vigorous exercise

I'm new to the forum, this has probably been discussed often. I am 72 and have continuous AF, diagnosed just 5 years ago. I have continued workouts that I think are quite vigorous for my age and wondering if this is ok with AF. I do 30 min on a cardio machine and 20 min light weights, but high reps. I push the reps to the point I am breathing harder than when I am doing the cardio. Comments?

That's perfectly fine. There's absolutely no reason to limit exercise because you have afib so keep it up. :-)

Are you sure about that? Wouldn't vigorous exercise cause the heart to "work more", coupled with a troubled heart in afib wouldn't that make things worse?

I've always advised people with afib to "cool it" when it comes to exercise. By that I mean, I tell them to move forward with moderate exercise - both in cardio and weight lifting.

I'm no expert but if your heart isn't beating normally (i.e. when you're in afib) and thus blood isn't moving around the body like it should and the heart has to work harder to begin with because it's in afib, adding more stress to the heart (i.e. vigorous exercise) will only make things worse.

What am I missing?

Travis

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Carey
That's perfectly fine. There's absolutely no reason to limit exercise because you have afib so keep it up. :-)

When I first had afib, 14 years ago, i had a 2.5 month episode. I acted as if nothing happened and continued my exercise as before. I noticed that my heart rate was about 25% higher when in afib to do equivalent activity.

Subsequently I approached it from Travis's point of view and moderated activity when in afib. I also created an afib remission program <[www.afibbers.org] which has kept me in relative (not perfect) remission since. Not sure how I would approach it if I was in permanent afib.

I don't have data to support either side of this position.

George

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tvanslooten
Are you sure about that? Wouldn't vigorous exercise cause the heart to "work more", coupled with a troubled heart in afib wouldn't that make things worse?

As with all exercise, just pace yourself with what feels right for you. Grampy says he feels fine doing the level of exercise he's doing, which means his heart is compensating adequately. So it does him no harm and you'd be hard pressed to find any EP who would say he should back off. If you feel better slowing down, then fine, slow down, but a lot of people, especially the ones in persistent afib, don't feel the symptoms like paroxysmal folks do. There's just no reason for them to curb reasonable exercise levels that feel right for them.

Grampy:

What is your HR? both at rest, and while exercising? Are you on Medication to control your rate like Beta-Blockers?

In general if someones HR in AFIB is controlled close to their normal HR while in NSR, then all they are losing in Cardiac output is about 5% points on their Ejection fraction. If the HR is higher, then Cardiac output goes down because the Ventricles don't fill with Blood fast enough, before the Blood is pumped out.

I see no reason not to exercise as you are. If you were going in and out of AFIB, then excessive exercise might stretch out the Atria when in NSR, contributing to AFIB. Since your Atria is always fibrillating, the exercise is not really impacting the Atria.

If your car would have a flat tire, you would not drive it. And when your heart goes "flat", you expect it to function like nothing has happened. So many of us were keen to maintain our body fit, but it has in the end brought us here, where we are. Are you really so strongly addicted to the exercise, that you do not care about how your heart performs its task? Maybe all of you, with permanent AF and still exercising, should keep in mind that the very next level of atrial arrhythmias, starting from AF, is SCA (sudden cardiac arrest). About a year ago, I lost a close friend of mine while he was exercising (the girl was much younger, and he was in AF by the time). Take care!

Grampy –
Knowing your ejection fraction as well as your blood viscosity measurement would be good preventive/precautionary measures while you continue to enjoy your workouts as long as you don’t push too hard or too long.

When I attended an Atrial Fibrillation Summit hosted by Dr. Natale and the Cleveland Clinic in 2005, one of the presenters showed a video clip of a surgically-exposed heart struggling mightily while beating in atrial fibrillation at a high rate. It was sad and tragic sight … especially when compared to a similar clip of a heart beating in NSR and, obviously, one I’ve not forgotten.

With my long history of Afib prior to ablation - 8 years after onset, I learned to adjust my workouts to be comfortable but still moving and keeping as active as possible and comfortable. It's smart to be aware not to become dehydrated as that thickens your blood and puts you at risk of “pumping sludge.”…. (copied from Meridian Valley Lab’s “Is your heart pumping sludge” banner.)

Since I was not on a blood thinner, but rather was using fibrinolytic enzymes… nattokinase and serrapeptase, I was very careful to be sure that I was always well-hydrated.

Be well, grampy and be safe.

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baraba
Are you really so strongly addicted to the exercise, that you do not care about how your heart performs its task?

You might want to keep in mind that regular exercise improves heart health and that applies to people with afib just as much as it does to everyone else.

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Maybe all of you, with permanent AF and still exercising, should keep in mind that the very next level of atrial arrhythmias, starting from AF, is SCA (sudden cardiac arrest).

I'm sorry but this is entirely incorrect. Atrial arrhythmias are not responsible for SCA, or even connected to SCA in any way.

Baraba:

it would appear that you are correct about exercising too strenuously when the heart is not able to pump as well when in AF.

Arrhythmias can produce a broad range of symptoms, from barely perceptible to cardiovascular collapse and death. When they’re very brief, arrhythmias are most likely to be almost symptomless. For example, a single premature beat may be perceived as a palpitation or skipped beat. Premature beats that are frequent or occur in rapid succes- sion during a nonsustained or sustained tachycardia may cause a greater awareness of heart palpitations or a fluttering sensation in the chest or neck.

A certain amount of exercise is great but a very strenuous workout might be too much. George N. (a poster here0 cut down on his strenuous exercise because he believed it led to his AF episodes. He still exercises but doesn't go overbroad, he also is not in AF.

liz

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Elizabeth
Arrhythmias can produce a broad range of symptoms, from barely perceptible to cardiovascular collapse and death.

Atrial arrhythmias do not cause cardiovascular collapse or death.

Ok; THAT IS NO DOUBT CORRECT

in reading the following, weight lifting is rather hard on the heart in AF, If the guy wants to lifts weights, ok with me.


Exercises to avoid with AFib

If you haven’t exercised in a while, you don’t want to start with intense, high-impact exercise. When you exercise with AFib, you may want to start with short intervals of low-impact exercise. Then you can gradually increase the length and intensity of your workouts.

Try to avoid activities with a higher risk of causing injury, such as skiing or outdoor biking. Many blood thinner medications used to treat AFib may make you bleed more heavily when you’re injured.

If you plan to lift weights, talk to your doctor or a physical therapist about how much weight is safe for you to lift. Lifting too much can put a lot of strain on your heart.

I first experienced affib in my early 20's I'm currently in my early 50's. During that time i continued to train and race bicycles. In the early stages of my afffib the monster would show up on occasion. Sometimes I would just stop riding and wait to convert and proceed on my way. Other times, fewer times that is, during races I would just continue on.. The only issues I ever experienced from that was when I would convert the lactic acid that was building in my legs because of the erratic beating of my heart would shoot through my body and create hellsh cramping.

That being said I personally would not recommend this. Exercise did seem to keep the affib at bay. The more fit I was the less likely I was to have an attack.

Ended up having my first ablation in 2009. Had my second just this past january.

An online friend, who went into afib in Dec 2016 because, as i understand it, from pneumonia, continued to exercise, doing bike rides. His ejection fraction (EF) got pretty low (don't recall the specifics). He decided to attack the issue with fasts of various lengths (including some of many days), as well as a keto diet when not fasting, while continuing to exercise. He recently reported he returned to NSR after ~14 months of persistent afib. He had previously reported his EF had improved matrially. He's now been in NSR for 21 days and continues his bike rides with heart rates (in NSR) of 150 vs 190 in afib. If thie NSR persists, I will ask him to write up his story and post it here. Because of an injury some years ago, which limited physical activity, he is not a small man.

George

Fascinating, did he take any medications while in afib?

Fourteen months of persistent AF and coming out of it, that is inspiring. During that AF time did he take any blood thinners and George when you were in the 2 month period did you take any blood thinners?

Liz

During my 5 years of diagnosed afib (2-3 episodes per month), exercising in afib was almost impossible because of oxygen debt. My afib was not exercised induced, but did show up a few times while working out. I simply had to stop. If I was in a fib, I would not go for a work out. All other activity was normal.

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Joe
Fascinating, did he take any medications while in afib?

I don't know about meds. As I said, if this persists, I think I can get him to write up the details.

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Elizabeth
Fourteen months of persistent AF and coming out of it, that is inspiring. During that AF time did he take any blood thinners and George when you were in the 2 month period did you take any blood thinners?
Liz

Don't know about his use of anticoagulation, again, if he writes it up, I'll suggest he puts in that detail. As for me, yes I was prescribed Warfarin - they would not convert me unless I'd been anticoagulated for some weeks (don't recall the exact length now). I was ultimately converted with 300 mg flecainide. I as I recall, they had me take Warfarin for 4 weeks after conversion, too.

George

One other oddity was that once I converted back to nsr while riding. I could ride as hard as I wanted to and for however long with no more events.

Following my ablation in 2009 I noticed that my heart reactivity to cycling seamed to change. Before the ablation I was a decent sprinter. Not world class but could hold my own. I could easily ramp my heartrate up. Following the ablation I could still drive my heartrate up and hold it there but not like before. More like a steam locomotive.

In the early days of my journey I tried several different types of medications with zero positive effects. I do think that the magnesium and potassium helped but was not the be all end all to solving the problem. The only time I have ever been on blood thinners was following my ablations.

Grampy –
Knowing your ejection fraction as well as your blood viscosity measurement would be good preventive/precautionary measures while you continue to enjoy your workouts as long as you don’t push too hard or long.

When I attended an Atrial Fibrillation Summit hosted by Dr. Natale and the Cleveland Clinic in 2005, one of the presenters showed a video clip of a surgically-exposed heart struggling mightily while beating in atrial fibrillation at a high rate. It was sad and tragic sight … especially when compared to a similar clip of a heart beating in NSR and, obviously, one I’ve not forgotten.

With my long history of AF prior to ablation 8 years after onset, I learned to adjust my workouts to be comfortable but still moving and keeping as active as possible. It's smart to be aware not to become dehydrated as that thickens your blood and puts you at risk of “pumping sludge.”…. (copied from Meridian Valley Lab’s “Is your heart pumping sludge” banner.)

Since I was not on a blood thinner, but rather was using fibrinolytic enzymes… nattokinase and serrapeptase, I was very careful to be sure that I was always well-hydrated.

Be well, grampy and be safe.

Jackie

[meridianvalleylab.com]

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Carey

I'm sorry but this is entirely incorrect. Atrial arrhythmias are not responsible for SCA, or even connected to SCA in any way.

A portion of a comment by Baffafly in HealthUnlocked forum on 22.03.2018.:

"I have hesitated to post my last comment, for fear of scaring members, but as this subject has come up, I'm going to, then I'll duck! I was watching a documentary programe 'Inside the Ambulance' when the crew were called to a man in a state of semi-collapse. It turned out he had recently had an episode of AF and was still feeling ill though now in NSR. One of the crew explained to camera later that this was because a long episode of AF was like running several marathons back to back without training so therefore the heart would still be tired for some time afterwards. She added that AF was dangerous because a too high HR for too long would cause cardiac arrest, so they took AF very seriously."

I am not of scared ones and I would not like to scare others, but knowing the truth may be life saving. Wishing to all of you best of health,
Baraba

Yes, The technical term is Tachy-Cardia induced CardioMyopathy. It happens with AFIB, and can lead to Heart Failure. A similar issue happens under Hypoxia conditions involving Sleep Apnea. That's why I asked Grampy about his HR, both at rest, and during exercise. We can't definitively answer his question without that information, although from his description he probably doesn't have that high of a AFIB HR. AFIB effects people differently in terms of the Heart Rate. Some stay only at 60-70, while other go as high as 180.

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baraba
"I have hesitated to post my last comment, for fear of scaring members, but as this subject has come up, I'm going to, then I'll duck! I was watching a documentary programe 'Inside the Ambulance' when the crew were called to a man in a state of semi-collapse. It turned out he had recently had an episode of AF and was still feeling ill though now in NSR. One of the crew explained to camera later that this was because a long episode of AF was like running several marathons back to back without training so therefore the heart would still be tired for some time afterwards. She added that AF was dangerous because a too high HR for too long would cause cardiac arrest, so they took AF very seriously."

I am not of scared ones and I would not like to scare others, but knowing the truth may be life saving. Wishing to all of you best of health,

The show you watched was either dramatized or simply incorrect. I was the guy in the back of the ambulance for 15 years. Nobody suffers cardiac arrest due to afib. Nobody.

Heart failure from prolonged, uncontrolled high heart rates? Yes, that can happen, but it takes weeks or months to develop and heart failure is not cardiac arrest.

I agree that this information is suspect. As I stated before following an Affib attack while cycling. Once my heart converted to NSR I could ride as far and as hard as I wanted to without fear of a second attack.

My HR during my episodes would go above 200 bpm.

Sorry, but when my HR is at 190-200 bpm and chaotic, stopping and starting...my greatest feat is sudden cardiac arrest.
The ENGAGE AF-TIMI 48 trial showed a link between AF and sudden cardiac death.
Whilst I don’t linger over or become morbidly obsessed about reports (there are so many) it pays to be cautious and give your heart the care it deserves.
After all it is working hard to keep you alive and deserves all the TLC you can give it.
I wouldn’t be flying down the freeway at 200 miles an hour in a 70 year old car with a faulty engine, so why would I do it to my heart?

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JoyWin
Sorry, but when my HR is at 190-200 bpm and chaotic, stopping and starting...my greatest feat is sudden cardiac arrest.
The ENGAGE AF-TIMI 48 trial showed a link between AF and sudden cardiac death.
Whilst I don’t linger over or become morbidly obsessed about reports (there are so many) it pays to be cautious and give your heart the care it deserves.
After all it is working hard to keep you alive and deserves all the TLC you can give it.
I wouldn’t be flying down the freeway at 200 miles an hour in a 70 year old car with a faulty engine, so why would I do it to my heart?

Your greatest feat in life was to survive Sudden Cardiac Arrest resulting from exercising in AFIB with a HR of 200?

Joy Winn probably meant her greatest "fear" not feat. I would say a lot of us might feel the same way.

Liz

I want to second the point that Afib or any atrial arrhythmia does not lead to cardiac death. Only in an EXTREMELY rare case of something called Wolff-Parkinson-White (WPW) syndrome could that be a possibility. WPW is kind of a “short-circuit” around the heart’s atrio-ventricular (AV) node, which gates the electrical activity in the atria from the ventricles. In a normal patient, the AV node will block every second (or third, or even fourth) errant atrial signal from ever reaching the ventricles. It’s a really cool failsafe mechanism that nature gave us! You also cannot develop WPW. It is congenital and you were either born with it or not.

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JoyWin
Sorry, but when my HR is at 190-200 bpm and chaotic, stopping and starting...my greatest feat is sudden cardiac arrest.
The ENGAGE AF-TIMI 48 trial showed a link between AF and sudden cardiac death.

I'm sorry, but the study you cited had nothing to do with AF and sudden cardiac arrest. It was a comparison between edoxaban (Savaysa) and warfarin. Maybe you had some other study in mind?

I have no doubt SCA is your greatest fear at those times. Trust me, I know how it feels. I spent years hitting rates of 230-250 on a regular basis. But your fear is unfounded. Afib does not lead to cardiac arrest in otherwise healthy people. It simply doesn't, and I wish you would stop telling yourself and others that it does.

Just saw your response Carey...and if only I could convince myself of this when I'm flat on my back trying to get my HR down and trying not to pass out or throw up.

I'm not telling people that it has happened or is likely to, I am merely saying that when you have very significant heart rates and quite severe symptoms it is hard not to be afraid.

Of all my chronic conditions AF is the one that scares the hell out of me. Why? Because it's my heart.

We all want to live and threats to our existence whether real or imaginary are difficult to dismiss.

A cure may be just around the corner, or maybe not, but at 77 years young, I continue to enjoy life to the fullest (except when I'm in AF)