New member advice request

Hi All

I am due to have a pacemaker fitted next week and would be grateful for any advice on settings to enable me to continue running to a similar level than at present.

I am a 63 year old  male and ran a sub 20 minute 5k before lockdown with a HR max of around 155 to 165 when racing and 125 to 130 when running steadily 

I would be grateful for advice on settings and questions I should ask to find what suits though appreciate from other posts that it might take further adjustments to find the optimum settings.

Many thanks 


New pacemaker

by AgentX86 - 2020-09-09 22:12:07

It's a little early to start asking these questions.  You might want to discuss which PM your surgeon is going to implant but worrying about settings is a ways off.  There are too many variables to even guess at the basics.

You don't mention why you need a PM (it would be good to fill out your profile with this information).  Anything important other than running?

Get your PM tuned once the leads have bedded in.

by crustyg - 2020-09-10 06:36:54

As AgentX86 says, it's not easy to give the best possible advice if we don't know why you need a PM.

You are unlikely to be given/allowed the same maximum HR at first: chances are they'll set you to 50/130BPM for about 4-6 weeks.

Make sure your EP doc knows and understands which athletic activities are important to you (running, perhaps swimming and cycling) as these *may* affect choice of PM too.  In the UK it's often very important to get this information over as otherwise you'll get the manufacturer's model that they usually use.

Once you're past the early stages you can get them to organise a treadmill tuning session to get your PM set up for you to give you maxHR when you need it and something a little less when you're easing back.  If all is well, and your heart muscle continues to be healthy you can look forward to getting back to where you were before, once your running edge comes back.  You will be told 'don't get all hot and sweaty' while the skin incision over the PM pocket heals, and within reason that's good advice, but it shouldn't mean 'NO EXERCISE'.

Best wishes.

NEW PM settings

by WazzA - 2020-09-10 06:47:22

By far & above the best person to talk to is your CARDIO/EP.

Let them know your lifestyle & what expectations you would like to achieve , modern PM's are capable of so much & can be adjusted to your needs as they change.

Your PM will probably be rate responsive so will allow your heart to react to physical activity but your Cardio & EP will need to know . 

As AgentX86 points out recovery is the first thing to be done.  Best Wishes on your journey!


Hisbundle pacing

by marylandpm - 2020-09-10 17:56:05

  Look up HisBundle Pacing.  

let the doc know

by dwelch - 2020-09-10 23:14:36

If you have not already mentioned this to the doc, let them know immediately as they already have your device or are getting it soon.  It may make a difference what device they choose based on what you hope the device will do.  If you have then fine.  You will naturally have a recovery period and then will be able to get back to it.


New Pacemaker Advice

by Grc64 - 2020-09-11 09:16:14

Hi All

Many thanks for all of the advice and apologies for not providing more details around the reason for the pacemaker.

I was originally advised to have a PM around 5 years ago when second degree AV block was diagnosed during a routine medical. However, after an MRI and eP study confirmed my heart was otherwise healthy and block was originating in the AV node with likely cause being linked to endurance running it was agreed that the risk  of anything serious happening was low and I  chose not to have a PM.

The situation changed recently when I started to have occasional shortage of breath during night with my HR dropping to 30 / 32 and being tired during daytime  when my HR  was around 40 / 45 I visited the same cardiologist I saw 5 years ago and he again recommended a PM and this is scheduled for next week. The cardiologist is aware of my exercise regime and is confident I will be able to continue this after healing and setting of the PM.

I am still slightly reluctant to go ahead due to the uncertainties and impact on lifestyle but I guess most people are when faced with the situation.However the positive postings on the site do really help and hopefully everything will work out fine.

Pacemaker Settings

by bobrichards55 - 2020-09-13 14:56:05


I recommend that the upper setting be around 160-165 or so for someone who is active like you.  I am a 65 year old, former marathon runner, and current pick-up hockey player so that is what I had done.  They normally set it lower.  If you exceed the set rate they tell me that you could have the odd missed ventricular beat; still no big deal.

Also, with your history it seems of somewhat intermittent heart block I would recommend that you have the pacemaker set in MVP mode (managed ventricular pacing) which will minimize the ventricular pacing (better for long term heart health).  I have intermittent third degree block and I went from pacing at 70-80% to around 30% when switched to MVP.  Also, it is possible that the signal to your ventrical is delayed.  They can set it to allow say 250 milliseconds (normal heart function is around 150ms) to give your heart a bit longer to naturally get the signal before pacing.  Again, this will minimize pacing.

Hope this helps.  I have noticed no difference when exercising after getting my pacemaker.



by PacedNRunning - 2020-09-13 22:25:02

Based on the reason for your PM, bradycardia? I'm guessing you will only use your PM when you are sleeping or resting.  So when you get up to run, you will probably not need the pacemaker at all.  It will all be you. Even if you have intermittent heart block 2nd or 3rd most peoples AV node wakes up during high rates and beats normally.  Like someone said above see if they can minimize pacing. Each PM company has an algorithm to limit pacing.  I will also say since your a runner and I am also. My lower rate limit is 45bpm vs the normal 60bpm. 60 bpm was too high for me and I felt it made my heart work more than it was use too. Since PM is not for symptomatic bradycardia but heart block, my doctor felt comfortable lowering it to 45bpm. Yours may not since you are getting a PM for symptomatic bradycardia.  But it's worth asking if you find 60bpm too much.  Perhaps you just need support from the PM intermittently and not all day.  Best of luck with surgery.  Boston Scientific is the best PM for athletes.  So ask your doctor about that one and get his/her feedback.


by runningfree - 2020-10-28 09:42:58

I have very recently (September 2020) had a St Jude medical Ingevity MRI safe pacemaker implant. The cause being a asymptomatic complete (3rd degree) heart block, only discovered whilst undergoing a prep for a right knee replacement.  (The latter resulting from 40 years of Marathon & Ultra Marathon running).

Now aged 79, I had not experienced any problems with said heart block, but was told it was life threatening, resulting in the PM being fitted within a week!  After 6 weeks, I now await a remote telephone or video assessment using a Merlin@home TM Transmitter Model EX.

My query relates to the very helpful advice above concerning settings for a PM, in particular references to “MPV Mode”. Living in the UK, my PM operation was carried out by the NHS – which as you may know – has been under extreme pressure with the current Covid-19 pandemic. Consequently (and understandably), I have received no comprehensive information as to settings for a PM, or any other advice as to what I can or cannot do when exercising. For example, as my running had ceased for the time being, I took to rowing on a Concept Rowing Ergometer but now am concerned that exercise may loosen wiring etc. Again, being a “gym rat”, how much stress can the PM take, for example with weight lifting? All I do know is that during the operation, which I watched on a monitor, there was a discussion about the setting of the lower rate of bpm – my bpm had been around 38-40, the surgeon suggested 60 bpm, I asked for 45 and the compromise was 50bpm – but no upper limit was mentioned?  Sorry to be so long winded, any advice very welcome.





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It is just over 10 years since a dual lead device was implanted for complete heart block. It has worked perfectly and I have traveled well near two million miles internationally since then.