I have had a pacemaker due to Bradycardia. I still feel it when those episodes kick in, but the PM stops it going below 70 bpm. I think it happens sometimes whem I exercise because I feel tired and have to slow down. Anybody else with this issue? 



by Tracey_E - 2022-12-20 16:31:04

You may need your settings adjusted. It can keep you from going below 70, but it can also make sure your rate goes up appropriately on exertion.


by Gemita - 2022-12-20 16:53:29

Jeremy, thank you for your post.  I suppose we have to remember that bradycardia is an electrical disturbance which causes our hearts to slow down, to pause or to throw out irregular heart beats depending on the degree/cause of our sinus node dysfunction.  Whenever intermittent disturbances occur, we are bound to feel some symptoms even with our pacemakers set at a steady 70 bpm.  Mine is also set at this rate.  

I see from your history that you have had some problems with your Rate Response settings.  I do not know whether this has been fully resolved? 

It is difficult to know whether your symptoms are caused by a pacemaker setting that needs adjusting or whether there is something else going on?  It certainly sounds to me as though you might also have some additional electrical disturbances like ectopic beats or other arrhythmias present that could be causing your symptoms of tiredness or the sensation that your heart rate is suddenly dropping when you exercise?  I know when I am having arrhythmias, I can feel extremely tired when I try to push myself and I certainly experience some uncomfortable sensations as though my pacemaker is not keeping up with my requirements.  I am also having problems with RR (Rate Response setting) which has now been turned off because I had an increase in my arrhythmias with it turned on.  This of course is not the answer for me either.

Do you have home monitoring.  You could always send a transmission to your clinic and get them to check whether you are in sinus rhythm when your symptoms occur or whether you are having some rhythm disturbances?  That together with pacemaker setting adjustments is all I can suggest Jeremy.  Are you on any meds?  They may either help or worsen some arrhythmias in my experience so you may need to work with your doctors until you find something suitable for you

Understanding settings

by Penguin - 2022-12-22 09:57:06


Just wondering what type of pacemaker you have and whether you have something called chronotropic incompetence which is when your heart rate doesn't rise appropriately when exercising.  Rate response is usually programmed to help with this. 

That said, rate response works differently on different pacemakers and some PMs are more efficient than others at detecting when you need the extra help. You may feel tired when exercising if your device doesn't have a brilliant rate response function or if it isn't great at detecting the type of exercise you take part in. For example some PMs work out that you're exercising from your upper body movements and others monitor your breathing.  If you're a cyclist and your upper body doesn't move much when cycling but you need extra help from rate response some pacemakers won't be very helpful (that detect upper body movements) whilst others will really help (that work with your breathing).  Ask your pacing team how your device detects exercise and how rate response works. 

Do you have a heart rate tracker to wear at the gym? This might help you get some idea of how your rate response is behaving. Does your heart rate go up easily as you increase your exertions or does it struggle to get much higher than your upper pacing rate.  .  An exercise stress test would help your pacing team work out what is going on and how your heart and the pacemaker behave during exercise. 

In terms of the pacemaker dipping below 70 bpm, you might have something called a 'hysteresis' programmed.  A hysteresis is like a 'second chance' for your sinus node to work before the pacemaker jumps in. For example if you have a 10 % hysteresis programmed and a 70 bpm base rate, the device will allow your heart rate to reduce to roughly 63 bpm (10% of 70 bpm) before it decides to pace you.  This can be a good thing if your sinus node function is working intermittently and makes sure that the pacemaker doesn't 'take over' completely and pace you when your heart could manage itself if it was given a second chance. 

Does any of that help at all? 

Take care 



by gingerrs - 2022-12-22 23:30:23

I have the same problem of feeling the pacemaker going off. I am tired a lot off and on but I do feel better after the placement of pacemaker.


by JEREMYP - 2022-12-28 22:20:49

I have a monitor but the woman who has the data is hard to reach. I'm not too worried at this time as the incidents are few and far between. I appreciate all the comments though.

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