Maybe I should explain a little more why I suggested seeing an electrophysiologist (ep) might help with your problem. I don't know if an ep installed your pm; I understand that sometimes an ordinary cardiologist does the surgery. So I would ask you if a cardiologist or a cardiac electrophysiologist performed your surgery.

I'm not sure what kind of rehab you are requesting after a pm implant. Or exactly why you think "rehab" is necessary. But I can tell you about my experience, which may or may not be helpful.

I had a pm installed four years ago for bradycardia (low heart rate, dizziness, chest tightness, one fainting episode), much like what you say you experienced. Two months after the pm went in I continued having some of the same symptoms--trouble breathing (getting exhausted after a short walk) and chest tightness. The ep (a cardiologist who specializes in the electrical (f) of the heart) who did the surgery refused to give me a follow-up appointment. Instead, the device technician checking to see if the pm was performing as expected said everything was fine when I went in for a checkup. I later saw another cardiologist (not an ep) who looked at how the pm was working and could see nothing wrong.

Only four years later did I discover that pacemakers have hundreds of features that have to be "set" when the pm is implanted. There's something they call the fitness level (of which there are four), there's a breathing sensor, a motion sensor, and many other features that get set by the ep who installs it. There are also different names given to these features, which may differ according to the manufacturer of the device.

In my case, the way my pm was set up was wrong for me. I got help from Boston Scientific, the manufacturer of my pm (they will often give help over the phone), and from another ep (not the guy who installed it) who was willing to work with me to change some of the settings. There are hundreds of combinations and ways to "set" the pm. The device is very complicated.

The health profession is in a state of chaos. There are many inattentive providers out there. You have to hunt for the good ones.