correlation between over exercising and having to get a pacemaker

I had a pacemaker implanted on dec 27, 2004. I'm a 43 year old and was an avid jogger, sometimes jogging 5-8 miles a day seven days a week.

I was diagnosed with bradycardia which is a slow pulse rate. That in and of itself is normal for a person that works out somewhat excessively. The problem was I would have periodic pauses of 3 seconds or more. Because of this the doctor knew the recommendation for pauses over 3 seconds was to have a pacemaker implanted. I had a second and third opinion. The 2nd doctor looked at my holter monitor and stated he didn't think I needed the pacemaker. The 3rd doctor looked at my holter and stated that I could be sitting home, watching T.V. and my heart could stop. The problem with this was my wife was in the room at the time the doctor made the statement. I informed the doctor I had to think about it but my wife said, " I don't think there's anything to think about".

A few months after the procedure I was at the YMCA and I ran into a fellow runner that has basically ran most of his adult life. He informed me that he recently he had a pacemaker implanted. Based on the fact that we were both runners I mentioned to him that could it be possible that because we exercised excessively we had to get a pacemaker. Of course this is a coincedental. He proceeded to tell me that their may be some validity to my theory because he knows 3 other people (runners like ourselves that have pacemakers).
More recently a friend of mine called to say he needs to get a pacemaker.(another exercise fanatic).

I think pacemakers are great. I'm sure they've extended thousands and thousands of lives.
An M.D.'s jobs is to diagnose(assess) a problem and come up with a plan for a patient, which my doctor did.

My problem is I'm not sure if there has been enough research in this area. To have 5 people in one geographical area have to get a pacemaker seems a little more than coincidental to me.



13 Comments

Are All Pacemakers Needed

by SMITTY - 2009-02-28 06:02:28

Hello Cuddy,

Welcome to the Pacemaker Club, the club where there are lots of people that have a pacemaker when according to my guess, at the worst there was a 50/50 chance they and you did not even need one. Bradycardia (a heart rate below 60 BPM) is not unusual for people that exercise a lot, but then look at it from the doctors point of view. His job is to keep people alive whenever possible and to make money. You are still alive and he sold a pacemaker. Or did you get your pacemaker for free. Yes, I'm being sarcastic.

I have one that I needed about like I needed another hole in my head when I got it in 2000 at age 71. Mine has truly been a trip to hell and back and while it seldom causes me problems anymore, 75% of the time I'll find my heart rate at 60 or lower. But I've got it and at my age it is not worth the trouble to raise a ruckus and say take it out, especially since, like I said, it seldom bothers me. They tell me I'll have to get the thing replaced in the near future and when that day gets here, I will not automatically consent to it. I'll have hard evidence that it will help me before consenting.

So far as I concerned that doctor that stated that you could be sitting home, watching TV and your heart could stop took a cheap shot at you especially by saying such in front of your wife. You and I know that statement is true for anyone whether they do or do not have a pacemaker. But to imply in front of a wife that the implanting of a PM decreases the likelihood of your dropping dead is a sure way to sell a PM.

It is quite possible, as you say, that not enough research has been done to be able to establish the fine line of when a person like you absolutley has to have a pacemaker. But, the things are available and I think there is sufficient evidence to establish a case of the likelihood too many doctors are trying to be safe rather than sorry and make a few bucks in the process.

One final word before I tick off a few of my friends here. I know a lot of you would not be here if it were not for your PM. In fact this site probably would not exist if it were not for pacemakers, so yes I know many people are alive because of the invention of the pacemaker. I just wish there was a more scientific way of establishing an absolute need for a PM for those of us that fall into that gray area, or docs need for a high price surgery.

Good luck,

Smitty

Smitty......

by Pookie - 2009-02-28 07:02:22

very well put Smitty.

thanks
Pookie

thanks for the response smitty

by cuddy36602 - 2009-02-28 07:02:38

great response. thank you very much.

free

by Coolhandlule - 2009-02-28 07:02:39

I got my pacemaker for free.. yay canada

Good one Smitty

by ElectricFrank - 2009-02-28 07:02:49

You hit it on the head.

My response to those sort of statements is to say to the doc "Is that what you mean by science based medicine?"

Or during my semi annual cholesterol lectrure my cardiologist said "So how are you going to feel when you have a heart attack?". My answer was "probably not much for long".

My advice: Be wary of advice from a salesman.

frank

The other side of PM

by Smart Redd - 2009-02-28 08:02:47

Our HS principal, an avid runner, an extremely health conscious diet, and zero medical problems dropped dead during his morning run of a heart attack at 45.

Coincidence or not? I'm neither scientist nor doctor. I don't know if the Doctor needed money for his ex-wife or his new one. I don't know if entensive running, (like excessive stress causes problems) causes changes in the heart.

Perhaps it is the type of personality that thrives on running or a high exercise level that is the PM connection and not the running per se.

Just a comment from the devil's advocate, here.

Red

How low did you go?

by BillMFl - 2009-02-28 09:02:47

Under 60 at rest is not unusual for an avid runner. Under 50 is the definition of brady at my hospital. That is when the alarm goes off if you are hooked up to a moniter. My cardiologist says that if someone is obviously very well conditioned, not symptomatic (Not feeling faint, passing out, etc) and has a resting pulse close to 50 then there is no immediate need for a PM, but close monitering and regular check ups are advisable. Like you, I was in top shape, but my pulse was down to 40 even if I was walking around. With a high ejection fraction I was hardly ever symptomatic, but..... I did begin to have brief moments of near blackouts. I could go like hell on the treadmill tests and my heart rate would go up normally, but it kept getting slower if I wasn't exercising. So once again, were you symptomatic? How low was your heart rate? Answer those two questions honestly and you will have your answer. I think a lot of us, in the back of our minds, wonder "did I really need it"? But then the price of denial can be very extreme. Roll of the dice eh?

Heart Problems

by SMITTY - 2009-02-28 10:02:36

Hi Red,

I don't see what you had to say as coming from a devil's advocate. I think you have giving a perfect example of how anytime one of us can have a heart attack and die. What you didn't tell us is did this fellow have a pacemaker, or had one ever been recommended?

There are many heart problems that a pacemaker cannot help. At the bottom of this is a list of heart problems (not the complete list I know but all that I have) many of which can kill, but only a few of them can be helped by a a pacemaker.

When I had my first heart attack in 1982 and learned that I was going to have bypass surgery, I may as well have been told that I had just had a death sentence pronounced and it would be carried out within the next few years. But I was very fortunate. My cardiologist was my wife's employer, and a close friend. He could see that the prospect of my being an invalid before I died really rattled my cage as I was more afraid of that prospect than I was dying. The result was I was free to call on him anytime I needed information about heart problems and he had the knowledge and patience to try to break his answer down to where a layman could understand.

One of the things he impressed on me when he was trying to get me to exercise but not over do, was that one thing that will cause a fatal heart attack is physical stress on the heart muscle. His point was that if I overdid my exercise to some point my heart had a self preservation mode and it would shut down. Sometimes it could restart itself after a little rest but too often it would not restart and if that happened that would be the end of Smitty. So I exercised to what I thought was my limit but always being aware I had a damaged heart so that I must not over do and take a chance of pushing my heart into its self preservation mode.

Just food for thought.

Smitty

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Bradycardia

by pacergirl - 2009-02-28 11:02:43

Bradycardia is a symptom... I'd like to know when the doctors are going to start looking for the real problem and getting that fixed! My problem has been all along a lot of pinched nerves in my spine. I can show anyone the curves in my back and they were not where they should be! If anyone would like to see my x-rays I'd be happy to show them. I have gone from pacing at 95% to 50% after a major change in the curvature from 20% to less than 5%. Now that was the only change in me. The curve! So... did I really need a pacemaker or did I just need to be straightened out? There isn't much money in straightening people out, but a lot of money in pacemakers!

response to bill

by cuddy36602 - 2009-03-01 07:03:02

Bill,

My resting pulse rate was 47-60. I never felt faint or winded but I did have what I described to my primary care provider " a heavy feeling in my chest area". This is what prompted the holter monitor, then the stress test. I still to this day have that feeling.( probably muscle pain, pinched nerve?etc...)

A couple interesting points.
The doctor that stated I needed a pacemaker was going to program the pacer to regulate my heart by having it fire periodically in both chambers.(If I remember correctly)
The doctor who implanted the device ultimately programmed the device to only fire if my pulse goes below 35 bpm, on average.

Now if I was diagnosed with a specific diagnosis why would the doctors have a treatment plan that is completely different?

Also, I have had this for over four years and every time I go to the office for a pacer check the nurse tells me that I'm using my own heart 99% of the time. I ask her is that 99.999999999999999999999999(seeing that pretty much nothing is 100%)and she doesn't really answer. When I have my appointment with the doctor he informs me that over the years I will be relying more and more on the pacer. I asked him if he will be around in 20 years because I honestly think this thing will never fire.

Another issue that I'm having right now is I'm having chronic pain in my left arm and shoulder blade. It is extremely painful. When I mention to the cardiologist if it could be possible that the pacer may be resting on a nerve he tells me there is no possible way. I'm wondering if anyone else is having this type of pain that they didn't have before the pacer? I have gone to prim care, ortho and chiropractor but nothing seems to help.

Thanks for the response,
cuddy

Well your low rate is set very low.

by BillMFl - 2009-03-01 08:03:45

Most people have a low rate set at 50 or 60. Its no wonder your PM rarely fires. Your overall conditioning and a possibly very convincing personality may have influenced your cardiologist to minimize your settings. A resting HR of 47 to 60 would be considered acceptable by a conservative cardiologist if you were not symptomatic and you very well may not have needed a PM. I pace at 60 over 30% of the time. Chronic pain specific to the shoulder blade and radiating to the arm is usually a pinched nerve (assuming your docs have ruled out a cardiac issue). A good chiropractor or massuse can usually put their finger right on the trigger point, typically just under the edge or along the edge of the shoulder blade. I get a massage every other week and have had the same pain you describe, but with a very specific trigger point. If your pain onset isn't induced or made worse when you run it isn't likely cardiac related. Do you lift weights too? And that heavy chest feeling can be caused by stress and anxiety. I have had gym rat friends who were literally "running away" from issues in their life. Not to say you are, but consider the possibility that you are pushing yourself for a reason you are not fully aware of. Unfortunately, you very well may have received a PM that you really didn't need. But the reality is you have it, so you may as well optimize the settings. 35 is too low in my opinion. Do you check your HR frequently? Keep a log for a while and see how low you actually get when you have been lying down or napping.

Hi

by Jules - 2009-03-13 04:03:00

Just to say and add to the bradycardia. I was in France when I had my pacemaker inserted (if that is the right word) I was kept in for a week in the hospital on a holter monitor and at night or if at rest my heart would go down to 29-30. It started pausing and causing me to feel unwell. I was OK all the time I was walking, or active but at rest it was a nightmare.

I have had my pacemaker for a year now and with the help of this site and the input from Smitty and Frank I have now learnt to live and trust the pacemaker.

I sleep at night and feel more comfortable with the thought of this in the background helping me.

Julie

I'm Drowning in medical bills

by Battery operated - 2009-06-15 11:06:47

Hi, I'm new to Pacemaker club. Thought I'd check it out. So my backround. I'm 23years old, I got my pacemaker 3 years ago. Basicly I have some "issue" with my heart that it beats realy slow, like 24 bpm when awake, or stops all together causing me to pass out, like while driving....oh ya it happened, I call it lazy heart...the doctor calls it something realy long and annoying, so I got the pacemaker. I was realy young and didnt have insurance and now am drowning in debt. I want to get on top of this problem before I have to have it replaced in 3-4 years. Since you all have been in my situation do you know of any grant programs or state or federal programs to help. I cant immaging getting this all payed off on my own before the next round.
Please help...

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