High altitude and soreness

Hi All,

Got my ICD, October 2021. I've relocated to a high altitude location in California (5,000ft+ elevation). I've noticed that the area around my implant site becomes a little bit sore during the colder months here (right now actually). I am assuming this is normal correct ? I can feel a distinct lack of soreness when we do head down to lower and normal elevation. I also feel more active in lower altitudes. This is all normal right ? Does anyone else deal with a high elevation, ICD or pacemaker implant ?



by ar_vin - 2021-12-21 21:55:58

5000 ft is not really high altitude; of course it is higher than sea level and it might be colder at this time of year at those altitudes especially now that we seem to be getting a fair amount of rain and snow this winter.

I spend a significant amount of time hiking, backpacking etc in the summer at altitude (7000 ft - 14000+ ft) and also camping, snowshoeing, other snow sports at 7000 ft - 10000+ ft in the winter.

My PM was implanted in late 2018 but I've never felt any different at altitude or in the cold for that matter. Even  at sea level I spend a significant amount of time hiking, running, biking, etc in the cold for hours at a time even while it's raining (temperature down to low 30s at times). I just make sure I am adequately dressed for the weather and the activity.

I've always been very active year round even prior to the PM implant.

The only thing I can think is that maybe you're not dressed for the weather. Do you feel cold and uncomfortable?

not really

by Alexander - 2021-12-22 01:28:56

I suppose I am most of the time I am prepared in cold weather conditions. I am well prepared with gear. I am dressed appropriately for the cold. I just feel generally more winded in this higher elevation than elevations that I am accustomed to. I've spent a large portion of my life in NYC and just recently moved to where I am. 

Is it my ICD or is it my physiology that is causing this ? I have ok fitness, not great but not bad. I am not overweight or suffer from anything that I believe may be causing some sort of physical strain on me. I can't figure it all out...


by ar_vin - 2021-12-22 03:09:35

It's likely that you simply need to give your body time to acclimate to living at altitude.

The other factor is improving your physical conditioning. You're young and if in otherwise good health you ought to be able to gradually get in better shape with consistent effort over time.

Then you won't experience the physical strain of being active at altitude; of course it may take some time.

The following short book is an excellent resource and reference - it's written by a medical professional who is an experienced mountaineer and spends a considerable amount of time in high mountains around the world:

Altitude Illness
Prevention & Treatment, 2nd Edition
by Stephen Bezruchka, M.D.


Higher altitude, feeling cold and soreness

by Gemita - 2021-12-22 06:42:37


Not much more I can add to ar_vin's helpful posts, except to say that many people find their arrhythmias worsen at higher altitudes, so don't push through if you find yourself struggling.  Perhaps a period of acclimatization is all that will be needed.  Cannot answer the point on "soreness" however since I still feel this since 2018 at times.  I am also extremely sensitive to the cold and everything is intensified until I warm up


by AgentX86 - 2021-12-22 15:41:49

My first reaction was that 500ft was absolutely nothing, then I got a little intrigued.  What exactly is "nothing" and is there a way to realate it to something real?

The "normal" atmospheric pressure at sea level is 1013mb.  At 5000ft, the mean pressure would be 843mb or 83% of the sea level pressure (17% drop). Is this a lot? Some think they can feel a storm coming "in their bones".  The eye of a category-4 huricane has a pressure of 920 to 944mb. Can you feel 5000' or is a nocebo?  Seems like an interesting question to me (no answers here).

BTW, the normal atmospheric pressure at 10,000ft is about 28% of sea level pressure.  At 14,000ft, it's about 14%. It's easy to see why oxygen gets to be a problem at high altitudes, particularly for those who have heart or lung problems.


by ar_vin - 2021-12-22 17:21:21

Most people don't experience the effects of altitude below around 7000 ft but clearly some people feel the effects of altitude even at 5000 ft or lower. In altitiude medicine anythng below 7000 ft is not considered high altitude. Also, children (15 and under) tend to experience ill effects of altitude more than adults. Over many years I've seen this myself in my numerous trips up to higher elevations with varied groups of adults and children for skiing, hiking, backpacking, camping etc during summer, fall and winter.

At any typical ski area in the Western US (Colorado, California, Utah etc) you'll see thousands of people of all shapes, sizes, ages and genders who have no trouble with exertion. The ski areas in the Sierra (northern California) range in elevation from 7000-9000+ ft. Some even make a day trip up to the mountains, ski for the day and head back the same day. Others might spend multiple days skiing and will spend a couple of nights in a nearby hotel or vacation rental; these accomodations are probably a bit lower in altitude than the ski resorts.

It is a fact of altitude medicine that sleeping at altitude can feel much worse than just spending a day at altitude and descending. Most people start to feel better after a couple of nights at altitude even if, at first, they feel some discomfort. 

The highest mountains in the contiguous US are all below 14500 ft. which is not really considered very high altitude by the measures of mountaineering. But even at these relatively "low" altitudes there have been fatal cases of altitude illness in experienced mountaineers. It is always good to understand and know the signs of AMS (acute mountain sickness) which. if ignored, can progress to HAPE (high altitude pulmonary edema) or HACE (high altitude cerebral edema). Both HAPE and HACE can be fatal. The *only* "treatment" for AMS is to descend to an altitude where the symptoms of AMS resolve.




thank you all

by Alexander - 2021-12-22 17:30:19

I'm going to order that book ar_vin. I guess now that I feel like I've healed, now's the time to better improve my physical conditioning I suppose. I truly appreciate everyone's input. I've been here for about 2 months or so, I suppose I have not acclimated yet.

Acclimation to altitude

by ar_vin - 2021-12-22 18:50:52

In two months you're likely fully acclimated to altitude. However, you might need to work on your physical conditioning. In addition your body is likely still healing from the procedure and getting used to being paced. It appears that you've had at least one round of settings adjustment; it can take a few adjustments to get the settings dialed in for your needs.

Please keep us posted on progress!


Atomspheric pressure

by sgmfish - 2022-02-05 20:12:16

"BTW, the normal atmospheric pressure at 10,000ft is about 28% of sea level pressure.  At 14,000ft, it's about 14%."

This is not correct. Perhaps you are reading a chart incorrectly. Atmospheric pressure at 10,000ft is about 70% and at 14,000 about 58%. Before my PM install, I'd gone to 14,000 many times (even camped there), and I can assure you I would not be here to talk about it if the pressure were 14% <grin>. Once I hiked to 17,000 without ill effects. (BTW, what we mountaineers call the "death zone" is about 26,000 and has a pressure of a around 35% of sea level pressure. Even in youthful perfect health, above the death zone one doesn't live much more than a day.)

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