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Just got 24hr ecg results....rate of 38bpm when sleeping.......

Hi....I recently had a 24hour ecg after a years battle with my GP getting them to believe me when I said that there was something wrong whilst resting!.  The results showed that we heart beat was irregular whilst resting and that at night it dropped to about 38bpm throughout the night.

I have an appointment with a specialist in a weeks time but am extremely concerned.  Is this something to worry about?  Is the only way of rectifying it with a pacemaker?  Apparently my heart rate is fine when exercising.

Any help/advice would be very much appreciated...I dont know where else to turn for some advice.

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238668 tn?1232732330
MEDICAL PROFESSIONAL
In general we do not worry too much about low heart rates during sleep.  In fact in some people heart rate can drop as low as 20 during the night.  A key factor here is what is the heart rate during the day and are there any symptoms associated.  The specialist will use this information to determine if you need a pacemaker or if this is within normal limits.
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Avatar universal
A related discussion, Sinus Bradycardia was started.
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Avatar universal
Dear Steve and everybody else in this Forum.  
Thanks for all the information.
I am 59 yrs old and have had a very slow pulse 40's during the day and 30 when sleeping--together with chronic atrial fibrillation for many years.  My doctor always told me that as long as I do not have any symptoms, I should leave it alone. I take 3 children's aspirin a day.
I have an older brother and a younger sister who already have a pacemaker (both had problems with them)
I bought a Polar Accurex Plus watch used for exercising, together with it's software. It has memory and I could check my heart rate while sleeping for 5 1/2 hours at 5 seconds intervals. I was able to  see that my heart rate was 30 or sometimes lower while sleeping. I went to walk in the treadmill and my rate went from 40 to 100, walking up to 3.5 miles per hr. for 20 minutes.
I printed the results for several days and made an appointment with another cardiologist to get another opinion.
I just had an EKG and echocardiogram.
This new doctor just told me that his major concern is to prevent a stroke and would like to put me on coumadin but to do that, he would like me to have a pacemaker before I start the medicine so I would not have a problem fainting or falling. That my heart rate would go to 60.
I am now going to compare my last echo with the new one to see if they were any important changes, as I prefer not to have the pacemaker or coumadin and I am going back to the first cardiologist for his opinion.
Anybody knows of a research center where they have made studies and can tell me risks involved with strokes if I do not go on Coumadin?
Any information would be appreciated.
Helpful - 1
Avatar universal
Hi, Steve,
     What is your heart rate at rest during the day? I have had a heart rate of 44 per minute during rest. (Normally runs 72-80 per minute.) It was affecting my quality of life drastically. I was having spells of getting feight, very week, short of breath, and just unable to function. Ended up admitted to the hospital and haveing a complete cardiac workup that ended up ok except for the slow heart rate. When I was doing something it never went over 40 per minute. I had to keep after the Dr's because I knew something was wrong. They kept saying nothing was wrong because all the tests (I.E. Echo, Stress Test, blood work, and Scans)would come back normal. I later found out that it was all caused by a viral infection. I finally got them to refer me to a different Cardiology clinic with my Dr's help. They did a Electrophysiology study (EPS) and found that my S-A node was not working properly. They went in thinking they were going to find "extra nodes" and do an ablation. They started me on a beta-blocker and stated that I would probably need a pacemaker. But did not qualify for it yet. You have to meet certain standards before you get one. I was transferred back to the regional center where I had the EPS study in 2 days with a heart rate of below 20. Had the pacemaker put in the next morning. I am still having some complications (edema, and Shortness of breath). I continue taking the beta-blocker due to the fact that I also have Tachycardia.  The pacemaker doesn't control it but the meds do somewhat. I will have to stay on medication for the rest of my life. I also take Demadex and Potassium.  
                                                  Carol
Helpful - 1
Avatar universal
Steve,

I too had slow heart rates.  I had as low as 32 at night, and during the day that aalternated with rapid rates.  But I was very symptomatic.  The CCF Doc is so right about what he said, as well as the others.  If you are waking up very tired al the time and or are tired during the day, then the EP doc or cardio needs to know about this.  But, you need to think long AND hard about a pacemaker.  They are not a perfect machine, and it is a life long partnership.  They only work as well as the EP doc that knows about them.  If you get doctors that are not VERY WELL educated with them, you may not get the pacer to work at it's best for you.

This comes from having 3 pacers in 2- 1/2 yrs, I run a pacer support group and work in the medical field too.  At the moment I have the best pacer doc in the States!!
Please, do not get me wrong.....I feel so much better then I did before the pacer, I have my energy back, and my heart rate never goes below 60 at night and 70 during the day.

But it IS NOT a cure all by any means.
Helpful - 1
Avatar universal
Steve,
This should be no cause for real concern unless you are having symptoms besides irregular heartbeats. Are you athletic? Most athletes have low heart rates. I take a beta-blocker for pvc's and my heart rate is in the 40's-50's during the day and goes down into the 30's while resting. Everyone's heart rate slows while resting, some dramatically more than others, and I have been told by my cardio that as long as there are no symptoms it's fine. I also run 3-4miles 5x week.
I'm not a Dr. but have had this slow rate for years on beta-blockers and honestly even when I'm not on the meds my HR hardly gets above 40's while resting.
Hope this helps ease the anxiety.
-Chris
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Avatar universal
A related discussion, heart rate was started.
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Avatar universal
I've been reading all your postings about slow heart rates.  I am almost jealous of the slow pulses you are all experiencing because I have just the opposite problem.  i was diagnosed with SVT four years ago and have been on beta blockers to slow my heart rate down.  It has been clocked over 250bpm while on a monitor.  I too have had all tests done and see my cardiologist every 3-6 months.  Absolutely nothing has been found- not even mitro- valve.  My tachychardia acts up at any given time- day or night and scares me to death every time like it was the first. I have developed horrible anxiety and panic attacks from it and have to take ativan as needed.  I wish I had a slow rate that I couldn't feel or have to be reminded of 24/7!!  I enjoy reading your postings.  It makes me feel better to know others are in similar situations as me.
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Avatar universal
Steve

I want to kind of echo what Chris said about your heart rate.  I run 35 to 40 miles per week and my heart rate slows to around 45 beats per minute at night.  That is only 7 more than yours.  Do you exercise a lot?  Are you having some sort of symptoms?  If you are not having symptoms I would worry so much.  Maybe your heart isd in really good shape and doesn't require as much pumping.  Maybe the doctor will have some advice for you.
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