A heart rate of less than 60 beats per minute is called bradycardia. Bradycardia generally does not require treatment, unless there are symptoms caused by insufficient blood flow to the brain. Symptoms include: fatigue, dizziness, swooning and fainting or near fainting. The elderly are more likely to have slow heart rate problems. Symptoms may sometimes be medication-related. However, in some cases, it may be necessary to implant a pacemaker under the skin to accelerate the heart rhythm to a more normal rate. Physically active people tend to have a low heart rate (below 60 beats per minute) when at rest. For them, this is not abnormally slow.