David is a 58-year-old male who received a dual-chamber ICD,…
David is a 58-year-old male who received a dual-chamber ICD, DDD-R, 8 weeks ago following an episode of sustained ventricular tachycardia. His ejection fraction is 32%. His ICD is programmed to deliver therapy at HR ≥ 170 bpm. He is on a beta-blocker, and his VO₂peak is approximately 14 mL/kg/min. He is deconditioned but motivated to return to activity.Using ACSM guidelines, build an exercise prescription for David. Include aerobic and resistance training FITT components. Also answer:1. David’s ICD fires at HR ≥ 170 bpm. What is the maximum heart rate he should reach during exercise, and how will medication affect the ability to use THR?2. David is 8 weeks post-implant. What resistance training restrictions remain in place, and what upper-body limitations must still be observed?3. Describe the monitoring plan during David’s exercise sessions given his ICD and low ejection fraction.
Read DetailsRobert is a 55-year-old male with stable angina. During his…
Robert is a 55-year-old male with stable angina. During his graded exercise test, he develops angina symptoms at a heart rate of 130 bpm and a blood pressure of 160 mmHg, with RPP = 20,800. He is on a beta-blocker and sublingual nitroglycerin PRN. He has no prior MI or revascularization. His physician has cleared him for supervised exercise.Using ACSM guidelines, build an exercise prescription for Robert. Include aerobic and resistance training FITT components. Also answer:1. Robert’s anginal threshold occurs at an HR of 130 bpm. What should his target heart rate ceiling be during aerobic exercise, and why?2. Under what circumstances should Robert use prophylactic nitroglycerin before exercise, and what side effect must be monitored after administration?3. What absolute test termination criteria applied during Robert’s GXT, and which criterion should be watched most closely during exercise sessions?
Read Details