High Heart Rate with Certain Exercises

Have always been interested in exercise my whole life (used to nordic ski competitively, swim, play hockey, play handball and tennis). I continue to do swimming, hiking/walking, light weightlifting, gym machines (stationary bike, stair climber, elliptical). About a year ago I noticed a highly irregular, slow heart rate and did all the tests which showed I had first degree heart block along with bradycardia. I continued to do pretty hard cardio like hiking up local hills and swimming, but could no longer get my heart rate above about 110 absolute maximum, whereas previously it was easy to get it up to 130-135 and cruise along peacefully. Had a pacemaker implant on June 22, 2023 and am still adjusting to it. Biggest problem is rapid rise in heart rate with certain exercises (e.g. stair climber, stationary bike), as high as 160, which is way over my max (I'm 77 years old), even when going really slowly and with low resistance. Some slight lightheadedness accompanies it. Have not been to a PM clinic since surgery and a visit is not scheduled until September. I have a Biotronik Edora 8 DR-T, but have no idea of the current settings other than they are probably the default settings. Any ideas on what may be happening would be appreciated.

1 Comments

Way over max

by AgentX86 - 2023-07-05 22:36:43

This is why knowing, at least the rudimentary, settings is important.  Your cardiologist should have, and probably did, set your max to something lower.

Since you have a first-degree block, it may not be appearing when this is happening. In this case the pacemaker can't limit the max beause the heart is in complete control.  A first-degree block isn't usually a reason for a pacemaker so I would guess that the Bradycardia is the reason and that it's SI node related (SSS). Most, with higher grade block will have a complete AV disconnect so the pacemaker controls the ventricles.

Anyway, all this is the long way around saying that it doesn't sound to me  like anything that the pacemaker is doing, or can mediate. Since you have Bradycardia, that I'm assuming, caused by a defective SI node, it's also responsibility for this tachycardia.  Tachy-Brady is fairly common with Sick Sinus Syndrome.

All of this is a guess so you need to see your cardiologist.

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A properly implanted and adjusted pacemaker will not even be noticeable after you get over the surgery.