Not feeling "oomph" while running

Hi All!

  My first post and thankful I found this club/forum. I had a PM implanted in late September 2019 due to syncope/heart rate pauses. I had two quite serious incidences and some episodes in between the two; after the second serious incident I had the PM implanted within 24 hours, so I didn't really have much time to "take in" everything that was happening. There is some neurological relationship to everything which is still being looked into, but at the moment, I am dealing more with maybe my settings not being optimal, which is frustrating. I do have an interoggation and follow-up after scheduled.

 I am a runner who is training for a marathon and running between 44-50+ miles a week and having problems with speedwork runs and running hills. This isn't my first marathon and actually I ran a marathon in early November 2019 after my implantation. I even felt in better shape in November but I also was not running 50 miles per week at that point due to tapering for the marathon and then recovery after. Before this incident which led to the PM, my fitness was quite good and I suppose it still is, but I am not feeling any oomph when trying to complete speedier workouts and hill work.

Could this be due to PM settings? I have not been interrogated since October 2019 and I am right about in the middle of my training cycle (marathon is in late April). I believe my PM is set at 40/170 bpm. My stress tests reveal that I have problems with my heart rate/bp increasing with exercise (unsure exactly how much of a problem...that info was not really made known to me...yet anyway), so I guess it's hard for me to know if my heart rate is even reaching near 170 bpm. I did not have problems with this prior to my PM...I felt that speedwork and hills weren't a problem as my fitness got better. I guess there could be some other things going on and not the PM, but if anyone can provide any insight or has any experience with this that they would like to share/advise, that would be great.


Thank You!!


It sounds like ......

by IAN MC - 2020-02-25 15:57:56

.... you are suffering from Chronotropic  Incompetence which means that your heart rate does not increase as it should when you run.

I was also a marathon runner and had exactly the same problem.  My life returned to moreorless normal after I had PM adjustments done while I ran on a treadmill.  The setting which needs switching on or adjusting is called Rate Response. Discuss it with your Dr

Best of luck





Training and HR

by Shana - 2020-02-25 17:15:16


Sorry! It's frustrating to figure out pm's and exercise/training.

As per Ian's suggestion, we have used clinic stairs and a treadmill stress test to help diagnose heart rate/ breathlessness/pm settings. Both visits were super informative as an athlete.  Highly recommend it.



Worth considering investing in a quality HR chest strap

by crustyg - 2020-02-25 18:24:47

Agree with the excellent advice already given.  You might consider investing in a quality heart rate chest strap (nothing based on pulseox readings will be reliable when exercising vigorously) and pairing it with your training gadget.  Two advantages: 1) keeps a record of your HR so that you can assess how much of your perceived effort is lack of muscle training and how much lack of blood supply - ideally the two should max out at much the same effort level, and 2) useful to keep an eye out for abnormal, fast heart rates, quite common in athletic types performing endurance events with athletic hearts and SA nodes that don't work very well (leading to very low resting HR, not always a good thing).

The Haywire Heart is a useful read too, along with Noakes bible, 'The Lore of Running'.  Turns out that while exercise is *way* better for you than no exercise, too much isn't without its price.



by SPiper80 - 2020-02-26 09:09:52

Thank you everyone for responding! Definitely will take/use these recommendations and hoping I can get it resolved or at least more to my satisfaction shortly. Thanks again!! :)

Medtronic PM settings

by ar_vin - 2020-02-26 13:55:20

You've got some great suggestions already; I second the suggestion to get a chest strap HR monitor and use it during your runs to see how your HR varies on your runs. I use a Polar H10 which is very well reviewed and works very well for me.

I see that you have a Medtronic PM. You'll find a lot of posts if you search in the archives on settings for athletic activities such as running, hiking up hills etc.

One of the key settings to turn OFF is Optimization.

I'd suggest downloading the PDF manual from the Medtronic website and going through the Rate Response section along with the archived posts on here. Then make an appointment with your PM clinic and have the settings tweaked.

You'll find a quantum improvement once you have the settings adjusted to match your activity.

Please do report back!




Update after Interrogation

by SPiper80 - 2020-02-28 11:54:31

Thanks again to everyone who was commented/made recommendations! Very much appreciated. I was interrogated yesterday, 02/27, and hoping some setting changes would be the resolution. Unfortunately, it's not the PM that is the issue. My heart rate readings over the past 4 months show my heart rate mainly being between 40-90s bpm even with running. I am touching upon some beats in the 100s and even up to 170 bpm but very little.

I cannnot imagine that I am in such great physical condition that my heart rate is staying in the 90s during speed work and hill work, especially since I am feeling like I can't exert myself any further during these sessions. I am not wearing a heart rate monitor (yet) during running, only my Garmin, but that isn't a reliable means for determining HR. According to online calculations, my healthy target HR zone would be 129-142 but again, not hitting near that a majority of the time. I do feel like this issue has gotten worse over the past few months. I have a Cardiology appointment on 03/13 and my last stress test did reveal that my HR/BP doesn't increase appropriately with exercise/running, so I am guessing that this is getting worse. I am pacing so Rate Response to increase my HR (I think...) can't be used because that would require increasing the Rate Drop lower limit and risking more syncope episodes. I am not sure I am explaining correctly lol.

Back to the drawing board, I guess, and trying to figure this out, but thankful I am at least not passing out!



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