Active Triathlete with 3rd Degree Heart Block

I just got my PM on March 29th, 2019.  I was feeling dizzy on the morning of Mar 26, went to work and just blacked out.  My co-worker told me my head hit the concrete and my safety glasses were 5' behind me when I work up.  At the ER, my EKG heart strip showed a 15-20 sec. 3rd Degree Heart Block episode.  They immediately put on pacer pads and told me I will need a PM and I thought they were out of their minds!

After I was admitted to the Cardio Clinic, all the specialist told me it's a "no brainer" for complete heart block patients to receive PM implants.  After praying on this matter for four days I decided to give them the nod to implant the PM.  The next time I black out I didn’t want it to happen when I’m driving.

I’m a very active 140lbs triathlete (25 yrs.) with no previous signs of heart issues.  I will take 4-5 months off before training.  Are there any triathlete out there who got back into heavy duty training after a PM? 



Welcome to the club

by IAN MC - 2019-04-22 15:29:02

There is a surprising number of triathletes , marathon runners and competitive cyclists who end up with pacemakers and the first sign of a cardiac electrical problem  often occurs very suddenly as it did with you.

It is POSSIBLE that you will be able to carry on at the same level of performance as before but this is not definite.  The determining factor is whether or not your heart will still respond to exercise and increase its heart-rate when pushed  ..... if not, this is known as " chronotropic incompetence "  and although your Medtronic pacemaker will detect upper body movement and trigger off extra heart-beats you may struggle particularly with cycling.

With 3rd degree block this may not apply but nothing is guaranteed ... the only way to find out is to re-start training and see how you feel . I think you are being ultra-cautious to wait 4 or 5 months  , apart from a slight concern re arm movements when swimming. 

I felt OK  to re-start running 6 weeks after my implant date.

I was much luckier than you though   ;  I avoided concrete when I fainted after a 10 mile run.

Best of luck


Marathon runner here

by marathonpaced - 2019-04-24 01:28:02

Not a triathalete but 38 year old marathon runner and just got my first PM 2 months ago for complete heart block.  I felt good enough to start back running at 2 weeks (slowly!!) and at two months out I’m doing 10 mile long runs and about 25 miles per week.  See how you feel but there’s no reason you need to take 4-5 months off if your body feels ok and your EP approves.  Mine told me I was totally fine to start running whenever I felt up to it and that hard training and distance running wouldn’t be an issue. 

I think it’s funny that I was able to run long before I could do yoga because of the arm restrictions!  You’ll probably need to hold off on swimming for a bit because of that and even after 6 weeks, my pec muscle was still tight (sub pec implant) but that’s been loosening up more and more with movement and gentle stretching.  Biggest issue for me is my sports bra rubbing the incision.   

Good luck!!


by EilishBow - 2019-04-27 10:00:40


I am not a triathlete buuuut I have a very active life style. I also have a pacemaker for third degree heart block. I got this when I was 11 and I am now 22! Since my pacemaker I have swam competitively and long distance. Been part of the army cadet force and therefore experience high levels of physical activity. I am a paramedic so am constantly lifting (e.g people) and am active every day. My only issue ever when I first got my pacemaker was finding the settings that were right for me. Now that they are my pacemaker is no hinderance at all but it takes a while to find what works for you. Before I got to where is right for me I got out of breath easier than I ever did. They can do stress tests to help understand why and how your pacemaker is working when you are exercising in order to find the right settings.

I also had a problem as they accidentally didnt turn my rate response on for 4 years!! So there was me wondering why I felt out of breath when my heart rate could not go any higher than 60bpm ! Just listen to your body, and dont let them change things without explaining to you what they are doing. Sometimes I feel like they see people with pacemakers all the time that they forget even the smallest settings change can make us feeling horrid!

But good luck with your journey and welcome to the club :P 

Be prepared for setting adjustments

by Elisabet - 2019-05-04 22:39:58

I want to reiterate what ElishBow said about settings. I'm not a runner or triathelete but I can tell you settings make all the difference in the world. Mine was also left on the "old lady" settings that they may start you off with - I had a stroke for totally unrelated reasons right before I was supposed to get my 6 month tune-up and that kind of fell by the wayside for way too long.

What happened with me is that, while I have complete heart block, it's the signal between my atrium and the ventricles that is blocked. My heart rate is controled by my bodymost of the time, so it theoretically responds to exercise. However, the upper limit was left in the default setting. What that meant was that the PM would never go faster than, I think it was 130. Whenever my "natural" rate crept up to 132 or so, the PM would sense the atrium beating but it was too soon to fire for my ventricles. So it would skip a beat every second or third or fourth time, effectively putting me in to bigeminy or trigeminy or whatever-geminy - so my ventricles would be beating at 130 and then suddenly drop to half or two thirds that number. 

Obviously, that put a cramp on my performance, lol. Mostly that was happening when I was on the erg. The Medronic tech and the nurse thought that the rowing motion wasn't providing enough verticle motion to make the device recognize that you needed a faster pace - it works better for running. They told me I could tap my chest over my PM like bicylists often have to do. Of course that wasn't actually the issue since my atrium was almost never being paced.

The EP was really great at getting it sorted out, and the new settings, better for a younger more active person, have made a big difference in what I can do. 

For what it's worth, when the PM was put in, it was for intermittent complete block, so that setting didn't really make much difference for those two or three short episodes per day. My situation was deteriorating rapidly though and I was completly dependent less than a month after my post-op check, but no one knew for almost six months. If I had continued to need pacing less than 2% of the time I doubt that setting would have affected my exercise at all. My inability to exercise hard was actually a pretty good clue about what was going on, but I didn't know that. 


by cmoser3558 - 2019-05-07 20:36:29

I am not a triathelete; however, I am 61 years old and very active physically (run 6 miles or lift heavy every day). I was running within 3 days of my pacemaker surgery and lifting at 90% of my max within 3 weeks of surgery. Like most things in life, you define with your self talk whether the experience is positive or negative. I viewed it as a temporarily set back. Now, I'm 3 months post surgery and I seldom think about the fact that I have a pacemaker. Go for it! Listen to your body but not to any limitation that someone else is trying to put on you. 


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