Pulse refers to the rhythm of the heart pumping blood throughout the body.
The standard pulse rate for adults is 60 to 100 beats/minute, but some people have less.
The standard pulse rate for the elderly is 50-70 beats/minute.
There are various people, such as those who feel slow pulse as a subjective symptom, and those who only know it after being pointed out during a health checkup.
If the pulse is slow, there are cases where you can see the situation as it is, and there are cases where you have to see a medical institution.
Here, we will discuss the causes and treatment of slow heartbeat.
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causes of slow pulse
The causes of a slow pulse can be broadly divided into non-disease and disease-related causes.
not caused by illness
(1) Due to physical constitution and sports habits
Some people are born with a slow pulse. In addition, if you practice sports regularly and for a long time, the amount of blood pumped from the heart per stroke increases, so the frequency of pumping (pulse rate) can be reduced. This is called "sports heart".
An electrocardiogram of such patients shows a waveform called sinus bradycardia.
Sinus bradycardia means that the electrical signals in the heart are normal and the pulse rate is low. The rhythm of the waveform is constant and the pulse rate will be less than 60 beats. Subjective symptoms are rare. Sinus bradycardia does not require treatment.
(2) Caused by temporary arrhythmia
One of the arrhythmias is an extrasystole.
Extrasystoles①In , the electrical signals in the heart come from different places and earlier. Because the electrical signals are not transmitted well in the heart, the force that pumps blood around the body is weakened, so the pulse is not counted and the pulse rate is low. Electrocardiography shows sporadically irregular waveform rhythms.
Subjective symptoms are rare. In addition, premature contractions are said to increase with aging.
Most premature contractions do not require treatment, but sometimes premature contractions require attention
. If you have subjective symptoms such as dizziness or dizziness in addition to the extrasystoles that occur continuously, there is a possibility that you have extrasystoles due to illness.
(3) Due to internal medicine
If you are taking medicine for a disease that causes a rapid pulse, or if you are taking tranquilizers or antipsychotics, the action of these medicines may reduce your pulse rate. Since it is due to treatment, it is often observed, but if the dizziness or dizziness is severe, adjustment of the oral medicine is necessary.
reference)
caused by illness②
① sick sinus syndrome
Sick sinus syndrome is a disease that causes the electrical impulses in the heart to fail. This causes a persistent slow pulse, light-headedness, and fainting.
It can also cause heart failure and heart failure. It is classified into 1st, 2nd, and 3rd degrees, and the higher the number, the more severe the disease. Many of the causes are said to be associated with aging, and there are also antihypertensive drugs and antiarrhythmic drugs.
② Atrioventricular block
Atrioventricular block is a disease in which the heart's ability to regulate electrical signals is impaired, resulting in a slow pulse.
It is classified into 1st, 2nd, and 3rd degrees, and the higher the number, the more severe the disease.
First- and second-degree atrioventricular block may occur as a physiological phenomenon in people who have a habit of exercising and in young people, but in others, myocardial infarction and cardiomyopathy are often hidden.
If a second or third degree atrioventricular block occurs due to these diseases, subjective symptoms such as dizziness and dizziness may occur, and in the worst case, the heart may stop.
reference)
treatment for illness
Treatment for the disease can be divided into:
①Treatment of myocardial infarction and cardiomyopathy
If the slow pulse is caused by myocardial infarction or cardiomyopathy, these are treated.
② Pacemaker③④
A pacemaker is a defibrillator implanted in the body that constantly monitors the movement of the heart and restores the movement of the heart by giving electrical stimulation when bradycardia or the heart is about to stop.
Pacemaker implantation surgery is not uncommon, and many medical institutions perform it.
The surgery is performed under local anesthesia, an incision of about 5 cm is made under the left collarbone, and the body is embedded subcutaneously. Wires called leads are then inserted into veins leading to the heart and fixed in place inside the heart.
Surgery takes about 1-2 hours. It is a surgery that is covered by insurance, and it can be said that it poses little burden on the patient, both physically and economically.
After surgery, regular outpatient visits are required to check the condition of the battery and leads.
As a precaution after implanting a pacemaker, there is a possibility of malfunction due to electromagnetic waves. Therefore, please pay attention to the following points in your daily life. ⑤
・Do not get too close to the IH rice cooker or IH cooker in use.
・Do not use devices that energize the body or emit electromagnetic waves (low-frequency therapeutic devices such as stiff shoulders, body fat scales, etc.)
・When using a mobile phone, keep it at least 15 cm away from a pacemaker.
・Do not use quick chargers for electric vehicles
・In principle, MRI examinations cannot be performed at hospitals (some pacemakers can be used), and CT examinations and X-ray examinations may not be possible in some cases, so be sure to self-report that you have a pacemaker implanted.
reference)
③⑤ Japan Arrhythmia Device Manufacturers Association ICDguide.pdf (jadia.or.jp)
④Bradyarrhythmia｜Keio University Hospital KOMPAS (keio.ac.jp)
summary
This time, we talked about the causes and treatments of slow heartbeat.
If there are no subjective symptoms, there is usually no problem. It can be life-threatening if symptoms are present. Early treatment can save lives and reduce the burden on the heart, so be sure to visit a medical institution.
Supervision: Dr. Yasushi Tsuda