Pacemaker settings.

I just got my device check info. and it has my settings at 60 low and 120 high. I have sob walking up stairs. Could raising upper limit help with that. Iam 76 and quite active.I can walk 3.5 mph on lever ground with no problem. I have afib and minor heart failure.

  Thanks, for any info.


Perhaps Atrial Fibrillation is causing your shortness of breath?

by Gemita - 2022-04-06 15:30:16


My upper rate is set low as well at 130 bpm.  I am 72.  I am going to ask if it would be possible to raise it when I return to clinic in a few months.

I feel though in your case that both Atrial Fibrillation and your minor heart failure will be contributing to your shortness of breath on climbing stairs.  It happens to me when I am in AF and I can really struggle and get chest pain as well going upstairs, whereas without AF I have no issues.  But please ask your doctors.  You could also ask for a treadmill test to see how well you perform under stress to find a safe “setting” level for you.  I might also ask and we can compare notes in the future.

Hopefully you are being treated for your Atrial Fibrillation, although medication like a beta blocker may also slow us down and make climbing stairs more difficult.

I attach a heart rate calculator link which might be helpful which you will need to copy and paste into your main browser:-

I agree with Gemita.

by Good Dog - 2022-04-06 16:00:22

My limits are similar to yours. Mine are 50-120 bpm. Without knowing if your activity monitor is turned-on, it is hard to know. I would take my pulse at the top of the stairs if/when I am out of breath. If it is not maxed-out at 120 bpm, then raising the limit will not help (assuming the activity monitor is not turned-on). I think as Gemita said, it is more likely to be your HF or Afib causing the problem. I also wonder what your most recent EF is?

This is something it is important to run past your Doc. Especially if it is a new symptom!




by tachy - 2022-04-07 16:47:26


 Thank you for your answer. I called clinic and they believe it is caused by both afib and heart failure. I am  taking Pradaxa, and Lasix, for problems.I am going to pursue increasing     top rate at my next visit.  Iam still trying to digest all info on pacemaker report.

 Thanks, I will let you know what they say.


Rate Response

by Gotrhythm - 2022-04-09 14:25:41

You might want to also ask about your Rate Response settings. If you tend to climb stairs fast, you might need your pacemaker adjusted so that it can keep up with you better. Rate response is not just about the maximum rate but how quickly it speeds up to that rate.

When my EP changed the RR from medium to the very fastest (very unsusual for someone my age!) it made all the difference in allowing my to climb stairs without getting SOB.

Some people find the sensation of having their heart speed up or beat hard very unsettling, so cardiologists are kind of conservative when setting the RR, expecting older people to climb stairs slowly, assuming they can climb at all. They probably wouldn't start someone your age on a very quick RR.




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I have a well tuned pacer. I hardly know I have it. I am 76 year old, hike and camp alone in the desert. I have more energy than I have had in a long time. The only problem is my wife wants to have a knob installed so she can turn the pacer down.