Causes Of A Slow Heart Rate
Its normal for your heart rate to change throughout the day. It speeds up when you exercise, slows down as you recover from exercising, and is usually at its lowest while you sleep.
Sometimes people have a slower heart rate than normal. This is called bradycardia, and it isnt necessarily a problem. Its diagnosed when your heart beats less than 60 beats per minute.
There are several causes of a slow heart rate. The most common are being young or physically fit. The heart is a muscle, and just like the other muscles in your body, it responds positively to exercise. When youre in good shape, your heart doesnt need to beat as often to supply your body with enough oxygen.
But a slow heart rate can also be a sign of a medical problem, such as a heart condition. If your resting heart rate is slow and you have other symptoms of bradycardia such as lightheadedness, call your doctor or go to the ER.
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How Are Arrhythmias Treated
Many arrhythmias don’t need treatment. For those that do,;these options might be used:
- Medicines. Many types of prescription anti-arrhythmic medicines are available to treat arrhythmia. Sometimes, these can increase symptoms and cause side effects, so the patient will be closely watched by the doctor.
- Pacemakers. A pacemaker is a small battery-operated device implanted into the body through a surgical procedure. Connected to the heart by a wire, a pacemaker can detect if the heart rate is too slow and send electrical signals to speed up the heartbeat.
- Defibrillators. A small battery-operated implantable cardioverter defibrillator is surgically placed near the left collarbone. Wires run from the defibrillator to the heart. The ICD senses if the heart has a dangerously fast or irregular rhythm and sends an electrical signal to restore a normal heartbeat.
- Catheter ablation.;A catheter is guided through a vein in the leg to the heart. Arrhythmias often are caused by microscopic defects in the heart muscle. Once the problem area of the heart is pinpointed, the catheter heats or freezes the defective muscle cells and destroys them.
- Surgery. Surgery is usually the treatment recommended only if all other options have failed. In this case, a person is put under anesthesia and a surgeon removes the tissue causing the arrhythmia.
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How Can You Care For Yourself
Bradycardia is often the result of another heart condition, so taking steps to live a heart-healthy lifestyle will usually improve your overall health. The steps include:
- Having a heart-healthy eating plan that includes vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit alcohol, sodium, and sugar.
- Being active on most, if not all, days of the week. Your doctor can tell you what level of exercise is safe for you.
- Losing weight if you need to, and staying at a healthy weight.
- Not smoking.
- Managing other health problems, such as high blood pressure, high cholesterol, and diabetes.
The Conduction System Of The Heart
The heart has its own natural pacemaker made up of a specialized collection of cells in the top chamber of the heart known as the SA node. This generates an impulse that travels through another collection of cells in the middle of the heart known as the AV node. The pathways taken by the impulses are known as the conduction system.
Problems with a low heart rate can be caused by dysfunction of the SA node, the AV node or the conduction system! It gets even more complex. The conduction system of the heart has many nerves attached to it; some of these nerves decrease the rate of conduction whereas others increase the rate of conduction. The nerves that decrease the rate of conduction and therefore lower heart rate are known as parasympathetic nerves. An example is when someone vomits; this can increase impulses in the parasympathetic nerves and slow the heart rate significantly for a while. This can even lead to passing out, which is known as a vagal event.
A balance of impulse from the sympathetic and the parasympathetic nerves determine a persons baseline heart rate. Interestingly, in experiments where a persons nerve supply is blocked, the heart rate is often higher; this would suggest that the parasympathetic nerve impulses that serve to slow the heart rate down are the predominant force under normal resting conditions. This is particularly evident at night when most people have a significant drop in heart rate.
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Slow Heart Rate And Tired
Submitted by Dr T on April 13, 2013 9:12am
Unless you are an athlete , your slow heart rate and symptoms are abnormal, nor can your EKG look great.
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
Treatment For Bradycardia Arrhythmia
If you are not experiencing symptoms of bradycardia, you are not typically treated. If you are experiencing symptoms, treatment will vary based upon what is causing the condition. Your doctor will typically start by diagnosing what might be causing the slow heart rate, such as hypothyroidism.
If the medication you are taking for an underlying condition is causing your slow heart rate, your doctor may discuss alternative medication choices.
A cardiac pacemaker, a device implanted under the skin, can help correct abnormally slow heart rate. Pacemakers are more commonly used in patients over 65 years old.
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How Are Arrhythmias Diagnosed
Arrhythmias can be diagnosed in several ways. The doctor will use a person’s medical history information, along with a physical examination, to begin the evaluation. If an arrhythmia is suspected, the doctor will probably recommend an ECG/EKG to measure the heart’s electrical activity.
There’s nothing painful about an ECG/EKG it’s just a procedure where a series of electrodes are attached to the skin with sticky papers. The electrodes have wires attached to them, which connect to the EKG machine.
The electrical signals from the heart are then briefly recorded, usually for just 10 seconds. This information is sent to a computer, where it’s interpreted and drawn as a graph.
A doctor might recommend these types of ECG/EKG tests:
Other Heart Electrical Issues
The heart communicates by sending electrical signals. For example, one chamber of the heart sends electrical signals to another, telling it how and when to squeeze blood into the next chamber.
The pacemaker helps regulate this electrical system. If the heart is not able to send the correct electrical signals, due to a blockage or heart disease, it can cause bradycardia.
Complete heart block is a type of electrical issue that makes it impossible for electrical signals to travel from the atria the top two chambers of the heart to the ventricles, which are the bottom two chambers. In complete heart block, the top two chambers may have totally different rhythms to the bottom two.
Nonsurgical Treatments For Bradycardia
- Changing or adjusting medications. Some medications, including those used to treat high blood pressure and other heart conditions, can cause your heart to beat too slowly. Your doctor will review the medications you are taking and may recommend different medications or lower doses of your current medications to treat your slow heart rate.
- Treating other medical problems. Other medical problems, such as thyroid conditions or obstructive sleep apnea, can cause your heart to beat too slowly. In some cases, treating these underlying medical conditions may correct your slow heartbeat.
Understanding Your Heart Rate By The Numbers
You can measure your own heart rate. First, find your heart rate by holding a finger to the radial artery at the wrist. Then, count the number of beats per minute while youre resting.
Other places your heart rate can be measured are at the neck , the groin , and the feet .
Here are some numbers to keep in mind:
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Why Could A Low Heart Rate Be Bad In Some Situations
The heart needs to pump out a certain amount of blood to provide the body with the blood it needs to function. The amount of blood pumped is known as cardiac output and is usually defined as liters per minute. Heart rate of course affects this output. In some patients a low heart rate can lead to a low output and cause symptoms such as dizziness, shortness of breath and fatigue. These symptoms are associated with low output heart failure. In other patients a low heart rate causes no effect whatsoever as the heart simply pumps out more blood with each beat to compensate.
Is Bradycardia Dangerous
For most young people, highly trained athletes, and people who exercise regularly, a below-60 heart rate is normal and healthy. It is very possible to have a slow heart rate and experience no symptoms.
However, if you have symptoms but ignore them, it can sometimes cause more serious problems.
Consult your doctor if you are experiencing some of these symptoms and you have an associated slow heart rate:
- Lack of energy.
- Confusion/memory problems.
- Heart palpitations or flutters.
If your heart rate drops into the 30s, you might not get enough oxygen to your brain, making fainting, lightheadedness, and shortness of breath possible. Blood can also pool in your heart chambers, causing congestive heart failure.
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Causes Of Low Heart Rate
Firstly we will discuss things directly affecting the heart tissue and the conduction system called intrinsic disease. Aging is a common cause of slow heart rate, which results from degeneration of the conduction system of the heart. Heart attacks may damage areas of the conduction system also. Conditions that affect many organs of the body such as sarcoid, lupus and others can also affect the conduction system of the heart. Undergoing heart valve surgery such as the TAVR procedure for aortic stenosis, the mitraclip procedure for mitral regurgitation, mitral valve replacement or mitral valve repair, aortic valve replacement, or other complex heart surgeries may also cause trauma to the conduction system of the heart. Sometimes infection of the heart valves can extend in to the conduction system of the heart also.
Next we will discuss outside influences on the heart and conduction system known as extrinsic causes. Certain situations such as coughing, vomiting and others can lead to slow heart rate through the nerve system. Drugs that directly slow the heart rate include beta-blockers, calcium channel blockers and others. Metabolic disorders such as hypothyroidism can lead to a slow heart rate. Levels of electrolytes such as potassium derangement can lead to a slow heart rate.
What Are The Symptoms Of Bradycardia
Bradycardia may not cause any symptoms. However, bradycardia may cause you to feel:
- Dizzy or light-headed. You might even experience faints or sudden collapse.
- Short of breath, especially with exercise.
- Very tired.
- A pain in your chest or a thumping or fluttering feeling in your chest .
- Confused or that you are having trouble concentrating.
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What You Can Do
Additionally, you should plan to visit your doctor regularly for physicals. Not only is it good practice, but it can also help with early detection of things like high cholesterol or blood pressure abnormalities.
If you already have heart disease, you should carefully monitor your condition and stick to your treatment plan. Take all medications as instructed by your doctor. Be sure to promptly report any new or worsening symptoms.
Some additional preventative health tips to help keep your heart healthy and happy include:
- Find ways to reduce stress. Examples of ways to do this can include things like yoga or meditation.
- Limit your caffeine intake. Using too much caffeine can lead to increases in heart rate.
- Moderate your drinking. Women and men over 65 should only have one drink per day. Men under 65 should only have two drinks per day.
- Quit smoking. Smoking increases your heart rate and quitting can help bring it back down.
- Be aware of medication side effects. Some medications can affect your heart rate. Always be aware of possible side effects before taking a medication.
Your heart is a muscular organ that works to pump oxygen-rich blood and nutrients to the tissues of your body. The muscles of your heart contract and relax to push blood through your blood vessels.
Surgical Procedures For Bradycardia
Our physicians perform hundreds of surgical procedures each year to treat bradycardia and other irregular heart rhythms using implantable devices. Implantable devices include:
- cc A pacemaker is a small battery-powered device that is permanently implanted under your skin. It sends electrical signals to start or regulate a slow heartbeat.
- Implantable cardioverter defibrillator . An ICD is a small electronic device that is implanted under your skin to continuously monitor your heart’s electrical activity. If an irregular heartbeat is detected, your ICD will send an electric impulse to your heart that will restore normal rhythm.
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What Is Bradycardia
Having bradycardia means that your heart beats very slowly. For most adults, a heart rate of about 60 to 100 beats a minute while at rest is considered normal. If your heart beats less than 60 times a minute, it is slower than normal.
A slow heart rate can be normal and healthy. Or it could be a sign of a problem with the heart’s electrical system.
For some people, a slow heart rate does not cause any problems. It can be a sign of being very fit. Healthy young adults and athletes often have heart rates of less than 60 beats a minute.
In other people, bradycardia is a sign of a problem with the heart’s electrical system. It means that the heart’s natural pacemaker isn’t working right or that the electrical pathways of the heart are disrupted. Sometimes, the heart beats so slowly that it doesn’t pump enough blood to meet the body’s needs. This can cause symptoms, such as feeling dizzy or weak. In some cases, it can be life-threatening.
How Is It Treated
How bradycardia is treated depends on what is causing it. Treatment also depends on the symptoms. If bradycardia doesn’t cause symptoms, it may not be treated. You and your doctor can decide what treatment is right for you.
- If damage to the heart’s electrical system causes your heart to beat too slowly, you will probably need to have a pacemaker. A pacemaker is an implanted device that helps correct the slow heart rate.
- If another medical problem, such as hypothyroidism or an electrolyte imbalance, is causing a slow heart rate, treating that problem may cure the bradycardia.
- If a medicine is causing your heart to beat too slowly, your doctor may adjust the dose or prescribe a different medicine.
The goal of treatment is to raise your heart rate and relieve symptoms. For certain types of bradycardia, treatment may help prevent serious problems. These problems include fainting, injuries from fainting, and even death.
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When I See A Patient With A Low Heart Rate I Ask Myself The Following
Is the low heart rate a physiologic finding or a pathologic finding? An example of a physiologic low heart rate would be an athlete with a low resting heart rate from being trained, which is absolutely fine. An example of a pathologic heart rate would be a disorder of the internal pacemaker system of the heart such as heart block that would often need a pacemaker inserted as treatment.
Is the low heart rate the likely cause of symptoms? Symptoms of a low heart rate may include dizziness and fatigue. In order to be attributed to a low heart rate the symptoms should occur at the same time the heart rate is low.
Are there any reversible causes for the low heart rate? Medicines such as beta-blockers or disorders such as hypothyroidism may lead to low heart rate and if the heart rate is dangerously low and causing symptoms as a result of this, stopping the medication or treating the underlying conditions will likely reverse the symptoms.