Attention if your heart rate is less than 60 beats per minute: there is nothing wrong with your heart!

Since the day we started studying medicine, we have known a medical standard: a heart rate below 60 beats per minute is definitely abnormal. And in terms of terminology, it is sinus bradycardia, or "sinus bradycardia" for short.

Although we have questioned "how can a tortoise's slow heart rate be normal?" and not only is it alive and well, but we are not experts. Therefore, we can only accept the theory that "below 60 is abnormal".

In clinical work, we often encounter patients who have low heart rates but are still alive and well, but we can only bite the bullet and say that they are abnormal. Sometimes, we even have to force them to do the "stair climbing test" or "atropine test."

Both experiments have only one purpose - to detect whether the heart has a reflex increase in heart rate due to this high-intensity exercise or whether it responds to drugs that increase the heart rate.

If we encounter a situation caused by sinus node disease, we will not only have to postpone the surgery, but also force the patient to get a pacemaker installed.

Some people may say, is it necessary to make such a big fuss for just a small operation?

As an anesthesiologist, I can say responsibly: We are not afraid of ten thousand, but we are afraid of one. No one can afford to gamble with their lives. Even if there is only a one in ten thousand chance, we will do everything we can to avoid it. Because our work is not just about anesthesia, but more importantly, saving lives!

However, recent news in the industry said: The standard for sinusitis has changed!

When this news came out, perhaps no one was more concerned than us anesthesiologists.

This is because Dou Huanye has indeed troubled us for many years.

We all know that some people have a slow heart rate, but the medical standards are there!

After searching for information, I found that this is not groundless: as early as 2020, the "Expert Consensus on the Evaluation and Management of Patients with Bradycardia and Conduction Abnormalities 2020"

The Chinese Medical Journal clearly defines sinus bradycardia as a sinus frequency of < 50 beats/min. This shows that Chinese experts agree that the diagnostic standard for sinus bradycardia should be < 50 beats/min.

Let's look at foreign countries: The 2018 ACC/AHA/HRS guidelines clearly define sinus bradycardia as less than 50 beats/minute, and the evidence is cited from two papers in 2014. It points out that population studies often use 50 beats/minute as the cutoff value for normal heart rate.

With this evidence, we don't have to worry so much in future clinical work. When the patient's heart rate is not less than 50 times and there are no obvious clinical symptoms, it can be regarded as "normal". Although the current electrocardiogram report will still report abnormalities (sinus bradycardia), don't worry too much. We believe that the current period should be a precursor to textbook reform that can serve as strong evidence.

Of course, we also have to pay attention to the particularity of this special period. For example, when surgeons are hesitant and patients are worried, there is no need for us to insist on not giving patients further examinations.

When textbooks and all guidelines agree that the standard is to be less than 50 times, we can argue for it!

Tell your colleagues about this important news quickly~ Let's grasp the pulse of the medical frontier together~