Heart rate when exercising post AVR

[acr]

Hiya,

I'm trying to get fit, I love cycling and always have. I've been using the exercise bike to get my stamina and fitness improved before taking my bike out on the roads. I'm running at the same intensity that I used before the Op, ie. 80 pedal revoultions per min, same level (3). However my heart rate rarely goes above 120, which I'm not complaining about. Pre-Op I'd be in the 150 range, and I thought I was pretty fit! I'm not on any beta blockers or anything to slow my heart, just good old Warfarin. Just wanted to understand what happens at the physical level to account for the more chilled out heart, does a leaking valve compensate by running faster/harder etc.

Ta,

Ade

 

[Philip B]

Heart Rate

Heart Rate

Hi Ade,

How hard you work your heart to get it back in shape really depends upon a number of factors. There are a lot of resources available that can help you develop cardiac fitness goals. My focus is primarily cycling.

The system I use requires me to know what my maximum heart rate is and calculate what my different aerobic and anerobic exercise zones are. My maximum is around 171 bpm so maintaining 120 bpm would represent a low,medium aerobic pace for me. That's enough to receive benefit, but I prefer to exercise at a higher aerobic level and push myself into my anerobic range (above 153 bpm) during the course of my rides.

You should be able to increase your heart rate over 120 bpm. Immediately following my AVR surgery, the cap my cardiologist placed on my heart rate during exercise was 120 bpm. This cap was quickly removed as my heart healed. Replacement valves typically run just as fast as original equipment.

I was concerned before my surgery about my implanted valve not being able to keep up with high heart rates. Someone had told me some nonsence about artificial valves being unable to run as fast as tissue. My valve performs just fine when I push myself to my maximum heart rate and I suspect it can handle lots faster rates than I ask it to do.

All this said, you don't have to be overly technical with an exercise program. Simply exercise at a rate where you feel comfortable and push youself abit when you feel like it. If you want to push yourself harder, look for some resources that will help you build a good cardio improvement program. There are lots of really good books available. People are more likely to stick with a good exercise program if it's fun and interesting.

-Philip

 

[Mentu]

Ade, when I asked this same question, one of the physiologist at Cardiac Rehab said because the healthier post op heart is able to move a lot more blood with much greater efficiency we have to work harder to push above that 120-130 plateau. As Philip said, there are some good books that discuss maximizing aerobic exercise. You might also look for some hills. One of my riding partners is fond of saying "Hills make us strong".

Larry

 

[MarkU]

Pre-op with my leaky valve and enlarged left ventricle, my resting HR was around 75 and was getting up to 160-170 during exercise.
24 months post-op with my mech valve and the enlargement having reversed itself, my resting HR was in the low 40's. It was able to pump a lot more efficiently with a non-leaky valve.
About that time I was getting into serious triathlon training and had some lab testing done to determine my lactic threshold HR, which turned out to be 159. For Zone 2 endurance training that puts me at 134-143 on my bike and 127-140 when running.
I will occasionally see a HR rate in the mid 150's, particularly in the FL summer heat, but have to work pretty hard to get it there.

Mark

 

[acr]

Cheers for responses folks, all makes sense. Mentu, good advice re: find some hills. Alas I live in Liverpool, UK, no hills here.

Ade

 

[Bill B]

MarkU - Low 40's! That's Peter Snell territory! Remember him? I didn't think anyone else had a resting HR that low. Historically, mine was always 60, but now after the AVR it's in the mid-50s.

 

[MarkU]

MarkU - Low 40's! That's Peter Snell territory! Remember him? I didn't think anyone else had a resting HR that low. Historically, mine was always 60, but now after the AVR it's in the mid-50s.

I've been lucky in that regard. I've had nurses who didn't believe it during my annual check-ups and took my pulse two or three times. My blood pressure has also dropped from the pre-hypertensive range down to 120/74.
If you want to talk about low heart rates, Lance Armstrong is at about 32-36.
Mark

 

[Doug]

Hello Ade, did you attend any rehab sessions? If so, what was your HR in rehab? My beta blockers keep my rate below 125.

 

[Guest]

I'm a runner. Check out Cardiac Athletes for a lot of good info: CARDIAC ATHLETES. Always wear a heart rate monitor when working out. I use the Polar with chest band, wrist heart rate monitors are not as accurate. No beta blocker for now. For my age, I'll be 50 this year, the calculator says my maximum heart rate is 145. They must be calculating the average person and not an athletic type as I have read athletes have higher maximum heart rates, I've been running for 21 years now.

I have found that my heart rate post AVR goes into the 170s if I push myself. My legs can go faster but my heart rate gets too high. Cardio says not to let my heart rate get into the 180s. I used to run 7 min miles 17 years ago. I can run in the 170s for several minutes, I average around 165 to 168 when all said and done. I've combined an aerobics class and a cardio sculpt class to my regimen to tone muscle and strengthen my legs, and I walk 5 miles on Sundays with my neighbor. A well rounded fitness program is serving me well. Pay attention to any symptoms you may experience out of the ordinary, chest pain, shortness of breath. Cardio advice to me was to report anything unusual.

The most problematic thing post op for me was letting go of the fear that something would happen if I pushed too hard. Take it slow, be smart about it and enjoy your new post op life. I'm loving mine!

 

[Philip B]

Leaking Valve

Leaking Valve

Oops, I skipped the question about the affect of a leaking valve...

Prior to my AVR surgery, as my heart rate increased with exercise or activity, my leaky aortic valve would regurgitate blood back into my heart. Basically, this would result in the heart swelling. For many who have the same issue, this results in stretching the heart muscle so it cannot pump as effectively. Congestive heart problems are often the result of this problem.

In my case, my heart had to work harder to pump blood, but my heart rate never really increased. Mine simply didn't move blood as effectively. Others may have had a different experience.

-Philip

 

[JeffM]

This thread offers a great example of how everyone is different. I suffered from BAV with regurgitation but no stenosis. I'm a cyclist and former competitve runner and swimmer so I have seen the differences in the way my HR responds to each of the sports. Slowest with swimming, faster with cycling and fastest with running. When I ran, I stayed closer to my AT (anaerobic threshold ) for most of the run. I averaged 37 min 10K times. With cycling, I find since my heart surgery that I am just now developing the leg strength to work my heart hard enough to elevate it and keep it high. I beleive that's a testament to a more efficient heart but also some leg weakness due to back issues (nerve damage). My max HR was in the 170s (used to be 180s but has come down with age). My max HR post op is 175. I expect before September, my max HR will be even a few beats higher, right where it was pre-op. And I've never read or been told that it should be anything less....at least in my case. My resting HR was 46 - 48 pre-op. Now it will rarely go as low as 48, but it's more often in the mid 50s. Sort of the reverse trend from what Mark experienced. So, I guess the take away should be, as already advised, do a little research and get on a program designed to increase your ability to work anaerobically, both in terms of the length of level of intensity and the length of time you can maintain it. From what I've been told by my cardiologist and from what I've read, once the heart has healed, there should be no limitations as long as there are no other underlying health concerns. Go for it!!

 

[kodi]

I’m not Peter Snell except for matching his slow HR. Mine has been in the high 30s and low 40s since I started monitoring it probably 25 years ago. It was slightly elevated after surgery but returned to ‘normal’ within about six months post-surgery. It is always kind of fun for me when I go for any type of medical treatment and they take it. The nurses almost always ask me if I’m okay. I usually ask them how high it is and if they say anything over 45 (higher later in the day) I tell them they need to take it again. My blood pressure is usually in the 120/72 range also. I’m on no medications except for a daily baby aspirin. When I workout, I wear a RoadId bracelet with my RHR on it. I have on previous occasions worn a Halter Monitor for 24 hours and there are times during the night when I’d go into the high 20s. There are mornings now when it is 37 or 38. Right now it is 5:00PM Sunday, I’m drinking a glass of wine and it is 46BPM. Because of my age (72) my max should be 148 or 169 depending on what method I use. I frequently get into the mid 160s when doing track workouts. I never train at a specific rate, I wait until I’m finished then see what my Garmin tells me I did.

 

[Jeanie]

This is a very interesting thread! My surgeon and cardiologist both told me that, for the time being anyway (am just 3 months beyond surgery), they do not want my HR above 113, and am on a Beta Blocker. It was explained to me that the HR on BB is equivalent to the effort that would result in a faster rate without them. They also both said that because of left ventricle enlargement (was so glad to read that is reversible over time), it is best not to push the heart too hard early on in recovery . So, it would seem that the answer to what is a good HR may depend upon multiple factors?

 

[acr]

Apologies for not replying to my own thread, busy busy.....

Doug - yep I did rehab, but I was staking 75mg of Atenolol daily, so HR was pretty normal. 60 or below resting. Without the BB's it was 100+ resting

LucyLou - yea I've checked out that site, I'm actually a member but don't find the layout that intuitive so I don't really use it. Good advice re: HRM. Having said that I find myself slowing down when I use one. Scary numbers! Like I perceive I'm doing a nice bike ride, then look at the HRM...and yikes! Mind you that was 3 months after surgery, and have not bothered since.

Jeanie - I was never given any numbers to stick to, but I finally got off BB's at the end of November 09, so 8.5 months on them ? Last Echo said heart was back to normal size, yay!

Anyway cycling is good now, am increasing intensity/duration towards where I was pre-surgery. Seems the heart is not a limiting factor, it's more my leg muscle (or lack of) after 12 months out.

Ade

 

[Jeanie]

Whoohoo, congrats on that! I am referring to the 'Last Echo said heart was back to normal size, yay!' comment. That is truly hope-inspiring.

 

[Luana]

My resting heart rate now is just about always in the 60s. Before surgery, it was mostly in the 80s, and that was with the same dosage of beta blocker that I take now.

 

[rodok68]

Heart Rate

Heart Rate

Ade, Congrat on riding after valve replacement. I am 64 male with porcine root and aorta valve. I started riding bike after my OHS 6 years ago and still challenge myself. Rode 27 miles yesterday-hold my HR between 106 to 115. Probably should push harder but I am comfortable yet challenged. I wear a HR mointor when riding. I take beta blocker and bp med.

 

[acr]

Ade, Congrat on riding after valve replacement. I am 64 male with porcine root and aorta valve. I started riding bike after my OHS 6 years ago and still challenge myself. Rode 27 miles yesterday-hold my HR between 106 to 115. Probably should push harder but I am comfortable yet challenged. I wear a HR mointor when riding. I take beta blocker and bp med.

Thanks, have been out this evening. Very cold in sunny Liverpool, must wear gloves next time, not good when you can't feel your fingers! Congrats to you too, you beat me, I'm nowhere near 27 miles. Busy lives here, work, 3 kids, they have a better social life than I do. So bike time is at a premium, boo hoo. Still, I love my Specialized Langster. Gotta work on those leg muscles though. Ade.

 

[d333gs]

Heart Rate

Heart Rate

Hi Ade,

How hard you work your heart to get it back in shape really depends upon a number of factors. There are a lot of resources available that can help you develop cardiac fitness goals. My focus is primarily cycling.

The system I use requires me to know what my maximum heart rate is and calculate what my different aerobic and anerobic exercise zones are. My maximum is around 171 bpm so maintaining 120 bpm would represent a low,medium aerobic pace for me. That's enough to receive benefit, but I prefer to exercise at a higher aerobic level and push myself into my anerobic range (above 153 bpm) during the course of my rides.

You should be able to increase your heart rate over 120 bpm. Immediately following my AVR surgery, the cap my cardiologist placed on my heart rate during exercise was 120 bpm. This cap was quickly removed as my heart healed. Replacement valves typically run just as fast as original equipment.

I was concerned before my surgery about my implanted valve not being able to keep up with high heart rates. Someone had told me some nonsence about artificial valves being unable to run as fast as tissue. My valve performs just fine when I push myself to my maximum heart rate and I suspect it can handle lots faster rates than I ask it to do.

All this said, you don't have to be overly technical with an exercise program. Simply exercise at a rate where you feel comfortable and push youself abit when you feel like it. If you want to push yourself harder, look for some resources that will help you build a good cardio improvement program. There are lots of really good books available. People are more likely to stick with a good exercise program if it's fun and interesting.

-Philip

I thought my new bovine av , which is about three times as large as the calcified one it replaced, would at a minimum, allow the same good performance I had up to replacement . It appears they gave me a one time med to calm the fluctuations of BP 100 to the 150s and I have since stayed between 110 and 120. Resting is settling in about about 60 vs pre op 55. This morning I went for a near brisk 45 minute 3.5k walk on flat land and bpm held under 100. No idea what BP was but I felt super. 35 minutes on a stationary bike set low at at 40 and a limited rpm? Of 65 , was a boring breeze.I was doing 12k hard cross country walks in two hours and 28 k cross country very hilly on an vintage gt lts mountain bike in 1hour 38 minutes and felt great. Spikes in bpm were around 148. The way I felt today , getting back to those levels won’t be too hard in the near future.

 

[Al3x]

This is an interesting thread. I think I've had the opposite experience to most. My HR is higher post op for the same perceived exertion, even though I'm performing much slower.

Part of that is without doubt a general decrease in fitness due to lower levels of exercise. Resting HR is about 42, compared to mid 30s previously. Estimated VO2 max from my Garmin is 54, down from 65 a few months pre surgery. At a comfortable running pace, my HR is over 160, compared to about 145 previously.

That being said, I'm happy with my progress. I'm 6 months post op and can run 5km in 21 minutes. I will also be running a half marathon in early March at around 1h40 pace. Hopefully I haven't reached my max fitness yet! Even if I have, I'm just thankful to still be alive.