For years, pacemaker users faced a frustrating gap in consumer health tracking: most apps rely heavily on heart rate variability, a metric that becomes unreliable when a pacemaker enforces a fixed heart rate floor. My Bio Age closes that gap with a specialized pacemaker support mode that excludes fixed HRV values and intelligently redistributes scoring weight to other cardiovascular and metabolic metrics. The result is an accurate biological age estimate that respects your unique physiology without penalizing you for device-managed heart rhythms.

Why standard HRV fails for pacemaker users

Heart rate variability measures the time variation between consecutive heartbeats, reflecting autonomic nervous system balance. Pacemakers, however, deliver electrical impulses at fixed intervals when natural heart rate drops below a programmed threshold. This intervention artificially suppresses HRV, making standard algorithms interpret pacemaker users as perpetually stressed or under-recovered. My Bio Age detects this pattern and switches to pacemaker mode automatically or when you manually enable the setting.

How pacemaker mode recalculates biological age

When pacemaker mode activates, My Bio Age removes HRV from the scoring model and redistributes that weight proportionally across the remaining metrics. VO₂max becomes an even larger contributor, and Recovery Capacity, Sleep, Resting HR, Walking HR, and Active Energy also receive increased emphasis. Blood Pressure, if tracked, gains additional weight. The recalibrated model maintains scientific validity by leaning on metrics that remain unaffected by pacemaker intervention.

Metrics that remain reliable with a pacemaker

VO₂max. Cardiorespiratory fitness estimation works normally because it depends on sustained heart rate response during exercise, which pacemakers do not inhibit at higher intensities.

Recovery Capacity. Post-exercise heart rate recovery and overnight HR trends remain informative even with pacemaker support, as the device primarily influences resting floors rather than recovery dynamics.

Sleep metrics. Sleep duration, regularity, and architecture are unaffected by pacemaker activity, making them fully reliable inputs.

Blood Pressure. If you track BP, it becomes even more valuable in pacemaker mode, as vascular health remains a critical aging signal independent of heart rate control.

Enabling pacemaker mode in My Bio Age

Navigate to Settings inside the app and toggle Pacemaker Support Mode. The app will immediately recalculate your MyBioAge Index using the adjusted weighting model. If you are unsure whether you need this mode, consult your cardiologist or review your Apple Health HRV data for unusually low and stable readings that do not respond to lifestyle changes. You can disable pacemaker mode anytime if your device is removed or settings change.

What to expect from biological age trends in pacemaker mode

Your biological age will still respond to training, sleep quality, and stress management, but the sensitivity may shift. Improvements in VO₂max and Recovery Capacity will drive larger biological age reductions than they would in standard mode, reflecting their increased weight. Conversely, if sleep quality or Blood Pressure worsens, the impact on your score will be more pronounced. This heightened sensitivity encourages focus on the metrics you can most effectively control.

Privacy and support for pacemaker users

Pacemaker mode operates entirely on-device. My Bio Age does not share pacemaker status with any third parties, and enabling the mode does not trigger data uploads or notifications. If you have questions about how the recalibrated model applies to your specific pacemaker settings, contact our support team or discuss the app outputs with your cardiologist during routine follow-ups.

Pacemaker support mode is available now in My Bio Age. Enable it in Settings and start tracking biological age with confidence, knowing the algorithm adapts to your unique cardiovascular profile.