How much activity post ablation?

I am a new member, 60 years old, who had an ablation for atrial flutter and inducible fib 3 weeks ago. I had only had arrhythmias for 3 months prior to ablation but wanted to nip it in the bud. According to my EP, I have "athlete's heart" seen with long term endurance athletes...my rt atria has a 1x1.5 are of patchy fibrosis from over stretching. No ablation was need on left side but rt side fairly extensive. I have been truly resting but am cleared to teach yoga now. I have occasional mild chest pain and tingling in my left arm (probably lingering pericarditis). I am on Flecainide 100mg twice a day to keep arrhythmias down while my heart heals (day after procedure, I was a twitchy mess!). So i am seeking advice on what others have been told concerning easing back in to some activity. Is level walking a mile or so ok? Lifting light weights? I know NOT to get my heart rate up, but am getting no real guidance from my EP. What do y'all think?

Welcome Mntbikerlady,

I can guess the source of your 'exercise heart' syndrome by your moniker. you will often hear from many EPs a rather optimistic 7 to 10 days max before resuming full activity and technically that may be roughly right as far as not being triggered into AFIB or flutter, especially for more standard PVAI-like cases.

However, we have found its not always the best practical advice in many of our experiences of long timers who have actually had ablations first hand as almost all even super EPs have not.

Our time honored suggestion from years of direct experience here leans toward a more gradual resumption of full exercise activity and this is particularly true for folks I imagine like you, based on your report and moniker above, who tended to put the pedal to the metal and over did it regularly with exercise. It's fine to resume fast walking.
, stretching, yoga/Pilates and moderate resistance exercise (but no heavy overhead or bench presses for a longer time) after a week to two weeks depending on ones recovery and going by how you feel. However, take a good 4 to 6 weeks to gradually increase your bike riding intensity toward your new normal range.

And though we don't yet know your past history, with what you've indicated above that 'new normal' for you might well have to be a few steps lower intensity and/or duration if over-exercise was a significant driver of your AFIB .... especially in the first blanking period 3 months, at least, after an index ablation.

No worries though, you will be able to resume a robust and very effective training program that will keep you very fit and happy ... But if you were borderline always obsessive/driven in your exercise you will probably be best served to work on moderating that impulse a bit and not taking every session to the very edge and beyond like people with exercise induced AFIB often do.

You'll get more good advice here by and by.

Take care,
Shannon



Edited 1 time(s). Last edit at 11/11/2015 06:04PM by Shannon.

Hi
I am + months and have followed much what Shannon is saying here. I am doing lots of active stuff but no top end endurance leaving that for next year.
Les

Thank you so much for your reply...you hit the nail on the head with "obsessive and driven"! But this experience has scared the holy cr*p out of me too. I am working to find that new balance, the new moderation. I am hopeful that the fibrosis caused by over stretching (as opposed to a fib itself) will remodel to some extent with time. I am following "the strategy" with supplements also and am very grateful that I seemed to have caught this very early, even though the degree of irritation in my atria was pretty severe. I am positive that I created the "perfect storm" with over exercise, using too much caffeine and other performance enhancing substances, low magnesium and low potassium, and a boat load of oxidative stress. I am very grateful for this forum, and will try to "pay it forward" with my own experiences as I heal and adapt to a new, more heart healthy lifestyle.

Welcome. There are previous posts addressing fibrosis formation and the connection to magnesium deficiency.
Conference Room Sessions 24 and 75 offer good background info on Cardiac Fibrosis. [www.afibbers.org]

We never lose the need to remain optimized in intracellular magnesium (former afibbers, especially), so be sure you continue research here on this topic.

Enjoy life in blessed NSR.

Jackie

mntbikerlady,

I've been hanging around here for over 11 years. A decade ago, a very high percentage of afibbers who showed up here, got here via excessive exercise (me included). "Obsessive and driven" folks were very common.

In my case it took me two years to figure out I should not train for and compete in endurance activities. Though I remain very active, I don't train for endurance at all. In fact I've done almost no "cardio" training in years. Am I a couch potato? No. Currently I do body weight training 3-4 days/week (with different muscle groups each day), alpine ski a day or two per week (in season, which has started), rock climb and usually get in a bike ride. None of these put the stress on my body that training and competing in activities like the Pikes Peak Ascent race (7,800' elevation gain to 14,100' over 13 1/3 miles) did. Every once in a while, a mountaineering day will approximate it (all day, red line heart rate). I minimize those and if I do, I realize they are a potential delayed vagal trigger. My "normal" magnesium intake is ~5g/day. If I do something like a mountaineering day, I will amp up the mag even more. The "obsessive and driven" is the component that is most risky for me. For example, I can ski hard all day on the steeps and it is not an issue. When I decide if I can do 48-50,000' vertical on the steeps off piste (vs. 35-40,000' on a "normal" day), I push myself into the risk zone. This is because I'm skiing as hard and a fast as I can all day, all the time. I try to keep my competitive juices under control and adopt a "Type B" attitude.

Initially when I detrained, my weight increased. I'd been a football player in college. Even though I was fit, I maintained that weight and it increased upon detraining. I finally realized that I needed to revamp how I ate. Today, at 60, I'm 40 pounds lighter, with a BMI of 22.5 and a body fat % of 10-12. My diet is very low glycemic, low starch, low lectin and mostly raw plant based with a modest amount (up to 4 oz/day) of animal protein from white fish, shell fish or eggs. It is also has most of the calories from fat - avocados, unfiltered extra virgin olive oil & macadamia nuts. I also focus on maximizing nutrient density.

On the afib side, I've been able to keep it mostly in remission with a combination of magnesium, potassium & taurine with the occasional dose of on-demand flecainide to convert me when I go out of rhythm. My last dose was in Aug of 14 and the one before that was in May of 13 (after a mountaineering activity).

In this list <[www.afibbers.org] you'll find a section on exercise: <[www.afibbers.org]

Good luck!

George

Sounds great MntBikerlady and you will fit right in here perfectly with your obvious proactive nature and outlook. That is a lot to digest here so take it step by step and lots of very experienced folks here to lend a helping hand.

Cheers!
Shannon