Cardiac Autonomic Regulation Enhancement Through Exercise Trial

Exclusion Criteria

• •Patients who meet functional NYHA Class III or IV heart failure or angina symptoms
• •sinus node dysfunction that requires atrial pacing
• •atrial fibrillation
• •bi-ventricular ICD
• •are pacemaker-dependent
• •diagnosis of Brugada's Syndrome
• •diagnosis of arrhythmogenic right ventricular dysplasia
• •complex congenital heart disease
• •orthopedic restrictions, limitations, or disabilities that would jeopardize the patient's safety during exercise or form completing the treadmill stress test
• •Neurocognitive or cognitive impairments that will result in nonadherence (based on clinical evaluation)
• •Unstable angina
• •resting systolic blood pressure \>180mmHg or resting diastolic blood pressure \>110mm Hg will be evaluated on a case-by-case basis
• •orthostatic blood pressure drop of \>20mm Hg with symptoms
• •critical aortic stenosis (peak systolic pressure gradient \>50mm Hg with aortic valve orifice area \<0.75cm2 in average size adult)
• •acute systemic illness or fever
• •uncontrolled atrial or ventricular arrhythmias
• •uncontrolled sinus tachycardia (\>120 beats/min)
• •uncompensated CHF
• •3rd degree AV block (without pacemaker)
• •active pericarditis or myocarditis
• •recent embolism; thrombophlebitis
• •resting ST segment displacement (\>2mm)
• •uncontrolled diabetes (resting blood glucose \>400mg/dl)
• •metabolic problems, such as acute, hypo or hyperkalemia, hypovolemia
• •recent strongly positive exercise test as achieved by: significant decrease in systolic blood pressure with increasing workload, OR early onset, horizontal or downsloping ST segment depression (4mm), OR prolonged electrocardiogram (ECG) changes during recovery
• •hypertrophic obstructive cardiomyopathy
• •severe pulmonary hypertension
• •patients who do not pass the exercise stress test