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Hypothyroid or low Potassium and reversible Sinus Bradycardia?


I recently had some palpitation episodes (while going to sleep) that I had an extreme reaction to (anxiety, was also on 200mg seroquel for sleep at the time).  I've been off the seroquel for 2 weeks, alcohol free for 30 days, continue to take gabapentin 1200mg daily.  

I've had sinus bradycardia for the past 30 days and was probably having it at the time these incidents occurred.  I get palpitations in the late evening and when going to sleep (pulse drops to 45-50 before I'm asleep, stays there while sleeping).  I have symptoms whenever the pulse drops to 60 or below - fatigue, headache, palpitation, etc

When these incidents first happened, I was in the ER and found to have low potassium (3.1) as well as high TSH (7.3).  The potassium was back to normal within several days.  The TSH went back down to 2.1 in the past week.

Question is this:  I may have some kind autonomic disruption going on.  But in either case, are these scenarios possible?

1) Sinus bradycardia due to hypothyroid / high TSH - delayed response in the bradycardia self-correcting after thyroid levels returning to normal
2) Sinus bradycardia due to potassium / electrolyte imbalances - delayed response and self-correcting...

By delayed I mean some number of days or weeks between the underlying imbalances being fixed and the sinus bradycardia potentially going away.

Bonus question: Are these causes for sinus bradycardia related to autonomic disruption or are they entirely separate potential causes?  Or interrelated?

Thanks
1 Responses
Avatar universal
BTW:  Had cardio echo and 2 day holter.  Both normal aside from bradycardia.  Internist believes I have some kind of toxic autonomic neuropathy that is probably self-correcting / reversible but this is somewhat speculation.
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