Heart rate not increasing when exercising

Hello, I've been doing great, except, over the past week I've noticed that whenever I ride my bike, my heart rate rarely goes over 140 bpm even when I'm pushing hard & I fatigue much quicker(normal would be 160 - 180, I am 26, and have been riding for years).  I am on metoprolol 12.5mg once a day, I usually take it at night & with that dose, I still could reach the normal heart rates. I have a pacemaker/icd which is well looked after. Should I be concerned? is it worth calling my md? Thank you in advance


Have you developed chronotropic incompetence?

by ar_vin - 2021-07-21 20:47:49

Would be my first question to your EP; one reason why you might experience the symptoms you are.

If so, an easy fix is to adjust the rate response settings on your PM.




MaxHR, beta-blockers and an ICD at 26

by crustyg - 2021-07-22 03:24:50

I don't know your primary diagnosis: you're trying to achieve a higher maxHR on a beta-blocker, and as ar_vin points out, changes can occur in the heart so that things that used to work perfectly are now impaired.

Definitely time to have a sit-down chat with your EP-doc - describe what you want to achieve, how you feel when you cycle hard and what you used to be able to manage, and take it from there.


by Julros - 2021-07-22 10:13:02

I'm a little jealous that you can get your heart rate up to 140 while cycling. I top out about 100, although I can get up to 155 when I run. I am told this is because I don't have a minute ventilation (MV) feature on my CRT-P. 

Yes talk to your EP about what is the safest HR for you and if you have MV capability. 

few questions

by dwelch - 2021-07-22 23:44:01

what is your upper limit set to?  no reason to expect to go over that.

the higher rates, were you able to reach those with this pacer and settings?  but you added some meds?

heart rate monitors dont work well with us, do you have confidence that the monitor is measuring correctly?  do you have an led/light based finger one or an electrical signal one?  (are they consistent)?

you may need to talk to your doc to get the answers to these questions.  to see how high your pacer can go, if it is safe to go that high for your condition.  likewise to cover some of the confusion you may be having about what you are seeing.  and/or was this expected/


Try tapping it with your hand

by Elisabet - 2021-07-23 17:37:13

No one's mentioned this, but pacemakers on rate repsonse don't always do a great job detecting motion from bicycling (or rowing, apparently) because the motion for the upper body is too smooth. They are much better with the vertical impact from running - or driving on rough gravel, lol. 

A tip that a tech gave me is that bicylists will often use their hand to tap the pacemaker repeatedly to increase the rate.

(Not that it helped me - I'm naturally paced). 

You know you're wired when...

You have a little piece of high-tech in your chest.

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.