Cardiac rehabilitation for Pacemaker Implantation

When I got my pacemaker six months ago, I had some issues and I got absolutely no support from my cardiologist. They acted like I was crazy. I should just go on with my life. I got more support from this group than anybody.

That is really sad. I am so sorry. I just joined this group, and I hope it helps. Thanks for your feedback.

when I had my pacemaker put in for a rhythm issue I was actually told it would be a good Idea. I didn't have a heart attack either. So I went and it was beneficial to gain confidence in being able to exercise while they watched my heart and how it responded. My particular problem was heart failure which is basically a low Ejection Factor. So maybe if you ask again with how much it would help you they may write the order.

Thank you, Dana. I did ask again. They denied it. I have spent the last 2+ years trying to figure out why I was having chest pain and dizziness and fainting. It took going to the Mayo Clinic and being on a heart monitor to figure it out. I was told that maybe I was not drinking enough water, etc. The episodes happened when I was at rest. My cardiologist called me, and I answered when I was at pickleball. She said that if I could play pickleball, my request was not an emergency. I had an appointment in 3 months. When I finally had the paramedics here based on my Holter monitor, and they determined that my episodes were happening when I was at rest, it made sense. I could play pickleball for 2 hours and go to hot yoga for an hour because when my heart rate was up, it would function fine. When I was at rest, my heart rate would drop to 30 or below, and I would pass out. Plus, I had episodes of my sinus rhythm stopping for 10-15 seconds. Looking at the larger picture, I still do not understand why my chest pains that I had intermittently for 9 months and my dizziness and fainting during that period and even for the 2 years prior (less frequent) do not deem a pacemaker critical "enough" so that cardiac rehab is covered under insurance. It makes me sad. I am competent "enough" that I can look online and figure out what I need to do to rehab on my own. It sure would be nice to have support, especially emotional support. I guess this is what I am hearing on this site. You have all been through similar experiences, and you "get it". Together, we can support each other. I feel grateful to have found this site. Thanks again, Dana.

Here is an idea for you. See if you can make an appointment with a cardiac electrophysiologist. These are the doctors who can help regulate the settings on your pm. They may not engage in ‘rehab,’ but they can check your breathing and suggest changes to how your pm is set up.

When my pm was implanted the doctor who performed the surgery would not see me to discuss the problems I was still experiencing. I finally found another electrophysiologist who was willing to work with me.

Thank you, Jackie. I will give that a try.

Please make an appointment with your Cardiac Electrophysiologist. Their team should be following you.

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.

Hi, I have a pacemaker /defibrillator (ICD) implant. I was eligible for cardiac rehab because my ejection fraction was 35 or lower. The qualifying ejection fraction in my area is the 35 or lower. Heart attacks most often reduce the ejection fraction and it could be that the cardiology department set their own standards regarding cardiac rehab. I would suggest you contact your insurance carrier and ask for their guidelines regarding coverage for cardiac rehab. Best of luck.