Robert Gesink has raced several Grand Tours since getting a pacemaker for a cardiac arythmia with some solid results, so if your friend discusses things with his doctor before the operation it should be possible.

Most of the time you can yes...
If his heart rate 30 he probably had complete heart block or a sick sinus node.
In complete heart block the atria (top chambers) and the ventricles (bottom) work independently of one another... This is due to in most cases damage to the AV node which is part of the conduction system between the top and bottom.
In normal electrical conduction the SA node (hearts natural pacemaker situated in the atria) depolarizes and the wave of depolarization spreads over the atria causing them to contract... The impulse then travels to the AV node, is held for a short time there and then the impulse is sent down the bundle branches into each ventricle causing them to contract and push blood out to the lungs/body...
With a SA node problem it either beats too slow, too fast or irregularly.
The pacemaker wires are inserted into each chamber and when needed take over the role of the electrical tissue that is not working.
The pacemaker can be adjusted/optimized for different physical demands.
Sometimes swimming can be and issue due to the pacemaker wires being crushed but I think it is less of an issue these days.
Without knowing much about the situation it's hard to say much more, but generally people with pacemakers can continue to do very well with physical activity; but I'm sure your mates cardiologist will be able to give him very good advice.
I hope he can :-)

Usually, unless there are other issues going on, there are no long-term restrictions with a pacemaker. There are restrictions right after it is implanted. Normally for 3-4 weeks immediately after implant he would be limited on what he could do as the lead wires heal in place. The doctors I work with put patients on a 20 lb weight restriction and tell them to not put their arms above their head for 3-4 weeks. After the first month, everything is mostly healed in place and they would be released from all restrictions.

thank you all, he needs a lift as he is down at the moment as you can imagine

the very odd thing is that he blew them away with his treadmill stress test, it was very good

so they are still deciding what to do

these are all very good stories however

Wholly shit here I lay in a hospital due to bundle blockage.
I love racing having finished Placid and have my sights set on tremblanc and then this happens.
My daughter sent this forum and there is hope. 😍😍😍😍

I had the same thing happen and stress test , nuclear, eco all found nothing. I didn’t realize how bad it was until I passed out multiple times and ended up in the hospital yesterday.

Seems very likely a pace maker will be in the very near future. As I read up on it I find myself optimistic that I may be able to get back to racing. 😁

i'm heading next door right now for my buddy's son's 9th bday party. my buddy and i finished a set in the pool a couple of hours ago, 12 x 200yd repeating on the 3:10. not a exactly a manly leave, but we've only been in the pool for a month. point being, my buddy cruised it, him and his pacemaker. i'm not a doctor, so i don't know, but from a layman's POV, the only thing the pacemaker means is he's less likely to die than i am in the middle of a workout, because he's got a built-in rope pull, and i don't. he will chime in later, when he's off the grill duty.

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Dan Empfield
aka Slowman

I got a pacemaker in 2016 at the ripe old age of 36. Two days after surgery I was back on the trainer. Five days after the surgery I was running again, gently, and with my arm in a sling the first couple runs.

The slower return was swimming. I was out of the water for a recommended 6 weeks because you aren't supposed to lift your arm above your head while the leads are healing into place. When I did try to get back into swimming I quickly learned my left arm would get painfully engorged, which I found out was from blood clots from the surgery. I was on thinners and out of the water for another couple months, then eventually built back into swimming enough to do a few races that season. Then I found out that what little swimming I'd done was causing my leads to fail similar to what Jeremy mentioned above. I went into a bit more detail in this post so I won't repeat it here, but feel free to ask any questions.

Anyway, all was back to normal in time for a regular 2017 race season and I haven't had any issues since while racing sprints to IM.

Well technically a global pandemic shut down my 2020 season, but that had nothing to do with the pacemaker.

DTOCE on here is probably the best person to talk to about what to do afterwards etc.
It will depend partly on what sort of pacemaker you have and what the underlying issues are. There are a very wide variety of pacemakers that depend on the underlying pathology so it is hard to comment on what the outcomes will be at the moment.
It should be that you will have no problems going back to some form of exercise because of the pacemaker, the issue is more what level of exercise you can do because some pacemakers may pace you at a certain heart rate, whereas others will support a higher heart rate as you may get with serious exercise etc.