Exercising With a Pacemaker or Implantable Cardioverter Defibrillator: Prescription for Health

American College of Sports Medicine

April 14, 2010


Exercise plays an important role in rehabilitation after implantation of a pacemaker or other cardioverter defibrillator because it will counteract the deconditioning that occurred prior to implantation, and reduce your risk factors for heart disease, including high blood pressure and cholesterol, diabetes and obesity. The key to maximizing the benefits of exercise is to follow a well-designed program that you can stick to over the long-term.

Getting Started

  • Talk with your cardiologist before starting an exercise program and ask for specific programming recommendations.

  • Take all medications as recommended by your physician.

  • The goals of your program should be to improve your ability to perform activities of daily living, increase muscle strength and endurance, and maintain range of motion.

  • Pre-exercise testing is essential to determine your upper training heart rate. Be sure to keep your target heart rate below your ischemic threshold.

  • Choose activities that make it easy for you to monitor your intensity level, such as walking, cycling or water exercises.

  • Perform upper-body range-of-motion exercises, but avoid any strength-training exercises that may cause pulling at your incision site for at least 12 weeks after surgery

Exercise Cautions

  • Maintain at least a 10 percent safety margin between your exercise heart rate and the rate cutoff for your implanted device.

  • Even if you were active prior to surgery, you probably experienced a dramatic decrease in fitness during your recovery period. Use the Rating of Perceived Exertion scale in conjunction with heart rate to closely monitor exercise intensity.

  • Stop exercising immediately and contact your physician if you experience inappropriate shocks, chest pain or extreme fatigue. If you need immediate assistance, dial 911.

Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting a certified health and fitness professional* who can work with you and your health care provider to establish realistic

For more information, visit www.exerciseismedicine.org or e-mail eim@acsm.org.

* If your health care provider has not cleared you for independent physical activity and would like you to be monitored in a hospital setting or a medical fitness facility, you should exercise only under the supervision of a certified professional. The American College of Sports Medicine (ACSM) has two groups of certified fitness professionals that could meet your needs. The ACSM Certified Clinical Exercise Specialist (CES) is certified to support those with heart disease, diabetes and lung disease. The ACSM Registered Clinical Exercise Physiologist (RCEP) is qualified to support patients with a wide range of health challenges. You may locate all ACSM-certified fitness professionals by using the ProFinder at www.acsm.org.

Sources: ACSM’s Guidelines for Exercise Testing and Prescription and other ACSM publications.


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