Cardiovascular exercise guidelines for the effective and safe prescription of high-intensity interval training to patients with cardiovascular disease.


Criteria: HIIT will not be applied as a standard progression for all patients, but when it is determined that it may enhance patients care and/or achieving goals. Patients may be progressed to HIIT when considered medically appropriate and functionally able. Patients will be reviewed by staff with Clinical Medical Director on an individual basis for consideration prior to initiating HIIT. CRRNs orientation and programming as well as ongoing progression.


MET: Metabolic Equivalent

HHR: Heart Rate Reserve: 220-age―Resting HR x desired percentage + Resting HR

RPE: Rating of Perceived Exertion on a 0 - 10 Scale will be used in all patients and will supersede heart rates in patients who report high exertion levels and will be considered as the primary indicator of volitional fatigue especially in patients who are actively taking beta-blocker medications.


Warm up/Cool down: Exercise sessions will include a 5 - 10 minute warm-up, balance drills, and a 5 - 10 minute cool-down. Cardiac transplant patients and patients with chronic angina will perform a minimum of 10 minutes warm-up and cool-down.

Mode: Initial mode will be based on patient goal, functional status, medical concerns, and desire. Sternotomy patients will avoid Cardiovascular upper body exercise forapproximately8 weeks after surgery.

Frequency: 3× wk. at CR with goal of two times a wk. additional days.

Intensity: Exercise intensity will vary based on interval being performed and will follow the below guidelines:

Peak intensity intervals: 80% - 95% HRR, RPE 5 - 8.

Active recovery intervals: 50% - 70% HRR, RPE 2 - 5.

Intensity will be set based on patient tolerance, vital sign response and patient goals. Intensity will be adjusted/progressed to maintain or increase patient to within the above HRR ranges. Intensity will also be monitored with Rating of Perceived Exertion on a 1 - 10 scale and will supersede heart rate guidelines as described above.

Time: goal of 30 - 45 minutes of total duration including both peak and active recovery intervals.

Peak intensity intervals will range from 30 seconds to 4 minutes.

Active recovery intervals will range from 1 - 5 minutes.

Initially peak intensity intervals will be shorter duration with longer duration active recovery intervals. Interval duration will be based on patient tolerance, vital sign response and patient goals Progression will involve increasing peak intensity interval duration and/or decreasing active recovery interval duration.