I have a very slow heart rate (Bradycardia)

Question:

Sir before two years i performed a test which shows sinus braydicardia otherwise a noemal ecg. At that time i was having a pulse reate of 58 bpm but during these days my pulse remains only 48 bpm. Is this serious as in two years it has gone down.

Answer:

Before I can answer you, I need to ask you some questions:

• Do you take any medications for your heart or high blood pressure?
• Was sinus bradycardia the only abnormality shown on your EKG?
• Does your heart rate increase with exercise?
• What about your blood pressure; is it normal or low?
• Do you get short of breath with any type of exercise?
• Do you get dizzy or feel weak with exercise?
• Do you, or did you ever have fainting spells?

If the answer is yes to any of these questions, you may need treatment.

Bradycardia (slow heartbeat) means that your heart rate is slower than 60 beats per minute, either occasionally or all the time. For some people (like athletes) a slow heart rate might be normal. In others, it may be dangerous.

If you are not taking medications that slow your heart rate down, bradycardia may be caused by a blockage somewhere along the heart’s electrical pathway. Medications commonly used for high blood pressure may include including both drugs used to treat high blood pressure and/or arrhythmias. AA blockage in the heart’s electrical conduction system may be caused by a congenital heart problem, or an aging process.

In either case, the slower your heart beats, the less blood it pumps throughout your body. If your heart beats too slowly, your brain and body might not get enough blood to function well, leading to any or all of the following symptoms:

• Fatigue, weakness
• Dizziness
• Lightheadedness
• Fainting (syncope) or near fainting
• Shortness of breath

Types of bradycardia that may require treatment:

• Sick sinus syndrome
• Heart block

To make a diagnosis and locate what and where the electrical pathway is diseased, an EKG is needed, while others tests may be necessary to check your coronary arteries and the function of your heart muscle.

Treatment

If your bradycardia causes dangerous symptoms (any or all of the symptoms above), a pacemaker may be needed to correct your heart rate. If caused by medications, you should talk to your doctor about changing them.

What is a Pacemaker?

A pacemaker is a battery-powered device that generates electronic signals. The signals, or pacing pulses, are carried along thin leads to the heart muscle. The signals cause the heart muscle to begin the contractions that cause a heartbeat.

A pacemaker is usually placed under your skin just below your collar bone. It is programmed to stimulate the heart at pre-determined rates; the settings can be adjusted at any time. Routine evaluation, sometimes even via telephone, ensures the pacemaker is working properly and monitors battery life, which generally runs from five to ten years.

Pacemakers can last anywhere from 5 to 10 years or more before the battery needs replacement. Because people may have more energy after the pacemaker is implanted, they may be able to do much more after the operation.

When do I need a Pacemaker?

The most common indication for a pacemaker is bradycardia. A pacemaker resets the heart rate to an appropriate pace, ensuring adequate blood and oxygen are delivered to the brain and other parts of the body.

Pacemakers for slow heart rates may be used in a number of conditions, including:

• Bradycardia (as we discussed).
• Atrial fibrillation – a common heart rhythm disorder in which the upper chambers of the heart beat rapidly and chaotically. Sometimes people with atrial fibrillation can also have slow rhythms. Sometimes medication used to control atrial fibrillation may result in slow rhythms that may need to be treated by a pacemaker if the medicines are still needed.
• Heart failure – a condition in which the heartbeat is not sufficient to supply a normal volume of blood and oxygen to the brain and other parts of the body. A special pacemaker is used for this type of condition.
• Syncope – a condition best known as the common faint, is usually not serious. Some patients faint when their heart rhythm becomes very slow. For a small percentage of people who experience severe and frequent fainting spells, a pacemaker may prevent the heart rate from slowing to the point of fainting.

Implantable Cardioverter Defibrillators (ICD)

This is a special type of pacemakers for patients who are at high risk of the deadliest forms of arrhythmias – ventricular tachycardia and ventricular fibrillation.  ICDs are not just pacemakers; theyhave an internal “shocking” device that may provide the best defense against a condition called sudden cardiac arrest.

More about this in a different Blog!

Hope this helps,

Dr T