Posted by steve giddings on July 02, 2002 at 07:48:39:
In Reply to: I'm 3 mos post Maze and doing great posted by Tim Hawkins on June 30, 2002 at 14:19:57:
Tim:
I am delighted to hear that you are doing so well post maze. On your questions about resting heart rate and recovery from exercise: I don't think anything has been written about resting heart rate post exercise in the medical literature. I tried to look this up post maze, and found there was very little written on recorvery after the immediate post op period for any type of cardiac surgery. The maze is a little unique because everyone with lone af who has the maze tends to have a fundamenentally sound heart, unless some cad is found during the preop workup that includes a cardiac cath. The point is, for most survivors of heart surgery, there is still some significant damage remaining to the heart because of the underlying condition. For the maze, there is not.
My own experience was that my heart rate returned most of the way to baseline within the first 3 months post op. My resting heart rate before was quite low, about 35. I was back down to 50 -55 during that initial period. I think most of the decrease was due to recovery of the heart muscle from surgery per se, and the blood count returning to normal. The remaining portion of the recovery was due to conditioning. AS you have probably noticed, you decondition dramatically with the surgery and the enforced quiet time immediately post op. It only takes about 2 weeks of bed rest to completely decondition, and it takes months to years to get back to baseline, depending on where you started.
Your heart rate will probably come up a little, but not appreciably, as you come off the relatively low dose of beta blocker you are now on.
Your heart rate recovery from exercise should not be affected as much by the toprol. It is more a reflection of your current state of conditioning. You should continue to work on your exercise until your rate of decrease per minute upon stopping is greater than 12 bpm. The rapidity of increase in heart rate with onset of exercise is condition-dependent as well (the beter conditioned you are, the more rapidly your HR increases upon commmencing exercise).
On your comments about how much your heart rate increases when walking up your hill, this will be afected by the toprol to some degree as well. However, you have to take into consideration your baseline heart rate when evaluating your heart rate with exercise. There is a useful concept referred to as "heart rate reserve" This corresponds much better to your %VO2 max with any given level of exercise than your absoluite heart rate. The HRR is simply your HRmax-resting heart rate (RHR). Your resting heart rate is what you get before you get out of bed for the day. It is best determined as follows. When you first awake, get up and relieve yourself, as you would normally, go back to bed and lie quietly 5 minutes, then check your HR. The most accurate way to get your max hr is with a treadmill stress test, or some variant in which you exercise with the intensity increased every 2-3 minutes until you can't keep up. If you aren't on a beta blocker, a reasonable estimate for most is 220-age. On a beta blocker it is probably about 20 beats less, but there is a lot of variation. To estimate your percent effort using heart rate reserve and your actual heart rate, 60-70 % effort (where you should be doing most of your exercise) is RHR + 0.7xHRR. So is your resting heart rate is 50 and your max hr is 170, your HRR is 120. 70% of 120 is 86 so you should be exercising to am max HR of 50 +84 = 134 upper limit, 122 lower limit (RHR + 0.6 x HRR).
All of this stuff is summarized in various sports books that tell you how to train using a heart rate monitor. For rehab, the key is to start off slowly and build to the recomended level, not try to meet or exeed it from the start. The best web site by far that I know for all of this stuff is:
http://home.hia.no/~stephens/exphys.htm
Things will only get better from this point and you will be flying, figuratively as well as literally, in short time.
Steve Giddings
- Re: I'm 3 mos post Maze and doing great Carl Plaskett 21:16:50 7/02/2002 (0)