EXERCISE INSTRUCTIONS
Pacemakers &
Implantable Cardioverter Defibrillators (ICDs)
Always follow the advice of your provider (doctor/nurse practitioner/physician assistant).
The instructions below are general and should only be done with their approval.
General Guidelines
Target Heart Rate (HR) will not exceed 150 beats per min (bpm) for most patients. Ask
your doctor about heart rate and your pacemaker/ICD parameters.
Warm-up: 5-10 minutes
Aerobic: 20-45 minutes continuous exercise (use RPE – see back page).
Weight training: 10-20 minutes
Cool-down: 5-10 minutes
Stretching: Up to 5 minutes of light stretching
Warm-up
Easy/light movement that prepares your muscles for the aerobic and/or weight training
exercise.
Aerobic
Done most days of the week.
Uses large muscle groups working together.
Vigorous upper body workouts should be avoided.
Should cause an increase in heart rate (HR) and breathing rate, but you should still
be able to carry on a conversation.
Examples: walking, swimming, biking, and using a Nustep®.
If unable to perform 20 minutes of continuous exercise, try interval training.
Continuous exercise - exercise at the same pace for entire time
Interval Training - vary exercise with easier to harder segments, for example:
walk at a comfortable pace for 3 minutes
then try increasing speed or elevation for up to 1 minute,
then return back to original pace for another 3 minutes
repeat as tolerated.
Weight Training
Aim for high repetitions (reps) with light weights 2-3 days per week,
Start with 1 set of 15 reps per muscle group (legs, back, chest, shoulders, arms)
Progress by increasing to 2-3 sets of 15 reps as tolerated.
Strength training should only be performed after some form of cardiovascular/
aerobic warm-up.
Be sure to breathe out on the exertional part of the exercise
Note: it is not safe to do isometric training (pushing against a fixed object or a high
resistance without movement) at this time.
Control #: 321 Last reviewed: January 2014. -1-
Cool-down
Similar to the warm-up; light movement to help bring your heart rate (HR) back down to
its resting level.
Stretching
Stretching decreases muscle soreness and increases flexibility.
Done after every workout session.
Hold stretch up to 30 seconds (as tolerated) without moving, and be sure to keep
breathing.
PRECAUTIONS
Your physician should clear you before you start an exercise program.
Exercise may result in fluid loss (dehydration) so drink fluids to prevent low blood
pressure after exercise. Patients on fluid restriction should ask for more specific
advice from physician.
Do not participate in any contact sports (football, wrestling, etc.).
Heavy weight lifting is discouraged.
WHEN TO CALL & WHO TO CALL
If you have any of these symptoms before or during exercise, stop exercise immediately
and contact your physician:
Chest pain Lightheadedness, or
Shortness of breath Anything that feels different than usual.
RATING OF PERCEIVED 6
7 Very, Very Light
EXERTION (RPE) 8
Use this scale to find the intensity level of your
9 Very Light
exercise. A rating of 11-13 is ideal.
10
11 Fairly Light
12
13 Somewhat Hard
14
15 Hard
16
17 Very Hard
18
19 Very, Very Hard
20
For questions about exercise, call the exercise physiologists at:
Cardiovascular Center 734-936-5627
Cardiovascular Medicine at Domino’s Farms 734-998-5666 or 647-7321
Developed by Preventive Cardiology, UMHS.
Control #: 321 Last reviewed: January 2014. -2-