[The physical capacity of patients with pacemakers]

The pacemaker patient stimulated by unchanged frequency may realize the necessary regulation of his minute output of the heart only through a change of the stroke volume, not through the otherwise usual change of the heart rate. Thus this circle of persons shows a restricted breadth of regulation in orthostatic stress or physical work. Pharmacological or physiotherapeutic measures with vasodilatory effect increase the inclination to orthostasis with security for the acute application, potentially also in a long-term therapy. Greater loads may, probably by a release of catecholamines, reduce the degree of severity of a blockage and evoke a parasystoly in patients with devices with unchanged frequency. Patients with ventricle-regulated pacemaker do not show such disturbances as long as the heart may follow the own regulation and the own rhythm. By the transition to the stimulation with unchanged frequency possible at any time, however, may appear incisive restrictions also in this group of patients. The data of literature are to be confirmed that atrium-regulated pacemakers give the best prerequisite concerning the maximum stress of the patients. In all regulated devices the maximally possible heart rate is demarcated by the pacemaker itself. It is in most cases approximately 120/min. Independent of the type of the pacemaker moreover must be taken into consideration additional restrictions of the functional capacity which are very different from case to case and which are to be referred to the cardiologic basic disease.