Target heart rate and RBBB

I am a 67 year old woman who exercises a moderate amount. I am not overweight, have no health problems, and take no prescription drugs.Recently I noticed my very high heart rate (158-161) even with low exercise demands. I am not short of breath or profusely sweating or anywhere near my usual exercise level.Two years ago a nuclear/treadmill stress test showed incomplete RBBB.My internist told me to just "dial your exercise back" to maintain a lower heart rate.I want to be a fit person, not an athlete. What exercise recommendations do you have for me? What danger signs should I look for when exercising? Thank you very much.

Hi Judy,
Has your heart rate been documented by something different than the exercise machines (often very inaccurate)? Depending on how much your efforts is, your max. target heart rate=220-67=153bpm (Most people should exercise 75% of their max. heart rate, in your case 115bpm. However, if you don't work out that strenuously,and your HR is truly 158-161bpm, than you indeed need to have it checked out with a Holter monitor, because you may have an arrhythmia as well as RBBB.

Palpitations that are caused by an arrhythmia (irregular heartbeat or abnormal heart rhythm), may cause symptoms that may include dizziness, fainting, shortness of breath and chest discomfort (Dizziness or fainting may occur when the arrhythmia causes the heart to pump less blood to your brain than is needed there). It doesn't sound that you have any of these symptoms.

If you have palpitations you should see your doctor because you may need a variety of tests. Apart from  an EKG, blood tests that measure sodium, potassium, calcium, magnesium and thyroid hormone levels may be necessary. In some patients, an exercise treadmill test and/or a Holter monitor is used to detect arrhythmias that occur only with exertion.

You can read more here:

You might also want to check what your risk for heart disease is:

Last but not least, here is some advice about heart healthy living:

Once you are checked out (and I highly recommend that you instruct your doctor!) you should go back to your usual levels of exercise. I reject his advice of "dial your exercise back" unless it is based on a diagnosis!

Hope this helps,
Dr T


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