No P waves indicates sinoartrial block. It's likely because your heart rate
is so low. Bradycardia
is defined when heart rate drops below 50, which usually causes patients to be symptomatic with fainting
, breathlessness and dizziness
A very low pulse rate can be tolerated as long as the amount of blood pumped out of the left side of the heart per minute is adequate to oxygenate the brain and the other parts of the body. Once the heart is unable to fulfil this requirement you will become symptomatic.The level this is tolerated at varies from person to person. Below 40 is usually always a problem and is absolute bradycardia. .
If you are having sinus pauses (no P waves) and you are symptomatic then it may mean you need to have a pacemaker fitted if there is no identifiable cause. Are you taking any medication such as beta-blockers at present or drugs like Digoxin?