The aerobic threshold (AeT) is the exercise intensity where blood lactate first rises above resting levels, around 2 mmol/L. You can still talk comfortably and burn mostly fat. The anaerobic threshold (AnT) is a higher intensity where lactate accumulates faster than it can be cleared, around 4 mmol/L. Breathing is heavy, and carbs become the main fuel.

Clinical Pearls: Aerobic vs Anaerobic Threshold

1: Aerobic Threshold = Your Metabolic Foundation

Aerobic threshold (AeT) occurs at ~2 mmol/L blood lactate and marks peak fat oxidation. Higher AeT reflects better mitochondrial function, metabolic flexibility, and insulin sensitivity.

Your aerobic threshold is your body’s best “fuel economy” zone. The higher it is, the more fat you burn and the steadier your energy and blood sugar stay all day

2: Anaerobic Threshold = Your Performance Ceiling

Anaerobic threshold (AnT), or lactate threshold, is the highest intensity where lactate production and clearance remain balanced. It predicts endurance performance better than VO₂ max.

Your anaerobic threshold is your redline. Raise it, and you can run, bike, or swim faster for longer before fatigue hits.

3: Zone 2 Training Builds Mitochondria

Zone 2 training at or below AeT upregulates PGC-1α, driving mitochondrial biogenesis and improving type I muscle fiber oxidative capacity.

Easy Zone 2 training where you can still talk isn’t “junk miles.” It builds more energy factories in your cells, improving health, endurance, and longevity.

4: Lactate Is Fuel, Not the Enemy

Lactate acts as a key metabolic substrate and signaling molecule via the lactate shuttle. Fatigue correlates with hydrogen ion accumulation, not lactate itself.

Lactate doesn’t cause soreness. It’s actually high-octane fuel your muscles and brain reuse. The “burn” means you’re making it faster than you can clear it.

5: Thresholds Predict Health Better Than VO₂ Max

Anaerobic threshold is independently associated with functional capacity and prognosis in heart failure, COPD, and surgical outcomes.

A big engine matters less than how much of it you can use. Your aerobic and anaerobic thresholds show how well your body works in real life, not just in a lab

6: Type 2 Diabetes Shrinks Your Aerobic Threshold

Insulin resistance lowers aerobic threshold through reduced fat oxidation and mitochondrial dysfunction. Structured Zone 2 training can reverse these deficits.

With blood sugar issues, your “fat-burning zone” gets smaller. The fix: regular Zone 2 training expands it and helps control glucose naturally

7: Polarized Training Wins vs “Gray Zone”

Polarized models using ~80% volume below AeT and ~20% at/above AnT produce superior VO₂ max and threshold gains vs. chronic Zone 3 training.

Going “kind of hard” every workout backfires. Go easy most days, hard on purpose some days. That’s how elites and smart recreational athletes actually improve.

8: You Can Find Thresholds Without a Lab

Ventilatory threshold 1 (VT1) and VT2 from CPET closely approximate aerobic threshold and anaerobic threshold. The talk test and HR at VT1 are validated field surrogates.

No lab needed. If you can speak full sentences, you’re below your aerobic threshold. If you can only say 3 to 4 words, you’re at your anaerobic threshold.

Aerobic vs Anaerobic Threshold: Why These Two Numbers Matter More Than VO₂ Max

Whether you're training for a marathon, trying to improve cardiovascular fitness, managing type 2 diabetes, or simply looking to exercise more effectively, understanding your aerobic threshold (AeT) and anaerobic threshold (AnT) may be one of the most powerful steps you can take.

Most people focus on calories burned, heart rate zones, or VO₂ max. Yet research increasingly shows that metabolic thresholds often provide a more practical measure of real-world performance, endurance, and even long-term health.

In this comprehensive guide, you'll learn:

• What aerobic and anaerobic thresholds actually are

• How they influence fat burning and endurance

• Why thresholds matter for metabolic health and longevity

• How elite athletes use them to improve performance

• The best evidence-based training methods to raise each threshold

• Common mistakes that limit progress

What Is the Aerobic Threshold?

The aerobic threshold (AeT) is the exercise intensity at which blood lactate first begins to rise above resting levels, typically around 2 mmol/L.

At intensities below this threshold:

• Fat serves as the primary fuel source

• Oxygen delivery adequately meets energy demands

• Lactate production and clearance remain balanced

• Exercise can be sustained for long periods

In practical terms, the aerobic threshold represents your body's highest sustainable "easy" pace.

Most people experience aerobic-threshold exercise as:

• Comfortable breathing

• Conversational pace

• Steady energy levels

• Minimal fatigue accumulation

This intensity generally corresponds to Zone 2 training, which has become increasingly popular because of its effects on mitochondrial health and metabolic flexibility.

What Is the Anaerobic Threshold?

The anaerobic threshold (AnT) represents a higher exercise intensity where lactate accumulates faster than it can be removed.

Although often associated with approximately 4 mmol/L lactate, the exact value varies considerably between individuals.

At intensities above this threshold:

• Carbohydrate becomes the dominant fuel source

• Lactate accumulation accelerates

• Muscle acidity rises

• Fatigue develops rapidly

• Performance becomes time-limited

The anaerobic threshold is often called:

• Lactate Threshold 2 (LT2)

• Ventilatory Threshold 2 (VT2)

• Onset of Blood Lactate Accumulation (OBLA)

• Maximal Lactate Steady State (MLSS)

Think of the anaerobic threshold as your body's performance ceiling.

Aerobic vs Anaerobic Threshold: Key Differences

1. Blood Lactate Concentration

• Aerobic Threshold (AeT): Typically sits around 2 mmol/L. This represents the first initial, subtle rise in blood lactate above a person's resting baseline.

• Anaerobic Threshold (AnT): Generally approaches 4 mmol/L, though this value is highly variable between individuals. This marks the maximal lactate steady state where production still matches clearance.

2. Primary Fuel Substrate

• Aerobic Threshold (AeT): Relies on a balanced combination of fats and carbohydrates. This intensity maximizes the rate of fat oxidation within the working muscles.

• Anaerobic Threshold (AnT): Relies almost exclusively on carbohydrates. The body shifts heavily toward rapid glycolytic pathways to meet high energy demands.

3. Physical Sustainability

• Aerobic Threshold (AeT): Highly sustainable. An individual can maintain this level of effort for multiple hours, limited primarily by hydration, glycogen stores, and mental fatigue.

• Anaerobic Threshold (AnT): Strictly limited duration. This intensity can only be sustained from a few minutes up to approximately one hour before metabolic accumulation forces a slowdown.

4. Breathing Mechanics and Ventilation

• Aerobic Threshold (AeT): Comfortable, steady, and rhythmic. The respiratory system can easily meet the body's demands without a noticeable spike in breathing rate.

• Anaerobic Threshold (AnT): Heavy, rapid, and labored. Breathing increases sharply as the lungs work to buffer metabolic acidosis and clear accumulating carbon dioxide.

5. The Talk Test Field Surrogate

• Aerobic Threshold (AeT): Full conversation is entirely possible. A person can speak in continuous, unbroken sentences without needing to pause mid-phrase for a breath.

• Anaerobic Threshold (AnT): Communication is limited to short, broken phrases. An individual can generally manage only 3 to 4 words at a time before needing to inhale.

6. Target Training Zone

• Aerobic Threshold (AeT): Corresponds to Zone 2. This is the foundational intensity used to build an extensive base of systemic cardiovascular endurance.

• Anaerobic Threshold (AnT): Corresponds to Zone 4. This represents high-intensity, demanding work that targets systemic performance ceilings.

7. Core Physiological Adaptation

• Aerobic Threshold (AeT): Drives mitochondrial biogenesis, enhances the efficiency of fat oxidation, and increases the structural density of capillary networks in slow-twitch muscle fibers.

• Anaerobic Threshold (AnT): Improves systemic lactate tolerance, optimizes cellular buffering capacity, and trains the body to clear metabolic waste products under stress.

8. Primary Clinical Significance

• Aerobic Threshold (AeT): Serves as a vital indicator of foundational metabolic health, insulin sensitivity, mitochondrial function, and overall metabolic flexibility.

• Anaerobic Threshold (AnT): Acts as a critical predictor of peak functional capacity, athletic endurance potential, and cardiopulmonary prognosis in clinical populations.

The Physiology Behind Thresholds

Mitochondria: The Engine of Endurance

Mitochondria convert oxygen and nutrients into ATP, the body's energy currency.

Individuals with:

• Higher mitochondrial density

• Better capillary networks

• Greater oxygen extraction

typically have higher aerobic thresholds and better endurance.

According to recent exercise physiology research, Zone 2 training stimulates mitochondrial biogenesis, helping muscles become more efficient at producing energy.

Lactate Is Not the Enemy

One of the biggest misconceptions in exercise science is that lactate causes fatigue.

Modern research demonstrates that lactate:

• Serves as a valuable fuel source

• Functions as a signaling molecule

• Supports energy transfer between tissues

The body's ability to produce, transport, and recycle lactate largely determines where your thresholds occur.

Ventilatory Thresholds

Changes in breathing closely mirror metabolic thresholds.

Ventilatory Threshold 1 (VT1)

Closely corresponds to the aerobic threshold.

Signs include:

• Slight increase in breathing rate

• Comfortable conversation remains possible

Ventilatory Threshold 2 (VT2)

Closely corresponds to the anaerobic threshold.

Signs include:

• Rapid breathing

• Inability to speak comfortably

• Significant effort perception

Why Thresholds Matter More Than VO₂ Max

VO₂ max measures the maximum amount of oxygen your body can utilize.

However, performance depends on how much of that capacity you can sustain.

For example:

• Two athletes may have identical VO₂ max values

• One can sustain 90% of VO₂ max

• Another can sustain only 70%

The athlete with the higher threshold typically performs better.

This explains why threshold training is often more predictive of endurance performance than VO₂ max alone.

Thresholds and Metabolic Health

Thresholds are not just athletic metrics.

They are powerful indicators of health.

Research shows individuals with:

• Obesity

• Insulin resistance

• Type 2 diabetes

• Metabolic syndrome

often exhibit lower aerobic thresholds.

This reflects:

• Reduced fat oxidation

• Impaired mitochondrial function

• Decreased metabolic flexibility

Improving aerobic threshold through structured Zone 2 training can significantly improve:

• Insulin sensitivity

• Blood glucose control

• Body composition

• Cardiovascular function

How Are Thresholds Measured?

Laboratory Testing

The gold-standard methods include:

Blood Lactate Testing

Small blood samples are taken during progressively harder exercise.

Benefits:

• Highly accurate

• Direct measurement

Limitations:

• Requires specialized equipment

Cardiopulmonary Exercise Testing (CPET)

Measures:

• Oxygen consumption

• Carbon dioxide production

• Ventilatory thresholds

CPET is widely used in sports medicine and cardiology.

Field Methods

The Talk Test

Aerobic Threshold:

You can comfortably hold a conversation.

Anaerobic Threshold:

Conversation becomes difficult.

Heart Rate Monitoring

Approximate ranges:

• Aerobic threshold: 60–75% HRmax

• Anaerobic threshold: 80–90% HRmax

Wearable Devices

Many modern smartwatches estimate thresholds using:

• Heart rate variability

• Running pace

• Power output

How to Improve Your Aerobic Threshold

Zone 2 Training

Zone 2 remains the most effective method for increasing aerobic threshold.

Benefits include:

• Increased mitochondrial density

• Enhanced fat burning

• Improved endurance

• Better metabolic health

Sample Zone 2 Session

• 10-minute warm-up

• 45–90 minutes at conversational pace

• 5-minute cool-down

Weekly Recommendation

Most individuals benefit from:

• 3–5 Zone 2 sessions weekly

• 150–300 minutes total aerobic work

How to Improve Your Anaerobic Threshold

Improving the anaerobic threshold requires higher-intensity training.

Tempo Training

Example:

• 20–40 minutes at comfortably hard intensity

Benefits:

• Improved lactate clearance

• Increased sustainable speed

Threshold Intervals

Example:

• 4 × 10 minutes at threshold effort

• 2–3 minutes recovery

Benefits:

• Increased tolerance to high workloads

• Enhanced endurance performance

Training Zones Explained

1. Zone 1: Recovery

• Intensity Profile: Very easy and light effort.

• Primary Purpose: Promotes active recovery, stimulates gentle blood flow to flushing metabolic waste, and allows for psychological relaxation without adding any meaningful structural or physical stress to the body.

2. Zone 2: Easy Aerobic

• Intensity Profile: Easy and conversational pace.

• Primary Purpose: Explicitly targets raising the Aerobic Threshold. This zone stimulates mitochondrial biogenesis, enhances the efficiency of fat oxidation, and builds the baseline capillary network required for long-term endurance and metabolic flexibility.

3. Zone 3: Moderate

• Intensity Profile: "Comfortably hard" or steady-state tempo effort.

• Primary Purpose: Has limited direct use in polarized training models. While it accumulates substantial volume, it creates high autonomic nervous system stress and glycogen depletion without providing the maximal metabolic adaptations of Zone 2 or the high-intensity performance benefits of Zone 4.

4. Zone 4: Threshold

• Intensity Profile: Hard, sustainable, and controlled discomfort.

• Primary Purpose: Directly targets raising the Anaerobic Threshold. Training at this exact boundary teaches the body to optimize its lactate clearance kinetics, improves cellular buffering capacity, and extends the duration a person can sustain high-intensity efforts before hitting exhaustion.

5. Zone 5: Very Hard

• Intensity Profile: Max or near-maximal short-burst efforts.

• Primary Purpose: Specifically focused on VO2max development. This high-intensity stimulus challenges central cardiac output, maximizes stroke volume, and forces neuromuscular adaptations that expand the raw maximum capacity of the entire cardiopulmonary system.

Evidence Summary

1. Clinical Risk Prediction & Heart Failure

• Study: Ryuzaki et al. (2023)

• Core Finding: The anaerobic threshold (AT) is a powerful predictor of clinical outcomes and mortality risk in heart failure patients.

• The Details: During cardiopulmonary exercise testing (CPET), the anaerobic threshold represents the point where the cardiorespiratory system can no longer deliver enough oxygen to the muscles to sustain purely aerobic metabolism, causing lactic acid to begin accumulating. In heart failure patients, a low AT indicates advanced cardiac dysfunction, poor skeletal muscle perfusion, and altered fatty acid metabolism (often linked to underlying carnitine deficiencies) (Ito et al., 2023). Because AT measures functional capacity under stress rather than just a resting state, it serves as a highly accurate baseline for predicting hospitalization and overall survival rates.

2. High-Intensity Interval Training vs. Ventilatory Thresholds

• Study: Drwal & Maciejczyk (2025)

• Core Finding: Aerobic Interval Training (AIT) significantly improves the second ventilatory threshold (VT2) and overall aerobic power.

• The Details: In comparative trials tracking aerobic capacity, 6 weeks of Aerobic Interval Training (AIT) was proven to be uniquely effective at increasing oxygen uptake specifically at the VT2 level (Drwal, 2025).

  • What is VT2? It is the point of uncompensated metabolic acidosis—the intensity at which hyperventilation occurs because the body can no longer buffer accumulating blood lactate.

  • The Contrast: While higher-intensity Sprint Interval Training (SIT) or heavy strength training can successfully boost maximal oxygen uptake (VO2max) and raw peak power, they fail to move the VT2 milestone. AIT specifically adapts the body's cardiovascular system and blood flow mechanics to delay hyperventilation, meaning an individual can sustain submaximal, high-intensity efforts for a longer duration before hitting physical exhaustion.

3. The Irreplaceability of Base Training Volume

• Study: Ambaum & Hoppe (2025)

• Core Finding: High aerobic volume remains completely non-negotiable and essential for long-term endurance development.

• The Details: Despite the popularity of short, time-efficient interval methods, systematic evaluations of energy pathways confirm that structural endurance cannot be built on high intensity alone. Large volumes of lower-intensity, steady-state training induce critical micro-adaptations that intervals cannot replicate as effectively—such as increased mitochondrial density, capillary network expansion in skeletal muscle, and improved stroke volume of the heart (Ambaum, 2025). Furthermore, having a deeply developed aerobic base drastically accelerates post-exercise recovery by speeding up the replenishment of cellular energy stores (phosphocreatine resynthesis) between high-intensity bursts.

4. Physiological Adaptability of Thresholds

• Study: Armstrong & Welsman (2020)

• Core Finding: Metabolic and physiological thresholds are highly plastic and adapt significantly when exposed to structured training stimuli.

• The Details: This research counters the idea that an individual's aerobic and anaerobic thresholds are hardcoded biological limits. Somatic and cardiovascular systems exhibit high trainability across different age groups and maturity levels (Beyer et al., 2020). When exposed to consistent progressive overload, the point at which an individual begins to accumulate lactate or experience rapid breathing shifts upward toward a higher percentage of their total VO2max. This means that a trained athlete can work at an energy output that would trigger immediate, uncompensated fatigue in an untrained individual.

5. Systemic Cardiovascular Differentiation

• Study: Patel et al. (2017)

• Core Finding: Aerobic and anaerobic exercises generate entirely distinct structural and functional adaptations within the cardiovascular system.

• The Details: The heart and blood vessels respond to the unique mechanical stress imposed by different types of training:

  • Aerobic Exercise (Volume Overload): Activities like distance running or cycling require sustained cardiac output. This triggers eccentric left ventricular hypertrophy—meaning the heart chambers actually stretch and expand in volume to pump more blood per beat (improving stroke volume), while blood vessels become more compliant and expand their capillary networks.

  • Anaerobic Exercise (Pressure Overload): Short-burst, high-resistance activities (like heavy lifting or sprinting) subject the heart to intense, acute pressure spikes. This triggers concentric left ventricular hypertrophy, where the muscular walls of the heart thicken to force blood out against high vascular resistance, altering myocardial stiffness and arterial characteristics in a completely different manner.

Common Myths and Mistakes

Myth #1: Anaerobic Means No Oxygen

False.

Your body continues using oxygen even during intense exercise.

Myth #2: Lactate Causes Muscle Soreness

False.

Delayed-onset muscle soreness is primarily related to microscopic muscle damage and inflammation.

Myth #3: The Anaerobic Threshold Is Always 4 mmol/L

False.

Threshold values vary substantially among individuals.

Myth #4: Harder Training Is Always Better

False.

Most endurance adaptations occur through large volumes of lower-intensity training.

Myth #5: Zone 2 Is Too Easy to Be Effective

False.

Zone 2 stimulates many of the mitochondrial adaptations associated with improved endurance and metabolic health.

Frequently Asked Questions

Q1. What is the difference between the aerobic and anaerobic threshold?

The aerobic threshold (AeT) is the point at which lactate first rises above resting baseline (~2 mmol/L), marking a shift from predominantly fat-based to mixed fuel utilization. The anaerobic threshold (AnT) is the higher-intensity inflection point (~4 mmol/L, variable) beyond which lactate accumulates faster than it can be cleared, and exercise becomes unsustainable within minutes. Put simply: AeT = you can go all day; AnT = you have minutes to hours at most.

Q2. How do I know if I'm training at the right threshold?

The most accessible field test for the AeT is the talk test: if you can speak in complete, comfortable sentences, you're likely below or at AeT. For the AnT, "comfortably hard" — where you can manage a few words but not a conversation — is a reasonable proxy. For precision, laboratory lactate profiling or CPET is the gold standard.

Q3. Can I improve both thresholds simultaneously?

Yes — but different training stimuli drive each adaptation. Zone 2 training (long, slow, aerobic work) primarily improves the AeT, while threshold intervals and tempo running raise the AnT. Most well-designed programs include both within a periodized framework, prioritizing AeT base-building before adding AnT-specific work.

Q4. Is the 'anaerobic threshold' the same as 'lactic acid threshold'?

Nearly — but with an important clarification. What is commonly called the "lactic acid threshold" more accurately refers to the blood lactate threshold (lactate is the measurable form in the body). The terms LT1, LT2, OBLA, and anaerobic threshold are related but not always identical — context and testing methodology matter.

Q5. Why do elite athletes have higher thresholds than recreational athletes?

Elite endurance athletes typically have both a higher AeT (more efficient fat metabolism and greater mitochondrial density) and a higher AnT relative to their VO₂ max (often 85–90% vs. 60–70% in recreational athletes). This is the product of years of high-volume aerobic training and targeted threshold work — not genetics alone.

Q6. Are thresholds important for non-athletes or patients?

Absolutely — and arguably even more so. The anaerobic threshold identified during CPET carries independent prognostic value for cardiovascular mortality and surgical risk. For patients with heart failure, COPD, cancer, or metabolic syndrome, threshold-guided exercise prescription is both safer and more effective than generic recommendations.

Q7. How often should I get my thresholds tested?

For competitive athletes: every 8–12 weeks (corresponding to training blocks). For recreational athletes: once or twice per year. For patients in cardiac rehab or with chronic disease: frequency should be determined by a physician or exercise physiologist based on clinical status and program goals.

Key Takeaways

• Aerobic threshold reflects your ability to sustain long-duration exercise while efficiently burning fat.

• Anaerobic threshold represents the highest intensity you can maintain before fatigue rapidly develops.

• Thresholds often predict performance better than VO₂ max alone.

• Improving aerobic threshold enhances metabolic health, insulin sensitivity, and endurance.

• Improving anaerobic threshold increases speed, power, and performance capacity.

• Zone 2 training remains one of the most effective interventions for both health and longevity.

• Threshold-guided exercise provides a more personalized approach than generic heart-rate formulas.

For most people, the smartest training strategy is simple: spend the majority of your time building your aerobic engine and a smaller amount of time raising your performance ceiling. Over time, both health and athletic performance improve dramatically.

Author’s Note

This article was written with a dual purpose: to bridge the gap between exercise physiology and clinical medicine, and to make complex metabolic concepts accessible without compromising scientific accuracy. As clinicians, we are often trained to view exercise through broad guidelines—“moderate intensity,” “150 minutes per week”—yet physiology is far more nuanced. Aerobic and anaerobic thresholds offer a precision-based framework that aligns far more closely with how the human body actually responds to stress, adapts to training, and progresses toward health or disease.

In both athletic and patient populations, I have consistently observed that outcomes improve when training is guided by physiology rather than arbitrary zones or generalized prescriptions. A patient with insulin resistance struggling with fatigue, or an athlete plateauing despite high training volume, often shares a common issue: a mismatch between training intensity and underlying metabolic capacity. Understanding thresholds allows us to correct that mismatch.

At the same time, it is important to acknowledge that these concepts—while grounded in robust evidence—are not absolute. Threshold values vary between individuals, testing methods differ, and real-world application requires clinical judgment and contextual interpretation. This article is not intended to replace individualized assessment, but rather to provide a scientifically grounded lens through which both clinicians and readers can better understand performance, fatigue, and metabolic health.

Ultimately, the goal is simple: move beyond one-size-fits-all advice and toward a more personalized, physiology-driven approach to exercise and health—one that is both evidence-based and practically sustainable.

Medical Disclaimer: This article is intended for educational and informational purposes only. It does not constitute medical advice and should not be used as a substitute for consultation with a qualified healthcare professional. Always discuss exercise programmes and cardiac risk assessment with your doctor, particularly if you have existing cardiovascular disease or significant risk factors.

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References

Armstrong, N., & Welsman, J. (2020). The development of aerobic and anaerobic fitness with reference to youth athletes. Journal of Science in Sport and Exercise, 2, 275–286. https://doi.org/10.1007/s42978-020-00070-5

Aerobic VS anaerobic exercise on body composition and hormonal adaptations in athletes and non-athletes: A randomized controlled trial. (2025). Journal of Coaching and Sports Science. https://doi.org/10.58524/JCSS.V4I1.553

Ambaum, C., & Hoppe, M. W. (2025). Evaluation of methods to quantify aerobic-anaerobic energy contributions during sports and exercise — a systematic review and best-evidence synthesis. Frontiers in Sports and Active Living, 7, 1650741. https://doi.org/10.3389/fspor.2025.1650741

Chamari, K., & Padulo, J. (2015). 'Aerobic' and 'anaerobic' terms used in exercise physiology: A critical terminology reflection. Sports Medicine – Open, 1(1), 9. https://doi.org/10.1186/s40798-015-0012-1

Drwal, A., & Maciejczyk, M. (2025). Strength training vs. aerobic interval training: Effects on anaerobic capacity, aerobic power and second ventilatory threshold in men. Applied Sciences, 15(14), 7953. https://doi.org/10.3390/app15147953

Patel, H., Alkhawam, H., Madanieh, R., Shah, N., Kosmas, C. E., & Vittorio, T. J. (2017). Aerobic vs anaerobic exercise training effects on the cardiovascular system. World Journal of Cardiology, 9(2), 134–138. https://doi.org/10.4330/wjc.v9.i2.134

Ryuzaki, T., Shiraishi, Y., Miura, K., Ikura, H., Seki, Y., Azuma, K., Sato, K., Fukuda, K., & Katsumata, Y. (2023). Real-time estimation of anaerobic threshold during exercise using electrocardiogram in heart failure patients. Journal of Clinical Medicine, 12(16), 5225. https://doi.org/10.3390/jcm12165225

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