Heart Rate Monitor

[dtread]

Debbie, you've gotten some excellent advice already and there is not that much that I can add. Figuring that you are over a year post-op, and already have a good level of fitness and have gradually built up a cardio base with your workouts, I would see no reason why you could not do workouts of an hour, or even longer, at 150 bpm. I have always felt that the 220 minus your age is a conservative formula. But it should be, to prevent folks from pushing too hard, particularly those that are not in condition. If you build up gradually, over many weeks and months, I think you should be okay (my opinion).

 

[Debbie]

Thanks Chou and Dan, I know I won't damage my valve by having my HR up but I do know with a tissue valve they last longer in older patients because they don't "use" it as much. Don't have the stats. in front of me, but the more I use this valve the faster it will wear out. It's not a big differance, I think it is like 18-20yrs. it should last if I were older, and for the younger crowd it take off a few years. I already decided since I will be having another replacement in the future what's a few years differance if I can be healthy and as strong as I can be! I'll have to go find my stat's as to how much sooner the tissues wear out with the more active people. Thanks Debbie

 

[JeffM]

Debbie,

I'm not positive on this, but I think the reason tissue valves need to be replaced sooner in people under 60 - 65 is due to a younger body's stronger immune response. As a result, the valves tend to develop calcium deposits. I haven't seen anything that indicates a harder working or faster beating heart is a factor.

Regarding average exercise heart rate, it depends on the kind of workout I'm doing on the bike. Some rides are shorter and stress more work at or above my lactate or aerobic threshold (160ish), some are longer at a lower avg HR (135-145), some focus on hills or "big ring" days in which the emphasis is more on building up the legs and sometimes high cadence work. You don't need to work so hard that you feel like you're on the verge of collapsing and vomiting all at once, although, people who run, swim, bike, skate, etc at really competitive levels regularly incorporate that kind of training in their programs.

I don't think you can go too hard for your heart. It's just a matter of gradually increasing what you can do.

 

[Debbie]

Thanks Jeff, hey how much are you riding now-a-days??
Take care Debbie

 

[tprice54]

Debbie, I specifically asked my cardio (ok, my wife did) and he said 220-age is the same formula for us valvers, once we are all heeled. He also said I will not wear out the valve any sooner by running, it is the body's immune system that will do it in.
SO, if you want to exercize at a higher rate, talk with your cardio and push him on the details as to why 150 is your max. It helps that my cardio is aslo a runner, and he gets me!

 

[SumoRunner]

Here's a good web site that shows several methods for calculating Max HR which takes into account whether you are already a well trained athlete and whether the activity is running, biking or rowing. It gives me at age 61 anywhere from 159 for the simple 220-age, up to 169 and since I know that even while taking beta blockers I push for quite a while at 152, I would believe the higher values as my theoretical max.

http://www.brianmac.co.uk/maxhr.htm

I ran some intervals last night, 4x800 meters and I'd bet I got it pretty high but I don't own a HRM so I don't really know. Being old-school I train by feel not by the numbers.

 

[JeffM]

Thanks Jeff, hey how much are you riding now-a-days??
Take care Debbie

I just started riding again a few days ago and only on the rollers indoors for 20 - 30 min at a time. I've been doing steady riding with my HR staying in the 150s. I had lumbar surgery last month and am not supposed to get on the bike until I see the surgeon again May1. I've been combining this with 30 min. on the elliptical machine (same HR). I figure if I ride mostly with no hands I won't stress the back too much. So far, so good.

 

[Debbie]

Jeff, better be careful with that back!! It is very fragile. Hope your doing well and taking care of your self. Debbie

 

[jendyk]

Thanks Kodi, your answer was good, but that is for a normal heart that has not been worked on. I want to know if we should be more careful wiht our newly fixed heart and not do any damage to them. I want to do as much as i can, but I don't want to hurt my new valve in anyway by making it work too hard! So, is a fixed heart a healthy heart???? Debbie

As I understand, the valve is not the problem, but the heart muscle could be. The muscle needs to recuperate and a lower heart rate means less work, less work means less stress, less stress means repair at the cell level. It all depends how long your heart was working with a damaged valve and the effect on the heart muscle.

 

[Philip B]

Outdated Max Heart Rate Formula

Outdated Max Heart Rate Formula

Interesting to note the replies citing the old 220 minus your age equals your maximum heart rate formula. The formula has been around for years despite the lack of scientific research to validate it. I equate the old 220 formula to some of the misconceptions out there regarding coumadin. The formula is outdated and needs to go away.

If you really want to calculate your maximum heart rate, the most accurate methods involve doing some tests designed to determine what your maximum heart is. Research actually indicates that the true value in accurately determining your max heart rate involves determining the ranges of heart rate you need to exercise in to get the most benefit. The reality is that one cannot exercise for long at maximum heart rate anyway; the body simply refuses to do exercise at maximum heart rate for very long.

Maximum heart rate changes as people get in better physical condition. Even things like altitude can affect it. Several months ago, I travelled to St. Louis to complete some cycling coach coursework. While doing some tests to calculate my maximum heart rates, I noticed my maximum in St. Louis was over 15 beats higher than it was in the mountains of Colorado. I think it had something to do with more oxygen being available.

Opinions will undoubtedly vary concerning the heart being more fragile after valve replacement surgery. Both my surgeon and cardiologist expressed a high confidence level in my heart and aorta being in better shape after surgery than before. Both encouraged me to pursue whatever activities and levels of exercise I wanted to do.

During the first few weeks of my cardiac rehab program (I started two weeks post-op), my doctors placed caps on my heart rate because I was healing. Those caps increased and eventually disappeared as I healed.

-Philip

 

[MarkU]

You're confusing maximum heart rate with lactic threshhold heart rate (LTHR). Maximum heart rate can't be improved with exercise and decreases with age. LTHR is what is used to determine training zones and is the point where you go from aerobic to anaerobic.

Mark

 

[Philip B]

No Confusion Here

No Confusion Here

No Mark,

I'm not confusing maximum heart rate with LTHR. The 220 minus your age formula is not based on current research. I personally know a number of people who began fitness programs and increased their maximum heart rates as their level of cardio fitness increased...I'm one of them.

-Philip

 

[MarkU]

Increased fitness allows you to exercise at an higher percentage of your HRmax, but it doesn't increase your actual maximum heart rate which is primarily determined by genetics and actually decreases about 1 bpm after teenage years.

The major shortfall of the 220 formula is that it is based on averages and doesn't reflect the wide statisitcal variance or standard deviation of the general population. It gives an approximation which may or not be accurate for a given individual.

Ancedotally, my cardiologist had me undergo lab testing to determine my LTHR and V02 before he gave me a green light to start serious triathlon training. My resting HR had gradually creeped up to the mid high 70's prior to my AVR and I would routinely be in the 150 - 160 bpm range when working out. My heart was working harder due to the my leaky valve. Within about 18 months post-op (with a good valve in place) my resting HR dropped to the mid 40's. The testing determined my LTHR to be 159 bpm and we set my training ranges based on that number. I have to be working very hard now to get my HR into the mid 150's. LTHR can be increased through improved fitness but takes a lot of work to do so.


Mark

 

[Philip B]

220 Minus Age Formula

220 Minus Age Formula

The 220 Minus Age formula to determine maximum heart rate dates back to the 1970’s. The scientists (Fox, Naughton & Haskell) who developed it intended it only as a rough formulation rather than a representation for the entire population. This rough formulation is referred to in several of responses by members to this thread. So why isn’t the formula valid? Interestingly, all subjects referenced in their studies were under 55 and male. There has been no further research to support scientific validation of the formula. Personally, I’m 54 and the formula doesn’t fit me.

More recent research validates that there is no physiological reason that everyone who happens to be the same age should have the same maximum number of heartbeats per minute. Research also indicates that as fit individuals age, their maximum heart rate drops very little. Basically, research shows that maximum heart rate is a very individual thing. 220 Minus Age has been noted as usless by researchers like Carl Foster Ph.D (UC Berkeley & past president of the American College of Sports Medicine).

A major problem with the formula is that it can result in overestimating maximum heart rate in young people and underestimating it in older people. This represents a problem because starting in the 1990’s fitness equipment manufacturers began to build the formula into a lot of cardio-equipment. Despite lack of validation of the formula, manufacturers continue to use it. Working with the formula is also a requirement on many certification tests for personal trainers. Basically, overestimating maximum heart can put people at risk while underestimating denies people the benefits of exercising at effective intensity levels.

When developing an exercise program to achieve desired health benefits, I believe one would be well-advised to work with an equation which accurately prescribes the exercise intensity that is needed. There are scientifically validated methods available to safely and effectively estimate maximum heart rate.

Opinions regarding maximum heart rate and at what levels those who’ve had valve replacement surgery should exercise will differ. My cardiologist doesn’t believe that restrictions are necessary for me, but I suspect he has other patients who he restricts. Probably the best course is to have a conversation with a cardiologist whom one trusts to advise about how much is too much.

-Philip

 

[jendyk]

Agree with my buddy Jack...it will have an effect...in fact, many of our limitations post op are because of the meds we take. It''s good to know going back to exercize what drugs you are taking and what they can do to your metabolism during a workout.

What can the drugs do for your metabolism, Tom? Since my heart failure event 1 year ago and subsequent surgery, I've gained 25 pounds and that is fat not sterling. (-:

 

[jendyk]

No Mark,

I'm not confusing maximum heart rate with LTHR. The 220 minus your age formula is not based on current research. I personally know a number of people who began fitness programs and increased their maximum heart rates as their level of cardio fitness increased...I'm one of them.

-Philip

I am another, Phillip, but not an athlete; an ordinary Joe. I use the Borg RPE (rate of perceived exertion) scale together with a heart monitor. The suggestion after surgery was not to increase your heart rate to more than 20 beats per minute more than your resting HR. One week after surgery, I found that after a 5 minute walk, I would be breathless with a HR of 90 (Borg scale: 16). At 6 weeks and a stress test, it was determined that the ideal HR for recuperating for me was 96 and Borg Scale of 13. Some days I had to slow down to the 80's to keep the Borge Scale at 13.

Now after 4 months I can walk or bike with my HR at 110 and still feel comfortable (RPE: 13). I've been graduating myself. It is going to be a long grind for recuperating.

 

[Philip B]

Beta Blockers & HR

Beta Blockers & HR

Like a lot of others, I was on beta blockers in the weeks following AVR surgery. It was interesting to notice the way the drugs restricted my heart rate when I started a formal rehab program at two weeks post op. My heart rate would literally hit a proverbial wall and just drop. This was not a bad thing as it prevented me from pushing myself too hard and messing-up a bunch of high quality, expensive work that my surgeon had done. My cardio doc took me off the meds about six weeks into the program.

Getting my heart back in shape took time and a lot of work. It didn't happen in a few weeks. I certainly wasn't working in exercise zones based on my maximum heart rate 178 (@ 9,000' in Colorado) or 184 (@ St. Louis this spring) during my first year after surgery.

A member of my teaching staff who had worked with cardiac rehab patients while working on his Ph.D. in exercise physiology commented that I would need to continually work to keep my heart in shape. I think there's some truth in his comment. Even though I work with people to increase their levels of cardiac fitness, I don't think everyone needs to be an athlete or fitness junkie. Overall, I bet we'd see people with healthier hearts if they would simply find some physical activities they enjoy and do these activities on a regular basis.

-Philip

 

[Jeanie]

This is a really good topic! I just got an MIO wristwatch style HRM and really like it, especially since I got a good deal on it!

Regarding heart rate, I have gotten the impression from my Doctors that whether you do or do not have left ventricle enlargement will affect how hard they will want you to work the heart, and how soon.

 

[jendyk]

Debbie, I specifically asked my cardio (ok, my wife did) and he said 220-age is the same formula for us valvers, once we are all heeled. He also said I will not wear out the valve any sooner by running, it is the body's immune system that will do it in.
SO, if you want to exercize at a higher rate, talk with your cardio and push him on the details as to why 150 is your max. It helps that my cardio is aslo a runner, and he gets me!

in my case the left ventricle was enlarged, with the muscles stretched. If my exercising HR was too high, the muscles may not recover as quickly. My max is 96. When I was healthy pre-op, due to my age and extra fat I carried, the max was 132. Everyone has different needs to get to health. Hope this helps.

 

[jendyk]

Thanks Chou and Dan, I know I won't damage my valve by having my HR up but I do know with a tissue valve they last longer in older patients because they don't "use" it as much. Don't have the stats. in front of me, but the more I use this valve the faster it will wear out. It's not a big differance, I think it is like 18-20yrs. it should last if I were older, and for the younger crowd it take off a few years. I already decided since I will be having another replacement in the future what's a few years differance if I can be healthy and as strong as I can be! I'll have to go find my stat's as to how much sooner the tissues wear out with the more active people. Thanks Debbie

Good for you, Debbie. I plan to use my bovine valve with the 17 year warranty like my old one and do whatever I can. I want to get on with my life.

George