Recovery Heart Rate

New member with a question about factors impacting Recovery Heart Rate (how fast HR returns to resting level after exercise).

Background: 68 yr old male, >50 years competitive distance running and bicycle racing, Medtronic Protector XT DR installed after V-tach episodes beginning 2012. V-tach ablated Aug 2015, started using bicycle indoors on CycleOps trainer about 1 month ago after 1 1/2 years of no biking at all, only walking.

From other posts, understand that Medtronic doesn't detect cycling exercise well, and I am still on beta blockers. Noticed recently, when I watched my HR recovery, that after 45 minutes "hard" workout (altho' avg HR only ~110) that while HR dropped to 75 bpm quickly, it took another 30-40minutes to get back to resting HR ~50 bpm. This seemed very long, unless either the beta blockers or the programming of the Medtronic play a part. Does anyone have any insights?

6 Comments

Some Insight

by donr - 2016-02-16 05:02:41

About a yr ago, I entered a Cardiac Rehab program because I needed it! I've had my PM for SSS since Feb 2003 & been through several severe surgeries that left me in bad shape, mentally & physically. At the time I was 78 yrs old.

I take a beta Blocker & an antiarrhythmic med, plus two other BP meds.

Used three different machines - treadmill, recumbent bike & hand bike. I was really in lousy shape. Started out at doing 1 minute on each, & added a minute each week. I attended three sessions per week. Worked my way up to 30 plus minutes on each machine. BP always stayed w/i the envelope of 140/90, even at mid point of exercise period on the last machine, so that was not a problem.

Pulse never got above 115, no matter how hard I worked. For the post exercise vital signs, I had to check my HR while still on the machine - it dropped like a rock. After 1 min, I was back to below 90 BPM & at 3 min, I was back down to 83 BPM. My Pm is set at 75 for its lower limit & it took at least 5 min to get even close to that.

What I discovered is that 83 (Nominally) is where my HR stays under normal levels of inactivity. It only drops to 75 when practically asleep. Several times, I got my HR down to 75 post exercise, but I had to really concentrate on relaxing & practically clear my mind of any thoughts. Just moving an arm would raise it back up to the low 80's.

BP likewise dropped like a brick, back to its normal 130/80 (Nominally) in about 5-6 min.

I was dropping back to only 83 from 115 - a difference of 32 BPM. You are trying to drop a total of 60 BPM. That's quite a drop. You did not say what your HR is under inactivity prior to starting. I'd bet it is close to 75.

Beta Blockers are notorious for limiting HR at the upper end. Too much of them can turn you into a zombie - kind of shuffling along, walking slowly, talking slowly, acting like you are drugged. You even start thinking slowly. BTDT! Not fun

Donr

bpm recovery

by zazen_1 - 2016-02-18 07:02:04

I've been cycling (used to compete) for 27 years and continue year round just to keep in shape - am 72. Other than the Mobitz Type II the PM was recently installed for, I am in decent shape. I like to spend the majority of a ride above 80% of my max hr - 120 bpm. My hr would always recover quickly after a ride indicating to me all was in good shape. Prior to the PM install, the cardiologist put me on a tread mill and stopped the test after my hr was above 90% of my max hr - I could have gone more.

I take no pills for anything. I plan to resume workouts on a stationary bike soon, as it has only been a week since the install. This morning the PM tech turned RR off. This way supposedly my hr can go as high as needed without the governor effect of the PM with RR active. She also set the lower limit to 50 bpm. I did not understand why they initially set it to 60 when my resting pulse rate has been around 50.

Will report back after resuming cycling workouts regarding hr and recovery time. I am hopeful all will be the same as before.

further on recovery HR

by catthree - 2016-02-19 01:02:43

Thanks for the replies. I think the crux of my question is that after decades of training by HR zones, running and cycling lots of intervals, I no longer have any sense of "normal." With beta blockers trying to keep my HR down, and the RR function of the Medtronic trying to raise it for exercise, everything is now artificial.

Prior to the meds, etc., my resting HR was around 48, thanks to the almost 50 years of training for endurance events. When I was put on the beta blockers, and the ICD was installed, they set the low end at 50, because they were occasionally seeing the rate as low as 38-40 in the hospital during sleep (with the beta blockers). Currently, when I'm sitting watching TV or reading a book, my HR will be somewhere in the 50-53 range (because it cannot go below 50).

The RR function is set to increase my HR up to 125 (the ICD set point for detecting V-tach is 161). If I go for my "brisk" (i.e. say low 14-min/mile numbers) 6 mile walk, I end up with avg HR around 115-120, max 125, so clearly the ICD RR function is at work. If I ride the stationary bike, where the RR function doesn't work well (little upper body movement) I feel like I am working harder but my average HR is only around 105 ( I guess that is my heart fighting against the beta blocker on its own). And the HR recovery rates seem different. Today, after the brisk walk, my HR dropped almost 40 bpm in 2 minutes, from 125->88, and by 12 minutes was down to the low 50s. But when I rode the trainer yesterday, the recovery was slower, only dropping from 103->82 in 2 min, and taking a full 20 minutes to get back to the low 50s. I have no idea how to interpret any of this, other than to suspect that the beta blockers, RR function, and ICD detection of exercise are all playing a role.

bpm recovery

by zazen_1 - 2016-02-22 09:02:27

Have resumed cycling - currently on the stationary - still concerned about the road bike until more healing takes place so I can use the left arm.

Discovered my Axiom HRM (chest strap) will no longer function correctly apparently due to interference from the PM signals? I've been using this monitor for years - no problems. Anyone have a HRM that will work with a PM?

At any rate I periodically checked my pulse for 30 seconds and my hr was in the mid to upper teens - normal. I'm still easing back into cycling. Normally I work very hard for 35 minutes with at least two rest breaks. Going easy today I rode 35 minutes with no breaks. I've never had an issue with recovery afterwards. The hr rate usually drops back to a low rate quickly.

Other than the HRM, it appears all will work as before the PM install.

HRM & Medtronic

by catthree - 2016-02-25 01:02:02

Zazen_1: I use one of the cheaper Polar HRMs, and it seems to work OK with my Medtronic ICD/PM. Almost all of the time it reads normally. However it does seem subject to what are probably false peaks, i.e. when I look at the stored data after an indoor bike session, I sometimes see "normal" readings, say avg 107 bpm, max 128 bpm, but also sometimes avg 106 bpm max 192 bpm. Since my ICD would shock me at anything sustained above 161 bpm, those high numbers are in all likelihood false readings, and when I periodically glance at the readings during exercise, typically when the effort seems harder, they are always normal. The false peaks are more common on the indoor trainer, rare on "exercise walks" outside. Incidentally the wired powermeter on my bike also is picking up the HR from the Polar Strap, and the averages match quite closely.

HRM Readouts

by zazen_1 - 2016-02-25 07:02:01

catthree: Most likely my Axiom HRM produces false readings when I'm being paced by a St. Jude PM - especially at a normal HR. No shocks as my 2-wire PM is just for Mobitz Type II block. I switched to the Axiom from the Polar years ago since one can replace all batteries in the Axiom. I may checkout the Polar HRM offerings once again.

I'm starting to feel stronger so rode the stationary 35 minutes yesterday with a good effort. I spent 19 minutes in the "target zone." I was pleasantly surprised when my HR neared 80% of my max, the HRM began normal readouts?

I presume this is because I'm no longer being paced by the PM. I remained in the 120s up to a max of 135 with OK readouts. A normal workout for me. When I paused for a break, the readouts were once again no good, but became OK when the rate went above 80% again.

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