Fitness Testing for Cardiac Rehabilitation

After completing formal cardiac rehab, VO₂ max testing serves several important purposes:

• Objective Recovery Assessment: Measure how much cardiovascular fitness you have regained since your cardiac event
• Exercise Prescription: Get personalized heart rate zones for safe independent exercise at home, gym, or outdoors
• Track Long-Term Progress: Monitor whether your fitness continues to improve, stabilizes, or declines over months and years
• Motivation and Confidence: Seeing objective improvements can boost confidence in your recovery and motivate continued exercise adherence
• Return to Activities: Data can help your cardiologist clear you for activities like hiking, cycling, travel, or return to physical work
• Secondary Prevention: Regular exercise at appropriate intensity is crucial for preventing future cardiac events

VO₂ max (also called VO₂ peak in cardiac populations) measures your body's ability to consume and utilize oxygen during maximal exertion:

• Aerobic Capacity: Your cardiovascular system's maximum ability to deliver oxygen to working muscles. This reflects the combined function of your heart, lungs, blood vessels, and muscles
• Ventilatory Thresholds: VT1 and VT2 are the points where breathing patterns change. These define your heart rate zones for safe, effective training
• Heart Rate Response: How your heart rate increases with exercise intensity. Medications like beta-blockers significantly affect this
• Heart Rate Recovery: How quickly your heart rate returns to baseline after exercise stops. Faster recovery is associated with better cardiovascular health
• Exercise Tolerance: The overall duration and intensity you can sustain, which reflects your functional capacity for daily activities

For cardiac patients, we often report VO₂ peak rather than VO₂ max, as you may not reach a true physiological maximum due to medication, deconditioning, or exercise limitations.

You MUST have ALL of the following before we can schedule your test:

• Written Cardiologist Clearance: A signed note from your cardiologist specifically approving VO₂ max testing. General "cleared for exercise" is not sufficient-your cardiologist must approve maximal exercise testing
• Completed Phase II Cardiac Rehabilitation: You must have finished a formal, supervised cardiac rehab program (typically 8 to 12 weeks) OR have explicit cardiologist approval explaining why testing is appropriate without rehab completion
• Recent Medical Stress Test: Ideally within past 12 months. If available, bring results so we can compare
• Complete Medication List: Especially cardiac medications like beta-blockers, which significantly affect heart rate response
• Stable Cardiac Status: No angina (chest pain), no recent changes in symptoms, no new cardiac issues in past 3 months minimum
• No Recent Cardiac Events: Minimum 8 to 12 weeks (ideally 6 months) since heart attack, cardiac surgery, angioplasty, stenting, or other procedures

We will review your clearance documentation before scheduling. Your safety is our absolute priority.

Testing may be appropriate if you have history of:

• Myocardial infarction (heart attack) with complete recovery
• Coronary artery bypass graft (CABG) surgery
• Percutaneous coronary intervention (PCI), angioplasty, or stenting
• Stable angina that is well-controlled with medication
• Heart valve repair or replacement with good recovery
• Compensated heart failure with stable symptoms

Testing is NOT appropriate if you have:

• Unstable angina or chest pain at rest
• Uncontrolled arrhythmias
• Recent cardiac event (within 8 to 12 weeks minimum)
• Severe aortic stenosis or other critical valve disease
• Acute heart failure or decompensated heart failure
• Recent changes in cardiac symptoms or medications
• Any condition your cardiologist deems a contraindication

We follow modified protocols for cardiac patients:

• Extended Pre-Test Screening: Detailed health history, review of cardiac events, medications, and symptoms. We will contact your cardiologist if we have any concerns
• Conservative Protocol: We use more gradual increases in intensity compared to healthy populations. You control the test-stop anytime
• Extended Warm-Up: 5 to 10 minutes of very gentle movement to prepare your cardiovascular system
• Symptom Monitoring: We continuously monitor for chest pain, excessive shortness of breath, dizziness, unusual fatigue, or any concerning symptoms
• Immediate Termination Criteria: We stop testing immediately if you experience chest pain, significant arrhythmia symptoms, excessive breathlessness, dizziness, or request to stop
• Extended Cool-Down: At least 5 to 10 minutes of gentle movement to allow heart rate and blood pressure to gradually return to baseline
• Post-Test Monitoring: We monitor recovery until you are at baseline and feeling normal

Duration: Plan for 60 to 90 minutes total including pre-test screening, warm-up, testing, cool-down, and recovery monitoring.

Important safety information for cardiac patients:

• Not Medical Stress Testing: We do NOT perform diagnostic stress tests. We do not have ECG monitoring or physician supervision on site. This is fitness testing only, not a medical procedure
• Emergency Equipment: We have AED (automated external defibrillator) on site and staff trained in CPR and emergency response
• Emergency Protocols: Clear procedures for activating emergency medical services if needed. Dominican Hospital is approximately 2 miles away
• Your Responsibility: Report ANY unusual symptoms immediately. Do not push through chest pain, severe shortness of breath, dizziness, or other warning signs
• Medication Considerations: Beta-blockers and other cardiac medications affect your heart rate response. Your zones will be based on YOUR medicated heart rate, not generic formulas

Your VO₂ max test results provide valuable information:

• Share with Cardiologist: Your cardiologist can use VO₂ peak data to assess recovery progress and adjust treatment if needed
• Exercise Prescription: Use your heart rate zones for independent exercise. Zone 2 (60 to 70% of max) is typically the primary training zone for cardiac patients
• Work with Trainer: If working with a personal trainer (visit rockurbody.com), they can design workouts using your specific zones
• Functional Capacity: VO₂ peak is often expressed in METs (metabolic equivalents), which helps determine what activities are safe (household chores, yard work, travel, etc.)
• Retest Periodically: Test every 6 to 12 months to track whether fitness is improving, stable, or declining

General guidelines for cardiac patients (always follow your cardiologist's specific recommendations):

• Frequency: 5 to 7 days per week of some physical activity. Minimum 3 to 5 days per week of structured aerobic exercise
• Duration: 20 to 60 minutes per session. Can be broken into 10 minute bouts if needed
• Intensity: Moderate intensity (Zone 2, approximately 60 to 70% of your tested maximum heart rate). Should feel "somewhat hard" but you can speak in full sentences
• Type: Walking, cycling, swimming, rowing-choose activities you enjoy. Your VO₂ max test equipment choice (treadmill, bike, rower, stair mill) can match your preferred exercise modality
• Resistance Training: 2 days per week with cardiologist approval. Light to moderate weights, avoid breath-holding

Warning Signs to Stop Exercise: Chest pain or pressure, severe shortness of breath, dizziness, nausea, irregular heartbeat, or unusual fatigue. Seek immediate medical attention if symptoms occur.

Regular exercise is crucial for preventing future cardiac events:

• Reduces Mortality Risk: 20 to 30% lower risk of death in cardiac patients who exercise regularly
• Prevents Re-Infarction: Lower risk of second heart attack
• Improves Quality of Life: Better functional capacity for daily activities
• Reduces Hospital Readmissions: Fewer emergency room visits and hospitalizations
• Manages Risk Factors: Helps control blood pressure, cholesterol, blood sugar, and weight
• Psychological Benefits: Reduced anxiety and depression, common after cardiac events

VO₂ Max Test: $250

This is a cash-pay service. We do not bill insurance. However, some patients have successfully submitted receipts for reimbursement under out-of-network benefits or health savings accounts (HSA/FSA). Check with your insurance provider.

Before requesting clearance, discuss with your cardiologist:

• Is VO₂ max testing appropriate for my current cardiac status?
• Are there any specific limitations or precautions I should communicate to the testing facility?
• Should I take my medications as usual before testing?
• What symptoms should stop the test immediately?
• How can the VO₂ max data be useful for my ongoing care?

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com

Call to discuss your specific situation and clearance requirements before booking.