Since your family physician checked your medications to ensure that none would slow down your heart rate, that cause of a slow heart rate has been ruled out. If your heart rate is as slow as 40 and you're not having any symptoms like dizziness, light-headedness, or loss of consciousness, then it's doubtful you'll need a pacemaker. However, if those symptoms develop with a slow heart rate, a pacemaker may help. You may not need a pacemaker in the end but you should have another discussion with your cardiologist about this subject. I hope you find this information useful.
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