CABG, Exercise & BPM

[Snowflake01]

Hi - Looking for perspectives and any experiences on intensive cardio exercise and max bpm limits post CABG (dare I say on or at least near a competitive basis).

Standard Cardio Rehab programmes can only take you so far. No problem with mine in this respect, it's giving me the great guidance and provision to get started with (pleased to have done a successful run this week based on this guidance 🏃‍♂️).

However, I still have questions... How close to pre-op / pre-symptoms max levels can be safely achieved? How do you reach your full potential? Any experience of more specialised 'cardiac coaching' (e.g. specialists in a cardio based sport)? (think DWizza had gone down this route?)

I recognise specific bpm levels are different for variety of reasons (e.g. age, physique, medication, previous conditioning etc)... so, where can you go for some more ambitious and personalised guidance? Or am I being delusional... 🤔

All views greatly appreciated! 🙂

[Just adding a link to some related posts: healthunlocked.com/bhf/post...

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[pasigal]

I have struggled with this very question. I think the short answer is that it's up to the individual case. My cardiologist is pretty insistent that I try to stay under 130 bpm (assuming a max of around 165 -- I'm 56 and on bisoprolol), which is hardly pushing it for me -- would call it lower Zone 3). Every now and again it's OK to go above that but not for extended periods of time, I'm told.

There are some new studies that suggest high-intensity exercise can be overall beneficial but I would NOT use that as a guide.

At some point I'd like to consult with a private sports cardiologist to work up a training plan (cycling). It would require some coordination with my own cardio so it might be a bit involved. For now I'm OK with being a casual (if consistent) athlete and if I never get back to doing gran fondos again, at least I'm alive (having survived out of hospital cardiac arrest).

[Snowflake01 in reply to pasigal]

Sounds similar to me, 130ish, with 'bursts' up to 145ish (mid-50s & Bisoprolol), as advised through the Cardio Rehab. This is fine for me at 12 weeks post op and will be whilst I cautiously rebuild my fitness. Most guidance does appear to follow a set formula or be of a generic nature. There may/will be a point where I'd like to expand on this and a private sports cardiologist sounds a good way forward if you can find one and want spend some money 👍

[CyclingTime]

Hi there, I had a quad CABG 2.5 years ago.

My consultant after my final check with him said I can go as hard as I want now.

I'm a cyclist and I am doing better rides/numbers than I was 20 years ago. I did build it up gradually which is more of a confidence thing.

I use a chest HRM, I do have a good Garmin watch but it doesn't react as quickly or reliably. So in terms of BPM etc I just go to the max based on the old 220 minus age. It's not the ideal method but good enough, tbh my legs are gone before my heart rate 🤣

I do 4 x Zone 2 efforts and 1x Max effort in the week unless I am building up to something then it's 3xZ2 and 2xMax effort.

No point in max efforts every training session you will just gradually get worse

[fixedrider in reply to CyclingTime]

Similar to @CyclingTime, though my double CABG was five years ago. The consultant who discharged me said I could go as hard as I like, so I'm enjoying club 10s (short half-hour races), Audax rides and similar of up to 100 miles, and the like, without worrying too much about heart rates. I've never had talent, and I've always regarded training as a mild form of cheating, so I don't bother about the zone stuff any more than I did before.

It's all about the individual and the particular advice you're given for your condition though.

[Snowflake01 in reply to fixedrider]

Thanks - again interesting guidance from the consultant. Wish I'd asked more whilst being discharged from the hospital or at the 6 week follow up, but there's a lot of more pressing things to think about in the early days after the op.

Your final point is most important that we should emphasise as a disclaimer - everyone is different and we need to seek our own personal advice from qualified and experienced professionals and keep within that personal guidance.

[Snowflake01 in reply to CyclingTime]

Interesting advice from your Cardiologist, I might need to have a chat with him!

Now I'm further down the recovery road than my 6 wk post surgery appointment, it might be worth trying to have a follow up if I can manage it. We didn't really go into the bpm max topic at the time as there was so much other stuff to talk about.

[Bilbobuts]

Hi, I also am very interested to see how this thread develops - I am heading towards my 3rd ablation after a successful 1st ablation and 2 years free of AF where I was regularly attending HIT sessions with max HR 172, mountain biking and ran my fastest half marathon time. I went back into AF in October 2023 with no real trigger and certainly not related to intense exercise as had been sailing for the weekend, have had 2 x unsuccessful cardioversions and 2nd unsuccessful ablation in April this year. Despite this my cardiologist is happy for me to continue to exercise whilst in AF so have been listening to my body and still attend less intense exercise sessions, regularly MTB and try to run at least once a week (5k is enough) my chest Heart rate monitor and garmin do show ridiculous HR at times (199) but I reduce intensity depending on how I am feeling and will have more rest days in between if I feel tired. I am 58 and have regularly exercised all my life, generally my resting HR when not in AF is 46 and when in AF 62. Played a lot of rugby in my early days then progressed to triathlon, MTB & road cycling so am very aware of how my body feels and has always been more for enjoyment than competitive although by nature I am competitive - hydration is absolutely key I find.

I have always discussed with my cardiologist so this is very specific to my own condition and experience - 3rd ablation is October and looking forward to it being successful this time around.

[Snowflake01 in reply to Bilbobuts]

Good to hear the things you've been up to, including half marathons. I guess AF brings its own challenges in managing bpm and I certainly wouldn't be wanting to hit 199!

Agree, listening to your body is so important. With sports backgrounds, we tend to be very self-aware of 'feedback' from the body during exercise (and this self-awareness is a fundamental part of competing). This is how I ended up in our Hearties Club, by recognising chest discomfort during running that I couldn't explain and then seeking medical advice.

With the ongoing AF, you also seem to have much more contact with consultants. As a CABG patient (angina only), now the op has been complete and the 6 week follow up done, there is no further consultant contact, not even a 12 month checkup 😕...

All the best for October 👍

[Ralfthecav]

Will be watching this thread with interest. Before 3xCABG was regularly running 5k with HR up to 170 ish. Since op have been told to keep heart rate to around 125 (some of this to do with beta blockers slowing HR). Can’t get more than a gentle jog for a couple of mins without exceeding this - so not sure how I’m going to get back to proper running - maybe over time will get there as only 4.5 months after op.

[Snowflake01 in reply to Ralfthecav]

Yes, as frustrating as it is, a 'gentle jog' is probably best in the early days - sounds like you're doing well 👍. Further down the line, I would like to understand the safe limits better - still, it's good to get out there exercising! I think the only way to do this is to get some expert advice and support, but can't see it readily 'advertised' or offered anywhere.

[Chinkoflight]

Hi Snowflake, sounds like your making great progress since your last post. Following on from my last reply I think we are all maybe living on a knife edge but whilst we are doing something we love we are living. As I said before the competitive thing, to be better, has taken a back seat. But surprise, surprise I did a longer walk, 21k and 330m elevation around West Wight on Wednesday, and Strava said I had just done my best half marathon time! I had been jeffing it, jogging on the down hills! I've never actually run a half marathon but it's got me thinking!! Going round the bays of west wight involve going up or down the chines. One of my regulars, Widdick Chine is still one of those that tells me things are definitely not right! On this long walk I breezed up it and onwards. It forms part of my shorter routine 5k routes and a couple of days before it was a killer (😄). I try and review my metrics, re think what's happening to my body etc but I've yet to get a handle or understand why things can be so different from day to day.

As I said it's a bit of a knife edge. I'm sure there would be explanations and I suppose if we had access to a sports science facility approach we might get a better handle on it.

Just getting good data would help and understanding our own smart watch data and knowing whether it's trustworthy and not binworthy.

The thread responses have been interesting. There is clearly a market opportunity for a sports scientist to help and support us. I would probably buy into a session if I thought it was available.

[Snowflake01 in reply to Chinkoflight]

Yes, pleased with my progress so far, the strengthening of my sternum, particularly around week 10-11, makes a big difference 🙂

Maybe the competitive slant needs a reframing, as in doing new things to push a personal limits rather than be on the podium of a race (I have accepted this!). Even bettering own achievements can be the challenge and I like your thinking, it's what gets us out there doing it isn't it?

Having a bit of extra professional support would help provide some assurance in doing this safely so we're not living too close to the edge 😮