Q. I had a pacemaker implanted a few months ago. I am planning to join a gym to get back some strength in my arms and upper body, but I am afraid of damaging the wires with some of the presses and pull-down movements I would have to do to work out on the gym’s machines. Are there any exercises or movements I should avoid?
A. It’s great that you want to exercise and improve your upper-body strength. You just need to be a bit more careful going about it than someone without a pacemaker.
Pacemakers and implantable cardioverter-defibrillators (ICDs) have two basic working parts — the generator, which is implanted under the skin between the shoulder and chest, and one or more wires that stretch from the generator to the heart. These wires, called leads (pronounced leeds), are designed and built to flex and move freely when the arm or shoulder nearest the pacemaker or ICD moves.
Like all mechanical devices, leads are subject to wear and tear. It is minimal with the routine movements of everyday life, but can be substantial with repetitive arm movements. Using arm-strengthening machines, rowing, lifting weights, and the like cause the lead to bend and relax repeatedly at the same spot. Over time, this can damage the lead. Activity that involves excessive extension of the arm nearest the pacemaker or ICD, like using an overhead press machine or doing some yoga positions, poses a different problem. It can crush the lead between the collarbone and the first rib.
I tell my patients that they can and should do upper-arm exercises, but not go crazy with them. A moderate session once a week at the gym should be fine. Ask if a trainer can show you exercises that are suitable for someone with a pacemaker. Weightlifting with repetitive flexing of the chest muscle on the side where the device is implanted is ill-advised.
— Peter Zimetbaum, M.D.
Associate Professor of Medicine
Harvard Medical School
Beth Israel Deaconess Medical Center