Questions about low heart rates

[alicia]

I saw my Gyn/Onc on Monday for a follow up and when they took my vitals my BP was 100/50 and my pulse was 44...I questioned my Dr about the low pulse and she was not concerned as I was scheduled to see my cardiologist today. Well I saw my cardiologist today and since I have a history of arrthemias they did an EKG and it recorded my heartrate at 40 and my cardiologist was very very concerned and appaled that he was'nt alerted to this fact on Monday when I saw my other Dr. He told me he was going to have me stop the Digoxin and cut down on my Coreg and he put me on a 30 day recorder/monitor. My fear is just abruptly stopping the Digoxin at once. He said if this doesnt clear up soon by stopping the Digoxin we will have to seriously consider a pacemaker. Has anyone ever had this problem before and if so what where the affects. Is this as dangerous as my cardiologist made it out to be? Of course I am scared to say the least.

Alicia

 

[alicia]

In addition to above...My cardiologist explained to me that since he has followed me I have always had a LV malfunction and said something about the heart not firing or conducting properly. What does this all mean? The only symptom that I have noticed is extreme fatigue. Help please.....

Alicia

 

[Nancy]

Yes, Alicia, that kind of heart rate is a problem. Joe had that problem (in the 40s and lower) and had several very serious faints during which I could not feel a pulse. He did injure himself on more than one occasion.

He had a pacemaker implanted and has had no more faints.

In the mean time, he has had another valve surgery and is being treated for a lung problem which is serious, and his heart function has improved to the point that he barely uses the pacemaker. But it is there if he needs it. It's his safety net.

It's a very good thing that your cardiologist is on the ball and is being aggressive. I hope your medication change will help you.

Best wishes.

 

[tobagotwo]

Ask your cardiologist to taper you off the Digoxin, if possible, as people here have registered some reactions to sudden Digoxin withdrawal, including syncope and heavy arrhythmias.

He said some scary things, but he didn't send you to the emergency room, either. Don't let your cardiologist browbeat you. He's probably not as smart as he'd like you to think...

Best wishes,

 

[hensylee]

Alicia - my good friend had a heart rate of about 40 - the dr put her in hospital for a pacemaker, but didn't achieve it because of some of her problems. Whatever the cardio did (an accident of some sort) caused her heart to jump back up in rate. It may still have to be done eventually if it goes back down and the dr expects it will.

 

[Shine_on_Syd]

Found this Q and A

Found this Q and A

What are the side effects of digoxin?

Most people can take digoxin without many side effects. However, you could have side effects, especially if you get too much digoxin. These side effects include nausea, vomiting, diarrhea, stomach pain, loss of appetite, unusual tiredness or weakness, slow heartbeat, palpitations, irregular heartbeat, drowsiness, confusion, fainting or changes in your vision (seeing a yellow, green or white halo around objects). It is important to pay attention to these side effects, because too much digoxin is dangerous. You should call your doctor right away if you experience any of these side effects.

- - - - - - - - - - - - - - -

Digoxin RX, information , Side Effects and Uses.

Digoxin is used to treat conditions such as congestive heart failure and atrial fibrillation / atrial flutter (types of fast heartbeats).
Digoxin may also be used for purposes other than those listed in this medication guide.

Do not stop taking digoxin suddenly. Stopping suddenly could make your condition worse. Even if you feel better, you need to keep taking this medication to help the heart work properly. Make sure you always have enough digoxin on hand for vacations and holidays.
Ask your doctor to teach you how to monitor your heart rate and at what heart rate you should notify them before taking any more medication.

 

[Bryan B]

Do not stop taking digoxin suddenly. Stopping suddenly could make your condition worse.

Seems some physicians need to read their PDR or Facts & Comparisons books. We have had a couple members that were told to stop their digoxin cold turkey in the last few days.

 

[KimC]

Alicia,

My heartrate dips into the upper 30's and 40's during the day. Although I have sinus bradycardia, other than fatigue, I've never fainted but wonder if I will some day. When I was hospitalized last December, my heart rate dipped below 40 and the nurse came running into my room ... meanwhile, I was watching the tube and smiling.

My cardio also mentioned that I may need a pacemaker some day as the rate will probably continue to decline. I'm glad your cardio is being agressive with your care. Be sure to drink as much as you can within your health guidelines. I was told that being hydrated is important.

Best,

 

[JimL]

When the cardiologist told me to stop taking digoxin, I decided to wean myself off of it. So I took my last regular pill on a Monday, skipped taking it on Tuesday, and then took one on Wednesday, planning to skip Thursday and take another on Friday. On Wednesday I made a couple hour drive, and about halfway into it I was very faint, and struggled the rest of the way to stay awake and conscious.

When I finally did wean myself off, I took a whole pill one day, a half pill the next, then a whole, then a half, then a half, then skip, etc.

 

[Nancy]

Alicia-

I forgot to also mention that your body and all its organs rely on your heart to pump oxygen rich blood through them in order to sustain life. When heart rates get too low, the organs suffer because they do not get enough blood, and it will eventually lead to organ failure if it goes on too long.

That is another reason your doctor is so concerned.

 

[alicia]

Thanks to all. I hope I didnt make a mistake and end up regretting it, but I ended up throwing away my Digoxin pills and missed my dose last night and tonight and I am so darn tired I dont know what to do. I have slept all day today and just got up to check the site here and was amazed at all the negative feedback about stopping the Dig suddenly. I am praying I dont end up in the hospital again. I do have a wonderful cardiologist and he is always right on top of things and when he is so concerned, I pay attention. I tested this heart monitor thing yesterday and it worked fine. I press a record button IF I have any symptoms such as feeling faint or such and call the 800# and they record an EKG from my machine and fax to the cardios office. Its seems so high tech for me. I have to wear this thing for 30 days! It could be alot worse though. Well anyway, thanks and Im going back to bed again and will check back tomorrow. Thanks again everyone.

Friends in heart, Alicia

 

[Harpoon]

ALICIA

GET MORE DIGOXIN NOW!!!


http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/lan1218.shtml

Side effects may include: Apathy, blurred vision, breast development in males, change in heartbeat, confusion, diarrhea, dizziness, headache, loss of appetite, lower stomach pain, nausea, psychosis, rash, vomiting, weakness, yellow vision

"Why is this drug prescribed?

Lanoxin is used in the treatment of congestive heart failure, certain types of irregular heartbeat, and other heart problems. It improves the strength and efficiency of your heart, which leads to better circulation of blood and reduction of the uncomfortable swelling that is common in people with congestive heart failure. Lanoxin is usually prescribed along with a water pill (to help relieve swelling) and a drug called an ACE inhibitor (to further improve circulation). It belongs to a class of drugs known as digitalis glycosides.

Most important fact about this drug:

You should not stop taking Lanoxin without first consulting your doctor. A sudden absence of the drug could cause a serious change in your heart function. You will probably have to take Lanoxin for a long time--possibly for the rest of your life. "



It's a potent drug that works great for most people and there really doesn't seem to be any good reason to suddenly stop taking it unless you've taken just a few (day or two) doses and have developed bad reactions to it.


All the information I've heard including anectdotal information from this site indicates that if you go off digoxin for ANY reason it should be gradually....

 

[ALCapshaw2]

Hello Alicia,

You have a difficult dilema. It would probably be worthwhile to ask your Cardiologist about the risks of going 'cold turkey' with your digoxin vs. the risks of 'tapering off'.

FWIW, when I was on a higher dose of my Beta Blocker (Toprol) and complained of feeling 'dragged out', he told me to cut my dose in half for TWO WEEKS. If there were no problems, to then cut it in half again for ANOTHER TWO WEEKS. If there were no problems, to then stop it completely. After stopping, I did have an arrythmia so went back to the lowest dose which worked well for several years. Ask your Cardio if there is such a protocol for going off Digoxin. OTOH, I can understand his concern for a HR of 40 or less, especially if you are not a well conditioned athlete (like Lance Armstrong). Be diligent about recording and reporting ANY unusual events. Basically you are being your own 'nurse'. If your risk were any higher, hospitalization may be the safer course.

There is SLOW and there is STOPPED. A STOPPED Heart is NOT a good thing...

'AL'