training with a pacemaker – need some guidance

My wife had AV and SA node ablations to correct SV tachycardia and a motion sensitive pacemaker implanted to maintain resting heart rate. She’s had injuries to her back and knees, so reconditioning has been a frustrating nightmare. Her doctors have been thrilled that she can ride a motorcycle and keep a job on as little medication as she allows herself to use. She had an athletic youth and young adulthood before these developments. Now her heart rate doesn’t respond to oxygen debt, adrenaline, or acid buildup. She has to bounce to perfuse blood, but she can’t run. Strength work and elliptical machines both give her cramps. She wants to be active again, to relieve chronic back pain, and to lose the weight gained by extended inactivity. She actually requested that I bring this to the RKCs and see if we can do something together.

I need feedback from people with clinical backgrounds. I know, for example, that Kenneth Jay is a published researcher and that there are more than one MD and licensed PT on this forum. I’m positive somebody here runs a gym with one battery-powered client. Her unit is motion-sensitive, not oxygen-sensitive. Basal rate 70bpm, and the max rate is set to 160 or 180bpm. She used to be a paramedic and a runner, which is why the cap is so high. How do you train someone whose heart rate barely changes? How would you recondition a C-spine impact injury with facet calcification and impingement? Her doctor has cleared her for nerve blocks, medication, and whatever activity she can stand, but no course of PT has ever been recommended.

I have a theory that KB ballistics will provide enough movement to pick up her heart rate, but one does not just "go forth and snatch". After my recovery, honestly, I continued in this field for her. I can probably guide her through this with some trial and error, but she has been through enough. Please, send some experienced feedback either to the thread or via PM. Thanks.