Exercise Machines Restricting PM?

Hello all,

Haven't posted a new question in a while (which is progress!), but I am noticing some weird exercise trends that I am unsure of.

Had my Medtronic Azure implanted in early Sept. Also have a mechanical aortic valve. Things have been going good, for the most part. My BPM when sitting around and doing nothing can range anywhere from 70-90, which has been my normal for quite some time.

I noticed lately while up and walking around the house, I am able to get it up to 120bpm, which seems high to me, but I was also having vision issues right after the implant, so they urged me NOT to exercise and I think a month and a half of no exercise can easily push those numbers up.

I have since gotten my vision stuff under better control (additional blood pressure meds were apparently the fix) and have started working out more consistently.

When I go for a fast-paced walk or jog around the neighborhood, my BPM is anywhere from 130-160, which feels fine and normal and like I am getting a good workout. No concerns there.

However, when I tried returning to my gym last week, I hopped on an elliptical for 45 mins and could not get my heart to get over 118bpm. I was sweating to death and FEELING like I was getting a good exercise, but it would not go over that number.

The next day, I tried the same thing on a treadmill and experienced same results.

Is that okay? I know for sure I have not conditioned myself to all of a sudden exercise at those rates -- elliptical sessions before my PM were always in that same 130-160 range, depending on how hard I pushed myself.

Is it SAFE to keep using these machines if my bpm doesn't increase or am I doing any sort of damage to myself by continuing to push?

I have a cardiologist appt in Dec and I plan on asking these same questions, but I wasn't sure if I should back off the equipment in the meantime? It's getting harder to go for walks and jogs outside in Minnesota as the weather drops to much colder temps, so I'd love to transition to the gym and use ellipticals and treadmills, but that low bpm while working out has me concerned.

Wondering if anyone else has experienced something similiar or has more information in regards to why this might be happening?

Hopefully it's just a fluke or another minor speedbump on the road to recovery.

Take care all



Exercise Response

by Julros - 2021-11-12 14:57:13

I think most of us active pacer peeps have experienced this issue. When walking and running, I am able to get my pacer up to the maximum and it feels pretty darn good. However, when cycling not so much. I am only able to get up to about 110. Others can probably explain better than I, but the device depends on the movement of your upper body, and if it doesn't sense movement, it doesn't increase in speed. Your device is fairly new, so there may be some room for adjustment in rate response. 

Congrats on getting back to the gym. 


by MinimeJer05 - 2021-11-12 15:14:40

Thank you for the comment Julros! I had a feeling it was possibly related to rate response. Did you have to get yours changed or do you just keep the cycling around 110? It just feels so weird to know that it should be higher than it is.

I don't mind exercising with it lower, but I wanted to make sure I wasn't doing any sort of damage or causing issues by "confusing" the PM/my heart.



by Julros - 2021-11-12 16:27:47

I did get mine changed, but it took a few visits and then I finally got a treadmill. Before adjusting, my heart rate would only increase to 80 while walking or cycling, and that didn't feel so good. I'm told the only way to increase the rate response at this point is replacing the pacer with one that has a "minute ventilation" feature. So maybe in 9 years or so, I'll look into that. Otherwise, I just huff and puff my way up the hill, and stop if I need to. I fell once when I just couldn't pedal fast enough, and the abrasion on my knee and twisted ankle  convinced me that there's no shame in walking. 

You are not going to confuse the PM or your heart. You might have better luck on the gym treadmill if your goal is increasing your heart rate. 


Rate response tricks

by AgentX86 - 2021-11-12 19:35:35

One trick some have used successfully is to pat your pacemaker to turbo charge it.  It sounds silly but what you're doing is tricking it into thinking your feet are moving faster than they are.  It only works while you're patting it and people may give you strange looks but it may work.

You really need to get with your device techs to get rate response optimized.  It won't be perfect but it will help.

Easier to walk on treadmill

by PacedNRunning - 2021-11-17 01:20:46

I experience the same! When I run outside my average HR can be 140's-150's depending on the terrain I run.  Hills I tend to run higher than a flat run. When I run on a treadmill my average is much less 120-130 because it's much easier to run on a treadmill. Takes less effort than outside where you have to propel yourself. If you feel fine, I woudln't worry. I dont' use rate response because my own sinus node responds appropriately but I notice the diffence in HR between outdoor running and treadmill.  I feel like the treadmill gives my heart a break from running so high 

Tap, Tap, Tap

by lrmcnulty - 2021-11-17 22:14:50

Yes, as AgentX86 previously mentioned you do need to tap the PM ... I am a cyclist & was experiencing HR drops expecially on the hills so, I would pat 30secs before hitting the hill & my HR would elevate & get me over the incline. I had an interrogation last week & my cardiologist made an adjustment.  Since the adjustment I haven't needed to tap while cycling; my HR is now much more responsive to my physical demand. Not sure what was changed however, I believe it may have been something to do with the ADL setting.  I will ask her next time I see her; it is beautiful not having to tap!  PM is a Medtronic Azure W2DR01.

Tapping Away

by MinimeJer05 - 2021-11-19 09:49:02

Hello everyone,

Just wanted to circle back and say thank you for the tips! I am planning on making it to the gym this weekend and will "tap away" while on the treadmill and elliptical. Hopefully, it helps some.

I have a cardiologist and pacemaker appt set for Dec. 16th. Going to try to do my own studies and collect some data until then so I can positively explain to them what is going on so that they can make the right adjustments for me.

I'm mostly just terrified that I'm going to explode my heart on that elliptical as I usually push myself pretty dang hard (easily up to 150-160 on a good day) and seeing it "bottom out" at 120 is weird to me. But as long as I FEEL okay, then I doubt I am doing too much harm to myself. I'll make sure to relax for a few mins after getting off the equipment and be aware of my surroundings.

Time to stop fearing life and instead, start living it :)

Take care all


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