Heart Rate during cardio workouts

[chadn2n]

Hello all, I am about 1 1/2 years post surgery and generally feeling great. Also, for the record, I had aortic valve stenosis from birth and had my aortic valve replaced on May 4, 2016. Prior to my heart giving me troubles I was a pretty active runner, no races or anything just casual running, and would run about 15-20 miles a week. Before surgery I would always tend to push myself as hard as possible and enjoyed that feeling. My cardiologist has told me running shouldn't be any issue whatsoever, however, my family tends to worry more than I do about these kinds of things. My main question is should I worry about how high my heart rate gets when I'm running? I was out of commission for about a year prior to surgery due to it getting progressively harder and harder to continue running. I would greatly appreciate any advice anybody can give me, thanks.

 

[SumoRunner]

I never monitored my exercise HR. I was a runner decades before wearable devices were invented. I used a sun dial for short distances and a calendar for longer ones in the beginning. I ran by feel. I was enamored of the mile on a track. Ran many, many races from 200 meters up to 2 miles. Whatever my max was, I pinned it every time. Plus, in weekly interval sessions for years we did repeats of 200, 400, or 800 and I'm sure I spiked it every time then too. I count about 65 mile races post AVR, maybe 100 at other track distances. In 5k to half-marathon, I kept the HR more in control, but roughly 350 races after AVR

 

[spartangator]

I pay some attention to keeping heart rate below its absolute peak, but I've definitely gone hard in some races like Sumo Runner. My cardiologist isn't concerned about it, and I make sure to race in line with my training so apart from wearing a monitor, I don't stress it much. Listen to your care team, but it doesn't sound like you have much to worry about. Build capacity gently and be patient with yourself as you get back into things, but the fitness will come, and you'll be able to tell when you've gone too hard. Keep us updated as you make progress.

 

[RobThatsMe]

Here is some information that I have saved for years since my first OHS. It still applies today if you are taking Beta Blockers.

Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
low pulse from medication (by Arlyp (WebMD))
Re: Exercise with low pulse from medication
by ljandie91 (WebMD), 8/18/00 10:09 PM
Hello,
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtacting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most efffect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerly, Laurie Anderson, RN, BSN

 

[pellicle]

Hey Rob ... was about to fuzz out for the evening. Good to see ya

Here is some information that I have saved for years since my first OHS. It still applies today if you are taking Beta Blockers.
...Sincerly, Laurie Anderson, RN, BSN

thats actually good information and thanks for posting that.

I'm jealous that you know Laurie Anderson



Don't forget the open door invitation and the cellar stocked with red wine for when "disaster hits" and we can't get warfarin.

There'll probably be some goat curry (lots of curcumin) and tomato too

 

[epstns]

That's interesting, Rob. It certainly explains my current limitations. I'm taking metoprolol, and even at just 25 mg/day, it limits my max heart rate to about 140-145 BPM. I usually only hit 135-140 under exercise. It feels as if I'm getting the same workout that I got pre-BB, but at a lower HR. I do find, though, that the weight control impact of exercise is reduced due to the limitations imposed by the BB. Maybe is it "just" advancing age, but I find that I do not lose weight or build muscle as fast as I once did.

 

[ottagal]

Thanks for the good info, Rob.

 

[epstns]

Well, Rob, you're probably a "bad influence." Yesterday during my workout I hit 150 BPM. Tried to break it and the dratted thing just kept beating. . . ;-)

 

[RobThatsMe]

Hi Steve,

I can't get mine over 125 when I am jogging on the treadmill at a 4.5 mph pace. But then again I am taking 100 mg of Atenolol both AM and PM. I think the Tortoise can beat me in a race these days. Add to that, I am just now getting over having a Double Ablation last month. Two chambers, one procedure was for A-fib, and the other was for A-flutter. That was on Sept 6th, so far so good at keeping anymore A-fib/flutter issues away. Doctor said it will be about 3 months before he can really evaluate how successful the procedures were. In the meantime, I am sure enjoying my On-X valve clicking away like a Timex!

Cheers,
Rob

 

[RobThatsMe]

Hey Rob ... was about to fuzz out for the evening. Good to see ya


thats actually good information and thanks for posting that.

I'm jealous that you know Laurie Anderson



Don't forget the open door invitation and the cellar stocked with red wine for when "disaster hits" and we can't get warfarin.

There'll probably be some goat curry (lots of curcumin) and tomato too

Hi Pellicle,

Actually I used to participate often on an old WebMD forum/bulletin board. She was the RN that hosted it, and was very informative. I never personally met her, only interacted on the forum with her.

But.... I am liking that invitation to the wine cellar!!:Face-Smile:

Rob

 

[epstns]

Rob - I have one other wrinkle that clouds my ability to use max HR as any sort of measure of conditioning -- I have a pacemaker. It is one of the fancy new ones that has both rate response (senses bouncing, like running/walking) and minute response (senses breathing rate), but I am not 100% paced. So, although my natural pacing mechanism is often at work, and thus not limited by the PM, the beta blocker keeps me low. If I am being paced, then the PM will keep me at or below 160 BPM. I have to presume that I am mostly being naturally paced in the atrium, as I never seem to hit the 150's. There have been times, though, when I was obviously being electronically paced and went to the upper limit. When I do that, the PM automatically "thinks" I am going into afib, and drops its pacing rate to a flat 90 BPM. That works fine if I was just sitting or doing normal things, but when I'm on a treadmill or elliptical machine and that happens, it is like hitting a wall.

I'm glad you had that afib/flutter addressed. The few times I have experienced it, it ruined my day.

 

[jcgtok17]

I'm just past 9 month post op (AVR) and getting back to running has been great. My pace is still slow as my sensei (Dr.) recommends a range of 120-130 bpm, at this juncture. I have been running 5km every other day along with weight circuit training, but hit a milestone today in running for a continuous hour without interruption (keeping hr < 130). A snails pace at 7.4km for the hour (PB 1/2 marathon in 2011 was 1:47 for reference), but makes me hopeful I might get up to 1/2 marathon distance by late summer. I'd love to set a goal of running a full marathon. Honolulu is December 9, 2018. My only other full was New York 11' in 3:59:48. Not trying to best my time, but to finish post valve replacement would be a great feeling. Dropping some weight is proving helpful, down 5kg (5% body weight with a 100kg starting weight) in 3 weeks with a target of 12kg total in 7 more weeks. My Garmin Vivofit HR has proven a valuable companion in these efforts. Trying to keep resting at or just below 60 which I am close to (62 resting).

 

[Threeacres]

I also had an AVR about a 1 1/2 ago and was a fairly active runner before. When getting back to running at about 3 months post surgery I would monitor my heart rate with a watch and try to keep it under 130 bpm. I'm 54 and not fast, but I enjoyed competing in local 10K and 1/2 marathons. Over time I became more comfortable with letting my heart rate get higher during training and races. For instance a training run might average around 145bpm, with a peak rate of 171 (lots of hills in my area), but my last 1/2 averaged 166 with a 186 peak rate. I've never had any chest pain during exercise, I did get a little light headed if I pushed the pace when I first got back to running and I would back off. That hasn't happened in the last year though.

 

[marvsehn]

I had a bicuspid aortic replaced withe a mechanical 3 years ago. In the year after also had a stress test. Dr says no limit, however my body says arount 160 is far enough. I am 68. I cycle a fair amount and get to 140-150 routinely.
I where a monitor and watch for peaking. I also take 12 mg metoprolol twice a day.

 

[Brokenhip]

Similar to Marvshen, AVR with a tissue unit about 16 months ago & after stress test told no limit but suggested not to push as hard as prior to surgery.
At 67, appears my max heart rate is close to the 220 - age, say 153.
Cycle about 250kms per week & always use a heart rate monitor. Spend most of the time in the 110 - 140 region & only occasionally push above that and struggle to maintain that for very long anyway.
Have had to realise that it has been necessary to lower my expectations compared to the efforts put in before the AVR. Still great to be able to get out and exercise reasonably hard.

 

[neo]

Here is some information that I have saved for years since my first OHS. It still applies today if you are taking Beta Blockers.

Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
low pulse from medication (by Arlyp (WebMD))
Re: Exercise with low pulse from medication
by ljandie91 (WebMD), 8/18/00 10:09 PM
Hello,
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtacting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most efffect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerly, Laurie Anderson, RN, BSN

Hey RobThatsMe, very interesting article! I’m curious, if I’m on a beta blocker and I run to my “normal” target heart rate, which for me is around 152, am I potentially overdoing it or putting some damage on my heart/valve? My resting heart rate is about 10bpm lower on the beta blocker, but I can still run up to 152-165. Should I limit my target HR on purpose, to say 142, to protect my heart? Or is a lower target HR what someone would expect to hit because of the lowering effect of the beta blocker?

 

[epstns]

I can't answer your question specifically, neo, but my cardio tells me "If it feels good, do it." That seems to work for me in the gym. If it feels OK during and after, then no harm/no foul.

Of course, my knees won't let me run any more. If I try to run on day one, I will have to crawl for the rest of the week. These days, I use either an elliptical machine or an ARC trainer.