Exercising to Pacemaker Max

I am 43 years old, and was a pretty active individual, before an unexplained case of heart block forced me to get a pacemaker just over 3 weeks ago. I had in fact been training for several months for a 1/2 marathon, before the onslaught of the heart block. My doctor has released me to slowly start running again, but recommended I get a HRM, which I thankfully found a recommendation for on this site. I use my PM 100% of the time. My Dr warned me that my PM maxs out at 140, and if pushed beyond that could suddenly freak out and drop to 70. Has anyone experienced that before? I got my HRM today, and am anxious to hit the pavement, just not face first. Am a little nervous...

9 Comments

yep, been there

by Tracey_E - 2014-08-12 05:08:24

First of all, he can turn it up higher than 140! Unless there is something else going on with your heart that it's unsafe to go faster, that's generally considered a starting point. Young, active patients often have it turned up higher. Mine is 175.

Yes, there is a safety feature that senses a-fib and puts us in an artificial 2:1 block (hence the 140:70) to keep our rate under control. That's great if you have afib,a pita if you don't and just want to go for a run. They turned that feature off on mine.

Does your doc have other young, active patients? Sounds to me like maybe the answer to that is no. Imo, the answer isn't staying under 140 but rather adjusting the settings to suit your needs.

re: yep, been there

by MonicaNYC - 2014-08-12 06:08:27

I don't know if my Dr has many young patients. He did say he has seen only a couple patients like myself, patients who are relatively young, active, and otherwise healthy, who have unexplainable Heart Block that require a PM. He said PM patients are generally older, or have congenital heart conditions. I sent him an email about adjusting my settings. I will let you know what he says.

heart block

by Tracey_E - 2014-08-12 08:08:03

Mine is congenital. Most people newly diagnosed our age are like you, no known cause. It's not genetic, it's unrelated to lifestyle (lack of exercise and poor diet cause plumbing, not electrical, problems). Sometimes infection or some medications can cause it. Most of the time, it's a mystery. At this point, it doesn't much matter what the cause is! The fix is the same. Most of us have structurally normal hearts and clear arteries, the electrical disconnect is fixed by the pm so we shouldn't really have any restrictions once we heal. The settings they send us home with are often fine for the octogenarian couch potato but need to be tweaked if we are at all active. Upper limit of 140 is usually the first thing to change. Good luck! This should be an easy fix.

Does not feel good!

by Dee224 - 2014-08-12 09:08:53

Yup, the PM dropping off feels pretty bad. I have unexplained heart block too, although I an 59 so a bit older. My PM was originally set to 130, which did not work at all for me once I got back to swimming laps. For some reason back and breaststroke were fine, but as soon as I switched to freestyle I could only go a lap and a half before my PM would drop off. I have to say that dropping to a rate of 60 BPM halfway across the pool feels pretty crappy. They raised my rate to 150 which has helped, but I still have to watch it. I try to keep my rate no higher than 120-125. For some reason I have still had my PM cut out a couple of times, even with the higher setting.

Recovery

by LeeT - 2014-08-12 11:08:08

yea sounds like you want to do it all again right away. Which is cool but be mindful follow your Dr directions, they have much more experience than we do for sure. It took me several months to finally feel safe enough to attempt what I was doing before the PM. Recommend you listen to the Dr. You will be fine but these things take time to work out you need the time don't rush. I lift weights use to be heavy ones with fewer repetitions. Now it's less weight with much more repetitions. Solid compromise all works out to be the same in the end strong cool body.

Max. tracking rate

by golden_snitch - 2014-08-13 03:08:03

Hi Monica!

With a completel heart block "only" exercising should be no issue. Your sinus node is still functioning and will dictate the pace just like it did before the pacer. All the pacer will do is track that pace, and make the ventricles beat at the same pace. You will not need the rate response sensor switched on, which is great, because that sensor often needs lots of fine tuning in young & active patients. All you need is a high maximum tracking rate, and here I totally agree with the others that 140bpm is nothing! What was your maximum heart rate when you ran before the heart block appeared? Take that, and have the cardio adjust the max. tracking rate accordingly. Not sure about your Boston Scientific pacer, but most pacers can have the upper tracking rate programmed up to something between 180 - 220 bpm.

Best wishes

Inga

Thanks all!

by MonicaNYC - 2014-08-13 12:08:01

We'll I tried an easy run today, paying close attention to the HRM, which worked great by the way. At my slowest pace, depending on incline, I could only go 1.5 to 2 blocks before I reached 137. My Dr said it is something that can be adjusted over time. Sounds like it will just take sometime and work to get it to a setting I can comfortably workout with. Thank you all for your feedback! So glad to have found this site.

PMT Fear

by glidermikey - 2014-08-29 01:08:01

I have been a runner for 38 years and just had a PM put in six months ago for 2nd degree heart block. As with some of you, I am still in the learning curve, which is special for those of us who were athletes. In particular, we need to "educate" our docs and teach support people, because they see patients who are not athletes and who have lost much function. I asked the techies to set my PM to Wenkebach at 160bpm and drop to 2:1 at 180 bpm when sensing natural aorta and pacing ventricle. However, the techie is not willing to shorten the pacing time for fear of inducing Pacemaker Mediated Tachycardia. Consequently, I still drop beats when the atrial rate reaches about 130 bpm. Anybody else have that issue?
Thanks.

Mike

Happened today

by casmered - 2014-11-04 01:11:01

First time working out, besides walking and chasing my 20 month old around) since the PM was put in (4 weeks ago). About 20 minutes in I noticed my heart rate drop into the 70s. Thought my watch, which actually wasn't really working at all, the treadmill, and my phone app were all nuts. I walked for 2 minutes and decided to try again and it went back up into the 130s just fine. So thought the whole thing was a fluke, but this thread describes exactly what happened to me.

I'll see how this goes for the next few workouts, but I don't see my doctor for 3 more months. Is this something I should consider reaching out to him earlier about?

My stats: 38, fairly athletic, 3rd degree heart block.

Thanks,
Ed

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