What is a good training plan / workout for cardio patients?

Hi all. I am a longtime zwift user. medical issues now made me cap my actual output, and i am forced to train at low intensity.

I now want to join back on zwift with the aim of lowering my resting heart rate and rebuilding endurance/fitness. i am forced to use low intensity at any time, not allowed to ride harder than 150bpm hr.

Can anyone advise on a structured training plan or workout or regular ride/event that would fit to that aim? any feedback appreciated!

You should probably check with your doctor… I would choose a low w/kg pace/robo partner to start and continually monitor your HR to make sure you aren’t going anywhere close to 150 bpm.

I think most of the training programs have some intensity mixed in, so might not be a good idea. IIRC there is a “return to fitness” plan, maybe that would be an option? Again, review it with your doc.


doctor allows all activity up to 160bpm but mainly 140bpm…

i know it should be low intensity but increased endurance.
my point: i know i need a routine. so either a plan or a regular event.

i hoped there is a good tipp for “what to do if i want to train my resting hr”

This is from Whoop, they are kind of experts on RHR aren’t they?


By far, the No. 1 thing to do for lowering resting heart rate is exercise. In particular, aerobic exercise like running or cycling (activities you can sustain for long periods of time at 70-80% of your max heart rate) will assist you in building cardiovascular strength.

Additionally, each of the behaviors below can help you decrease your RHR:

In general, anything you can do to reduce stress and manage anxiety will benefit your resting heart rate.

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pace partners are your best bet, they added a lot of lower wkg ones now so you should be able to find something that is sustinable and keeps you under your target heart rate (ideally on a flat course, as pace partners increase power slightly on hills)

The Back To Fitness plan includes quite a bit of high intensity work. Riding with a pace partner that is paced appropriately to your target heart rate would be better than that. A much flatter power profile (compared to pace partners) is possible while free riding solo if you disable Trainer Difficulty in settings, pick a gear, and pedal a steady cadence. That will cause the trainer to make no resistance changes on hills, so you don’t have to confine yourself to flat routes in the game.

Hi Max;

You sound like you are in the same boat as me.

My “cardiologist orders” are also max 150bpm - he also likes the idea of me Zwifting rather than IRL riding as his supplementary instruction is “don’t exercise with no-one else around”. That is not bad advice either !!

4 years ago I did have my first cardiac arrest whilst on a solo ride in the middle of nowhere - I was lucky to be resuscitated by a very handy pedestrian whilst the air ambulance arrived. Hence no solo IRL riding for me anymore.

In Zwift now I generally free-ride or join D group rides - peta-z, EVO CC, DBR, SZR. Herd … all have regular social rides. For workouts; the first few weeks’ worth of “Back to Fitness” might suit or for individual sessions there’s the SSTs or maybe wave-rider to try. You can always dial down your FTP in a workout - see what works versus your <150bpm limit (with a safe margin maybe !!). I did that to make the Zwift Academy 2022 rides more comfortable, for instance.

Last bit of advice, if you are prescribed beta-blockers they will affect your power to HR ratio, and if your dosage is ever changed that ratio will change too. So you do have to keep on top of how your meds, your HR and your power output are all interacting.

Listen to your doctor’s advice and best of luck with the return to fitness


Thanks! Thanks to everyone above.

I did two pace partner rides but i find them a bit “stale” compared to the immersiveness of a nice group ride, or the “common do it” feel of a training plan.

From your comments it sounds there is no “way back after medical issue” workout plan. OK, accepted.

For a list of favorite rides that are easy-going I am happy!

Another plan (if not already mentioned in thread) to look at possibly suiting your needs is the “Baby On Board” plan.

Organised Chaos is one of my goto sessions for something mixed and pretty easy.

The “way back after medical issue” workout plan involves patience. Most Zwift workouts are not designed around this principle, but that doesn’t mean it’s impossible to get back, or that it’s impossible to create a workout plan around it. If workouts inspire you, you can still pick and choose from the workouts that keep you at your desired effort level (and use the FTP bias adjustment during the workout to dial down the difficulty appropriately) or copy existing workouts and lower the intensity. You also have the option of paying a coach/trainer to listen to your needs and develop a custom plan for you to follow in Zwift.