong wrong wrong.....the appropriate tests were not done, the doctor is not a specialist of the heart or they wouldn't be sending you to one...i personally would relax until this is confirmed....the heart doc will also make the determination on what is going on w. the palps because they may just be benign or anxiety related or easily treatable...this is where we say that someone has put the cart before the horse....it doesn't work right.....good luck to you and sorry about the tirade...this type of thing really irks me because there was no reason to scare you before confirmation was done by the appropriate medical professional.....

[Bromley]

One other thought.  Concerning a heart rate of 120bpm.  This is not a very high rate, but it is definitely achievable for most age groups.  If you are having trouble getting it over this, having the doctor being so adamant is a concern.  If you go for a second  opinion, do go about it diligently. Do your homework before making life altering decisions. Qualify your doctors before following life altering advice.

[Bromley]

Whenever I start any serious aerobic training, and endure through it for any length of time --- consistently for more than a few weeks --- my resting heart (taken in the morning before I rise) drops, almost like falling off a cliff.  Typically, if I have had the misfortune of being dormant over the winter, or over the summer, my resting pulse rate may be mid sixties, or more. After a few weeks of training, it drops to 48, or less. I believe this qualifies as bradycardia, but I generally do not have any symptoms, other than that I feel exceptionally well when I exercise enough to cause my heart rate to drop like this. I dont think that having a low heart rate is necessarily significant of any problem, especially in athletes, and I have never had a qualified medical professional tell me that this is cause for concern when I asked them about it.  I will say that I have read, and have experienced for myself, that as heart rate drops, ectopic/autonomous activity tends to increase. So you may suffer more PVC's if you heart rate is low, I think.

From the diagnosis you have, I dont see how they can say you are a bonified candidate for a pacer. They may have seen something in the data; sometimes valid inference can be drawn even without a decent 12 lead EKG, but based on my experience, and depending on the circumstances, this would potentially be a red flag to me. I would definitely consider an INDEPENDENT second opinion (from a known good source such as the cleveland clinic) before undergoing anything invasive, especially if you have had no problems in the past, and there is no family history of abnormal heart rhyhmns or SCD.  Last I checked, this can be done without visiting the hospital all for a fairly nominal fee. If being pressured, be diligent in getting your second opinion as soon as possible.

[Mom2four85]

Sorry to hear you're going through this, as scarey as it seems there's a few questions I would ask and get more info on before going through surgery.

Dr. Steven Park here on medhelp has alot of info about things related to sleep etc.  I attended a web seminar he had for sleep apnea, which talked about heart rates during the night.  

Please send him a message or ask in the sleep forum.  Normal HR is between 40-90 at night and 60-100 is normal for day time HR's, but again ask to confirm this with him or someone in the expert section.

Also, there's a formula for HR during exercise (racking my brain to remember) I know someone will know it - it's something like 220 - (your age) 39 = 181 x .65 or .85 = 117 - 153 - which your HR of 120 during aerobics would be in range; if not a bit on the low range...I know I just read this on a recent post (itdood posted it I think)

As for your palpitations, I'm not sure how many you're having or where they're orginating but that is important to know and if you're not having dizziness, fainting, sob, cp from them they may be ok and may be nothing to worry about.

Did you get a copy of your test results? That's always helpful to have and keep for your records.

Hope you get some answers soon - Take care