What should be limited for patients with a pacemaker/ICD during the initial exercise phase?

For patients with a pacemaker or implantable cardioverter-defibrillator (ICD), it's particularly important to limit upper body motion during the initial exercise phase. This limitation is primarily due to the positioning of the device, which is often implanted under the skin in the chest area, typically under the collarbone. Engaging in upper body movements or exercises can place stress on the area around the device, potentially leading to discomfort or even displacement of the device.

Moreover, excessive upper body activity can pose risks such as pulling on leads connected to the heart or causing irritation at the implantation site. Therefore, careful monitoring and a controlled approach are necessary to ensure that patients can gradually build strength and endurance without compromising the integrity and function of their pacemaker or ICD.

In contrast, lower body motions, cycling exercises, and endurance activities might be more easily tolerated once the initial precautions are in place, as these tend to involve less strain on the chest area compared to using the upper body.