What is bradycardia? How to know if your heart rate is too low

Bradycardia, or a heart rate that is too slow, can be a serious condition, especially if the heart is not pumping enough oxygen-rich blood throughout the body.

 Sara Lindberg 11 hrs ago 30 Jan 2020

Here's what medical experts consider to be a low heart rate, how to know if you have bradycardia and the most common ways to treat it.

© Boonchai Wedmakawand/Getty Images

What is bradycardia?

A normal resting heart rate for an adult is 60 to 100 beats per minute (bpm), but someone with bradycardia will have a resting heart rate lower than 50 to 60 bpm.

According to Srikant Duggirala, MD, a cardiologist with Emanate Health, bradycardia means that electrical signals to the heart slow down or are blocked. For some people, such as endurance athletes, a low resting heart rate is common and typically not a concern. In fact, elite athletes may have a resting heart rate as low as 40 bpm.

Exercise training-induced bradycardia may be due to electrical remodelling of the sinus node, resulting in a lower heart rate and an increase in heart rate variability. This is a healthy response to the heart's ability to pump blood more efficiently, which means your heart can beat less, and your body can still get what it needs.

© Getty Bradycardia.But for others, it is a condition that should be supervised by a doctor. If bradycardia is not caused by exercise, a low heart rate means that your heart - which isn't as efficient as a highly-trained athlete - is not pumping enough oxygen-rich blood in the body. When this happens, you may feel chest pain, light-headedness, and shortness of breath.

Suzanne Steinbaum, a cardiologist at Mount Sinai Hospital, says that other symptoms of bradycardia can include dizziness, confusion, fatigue, or fainting. If you are experiencing these symptoms, and have a resting heart rate lower than 50 bpm, it's critical to see your doctor for an accurate diagnosis.

What causes a low heart rate?

While anyone can experience bradycardia, these factors may increase your risk:

• Age: Bradycardia is more common in older adults, specifically those who have damage to their heart from heart disease, says Duggirala. Older adults are more likely to have heart rhythm disorders because of age-related changes in the cardiovascular system, which are also associated with a higher prevalence of heart disease.
• Lifestyle factors: Tobacco abuse, substance abuse, high blood pressure, stress, and anxiety can also predispose patients (especially older ones) to heart disease, and consequently, bradycardia.
• Health conditions: Bradycardia can be associated with damage to the heart, such as a heart attack, heart disease, or congenital heart defects. Hypothyroidism - insufficient thyroid hormone - and sleep apnea can also contribute to a lower than normal heart rate.
• Medication: Additionally, Duggirala says medications prescribed for high blood pressure, coronary artery disease, and heart failure - such as beta-blockers and calcium channel blockers - can cause a low heart rate.

Treating bradycardia

© Getty Heart rate monitor.The first step in finding treatment is getting diagnosed, which requires a visit to the doctor. The doctor will measure your heart rate with an electrocardiogram, or EKG/ECG. But if nothing comes up during your visit - possibly because you have a minor case of bradycardia that only occurs occasionally - the doctor may give you a portable EKG to take with you.

Another handy gadget may be activity tracking features on devices like the Apple Watch. These devices can help track your heart rate 24/7 over many months and years, so it's easier to detect if and when you have bouts of bradycardia.

After you've been diagnosed, treatment depends on the severity of your condition. Steinbaum says borderline or occasional bradycardia may not require medical intervention, and if there are no symptoms, it can be generally monitored. But if you have chronic or persistent bradycardia, she says your doctor may treat it in a few ways.

"If medication side effects are causing the slow heart rate, then the medication regimen can be adjusted or discontinued," says Steinbaum. "Also, a pacemaker can regulate the heart's rhythm, speeding up the heart rate as needed."

Additionally, Duggirala says if hypothyroidism or sleep apnea is causing bradycardia, treatment of the underlying disorder will often help.

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