21 bpm was measured while I was bundled up like a burrito in a microwave for a cardiac MRI. The machine has to synchronize to your pulse to only collect data between beats. Since my rate was so low, each scan pass took about 4x longer than usual, while having to hold my breath. That was a very long hour of my life.
For a while it was a bit of a Dr. House episode, between the root cause being unknown, and the pacemaker having a reliability issue that needed debugging. I estimate about a dozen cardiologists poked and prodded me. They even had a "conference" with something like 30 people, and it being a teaching hospital, they also did a case study.
I'm doing a lot better now, thanks to smart doctors and the marvels of modern medical technology.
It turned out that my heart rate had progressively slowed down over a couple months, dropping as low as 21 beats per minute. I was acclimated to it at rest, but my heart wouldn't beat faster regardless of activity level. I had to get a pacemaker that instantly jumped my rate up to 110 bpm. My blood pressure also shot up to something like 160/110. I had the worst "caffeine" headache I can remember from that. It was a long few days until everything balanced out.
I cherish my morning ritual pour-over or aero-press.