Getting a little nervous

Hi all,

I'm scheduled to receive a Biotronik pacemaker next Friday and the more I think about it the more questions I have.  I'm not sure which model I will be receiving other than it is a dual lead.  I'm a 72 YO male, the reason for the PM is heart block which caused me to pass out one time back in July.  My cardiologist had me wear a Holter monitor for 3 days and it showed 2 instances of heart block.  I am an avid cyclist, and ride at least 4 times a week.  While researching last night I read several posts about PMs and cycling and how some don't react to cycling since the upper body doesn't move.  I realize the PM is there to ensure I don't skip a beat but will it affect the natural action of the heart as I increase load/speed? 


Had the PM placed yesterday with no problems. The model that was used is a Biotronik Edora 8 DR-T. Very little pain or discomfort and no pain meds, only Aleve. Walked 4 miles this morning with no issues. 


While you wait for the Biotronik pacemaker members to respond . . .

by Gemita - 2020-10-18 08:02:32

I thought I would just say good luck CLE.  The actual "fine" setting adjustments will need to be discussed with your pacemaker team and will, I assume, be ongoing work in the future.  I hope you have told your team about your activities and what you hope to achieve with your pacemaker (apart from alleviating your heart block symptoms of course!).  If you have, I am sure your EP has chosen the most appropriate model for your needs.

I would hope when the pacemaker is adjusted appropriately, it will complement "the natural action of the heart" as you increase load/speed but I am not a cyclist.


by Tracey_E - 2020-10-18 09:58:30

Glad you found us! 

Make sure your doctors know you cycle. Some rate responses are better suited to cycling than others. Sounds like they may already know, tho, because Biotronik makes the one that uses breathing rather than movement. That said, with heart block it probably won't make a difference. Rate response is for people with sinus node issues, rate response helps the rate get up on exertion when the sinus node in the atria gets lazy. With heart block we usually have a perfectly normal sinus node, our problem is the signal gets lost on the way to the ventricles. So for us, the pacer is playing follow the leader, making sure the ventricles beat when the atria does. It's keeping the heart in sync, not setting the pace.

The only way it will affect your heart as you work harder is to make sure the ventricles never miss a beat. It only adds beats, it can't keep the heart from beating on its own. However, the pacer will only make the ventricles beat as fast as it's programmed to go, that's upper limit. They often start that around 120-130. If the atria goes faster than that, the heart will be out of sync again. That number can be adjusted as needed. Ideally you want it 10-15 bpm over the max rate you hit working out. I average 160 but get as high as 170-175 sometimes so my upper limit is 190.  The don't like to have it too high, and if you end up needing rate response it has a lot of setting options, so it may take a few adjustments to get it fine tuned to where you need it to be. We are all different so they send us home with settings at a good guess, then modify from there. If you ever feel symptomatic while exercising when you start back, back off and let them know.


by SNORTINGDONKEY - 2020-10-18 19:57:39

Hello CLE:

I am an endurance athlete/triathlete/tennis player and had to get a pacemaker because of complete ventricular heart block. I used to ride and run a lot, but unfortunately, I am only 25% active compared to before the pacemaker was installed. Some of my problems cannot be attributed to the pacemaker, but yes, cycling has been a huge problem with my Medtronic PM. (I have many posts about my travails on these forums if you want to look them up.)

I would suggest talking to your EP about the right PM. I lot of people are saying that the Boston Sci is the best one for cyclists.

Is your heart block just ventricular or ...?

Are you in Cleveland by any chance?

By the way, extremely interested in your experience whichever PM you go with...

Heart block

by CLE - 2020-10-24 14:09:19

My heart block is only ventricular and is type 2. I am in North Carolina near Charlotte. Doc set my minimum at 50bpm with a max of 160 bpm. I'll only be paced while I sleep and when I sit still for a while. My heart rate use to go to mid 40s if I sit for a while. 

You know you're wired when...

You always have something close to your heart.

Member Quotes

At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!