Heart Rate while Exercising

Hi All,

I'm a 54 y/o male and this is my first post here.  I had bradycardia and junctional rhythm for quite some time and in November of 2022, I received my first pacemaker.  

Initially, the rate response was set too high where a simple walk w/out any exertion, would jump my heartrate up to over 120 bpm.  I then asked to have the rate response turned off which caused the junctional rhythm symptoms to come back and I also felt somewhat winded while walking.  My doctor adjusted my min heart rate threshold from 50 bpm up to 60 bpm and he also re-activated the rate response again but at a much lower setting, which has been great.  

I started doing more intense cardio exercise, such as jumprope, and I've noticed how out of breath I easily get exercising at that level, and that my heart rate will not exceed 128 bpm.  My min/max threshold is 60/140.  

I intend to check w/ my doctor but has anyone experienced something like this where further adjustments to their pacemaker made it easier to do cardio exercise?

Thank you,




by Tracey_E - 2023-01-27 15:55:34

What was causing the bradycardia? That makes a big difference in what settings work best for us with exercise. 

It's possible you need a middle ground with the rate response. RR can get your rate up higher on exertion than it is now, but the cost of that may be some unnecessary jumps when you don't need it. I choose to have mine aggressive. It's annoying when I get sob walking across the room, but it's great when I work out, so it's a choice I made. But there should be something in the middle between where you are now and the previous settings.

It could also be that you got a bit deconditioned between the time your heart problems started and now, and it's just going to take some time to get back. 

Rate response at higher cardio level

by mikclark - 2023-01-27 16:33:30

Thank you Tracey.  I have sick sinus syndrome where my heartrate would fall below 40 bpm.  When my rate response was turned back on, but at a much lower setting, it seemed almost effortless to go on walks again.  It would be great if there were a way to set the rate response accordingly when my cardio activity is at a more instense level.  But as you say, maybe I need to find a middle ground w/ the rate response and see how that goes.

welcome to the club

by Tracey_E - 2023-01-27 17:57:13

Many of us have lamented that we'd love to be able to turn rr on and off! But settings are a prescription so even though the technology is probably there, they are never likely to give us that sort of control. Frustrating. But don't be shy about going back and asking to try something else.  Settings aren't one size fits all, and we don't always know what we need until we try it for a bit. 

Dealing with that now

by Mad Hatter - 2023-01-27 18:01:38

We are very similar--I'm 56, had pm inserted Aug 2022 due to SSS, initially set to keep above 50 with no rate response.  Was having light-headedness upon rising from a position with my head down, so they turned on RR.  This helped the light-headedness some but still having issues with intense exercises with my head down.  Cardio exercises like running and jump rope are fine and I regularly get up to around 160 bpm.  I have a Biotronik, so not the same manufacturer as yours, but thinking about asking for a more aggressive setting.  Did you have any issues with adjusting the min from 50 to 60?  My EP mentioned that, but I'm concerned that it might keep me from sleeping as I already have other issues affecting sleep.

Rate response

by AgentX86 - 2023-01-28 00:36:56

Rate response for an active person is always tricky.  It may not be possible to cover all bases.  It's like playing whack-a-mole.  In the end, you'll probably have to settle on a setting that sorta works for everything.

Mine is set as sensitive and as fast as it'll go.  Even so, it's  really not enough to do everything I want (stairs are an issue for pretty much all of us).  I can feel it kicking in when it's not really wanted.  Life's a trade-off.

Going from 50 to 60 and rate response

by mikclark - 2023-01-28 11:40:58

Good for you Mad Hatter on your cardio and heartrate at 160bpm.  I did get a response from my EP and he said they can definitely do some tweaking and will be sure to update on that.  As far as going from 50 to 60 bpm on the min threshold, I actually felt better with sleeping.   I didn't feel much of a difference in my chest when at rest or trying to fall asleep.  I almost felt more energetic when I went to 60 bpm.  

For AgentX86, after my PM procedure when the PM was originally set, I felt the rate response was too sensitive because a simple stroll outside would immediately drive my hr up causing anxiety.  

So fingers crossed on my next doctor's visit and adjustment.  Thanks everyone and I really appreciate the comments and support!

MDT Azure for endurance athletes

by Endurance_athlete - 2023-02-07 17:23:09

I just posted on this topic on another thread. I ended up replacing my MDT Azure with Boston Sci Accoladate and couldn't be happier.  Hope this link works: https://www.pacemakerclub.com/message/40000

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