Low heart rate post Natale ablation

My dad is 73 yrs old. About a year ago he had an extensive Natale RF ablation after having almost constant afib for a year or two. After that he's noted low heart rates, post ablation, especially during the past few months. His resting heart rate was in the 50's today. But he told me sometimes his Apple Watch wakes him up or alerts him that his heart rate is in the 30's to 40's.

Is this dangerous or a serious concern? Is there any way to increase his resting heart rate, other than a pace maker?

I'm worried that his heart is too scarred from the ablation and that it's having issues. When his heart rate is low he said he doesn't feel too faint or symptomatic. And his said his o2 levels and bp are usually good. Still, I'm worried.

The cardiologist mentioned the possibility about a pace maker eventually but this is a new concept for my dad and right now he's very hesitant.

Thanks in advance for your experiences, thoughts, and suggestions!



Edited 2 time(s). Last edit at 05/04/2022 08:39PM by cirenepurzalot.

The first question that has to be asked is what drugs is he taking?

If it’s not drug related (is he on a beta blocker?) and his hr started to drop after his ablation (like mine) maybe his sinus node got temporarily weakened? Or did his cardiologist ever mention SSS (sick sinus syndrome)? Did he have this before? Has he worn a 7-14 day holter monitor to check his continuous heart rate and ekg strips? My IWatch heart rate function is not always accurate. Perhaps wearing a holter monitor will be more beneficial.

Great question. He's only taking eliquis and an occassional flecainide (rarely). No bp meds or beta blockers, etc.

He mentioned his cardiologist thinks his heart is very scarred from the ablation and that this might be the cause. His avg HR has gone down at least 10 bpm since his ablation. It's been almost a year. I'm just worried about the 30's and 40's!

I will have him research sinus node and SSS. Great thoughts!

Thanks again!

In my case, my sleeping heart rate goes down significanty lower (42-46) when my room is 60-65 degrees as compared to 68-70 (50-55) degrees. What temperature is his room while sleeping?

Also I would be suspicious of how accurate HR is on Apple watch is for the times you sleep with your watch arm under your body weight.

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AsympPACs
In my case, my sleeping heart rate goes down significanty lower (42-46) when my room is 60-65 degrees as compared to 68-70 (50-55) degrees. What temperature is his room while sleeping?

Also I would be suspicious of how accurate HR is on Apple watch is for the times you sleep with your watch arm under your body weight.

Thanks for sharing. His house is usually warm so probably in the 70's when he sleeps. I'll mention about sleeping on the watch just to be extra accurate. But I don't think this is the case.

I would get your dad a Kardia ECG because they are very accurate. I tested mine in the ER the other night.

If his low heart rate (bradycardia) is at the point where he's having symptoms (dizziness, passing out or chest pains) then I don't think there's any way around the pacemaker, but I don't think there's a rush based on the information you've given. But if that's not the case just know that lots of people have low heart rates and live normal lives. My heart rate was in the 40s before my ablation. Now it's in the 140s, but that's another story. lol

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cirenepurzalot
My dad is 73 yrs old. About a year ago he had an extensive Natale RF ablation after having almost constant afib for a year or two. After that he's noted low heart rates, post ablation, especially during the past few months. His resting heart rate was in the 50's today. But he told me sometimes his Apple Watch wakes him up or alerts him that his heart rate is in the 30's to 40's.

Is this dangerous or a serious concern? Is there any way to increase his resting heart rate, other than a pace maker?

I'm worried that his heart is too scarred from the ablation and that it's having issues. When his heart rate is low he said he doesn't feel too faint or symptomatic. And his said his o2 levels and bp are usually good. Still, I'm worried.

The cardiologist mentioned the possibility about a pace maker eventually but this is a new concept for my dad and right now he's very hesitant.

Thanks in advance for your experiences, thoughts, and suggestions!

Thanks CaliGuy. Yes, he has an ECG. He said he notices the HR in the 30s sometimes when he checks his apple watch in the morning. But he's not complaining of symptoms. I just haven't heard of people having HRs in the 30's/40's before. (Not consistently though.)

If it is in the 30-40s perhaps his cardiologist should order a holter monitor

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cirenepurzalot
His resting heart rate was in the 50's today. But he told me sometimes his Apple Watch wakes him up or alerts him that his heart rate is in the 30's to 40's.

My resting heart rate is in the 50's. I'm 66. My sleeping heart rate commonly drops to 41. If he's asymptomatic, that's OK. What you really want is a medical grade monitor like a Holter to wear overnight and see if there are any long pauses (I have a beat to beat ECG quality recorder that I use). That would be grounds for a pacemaker. Also monitoring is blood oxygen (SpO2) to make sure it isn't dropping very low.

Thanks Susan and George!

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GeorgeN

His resting heart rate was in the 50's today. But he told me sometimes his Apple Watch wakes him up or alerts him that his heart rate is in the 30's to 40's.


My resting heart rate is in the 50's. I'm 66. My sleeping heart rate commonly drops to 41. If he's asymptomatic, that's OK. What you really want is a medical grade monitor like a Holter to wear overnight and see if there are any long pauses (I have a beat to beat ECG quality recorder that I use). That would be grounds for a pacemaker. Also monitoring is blood oxygen (SpO2) to make sure it isn't dropping very low.