Hockey With A Pacemaker: A Slippery Dilemma

Many people love to slip into their skates and hop onto a frozen lake or a chilly rink to play a favorite winter sport: hockey. Given its international popularity, it makes complete sense that someone would want to participate in it regardless of their cardiovascular condition, and whether or not they have a pacemaker.

So, given the nature of the sport with fast skating, pucks flying, and sticks hitting the ice, is it safe to participate in hockey if you have a pacemaker?

Let’s find out.

So, before you slip on your skates, let’s dive into this question.

According to my research, hockey appears to have both positive and negative effects on cardiovascular health, even in healthy individuals. The article, “The Double-Edged Blade Of Recreational Hockey” by Murray A. Mittleman describes how, “The results indicated that during recreational hockey it is not unusual for men to exceed the age-calculated target exercise heart rate, defined as 85% of the maximum age-predicted heart rate”(Mittleman, 2002), which, by default tips the scale from the sport serving to fulfill the cardiovascular benefits of exercise to potentially becoming dangerous.

However, this does not mean that the sport is necessarily dangerous, nor that people with cardiovascular problems should outright quit playing it. On the other hand, it does raise some potential red flags that it would be wise not to ignore. This is especially so since “previous studies have documented that intense physical exertion rarely triggers acute cardiovascular events. Although discrete episodes of vigorous exertion may transiently increase the risk of an acute cardiovascular event, even among fit individuals, the absolute risk associated with each episode of exercise is extremely low. A recent study estimated this risk as approximately 1 excess cardiac death per 1.5 million hours of exercise in a group of men at low to moderate risk” (Mittleman, 2002). That is why, even though there is a risk for heart problems to occur if the body is pushed too far, there is also “a clear net benefit of regular exercise despite the transient increase in the risk of triggering a cardiovascular event” (Mittleman, 2002). So, there is a risk of a cardiac event occurring when playing hockey, but the odds of it happening are relatively low in people with healthy hearts or those experiencing mild CVD (cardiovascular disease). Plus, the exercise the sport provides generally benefits not only the heart, but one’s general health.

While there is a cardiovascular risk in participating in exercise, via hockey, or any sport, it is less dangerous than remaining inactive because “the risk of an acute cardiovascular event is highest for men or women who are sedentary throughout the year and then play hockey competitively once per week during the hockey season” (Mittleman, 2002). The article concludes with stating how, “in summary, the most important message for men and women interested in participating in vigorous sports, including recreational hockey, is that they should exercise regularly throughout the year and avoid jumping on the ice without any preseason preparation. Regular exercise and adherence to current guidelines for the primary prevention of cardiovascular disease, including the control of dyslipidemia, will reduce the already small risk of an acute cardiovascular event during a hockey game. More importantly, staying fit and controlling other risk factors will reduce the risk of cardiovascular disease at all times of the year” (Mittleman, 2002). So, exercise in any form, even by playing hockey despite the risks, could benefit one’s health.

However, I think the article left out a key step in this decision. If someone wants to take part in an activity that is particularly dangerous to their heart, like hockey, whether or not they have a pacemaker, or even been diagnosed with CVD, it is important to consult one’s doctor before jumping on the ice.

As medical professionals, they have the broadest and most comprehensive understanding of your cardiovascular health, and. therefore, can make the wisest decision while also providing recommendations to help keep you safe should you choose to play the sport. Of course, they must also factor in your desires, wants, and needs for you to live your best and longest life possible. But safety must come first.

However, one should be prepared to hear that it is generally not recommended to play hockey if you have a pacemaker.

A key point of living with such a device is to avoid being hit in the area of the implant. Whether the device is embedded beneath the skin and muscle of the chest or the slightly more protected area, the armpit, it is still vulnerable.

So, a contact sport like hockey raises the likelihood of being struck in the chest hard enough to cause damage or dislodgement of the device to an exceptionally high level. While the wires are deeply nestled within layers of veins, muscles, and skin, it does not take too much to damage the device.

Should the device become damaged, or at worst, dislodged, it is an extremely dangerous situation to find oneself in. This happened to me because I had a too-intense cup of coffee, so I can imagine being body slammed or struck with a stick or a puck would also do the trick.

So, in my opinion, it is in one’s best interest to exercise extreme caution in regard to playing contact sports like hockey. However, please don’t just take my word for it. While most sources I found said it is best not to participate, others were more lenient.

Medtronic’s website, Heart Device Answers, states that, “one should discuss with a doctor whether playing hockey is safe. In general, rough physical contact that poses a risk of falling or hitting the implant site, which could damage the device or leads, should be avoided. Participating in hockey is ultimately a decision that should be discussed with a doctor” (Medtronic, n.d.). While I agree with most of this advice, I find that many of Medtronic’s guides lean toward the optimistic side of the spectrum. Understandably so, of course. However, sometimes it is to the point where they avoid the harsh realities of using their products. I mean that in the kindest way possible, because I have had Medtronic pacemakers all my life.

It should be noted that many other articles answer the same question of whether or not someone should play hockey with a pacemaker with the subtlety of a falling axe. This can be seen in the Epic Heart and Vascular Center article titled, “9 Things You Can’t Do With A Pacemaker,” which clearly states that “sports such as volleyball, basketball, hockey, etc., require close contact that may damage your pacemaker, so avoid playing these sports at all costs” (Heart, 2023). Now, I’m not saying one is right or wrong because each individual case is unique. But what I am saying is that when you decide to play a sport or do a potentially dangerous activity with a pacemaker, it is crucial to rely on your doctor’s opinion… maybe even as gospel. Because for controversial topics like playing hockey with a pacemaker, even though many websites, articles, and academic references are strictly against it, others may support trying it.

Yet it is the doctor who knows your history, your interests, and the device. That’s why it is best to consult one’s doctor before playing to gain a basic understanding of these devices and the damage they can cause in a contact sport like hockey.

Now, the key danger of having a pacemaker is that the device could be struck by something or someone with enough force to dislocate or damage it. Whether it is placed just under the skin and muscle of your chest or beneath the armpit for a little more safety and aesthetic appeal, this danger remains the same. So, for contact sports, whose very nature requires or at least risks “contact,” it is extra important to talk to your doctor beforehand.

However, given this research, one should be prepared for the medical professional to advise against taking part in this sport.

Better safe than sorry.

I can relate to having to leave games and sports one loves in the interest of one’s health. As a child, I was very good at skiing, but had to give it up because of the blood thinners for my mechanical heart valves. The pacemaker was also probably a concern, but it was not the key consideration at the time. While I miss flying down the mountain more than anything, if I didn’t stay safe, I wouldn’t be where I am today. In this case, it may be a necessary sacrifice.

So, in summary, hockey is a potentially heart-healthy sport if certain precautions are taken and the doctor remains informed about the player's condition. However, having a pacemaker may mean it's wise to avoid playing hockey for safety reasons.

Tune in on Thursday for the article about Hibiscus Tea and CVD.

Keep ticking, my friends!

What topics about CVD or pacemakers would you like to learn more about?

Let me know.

Reference List:

Heart, E. (2023). Epic Heart And Vascular Center. [online] Epic Heart And Vascular Center. Available at: https://epicheartandvascular.com/9-things-you-cant-do-with-a-pacemaker/ [Accessed 18 Nov. 2025].

Medtronic (n.d.). Can Someone With A Heart Device Play Hockey? [online] Heart Device Answers. Available at: https://www.medtronic.com/en-us/heart-device-answers/search-results/search-result.can-someone-with-a-heart-device-play-hockey.html#:~:text=Can%20someone%20with%20a%20heart,with%20a%20device%2C%20Everyday%20living.

Mittleman, M.A. (2002). The Double-Edged Blade Of Recreational Hockey. CMAJ: Canadian Medical Association Journal, [online] 166(3), p.331. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC99312/ [Accessed 12 Feb. 2025].

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