Maximum heart rate

I have had a St Jude/Abbott CRT for about 8 months.  I’ve been running (etc) for about 45 years (roughly 20 miles per week, more when I was younger) which I continue to do.  I’m 71.  I wondering if there are additional opinions about maximum heart rate since my resting HR is set at 60 bpm but I have not much trouble seeing my HR go to 160 running up hill (as determined by my fitbit, which I realize is problematic). 

I recently re-read some posts about maximum heart rate and consulted some calculators (like  https://www.alpinetrek.co.uk/heart-rate-calculator/ ) .  So I’m just wondering if these age-based maxima have meaning for those of us who are paced.  Before PM my resting heart rate was in the 40s for most of 40 years. 


4 Comments

Heart rate calculators

by AgentX86 - 2021-12-17 19:42:52

These are, at best, just estimates.  Depending on the reasons you have a PM (i.e. chronotropical incompetence or heart block), it may be all you anyway.

Since you have an EP/cardiologist on your team, he can make a much better, personalized, judgment of your maximum HR. If you think you need more for your lifestyle, maybe you can sweet-talk (negotiate with) him into bumping it up.

 

As Agent says, it's about negotiation.

by crustyg - 2021-12-18 05:48:31

The short answer to your Q "I’m just wondering if these age-based maxima have meaning for those of us who are paced" is that it doesn't matter whether you're paced or not.

Remember that blood only flows into the coronary arteries during diastole, so as HR increases - and hence cardiac muscle oxygen demand increases - delivery of oxygenated blood *decreases*.  Which is why even youngsters go into HF with a sustained vent rate much above 200BPM (e.g. WPW during an episode of SVT).

What is an appropriate HR for a fit senior like yourself?  Very personal, but it might well be somewhere between 160-170BPM.  The healthy, fit, athletic heart increases cardiac output more by increasing the volume of each contraction than it does by increasing HR - hence why HR recovery is a good marker of cardiac fitness.

But very few EP-docs have much personal experience of fit seniors who still exercise vigorously, so tend to be very cautious about maxHR (which they can often control via PM settings), and are well aware of the professional risk to themselves of giving you a maxHR that *appears* to lead to a cardiac event thereafter.

Your post doesn't say whether 160BPM for you is associated with poor uphill performance, or whether you're worried that 160BPM is too much.  Q for you is this: do you feel good?  Because that's what matters.  You could charm your EP-doc into a formalised test (treadmill +/-Bruce procotocol or static watt-bike) where the monitoring during exercise will give your EP-doc some objective data to work with.  It's a fairly reasonable assumption for us that your cardiac muscle health isn't all that it could be, otherwise why would you have a CRT device?

Maximum heart rate

by Gemita - 2021-12-18 06:46:21

Prof P,

Thank you so much for the calculator link.  I can see I am well below the calculator suggested maximum rate for age, gender, weight.

No I don’t believe these calculators have a great deal of meaning for those of us who are paced.  I always go by “how I feel” to determine whether my settings are right for me.  If I feel good, then whatever is set up in my pacemaker must I presume be working well enough at any given time.  

In the absence of other health conditions causing our symptoms, if we don’t feel well when exercising we might do well to consult our doctors, not a calculator for determination of a safe upper rate setting and to work with a technician during treadmill tests to get our settings tailored to suit our personal needs.

My upper tracking/sensor rate is set at 130 bpm.  Unfortunately I have atrial and some non sustained ventricular tachy arrhythmias.  I believe my EP is reluctant to increase my upper rate setting in order to limit the rate the ventricle can pace in the presence of a tachy arrhythmia

Max heart rate

by Prof P - 2021-12-18 15:12:28

Thanks to all of you for your comments and suggestions.  I'll certainly talk to my doc(s) about this.  I'm not running into a wall or feeling bad at 160 or so bpm.  The beta-blocker I take is supposed to control very high heart rate.  I know my performance is waning and that a good reason for that is being 71, near an age where performance declines anyway.  I'll report back what the doc(s) say - which up to now has been do what you want to do.  

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