Low heart rate

I went to a GP today for a matter unrelated to my heart. 
they took my vitals and my HR was 50.

i had a PM installed last October because my AV node gave up on me .

my understanding is this device is set at 60 on the low end to like 150 or so on the top. 

should I be concerned I was below 60 and only at 50?

i do take a beta blocker and have for 13 years after I had bypass surgery. 


Low heart rate

by Karri - 2020-08-04 00:06:50

Hi Pacer2019,

As long as you aren't having symptoms of  a low heartrate I wouldn't be too concerned.  I'm normally paced at 80,, but sometimes when I go to the doctors they tell me my pulse is somewhere in the 70's, which at first I found strange, but now I'm used to it. 

I've had a pacemaker since 2003 and just had my second pacemaker put in and a second lead. But if you ever have questions,  you should just call your doctor,  he would let you know if that's normal.  That's what he or she is there for! ☺


by Pacer2019 - 2020-08-04 00:27:52

Thank you for responding ...I was all over leaning the intracies of how the PM works last Fall  but kind of decided to just let it do its thing while I do mine. Hard to believe but most of the time I pretty much forget it's there. 
I'm real active with running and biking on trails ... every now and then I wonder if I reach a certain level of fitness do I need to be taking a beta blocker to slow my heart rate....I have been taking exactly the same dose for 13 years now ...Same true with a statin. My BP is fine and my chloresterol numbers are at time below what's even normal.

seems like no doctor out there is willing to tell me to stop or reduce either one and I guess I'm too scared to push for them to. 

but thanks and I probably will call it to my electricians attention 

How did they take your HR?

by crustyg - 2020-08-04 03:17:06

If they just used the figure from the automatic BP monitor it may well have produced bad data.

If your PM is set to give you a minimum HR of 60BPM then it will, regardless of what drugs you are on: if your heart is not beating at 60BPM or higher then something is wrong with your PM or lead(s).

Someone actually needs to check your pulse, by hand, for at least 30s before declaring that your PM isn't working correctly.

Ectopics ?

by Gemita - 2020-08-04 06:32:10

Hello Pacer2019,

Good to hear from you again.  

I wonder whether you are suffering from ectopics?  When I get ectopic beats, which can feel like slow, missed or skipped beats, with long pauses, my home monitors or digital monitors at the doctor's surgery do not always register correctly my pulse which can feel very very slow indeed and almost non existent.  In fact my minimum heart rate is set at 70 bpm and I still record mid 40s bpm during ectopic episodes.  

I too queried this with my EP who said it was likely to be ectopics and that my pacemaker would not allow my true heart rate to drop below 70 bpm.  Ectopic beats can certainly trick our digital monitors into thinking that our heart rate is slow I have found and it may be necessary to check the pulse manually or using an older, more reliable blood pressure monitor (aneroid sphygmomanometer and stethoscope).   Nonetheless ectopics beats are still an "irregularity of rhythm" which, when frequent and prolonged, certainly do cause me a great deal of discomfort.

Yes, I would bring this to the attention of your EP and maybe it is time for a review of your medication too.  He might also decide to monitor you for a short while to see whether an arrhythmia is occurring.  I wish you well, you certainly sound to be making good progress


Pulse rate of 50

by jfbuffy - 2020-08-04 08:31:09

Gee my pacemaker is only set for 50 on the low end so it sure doesn't sound to me like you have any issues. Before I got my pacemaker some of my heartbeats were only around 30 and I felt fine. Well I mean I think I did when I didn't know any better!   It was only after I read about " lightheadiness and being dizzy" that I started thinking to myself " gee do I feel lightheaded or dizzy" these thoughts never entered my mind until after I read about these symptoms !  Sure doesn't sound to me like you have anything to worry about but what would I know ? 

VERIFY & Contact cardiologist/Device nurse

by MissAshleigh - 2020-08-04 11:59:15


Can you get a "device check?" (they can do them in ER if it comes to that.) As people before stated, it doesn't matter what medicine you're on, whatever the pacemaker is set at, it should not deviate even with meds.

Please use a trusted human with a stopwatch or a different doc, have your pulse taken through your watch, or however you can get an *accurate* read. You're very active, which shouldn't impact your device, STLL, you want to make sure you haven't pulled out your leads. 

My BPM is set at 55 (no ceiling, no pacing, have bradycardia & SSS. Heart skips up to 9.6 seconds.) For the past year (implanted 4/2019,) I used to think I was getting palipatations right around the same time at night. I'm poor, so I have a Heart Rate app on my phone, I'm not 💯  it's accurate, but it's decent. (it uses the camera & flash.) Well, I discovered that when this happens, my heart rate is usually right at 54-55 BPM's. So, what I'm feeling is actually my pacemaker kicking in. I am incredibly sensitive… To the point where they had to take the ceiling & pacing mechanisms off & just leave the bottom so I can't drop below 55.

Also, I was 41 when it was implanted. The only way they found out is because I kept having brain injuries with no memory of falling & my neurologist was so irritated with me he finally said "fine, go wear a heart monitor for 24 hours." I saw a cardiologist & he recommended it for 30 days… Woke up the first morning to FOUR phone messages. Many of us on here are young... at least younger than 75. I'm fortunate to have very few concerning things so I only come to the site when I have questions. I felt compelled to answer your question, I am not an expert, but, if it were me, I would have a device check ASAP & contact doctor. It is probably nothing to worry about... it is almost certainly nothing to worry about… But it is 100% nothing to play with. 

Be well,



by AgentX86 - 2020-08-04 15:10:41

I think Gemita may be on the right track. Sometimes measuring one's heart rate in the arm, no matter how it's done yields an erroneous answer. If there is any doubt, take it in the groin/femoral or neck/carotid (don't let anyone else do this) arteries. You may also find there are "skipped" beats. As Ge.ita said, they aren't skipped at all, just very weak. Weak enough that a BP cuff may even miss them.

One one the purposes of metoprolol is to slow the heart to avoid tachycardia. Another is to lower blood pressure. If it's being prescribed,  it's for a reason.  It's a good idea to ask why but it's not for no reason.

When the readings are off

by Gotrhythm - 2020-08-06 18:56:12

A pretty common cause of low readings from a pulse/ox or automatic BP machine is some kind of arrythmia--like a PVC.

Before I found a really gifted EP to hand-program my pacemaker, I frequently would have pulse/ox readings of 35 BPM--exactly half my base rate of 70 BPM. I didn't feel at all well when that would happen.

It turned out I had bigeminy. That means every other heartbeat was a PVC. The PVCs were "real" heartbeats but too weak to be picked up by an electronic device.

PVCs are very common. So common, they're actually considered normal.

A really, really uncommon cause would be some kind pacemaker malfunction. 

Follow up

by Pacer2019 - 2020-08-06 19:08:09

I called my EP clinic .  I have a scheduled interrogation on 8/17.

i don't feel bad and don't see any evidence my fate is trending low -  I wear a fitness watch 24/7 which tracks my heart rate (I know it's not 100% reliable ) and I don't see any trend or anything like my rate is low. 

Im planning to just keep an eye on it and take some manual readings 

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