It can definitely become life threatening. I had to have a pacemaker implanted 11 years ago because of it. I also have times where my BP can get a low as 58/46 just from standing up (this is WITH medication). It can be a debilitating condition, but also includes just some annoying problems with temperature regulation, difficulty urinating, balance, heat intolerance, etc.

How low was your heart rate before the pacemaker? Could you elevate your heart rate with exercise? I've heard with autonomic issues some folks can't get their heart rate up.

Mine got down into the upper 30's while just sitting upright...low 30's if I lay down. I was able to get it a little higher if moving around, but I had profound PN with muscular weakness at this point, so 'exercise' (in the true sense of the word) wasn't possible.

I had already had 3 strokes (from another autoimmune condition called anti-phospholipid syndrome) and still having periodic TIA's (even with blood thinners). With the heart rate so low, they were concerned about enough blood getting to the brain and contributing to the TIA's, so the decided pacer was best way to go.

It was the right decision because the pacer keeps track of % of paced operation. At this point 89% of my heart beats are paced!! I would NOT be here without it.

Wow thank you for sharing that!

I'm an avid runner and my heart rate at rest in the evening is 48 bpm. Although my gut tells me the low resting heart rate is from a very efficient heart, a thought crossed my mind "autonomic neuropathy" lol

The difference is I can get my heart rate up to 160 and keep it there for an hour and then it drops to 100 quickly upon exercise cessation.

My primary care doctor always told me if I'm not symptomatic with a low heart rate it's nothing to be concerned about in a young healthy adult.

With this onset of neuropathy I was wondering if the slow heart rate was an issue with my autonomic nervous system.