Expert: JM Starkman, MD - 5/30/2009

Question
I am a female, 56 yrs old and am scheduled to have arthoscopic surgery on the knee. I was set to go next week for the surgery, but my Gen Practice Dr got my pre-admission test back, (blood work and EKG)  EKG said I had a 43 heart rate. My GP took me off my BP meds for a couple of days and did an EKG again, it went up to a 49 (resting heart rate) Sitting up heart rate was a 62.  I cant be cleared for surgery till I see a cardiologist which will be in 3 weeks. I have had a low heart rate on and off my whole life. Do you have any suggestions or comment on this situation?  I have had previous surgery...one...gall bladder removal a few years back.  I take altenenol for heart palpitations and have not been on them for a few days under drs. orders.

Answer
Ask the surgeon to have the anesthesiologist to do the "surgical clearance" (it is more properly referred to as a "preoperative risk evaluation". From what you have told me, you do not have any additional risks that will hinder your safe passage through the pre-, intra-, and postoperative periods.  Your anesthesiologist is more than qualified to determine if a delay or any additional tests are needed.  I REALLY don't think a cardiologist has anything to offer here. Isolated low heart rates--and asymptomatic ones at that--are routine in operating rooms and regularly, safely managed.

If that is unamenable to to your surgeon, you might want to find another surgeon.