High Heart Rate Walking

Hello all -  Haven't been on for a while and wanted to continue conversation about heart rate and walking.  I received PM May 5th this year.  When I go for a walk my heart rate goes up 124 and I get slightly short of breathe when I stop.  My Cardiologist said I need to be on antiarythmia med to stabilize my rate.  The EP says they don't see anything wrong get on with my life.  This after they changed the RR rate and the change wasn't tolerable. Have any of you experienced this? What was done to help?


High heart rate walking

by Gemita - 2022-10-20 03:23:43

Pacer, I am sorry you are still having symptoms and concerns about your heart rate.  First, you need to establish whether this is a rate response sensitivity setting issue or a heart rhythm problem?  You have received conflicting views which is unhelpful.  

Holter monitor for 7-10 days might help provide more information and you can then challenge yourself by walking and your monitor should pick up any rhythm disturbances causing an increased heart rate.

Alternatively, ask for a treadmill test and work with your pacemaker technician to get your rate response settings adjusted for you.  Rate Response can be difficult to get fine tuned to suit each one of us, but it is always worth the effort and you and your technician need to be persistent.  I have just had my rate response turned off for this very reason, but it is not the answer either.  However in my case, I do have arrhythmias and it was felt rate response had had an adverse effect on them.  I am currently in contact with my clinic to try to get this problem dealt with.

I see you have had intervention for heart disease (stent in LAD artery).  You also have a history of AF/tachycardia which is not uncommon with heart disease.  What meds do you take?  It is possible that your symptoms are related to your heart condition, so I would go back to your doctors for a proper diagnosis before doing anything else.

As an arrhythmia sufferer, runs of high heart rates (above 100 bpm) are fairly common for me and I usually tolerate them well unless episodes become prolonged when I might get chest pain and breathless.  However I have no history of heart disease, only electrical disturbances (Sick Sinus Syndrome).  I take a low dose beta blocker to control my heart rate.  I did try anti arrhythmic meds for several years but they can be difficult to tolerate and cause more side effects than either a low dose beta blocker or calcium channel blocker.  With any arrhythmia, stroke protection if needed and heart rate control would be two of the most important treatments.

I wish you well Pacer54

Thank you Gemita for your information.

by Pacer54 - 2022-10-20 22:50:41

I was told that I have SSS.  They put the PM in to take care of the Bradycardia but as noted above I have Issues with high heart rates when I exert myself.  Drives me nuts and I feel tired after my rate goes down.  I need to get moving to get this weight off.  I am currently on 1 Beta Blocker Carvidolol 12.5 mg x2 daily.   Tried Diazetrem and unable to tolerate it.  

I am seeing the EP next week.  Don't have much hope that they will do anything but will see.  Thank you again for the info!  It is very much appreciated.

I have the same problem on a beta blocker - weight gain

by Gemita - 2022-10-21 07:44:56

I wish you luck for next week.  I sometimes wonder if we put on weight because beta blockers may affect our metabolism, slowing everything down.  It may take an even bigger effort to lose weight for some of us.  I see you have tried an alternative rate control med in the form of a calcium channel blocker, Diltiazem, so you have experimented with your medication already.

I also feel tired after experiencing a tachy arrhythmia and the longer the arrhythmia lasts, the longer my fatigue goes on.  In your case however, while your EP may be perfectly happy that your arrhythmias are reasonably well controlled, clearly your cardiologist is not and wants you to have further treatment.  The two of them need to come together to decide what further treatment, if any, is needed to support your heart condition and to try to prevent any future problems.  

I would discuss with your EP/cardiologist whether your heart function is good.  Have you recently had an echocardiogram to check your Ejection Fraction for example?  I would also ask for further monitoring as previously mentioned to try to pinpoint the exact cause(s) for your high heart rates.  Have you by chance started getting arrhythmias (like atrial fibrillation) again or is this a Rate Response or another pacing problem?  These are the questions for your EP Pacer54.  

It can be normal after an implant to experience worsening heart rhythm/tachycardia symptoms which may often settle without treatment.  I had tachycardia symptoms for several months while my heart was healing and getting used to pacing.  

high heart rate

by new to pace.... - 2022-10-21 12:42:39

You might try to avoid eating the foods that cause the high  heart rate.  Such as smoked or processed foods, aged cheeses, pickled and fermented foods, chocolate.   Keep a food journal see how you feel after eating the above.  Might be all you need is to avoid some of these.

Of course make sure you stay hydrated.

new to pace  

It is complex....

by Mike417 - 2022-10-21 21:56:39

So, I am on carvedilol, same dose, and it can cause fluid retention. So you may need a diuretic to get rid of the fluid. The fluid makes your heart work harder due to capillary resistance, so that is not good. Weight loss is also important for the same reason.

Regarding HR, why do you think 124 is high, and why do you think it wouldn't go high with walking?  When I am walking at a brisk pace (>1.5 mph) my HR goes up to 120-140s. If you have not been exercising regularily your HR will go up with even mild exertion; then, as you become conditioned, your HR won't go up as much as it did before.



by MinimeJer05 - 2022-10-25 10:54:21


It sounds like everyone else here has provided you with some great information and tips -- I hope this helps you on your journey. I do agree with the previous poster in that, "what do you think is a high heart rate?".

I know many people with PMs are so use to a very low rate that when they get a PM, anything becomes "high" or "unusual" when in fact, that is how a "normal" rate should be.

When I am walking around my house and just existing, I think I range from 90-110ish. If I am actively going for a walk, I expect it to be 120-140 depending on how intense I go. A hard run/jog/lifting session is going to knock me into 140-170 without question.

Has your EP or cardiologist established what rates you should be seeing based on your activity level?



Update on High Heart Rate with exertion

by Pacer54 - 2022-10-27 22:29:05

Saw the EP Tuesday rather ARNP.   Only had two small, only minutes, of Afib.      Said nothing in the Vetricular chambers which is a good thing.  Talked about my heart rate increase upon exertion.  She said going up to about 113 is reasonable.  Said having sinus tachycardia.  She decided to add another 12.5 mg of Carvidolol a day.  One pill in am and two at night to see if that helps. Guess time will tell.  

Thank you for all of your support and thoughts.

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