palpitations during exercise

pacemaker since 2007 i notice that sometimes when i do exercise on the gym like threadmill and stairs machine i get this ramdom palpitations should i worry ? this is the first time i have felt them. also im about to see the pacemaker check in 10 days ..what does the settings on my device do thats the part i dont understand for example i heard somehting like 140 so what does that mean that my heart can only go 140? i dont have any other symptons while exercise only the palpitations any ideas ?


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by Gemita - 2021-06-19 06:15:18

Hello Cadaverock,

I see you are not new to pacemakers.  You have more experience than I have since my pacemaker was implanted in 2018.

Palpitations?  Should you worry about them?  Depends on what the arrhythmia is, the speed it is going at and the symptoms you are getting, particularly if you have a heart condition which could worsen with an arrhythmia.  Your check in 10 days will give you the opportunity to see whether any important "Events" have occurred and you can mention the palpitations at that time, giving date and time approx if you can recall when they occurred?

There are so many settings and some of us are successfully able to get a print out of these so that we can learn (from our pacemaker manual, from our doctors, from members here) over time what all these mean for us individually.  But it will be work in progress.  The 140 bpm you have heard about is probably your Upper Tracking Rate setting, but it doesn't mean that your heart cannot go above this naturally, or that your doctors cannot raise this limit to suit your lifestyle better (depending on your heart condition of course and whether it would be safe to do so) which is why you need to talk to your doctors.  Many members find a treadmill test very helpful to assess the best pacemaker settings for them to suit their personal requirements.

So, to conclude, if you notice palpitations say at rest but you have a normal heart rate between 60-100 bpm) and are relatively symptom free except for the palpitations, this may not be a cause for any concern.   Anything above 100 bpm though at rest would be classified as a tachycardia and would not be normal.  Normal exercise induced tachycardia triggering uncomfortable palpitations in my opinion needs to be assessed through monitoring.  You mention you do not have any other symptoms while exercising, only palpitations.  I get palpitations often if I increase my heart rate through vigorous, sudden exertion, but no harm usually comes to me, especially if I listen to my body and do not push through the palpitations when I struggle with symptoms, like breathlessness or chest pain.  However, in my case, I have known, diagnosed multiple arrhythmias.  Do you have diagnosed arrhythmias?

It is important to bring any new palpitations to the attention of your doctors who may do additional monitoring to confirm the arrhythmia present.  For example, they may diagnose benign ectopic beats coming from the atria or ventricles;  slow, fast, irregular atrial arrhythmia like Atrial Fibrillation, or a fast, regular (or rarely irregular) atrial arrhythmia like Atrial Flutter.  A fast arrhythmia coming from the ventricles would be concerning, particularly if it is sustained, which is why you need to speak to your doctors about any new symptoms, like palpitations.  Good luck and I hope your check up will give you some answers

Palpitations during exercise

by TAC - 2021-06-19 10:37:36

GEMITA has written an excellent comment. The only thing I will add, is that pacemakers are set up to prevent bradycardia, not tachycardia. In other words, they can have a limit on how slow the heart is allowed to go. However there is no way to prevent the heart from going fast. The device check will identify the type of arrhythmia you get when you exercise.

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