Hi all, I had a sleeve in 2014 and a revision to bypass in 2017 due to severe GERD. My resting heart rate has been low consistently for several years (40s-low 50’s) and although I exercise, I am by no means an athlete. I have dealt with on and off light headedness for a while, and have fainted probably 3-4 times over the years, the most recent time this last week. I honestly hadn’t even thought about my WLS being related, but came across an old post on here today that was talking about low heart rates and did some research online. It sounds like low heart rates aren’t that uncommon after surgery, but my understanding is that this is something that usually resolves itself eventually. Has anyone dealt with fainting or low heart rates this far out from surgery? I did reach out to my doctor this past episode and she’s referring me to a cardiologist, but I thought I would check here since I’m sure this isn’t something a normal PCP would come across often. Thanks so much!

I have this issue with low blood pressure but my heart rate seems to be normal. I am also, only 6 months post-op.

I have heard of people who have lower heart rates post surgery and those who get dizzy but not many who actually faint multiple times. I am glad you are seeing someone and I really hope they get to the bottom of it.

Orthostatic hypotension - low BP when quickly sitting up or standing - tends to resolve itself as the body adapts to being smaller, though some may continue with lowish normal BP, but not particularly symptomatic. Bradycardia - resting HR under 60 - is often long term but not a big deal if unsymptomatic, I've had that since shortly after surgery, normally about 50, and it is only notable when I go in for some procedure and the nurse notices the low rate; I mention that it's been that way since I lost 100 lb and they say, "fine, OK." When an anesthesiologist for an EGD noted that I was running 39 on their table we looked into a bit more, had a Holter monitor test done to see if anything untoward was going on over a day monitoring, and there wasn't. One might occasionally notice a palpitation or "skipped beat" because the heart has multiple pacing mechanisms and sometimes one of them gets overeager and decides that a beat "should have happened by now" and sends a signal out of sequence, but then things return to normal sinus rhythm. Again, that's not a big deal or worry.

I have seen someone on these forums whose bradycardia was not that well controlled and did show symptoms (possibly similar to yours, though can't quite remember the details,) and she needed a pacemaker to keep things running smoothly. That might be your situation, given the time since surgery indicates that this isn't just a transient thing.

I’ve read of people fainting with their orthostatic hypotension post surgery but it does usually only occur a few times & then resolves itself.

A few of us have persistent low blood pressure but I know I always had a tendency & it is a genetic thing in my mother’s family. Is there a history of low blood pressure in your family at all?

At my higher weight my BP sat at 120/80 with random drops. So my obesity kept my BP in the normal range. Now, at a much lower weight it’s always low & I live with it without issue - just know what to do to manage mine when it happens. Have never fainted though. I have a slow heart rate too but my doctor isn’t too concerned. Not slow enough I believe to consider bradycardia.

I recall someone posting here they had to get a pacemaker too but can’t recall who either.

Will be interested to hear what your cardiologist says.

Edited September 28, 20223 yr by Arabesque

Hi all, I had a sleeve in 2014 and a revision to bypass in 2017 due to severe GERD. My resting heart rate has been low consistently for several years (40s-low 50’s) and although I exercise, I am by no means an athlete. I have dealt with on and off light headedness for a while, and have fainted probably 3-4 times over the years, the most recent time this last week. I honestly hadn’t even thought about my WLS being related, but came across an old post on here today that was talking about low heart rates and did some research online. It sounds like low heart rates aren’t that uncommon after surgery, but my understanding is that this is something that usually resolves itself eventually. Has anyone dealt with fainting or low heart rates this far out from surgery? I did reach out to my doctor this past episode and she’s referring me to a cardiologist, but I thought I would check here since I’m sure this isn’t something a normal PCP would come across often. Thanks so much!

Me too and once had fainted and passed out

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I'm a physician assistant who had orthostasis for the first two years or so (now 4 yrs out), now just occasional. I've looked into this as much as possible and never found a good answer. One issue is the studies that evaluated adverse effects of surgery didn't include this issue in their outcomes, so there is essentially no data. I have looked for case reports, etc. but found very little, certainly nothing that made sense. My surgeon had no idea. At one point, they thought I might have a pituitary tumor because one of the hormone levels was elevated, but it turned out to be elevated BECAUSE of the low blood pressure, which is what is supposed to happen. The last time I saw my internist my BP was 84/62, and I felt "a little" dizzy here and there that day. Generally it runs in the 90s.

The way I've come to think of it is that there is "something" that leads obese people to be more likely to have hypertension. But when I was obese, my BP was normal. Now that obesity is absent, whatever "factor" that pushed my BP into the normal range is gone, leading to low BP. I read food labels looking for the MOST salt in a given item rather than the least. That has been helpful for me. I wish I had a better answer. Good luck!