Does a Faster Heart Rate Mean Better Exercise? What New Research Says About Heart Health and Activity

At our physical therapy clinic, we often work with people who have heart problems, especially those living with chronic heart failure (CHF). A common question we hear is:

“If my heart rate goes up during activity, does that mean my heart is getting stronger?”

A recent research study looked into this very question. The results may surprise you.

What Is Chronic Heart Failure?

Chronic heart failure means the heart isn’t pumping blood as well as it should. People with CHF often feel:

Tired all the time
Out of breath, especially during activity
Weak or dizzy

Doctors sometimes use special devices called pacemakers to help the heart beat more regularly and respond better to movement or exercise.

What Is Rate Adaptive Pacing?

Pacemakers can now be “smart.” They can adjust your heart rate when you’re active—this is called rate adaptive pacing (RAP). The idea is that when your body starts moving, the pacemaker tells your heart to beat faster to meet the demand.

Sounds great, right?

But here’s what researchers found.

The Surprising Study Results

In a study that reviewed 14 different research papers, scientists looked at how well rate adaptive pacing worked for people with CHF. They found:

Yes, RAP increased heart rate during exercise.
But no, it did not increase overall exercise capacity.

In simple terms: the heart beat faster, but the person didn’t feel like they could do more activity or walk longer distances.

Why Does This Matter?

This means that just raising your heart rate isn’t enough to help you feel better or move more. For people with heart failure, the heart and muscles don’t always work together the way they should. A faster heart doesn’t always mean stronger or better performance.

That’s where physical therapy comes in.

How Physical Therapy Can Help

Our job is to help your body—and your heart—move better, not just faster. With a personalized plan, we can:

Improve muscle strength and coordination
Teach safe ways to exercise with a heart condition
Help you do more with less fatigue
Monitor how your heart responds to activity

We work with your doctor to make sure your treatment is safe and effective, especially if you have a pacemaker or heart condition.

The Bottom Line

Technology like pacemakers is helpful, but it’s not a magic fix. Physical activity, guided by experts, is still one of the best ways to build real strength and endurance—especially at lower, safer levels of exertion.

At our clinic, we focus on what really matters: helping you feel stronger, safer, and more confident in your body.

Have questions about exercising with a heart condition or pacemaker?
We’re here to help. Call us today to schedule a consultation with one of our experienced physical therapists.

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🧾 References

Meta-Analysis on Rate Adaptive Pacing in Chronic Heart Failure
This article was informed by a systematic review analyzing 14 studies on the effects of rate adaptive pacing in individuals with chronic heart failure. The research found that while RAP increases heart rate during activity, it does not significantly improve exercise capacity or endurance.

Coats, A.J.S., et al. (Citations to this work). “Rate Adaptive Pacing in Chronic Heart Failure: A Meta-Analysis.” Referenced via Google Scholar.
View Cited Studies on Google Scholar

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