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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will A Pacemaker Be Prescribed For A Heart Rate Of 40 Bpm?

Hi, 26 years old male here. In decent health, I used to smoke,I drink occasionally, but I also eat pretty healthy and lift weights a few days a week. 5 8 158 pounds if that matters. For the past 7 years I have suffered with random runs of PVC s and occasional tachycardia for no apparent reason. I never really knew what my resting heart rate was when I was younger. After a really bad episode of PVC s that lasted for days (after a night of drinking), I went to a cardiologist and was put on beta blockers. These seemed to help for the first few years but recently my heart rate has begun to dip to around 45 at night. My resting heart rate during the day is often around 52-56. Nobody else in my family has a resting heart rate that low. My parents have been runners for the past 15 years, yet they both rest in the high sixties to low 70 s. My twin sister has a resting heart rate in the low 70 s as well. Anyways, I constantly feel very run down, for about the past year at least, and aside from randomly fluctuating blood pressure and the slower heart rate, nothing has changed in my life. My doctor ordered a sleep study and it was found that a had somewhat frequent hypopnea with occasional obstructive sleep apnea, overall it was diagnosed as an ahi of 5 mild apnea. I know that sleep apnea often causes bradycardia at night, but does it also cause bradychardia during the day? Often while sitting at work during the day it will dip into the mid 40 s briefly. When this happens I usually get pretty tired feeling, sometimes I get a strange pressure in my head. Very rarely I will feel nausea. I know it s not low enough to warrant a pacemaker, but I feel like it s really affecting my quality of life. I guess I m asking is, do you think the mild apnea if treated will reverse the daytime bradychardia? If not, is there a number like 40 bpm that a doctor determines when to put in a pacemaker?
Mon, 30 Mar 2020
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General Surgeon 's  Response
Hello,

The issue of low pulse rate in your case sounds to be due to Sinus Bradycardia and the same has to be evaluated with further co relation on certain measures. First of all, asymptomatic patients are not kept on pace maker just to raise the pulse rate. However, in presence of even minor symptoms, I do recommend an EKG with 2 D echo of the heart, electro conduction study of the cardiac tissues and decide further plan of action. The beta blocker are contraindicated in your situation for sure.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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Will A Pacemaker Be Prescribed For A Heart Rate Of 40 Bpm?

Hello, The issue of low pulse rate in your case sounds to be due to Sinus Bradycardia and the same has to be evaluated with further co relation on certain measures. First of all, asymptomatic patients are not kept on pace maker just to raise the pulse rate. However, in presence of even minor symptoms, I do recommend an EKG with 2 D echo of the heart, electro conduction study of the cardiac tissues and decide further plan of action. The beta blocker are contraindicated in your situation for sure. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon