Max Heart Rate Set Too Low

Hi All,

I have Brady Bradycardia so pacemaker was installed to keep it at 60bpm. I just found out 3 years later that the pacemaker also ramps up my heart rate faster and limits it to 150bpm. At the time of install they did a stress test and my heart worked great ramping up and recovering quickly. Now I find working out that my heart rate ramps up to 150 and stays there no matter how much more I push. I am used to seeing my heart rate reach 175. Also now it stays at 150 while recovering for up to 4 minutes after exercising. (I'm 62 and workout almost daily.)

My question is, is there any benefit to restricting my heart rate to 150 when there was no issue to begin with? Could this lead to other issues when pushing hard?

Thanks for any input.








by stevebne - 2023-01-06 20:40:04

Hi Mike

Depending on your heart disease, the MSR is often set at a seemingly low rate to prevent dangerous arrythmias such as heart block or worse which occur at higher rates. Best to check with your cardiologist whether it is safe to go higher. This may require an exercise test.

My MSR is 150 as I get HB at higher rates. I am a triathlete and have just learned to accept that my MSR is lower than my lactate threshold, let alone max HR. This means that all my Garmin and TP HR based metrics (VO2 max, ec) are wrong.


upper limit

by Tracey_E - 2023-01-07 09:40:39

I would ask for another stress test to see what's happening. If your upper limit is 150 but you were getting to 175 before, you were doing that on your own. The heart can go as fast as it wants on its own, the pacer can only assist up to the upper limit. They might be able to turn the pacer higher, but they'll want to see how your heart handles it first. 

Some pacers don't go much higher than 150. 

Agree with Tracey_E

by Penguin - 2023-01-07 14:04:06

Agree, your upper limit won't limit your heart rate.   

Tracey-E's comment - Worth checking if you have one of the pacers which don't go much above 150 bpm.

Sometimes it's difficult to get above the max heart rate programmed if you have a condition which makes it difficult for the heart to rise to the task .  Ask your EP / Doctor if your heart has such a condition.  As Tracey-E says an exercise test might be suggested. 


High heart rate

by Old male - 2023-01-07 18:48:15

Personally, with an already malfunctioning heart, I wouldn't want to see my rate anywhere near 150.  What is the health benefit vs. risk?

old male

by Tracey_E - 2023-01-09 09:39:10

Everyone is different and we are all paced for different reasons. If what is wrong with our heart is fixed with the pacer, and we are otherwise healthy, it's perfectly safe to go higher. After a stress test to make sure things look good when I am pushing hard, my upper limit was set to 190. I don't get that high, but that gives me a cushion over the 160-170 I need. Below 150 and I'm not working very hard. That would be too much for some people, but for many of us, it's perfectly safe and even encouraged. My ep would be on my case if I wasn't working out regularly. 


by Old male - 2023-01-10 00:18:33

I  have an ICD for Vtac episodes and low EF, not a pacemaker.  However it also is set to pace at 80 bpm.  Persistent Afib too.  Meds for years to control rate.  Last stress test about 5 years ago required chemicals to get rate high enough. If I remember correctly my device is programed to activate about 190 with pacing attempt then zap if that doesn't work.  I've trained in gyms regularly most of my life.  The big Covid shut down interruption has thrown me off track as my gym (owned by local hospital and medical group) for 20 years closed permanently. Have been semi regular recently.  Miss the good times and many friends from the gym.  Thanks for your comment.

HR Upper Limit

by RogerK - 2023-01-10 14:01:27

Hi - I am new to the pacemaker world, and the group, so some of what I say may be naive or incorrect.  I am a active Masters Swimmer and have had my PM set at 50-130.  I was concerned that the 130 upper limit would not be enough for me, so I questioned my electrophysiologist about it three times during my last appointment.  He was very clear to me, that at least with the PM that I have (Bost. Scientific Accolade) the upper limit is not set as a 'governor' on what my heart rate can go to.  Rather, if my activity level is demanding an HR greater than 130 then that is exactly how my heart will beat.  The PM will not damper my physiological demand for heart function below that which my body is calling for.  I have been back in the pool training now since Dec 23, and my Garmin Swim Watch has recorded my heart rate as being above 130 and even above 140 on a number of occasions.


steve triathlete

by stevebne - 2023-01-10 17:04:17

Hi Roger

It all depends on the underlying heart disease. I have chronotropic incompetence so without a PM my HR is in the 40s all the time. Hence, my max HR is whatever the PM is set at. Note that my Garmin Fenix + HRM strap sometimes has a different higher reading but when these have been checked with the tech at an exercise test session, Garmin was wrong and incorrectly recorded a higher rate.

You seem to have a different problem and are able to self generate a high HR. 


Upper Limit - update

by RogerK - 2023-01-26 12:16:08

Updating my earlier comment, this past Mon, the EP increased my upper limit to 165.  I was finding that in my swim WKOs my rate was frequently above the prior limit of 130, and even got to 160 on occasion.  I had no arrythmias above the 130, but was concerned that if I did I could have a problem if I wasn't paced.  The EP, along with the rep from Boston Scientific considered everything - including my training regimen - and increased me to the 165.  They will increase it more if it becomes necessary down the line.

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