Exercise prescription for patients with pacemakers

When developing an exercise program for pacemaker patients, basic information about the pacemaker must be understood. Atrial, ventricular, and dual-chamber devices can produce varying exercise responses and impact the exercise prescription. The type of rate adaptive sensor the pacemaker has will affect the nature of heart rate response, and therefore, must be taken into account when prescribing exercise. While rate modulation is used with most chronotropically incompetent patients, individuals with VVI pacemakers will also benefit from regular exercise. Although the value of exercise testing pacemaker-dependent patients for ECG interpretation may be limited, it is useful in determining exercise capacity and ensuring proper pacemaker function. Participation in a supervised exercise training program can greatly enhance the follow-up and management of pacemaker-dependent patients as well as afford them the opportunity to experience the physical and psychologic benefits typically associated with cardiac rehabilitation.