Low resting heart rate / Brachycardia

Hi everyone,

have been using the Visible app and have noticed that my resting heart rate is technically so low as to be defined as Brachycardia.
It's between 52 & 58bpm every morning over the last month.
I'm 33, (obviously) not an athlete, and walk an average of 4000 steps per day (averaged out over the whole year - some days much less, some more).
I'm assuming this is linked to my ME in some way, I'm currently waiting for an appointment with whichever of the 3 different ME specialists I'm on waiting lists for comes through first.
I'm not inclined to go to my GP specifically to talk about this resting heart rate issue, because they have been so unhelpful/ignorant about ME, but wondering if it's worth doing so just in case, and if anyone else here has similar results or any experience with the interaction between low heart rate and ME.

(edit: not currently taking any medication or supplements)

 

I wouldn’t worry. I have always hovered between 45 and 60, which cardiologists and other clinicians seem to regard as a minor quirk, not demanding of any explanation. It’s only been an issue when trying and failing to complete a stress echocardiogram.

 

I think what Trish said makes good sense. As unhelpful as GPs can be towards ME patients, it's still a good idea to have a record of anything you think is of concern. Even if you want to limit reports to "red flag" issues.

If you don't think your GP has taken your concerns seriously, you're entitled to ask them to provide their reasoning during the appointment. During this stage, I sometimes find they reconsider, as I often have to remind them of things they omitted or misheard, etc.

All the best.

 

Not an expert but I don't think a resting HR in the 50s is 'too low'. Mine can also be in the 50s, although usually around 60 bpm.

 

That's thing with measuring stuff - you get data and then you have a question of whether it means something - it's important to allow for the fact that it may not mean much at all. For heart rate Drs are going to be interested in whether it's associated with symptoms such as fainting, sweating, dizziness etc, if you are not experiencing anything like this then it's unlikely you will get a GP to order further investigation.

FWIW as a (long ago) youthful yoga-ist I could be very comfortable at 40 bpm, and I can still count a minute by my usual 60 bpm. I have had one event that alarmed the Drs enough for a cardiac referral and a 24 hour portable monitor, which showed nothing significant.

 

My pre-illness RHR was about 52 bpm (as a relatively fit recreational cyclist, walker).

I've been using a Polar watch with separate HR monitor for about 4 yrs 9 months (started using it 6 months after major relapse). For the first 15 months my morning resting HR was very erratic ranging between 60 & 104 bpm. I fitted POTS criteria on Tilt Table Testing at that time. I've never been on medication for my POTS.

Over time my RHR has become lower and more stable and is mostly now between 55 and 62 bpm, with outliers between 50 and 68. This corresponds with improved sleep and generally feeling less awful although activity capacity hasn't improved.

If it goes above 65 bpm now, for me it corresponds with doing too much.

 

My resting HR 48-55 is unusual compared to before even when I ran regularly. GP said I must be fit (years of ME later)

I went to GP because my HR can dive suddenly after or during an activity as low as 37 bpm. Blurry vision, dizzy etc. ECG showed up no major issues.

For me RHR correlates better than HRV for ME symptoms. Low 50’s tends to be when I am most stable. In a crash I head into the 60-70 region. I have heard only a few other pwME describe low RHR.

If in doubt and you haven’t had ECG and if any symptoms like palpitations or chest pains request 48 h monitor.

 

Also worth noting that different devices calculate RHR differently. This sounds weird because you'd think they're just counting heartbeats per minute. I suspect the devices also record some noise and then use different algorithms to clean up the data. At any rate, I've experimented with wearing two devices at the same time to measure RHR and one records very consistently 5-7 beats/minute higher than the other. Sometimes I also get random readings, way higher or lower than expected. That always turns out to be a device error. Repeating the measurement invariably gives a more realistic reading.

So I treat absolute measurements as less important than trends and correlations with symptoms. I feel best during periods when my RHR is around 55 plus/minus 3 on the one device or 60 plus/minus 3 on the other device. I don't recall any readings below that but higher readings correlate with increased symptoms.

Some people also report a sudden unexpected drop in RHR just after they have overdone things, roughly during the delay period between the overactivity and PEM setting in. This is then followed by a significant increase in RHR as PEM hits. As so often, it's a matter of figuring out what is normal for you, and what your patterns mean for you. That knowledge makes it easier to know when to seek medical help and also makes it easier to stand your ground should a doctor try to brush you off.

 

Just wondering, does anyone else here have good heart rate data from before falling ill? Especially if, unlike Ebb Tide, you weren't particularly fit before ME? I find it surprising that even after years of extremely sedentary life quite a few of us have a RHR that would be the envy of many athletes. Are we just people with naturally low RHR or is this one of the paradoxical quirks of ME?

 

Me too. No symptoms unless it gets into the low 40s.

I wonder if the "normal" resting heart rate range might be wider than conventionally thought, as until smart watches arrived on the scene, it would never occur to most people to monitor it. It would only be measured in medical settings, which probably doesn't even give a typical reading, let alone show longer-term trends.