Bradycardia worse with exercise

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Submitted by Dr T on March 7, 2012 – 10:12am

Question: 
When I was a teen I was diagnosed with bradycardia after an episode on syncope. At that time my resting pulse was 60 but the Holter monitor said it dropped into the low 30’s during sleep.  I’m now age 50 and have been exercising 6 days a week (cardio and resistence) for the last 2 years.  I am fit and trim and have no known health problems.  My problem is that over the last 2 years my pulse has been gradually declining as my fitness level increased.My only symptom is occasional dizziness if I stand quickly from a seated or prone position. As this symptom increased I went and bought a blood pressure monitor.  Over the last 10 days my BP has averaged 112/59 with an average pulse of 47.  Typically my pulse has been in the low 40’s every morning when I wake.I want to avoid a pace maker as much as possible, but I’m slightly concerned about how low my pulse might get during sleep and whether these numbers should be considered healthy or dangerous.  Like I said my only symptom is dizziness sometimes with no tiredness or fatigue or anything else at all.As long as  I’m careful (slow and deliberate) when I stand to prevent dizziness is this harmful to the body?  Or should I cut back on cardio which is clearly making me more fit (a bad thing it seems for bradycardia)?

Hi Jim,
Your symptoms are those of orthostatic hypotension and a slow heart rate aggravates this.
Read this:
https://www.cardiachealth.org/orthostatic-hypotension
Whatever the cause, you need to be evaluated by a cardiologist. You may indeed need a pacemaker!
Hope this helps,
Dr T

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