Looking for similar cases: exercise-induced sinus node failure / junctional escape I’m wondering whether anyone here has seen or experienced a similar exercise-associated rhythm issue. My diagnosis is exercise-induced sinus node dysfunction, where during running my sinus rhythm intermittently drops out and is replaced by a junctional rhythm / junctional escape, with absent P-waves on ECG. When this happens, I become suddenly short of breath and unable to continue running, even though the ventricular rate may still be in a moderate range. These episodes began as infrequent occurances (once per three months) nearly three years ago, but now occur in the majority of my runs. They have never occured during biking or rowing at similar intensity. Because the episodes are intermittent and have been difficult to reproduce in clinical settings, the Frontier X2 continuous ECG monitor was crucial in capturing the rhythm during symptoms and helping establish the diagnosis. I now have a dual-chamber pacemaker, but so far it does not seem to prevent these episodes. My understanding is that because the junctional rhythm is often not slow enough to trigger pacing, the device may not intervene even though the rhythm is hemodynamically ineffective for exercise. I’m interested in hearing from anyone who has encountered something similar, especially: * Exercise-induced sinus node failure or junctional escape * Loss of P-waves during exertion * Junctional rhythm that limits exercise despite a reasonable heart rate * Pacemaker programming strategies that helped, such as more aggressive rate response, atrial pacing preference, or other settings I’m already working with an excellent cardiology/electrophysiology team and am not looking for medical advice so much as similar experiences, published cases, or clues about what has been helpful in comparable situations.

Sun, 10 May 2026 15:42:57 +0000

Looking for similar cases: exercise-induced sinus node failure / junctional escape

I’m wondering whether anyone here has seen or experienced a similar exercise-associated rhythm issue.

My diagnosis is exercise-induced sinus node dysfunction, where during running my sinus rhythm intermittently drops out and is replaced by a junctional r…Read More

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