Fatigue feeling when running and increased asthma

Hi, I have had my PM now for six months now. I am 46 and pretty fit, running and cycling regularly. The PM was implanted as a response to episodes of bardycardia. I have noticed recently feelings of heavy fatigue when exercising and that my asthma has flared up more frequently. I don't know whether this is directly related to the PM or is due to some other elements but am interested if anyone else has experienced similar.


Fatigue on exertion ?

by Gemita - 2021-09-23 06:17:58


As you will know, fatigue is unfortunately all too common in the general population, even in those without pacemakers and can have a variety of causes.  I get severe fatigue from my heart rhythm problems, especially with an irregular rhythm like Atrial Fibrillation (AF) and if I try to exercise during an AF episode my fatigue increases substantially and I fight for air.   I also get fatigue from poor quality sleep, when I have an infection, from anaemia, from my medication (particularly my beta blocker) and so the list goes on.  In your case I would suggest an asthma flare up will quickly lead to exhaustion and fatigue if it is not adequately controlled.

Specifically with the pacemaker, at six months your heart should be used to pacing and the wound and any trauma from the procedure should have settled.  No doubt you have had the usual early pacemaker implant checks to see whether the leads and battery are sound, that your pacing settings are working for you "personally", that there have been no significant events recorded like a high heart rate or a new arrhythmia?  Do you only notice your fatigue on exertion or is it present at other times too?  Many athletic members here get their pacemaker settings adjusted to suit them personally by getting a stress echocardiogram and then working with a technician and their doctors to see whether their settings can be fine tuned to better suit them.  You might wish to ask about this.  

If your fatigue (on exertion?) and asthma continue, I would seek early advice from your general doctor who may wish to carry out a few checks.  I hope you feel better very soon.

PM rate response settings

by ar_vin - 2021-09-23 12:54:40

Given that you are young and assuming you've been fit and active prior to your PM implant I would guess that your PM settings need to be adjusted to your activity levels.
If your diagnosis is bradycardia and nothing more, a PM will completely resolve it. Often EPs are rather conservative in settings adjustments. You need to go back to your EP have them evaluate your PM settings and adjust them.

There are many threads on this site related to Medtronic settings for active folks.

One is:


There are many others which will come up if you search the site.

Member @frankmcw2 has an excellent write up on Medtronic rate response settings for active lifestyles. 

Please do report back on what you end up doing.


pacing and asthma

by Tracey_E - 2021-09-26 18:52:30

The two should be unrelated. All the pacer does is make your heart go faster. If the asthma isn't under control, doesn't matter how well fine tuned the pacer is, we are going to struggle. Oxygen is kind of important ;o)  I haven't noticed it the other way around, heart issues triggering asthma.

It's very possible your settings need tweaked. The cycling is going to be more of a challenge than running because most pacers use movement to trigger raising the heart rate, and when on a bike the chest doesn't move. 

Is your asthma exercise induced? If I'm working out, I know I will need the inhaler so my doctor suggested I do it 10-15 min before my workout. Prevent trouble rather than try to get it under control after it starts. Allergies are a factor for me also. The last two months have been awful and I'm 99% sure it's allergy related. It's definitely affecting my workouts and I'm counting the days until the change of season.

You know you're wired when...

You have a 25 year mortgage on your device.

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My eight year old son had a pacemaker since he was 6 months old. He does very well, plays soccer, baseball, and rides his bike. I am so glad he is not ashamed of his pacemaker. He will proudly show his "battery" to anyone.