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Bradycardia - Heart Rate 50/min - not athletic

Hi all - I'm new to the forum.  A year ago I was preparing to have a gastric by-pass for weight loss.  I weighed 337 lbs.  I had to have a cardio exam before I could have the surgery.  I passed the cardio with flying colors - with the exception of some plaque in the arteries and high blood pressure.  Soon after the surgery, the high blood pressure went away - I had lots of energy and felt wonderful.  I lost 137 lbs right away, and still have about 60 lbs to go.

Now, the problem comes about three months ago when I went in to see my pain doctor (oh, I have RSD and Fibromyalgia).  The nurse noticed that my pulse rate was low, and questioned me about it.  I thought to myself (oh, that is wonderful!).  She came back in and questioned me again after I told her that I thought low pulse rate was normal for me (what did I know - I thought my heart was taking a healthy break after having to work so hard when I was heavier).  She seemed alarm, but I didn't think anything about it again, and my doctor didn't mention it.  I went to the car and asked my husband if 50 was low, and he said, yes, but probably not alarming.  Later that night, out of boredom I looked up low pulse rate up on the internet.  At that point it said that 50 is normal if your an athlete....well, I am far from that.  Did I mention that I was visiting that pain doctor to find out if I had chronic fatique syndrome?  I was wondering, because I had noticed over the past 6 months that I was constantly fatiqued and overcomed with weakness when walking further than 50-70 feet.

After reading a few articles on the internet, I called my internist, who got me right in that afernoon.  She did an ekg and said my heart rate was around 50 with a few dips down to 47 and a few raises up to 60.  She made an appointment with the cardiologist that I had seen the previous year.  To make a long story short - she did some blood work and it showed normal levels of calcium, B vitamins, urine, blood count, and thyroid.  I wore the Holter Heart monitor that week-end (from the cardiologists office).  The report came back that the symptoms didn't match the monitor results.

I thought maybe I had mixed up some fibromyalgia and RSD symptoms with the weakness, so I requested that I retake the Holter Monitor (my Pain Doctor advised that the confusion could easily happen, and that retaking the test would be appropriate).  So, my cardiologist resecheuled the test.  In the meantime they did an ultrasound of my heart which showed everything was pumping normally.

After retaking the holter monitor, the same results came up....the symptoms didn't match the monitor results.  All of the tests confirm that I have bradycardia.  In fact, since then I have had several bouts where they have shown that my pulse rate has been down around 43 and 39.  I dont ever feel like I am going to faint, but I am so darn weak and the past two days have spent most of the day in bed because I am so tired and wore out!

Whats going on?  The cardiologist said that he "cant guarantee that a pacemaker would eliminate symptoms at this time."  I wasn't sure what "at this time" meant...does that mean the bradycardia could get worse?  

Do people get pacemakers when their heart rate is at 50?  If they aren't passing out, is it worth getting a pacemaker to relieve symptoms of weakness and fatique?

I'm so confused about what to do.  My cardiologist is giving me a treadmill test on Thursday, but I don't know what that will tell him.  Does anyone know?  I really need some information.  I feel so niave about all of this.  I am 57 years old - and expected to be playing tennis this summer with all of the weight gone.  Now, I don't have the energy to exercise like I had hoped, and I am not sure I can get the rest of my weight off if I can't exercise more than a minute at a time.  Any information you can give me is greatly appreciated!
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255722 tn?1452546541
I'm sorry you are going through this right now.  I never had gastric bypass, but I have a story that may help put your situation into perspective for you??? I'm not sure.

When I was in high school, my highest weight was 220 pounds.  During my junior year, I began the WW program and very healthily lost about 80 lbs.  Then my mind took over and I got into a cycle of "if I just lose 5 more pounds I can eat something I WANT to."  Then I'd try to lose 5 more, then 5 more.  Basically, I became anorexic, eating about 500 calories a day.  My lowest weight (at 5'6") was 109 lbs.  I looked like a skeleton.  The scariest thing?  My heart rate dropped to about 30 beats per minute.  Know why?  I wasn't getting enough calories to keep my metabolism up and my system was going into starvation mode trying to conserve as much accessible energy as possible.  Your metabolism slows dramatically...heart rate, respiratory rate, etc.  And...because of this, you feel SOOOOOO TIRED ALL THE TIME.  

I was scared, and started to eat healthier again.  I now weigh about 145 and maintain that weight on a healthy diet.  While I do suffer PVC's and what not, it is not related to my eating disorder at 18 (believe me....I cried over that one!!!)

Thing is, having gastric bypass is sort of like forced anorexia.  You can only eat the VERY LIMITED MEALS and your caloric intake is DRAMATICALLY LOWERED.  Though you say that you still have 60 lbs to go, it may well be that your body is struggling with the rapid decrease in readily available calories (food vs. fat) and has gone into "starvation mode" which is a perfectly logical...and even practical biological response to such a dramatic drop in caloric intake.  

Have you visited your Gastric Bypass surgeon or overseeing doctor?  They are probably very aware of this symptom and ready to help you through it.  A cardiologist and General practitioner will look more quickly at your presenting symptoms and disconnected from your weight loss and/or caloric intake.  A nutritionist and/or gastric specialist would look at them as connected I'd bet.  There are probably several things you could do to alter your caloric intake (without sabotaging your weight loss) to increase your metabolism (which will actually HELP your metabolism) and increase your HR and energy levels.

I'm not guarunteeing that this is what is happening to you, but it makes sense in my mind that the two are directly connected.  

I wish you luck in finding the answers.  Take care.....
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Avatar universal
My husband has a pacemaker for bradycardia but it was given as his heart was getting down to 30 or less per minute. The cardiologist will wnat to do alot more testing before giving a pacemaker. Keep your chin up and try not worry.
Donna
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