Who knew? Until this article, I used my watch for time, weather and notifications. Yesterday's workout - a brisk walk - proved shocking. I could barely wait to try it again today, better results but still appalling. It's on topics to discuss with my internist next week as well as that "on the fence" statin conversation. Numbers are screaming for my attention. Thanks, Dr. P!
I've seen evidence that mindfulness, meditation, deep breathing can acutely influence some parameters of parasympathetic tone. I'm all in favor of anything non pharmaceutical measure that lowers perceived stress, pain or dyspnea and improves happiness. But, I'm unaware of long-lasting changes on autonomic cardiovascular parameters from such approaches.
This is a great post, thank you. I will check my HRR tomorrow! I’ll do it the old fashioned Luddite way - two fingers on a carotid ❤️
I thought I would be funny and joke about taking a beta blocker- so I’m glad you already sort of addressed this.
And finally, I would assume that in addition to exercise being good for the autonomic tone, would you agree that mindfulness, meditation, and deep breathing regularly should also help increase parasympathetic tone? Especially important fort patients with bad OA or conditions like COPD or CAD that might limit exercise capacity and tolerance.
Here in Brazil, a "vagal" boy used to be the nickname for somebody (usually fat) easygoing. I do believe that - like all the millenial wisdom - BALANCE is the secret o life (yin against yang or, like we say, vagal against adrenergic). The asymmetric shape of the ventricular repolarization (recovery) indicates that there is room for improvement in this marvelous index.
I'm taking daily diltiazem which lowers my exercise heart rate significantly. I am therefore finding HRR numbers are only applicable in terms of my personal fitness level, but not as a marker for cardiac health compared to others. For example, if my exercise HR without Diltiazem is 130 and after one minute it drops to 100, that's one thing. But on Diltiazem, my exercise HR may only be 105 with the same exertion. So that would mean my HR would have to drop to 75 within one minute for the same HRR interpretation, but that appears to be a more difficult drop.
Any advice. I know you like to train and get PVCs.....Curious to know what you do/have changed personally. My HRR is 20s at 1 minute and 30 after 2. That said, I get PVCs and they are far more frequent (~6 per minute per kardia) AFTER an extended exercise (eg 2 hour hike/mountain bike with hills at 110-140 BPM) as my HR comes down into the 80s and 90s. My RHR is down in the 50s and high 40s overnight. I do not get PVCs below about 65 BPM so totally manageable. Had every test imaginable (echo, MRI, zio,CAC=0, LDL70 without drugs) and Cardilogist and EP both say "well don't go as hard as long." basically saying don't do certain things you love. I said can't we zap it? Total burden on zio is about 2-3%. Some PACs, PVCs and short SVT. RBBB. Take 50mg metoprolo, 10mg lisinopril (120/70 achieved). Do you still train? Happy to do an evisit!
The beta-blocker changes things due to it blockade of elements of the sympathetic nervous system. It is affecting both peak heart rate and recovery heart rate so it is not entirely clear to me how to adjust for being on them. I looked into the issue a bit but did not come away with a clear cut solution.
I believe those numbers I recorded back in 2019 were on the beta-blocker nebivolol.
The HRR should provide a guide to changes whether or not you are on a BB
Just took mine after a run before reading this on Garmin Forerunner 265. It was 50 (2 minutes recovery). Unfortunately Garmin does not save the data in your activity file.
Who knew? Until this article, I used my watch for time, weather and notifications. Yesterday's workout - a brisk walk - proved shocking. I could barely wait to try it again today, better results but still appalling. It's on topics to discuss with my internist next week as well as that "on the fence" statin conversation. Numbers are screaming for my attention. Thanks, Dr. P!
Ryan,
I've seen evidence that mindfulness, meditation, deep breathing can acutely influence some parameters of parasympathetic tone. I'm all in favor of anything non pharmaceutical measure that lowers perceived stress, pain or dyspnea and improves happiness. But, I'm unaware of long-lasting changes on autonomic cardiovascular parameters from such approaches.
This is a great post, thank you. I will check my HRR tomorrow! I’ll do it the old fashioned Luddite way - two fingers on a carotid ❤️
I thought I would be funny and joke about taking a beta blocker- so I’m glad you already sort of addressed this.
And finally, I would assume that in addition to exercise being good for the autonomic tone, would you agree that mindfulness, meditation, and deep breathing regularly should also help increase parasympathetic tone? Especially important fort patients with bad OA or conditions like COPD or CAD that might limit exercise capacity and tolerance.
Steven,
I "train" but not for the durations you describe. I empathize with your dilemma. I would avoid zapping.
Email me at dr._pearson@icloud.com to discuss the possibility of an evisit to review your case.
Dr. P
Dear (vagal) doc,
Here in Brazil, a "vagal" boy used to be the nickname for somebody (usually fat) easygoing. I do believe that - like all the millenial wisdom - BALANCE is the secret o life (yin against yang or, like we say, vagal against adrenergic). The asymmetric shape of the ventricular repolarization (recovery) indicates that there is room for improvement in this marvelous index.
I'm taking daily diltiazem which lowers my exercise heart rate significantly. I am therefore finding HRR numbers are only applicable in terms of my personal fitness level, but not as a marker for cardiac health compared to others. For example, if my exercise HR without Diltiazem is 130 and after one minute it drops to 100, that's one thing. But on Diltiazem, my exercise HR may only be 105 with the same exertion. So that would mean my HR would have to drop to 75 within one minute for the same HRR interpretation, but that appears to be a more difficult drop.
Any advice. I know you like to train and get PVCs.....Curious to know what you do/have changed personally. My HRR is 20s at 1 minute and 30 after 2. That said, I get PVCs and they are far more frequent (~6 per minute per kardia) AFTER an extended exercise (eg 2 hour hike/mountain bike with hills at 110-140 BPM) as my HR comes down into the 80s and 90s. My RHR is down in the 50s and high 40s overnight. I do not get PVCs below about 65 BPM so totally manageable. Had every test imaginable (echo, MRI, zio,CAC=0, LDL70 without drugs) and Cardilogist and EP both say "well don't go as hard as long." basically saying don't do certain things you love. I said can't we zap it? Total burden on zio is about 2-3%. Some PACs, PVCs and short SVT. RBBB. Take 50mg metoprolo, 10mg lisinopril (120/70 achieved). Do you still train? Happy to do an evisit!
The beta-blocker changes things due to it blockade of elements of the sympathetic nervous system. It is affecting both peak heart rate and recovery heart rate so it is not entirely clear to me how to adjust for being on them. I looked into the issue a bit but did not come away with a clear cut solution.
I believe those numbers I recorded back in 2019 were on the beta-blocker nebivolol.
The HRR should provide a guide to changes whether or not you are on a BB
Super article! Would a reduced EF of 40-45 and being on a beta-blocker require adjustments or could I use the same numbers?
I'm thinking > 50 one minute HRR puts you into a category of immortality!
If you want to increase yours, try Ultimate Frisbee. Mine is also 50+. Looks like I better keep funding my 401(k)
Just took mine after a run before reading this on Garmin Forerunner 265. It was 50 (2 minutes recovery). Unfortunately Garmin does not save the data in your activity file.