Excercise and AF

This post is really just an observation which may, or may not, be of interest and I wonder what experiences others have.

My PAF was almost certainly caused by me pushing myself too hard during a cycling event whilst suffering from a viral infection. I am currently doing the weekly INR thing in order to get my Warfarin level correct. I am not actually taking any prescribed medication for the PAF at the moment, I do have some Bisoprolol as a "pill in your" pocket but haven't used it. What I do take is Hawthorn Berry herbal supplement and I would say that circumstantial evidence suggests that this is helping reduce the number of PAF episodes that I experience.

Yesterday lunch time AF tripped in for no apparent reason. Initially my RHR went up to around 120bpm (my normal RHR is around 50-55) and then settled to around 100bpm with arythmia. It stayed that way for the rest of yesterday and was still much the same this morning.

I have a spinning class on a Wednesday morning and decided that I would go, but take things very easy. I use a HRM and monitored this finding that very gentle spinning was giving around 130bpm, a little bit of effort was putting me up to just over 150bpm which was well beyond what it should have been for that level of effort. However, by easing back I could bring the rate back down to 120-130, still too high but not enough to fret about.

With just a few minutes of the class remaining my HR simply dropped from 130bpm to 95bpm with no change in effort level. 95bpm was pretty much the right sort of level for the effort I was putting in at that time and so I stuck a couple of fingers against my neck to check pulse and sure enough, back to normal with no arythmia!

This isn't the first time that I've noticed this happen and so it would seem that, for me, excercise can just as easily switch off my AF as it can trigger it.

[BobD Volunteer]

When I first had AF about ten years ago I used to think that if I worked in such a way as to push my HR up to what it already was, when I cooled down it would return to normal. Sometimes it did, sometimes not but when I told my arrhythmia nurse she thought I was stupid to do this. Each to their own. Your story is not unknown.

[Hidden in reply to BobD]

As I mentioned in my post this really is just an observation. I'm certainly not advocating that anybody should view it as a possible method for stopping AF!

It was simply something that I actually saw happen whilst trying to keep my HR down during excercise.

Please don't try this at home!

[GolfMyrtleBeach in reply to BobD]

Interesting observation from the nurse. I had one of my nuclear stress test while in AF and the cardiolist was quite curious to see if the effort would "strip-out" ( his words). The arrhythmia. I have often told both he and my EP that cycling frequently stops AF episodes and they have been quite fine with it.. It's a awful quirky condition, isn't it??

[constabule in reply to BobD]

I had the same theory and the same response exercise yes but not strenuous . As that was the only dont i can manage that - no probs.

[howesgilly]

I was strictly advised not to go to gym when in AF due to the risk of strain on an already over functioning heart. I was told higher risk of heart failure especially if the ejection fraction was reduced from the af.

However I have often wondered if raising the natural av node rate by exercise would override the fibrillation and therefore bring on normal sinus rythum.

Seems like research needed in this area!

[Hidden in reply to howesgilly]

I suspect that the answer is either no or not neccasarily. I have had a return to sinus during excercise on a few occasions like today but it's probably no better than something like 1 in 4.

Both of the GPs that I have seen about AF know that I am quite active with cycling and I do spinning and they are happy for me to continue "but don't go mad". One suggested a maximum HR for when in AF and I try to stick to that.

I'm not really prepared to let my AF stop me from doing the things I enjoy but realise that I do have to ease back when my heart tells me to.

Frustratingly this means that when cross-country skiing and fell walking my wife now has to wait for me at the top!

[Hidden in reply to Hidden]

From my experience....... with frequent PAF that has gone away for 19 months now on Flecainide your GP's advice is in most cases is questionable, see a cardiologist.

On exercise..... take a long hard look at it. I loved my running (sprinting at 60yo started my AF probably), tennis, cross country skiing, cycling and have given it all up for walking and table tennis. Why...because any AF episodes increase the frequency of more episodes, as the heart develops a bad habit, which I wanted to stop dead. I hope to re-introduce exercise in a couple of years at a lighter level.

Getting out of AF....my go to first step is to focus on slow breathing in tune with normal pulse rate and then a brisk walk for 1 mile+. Other reversals for me could be a cold ginger beer (as that put me into AF a while back) and plunging face into cold water but I haven't tested these and I guess they could make matters worse.

Good luck!

[Sumath]

I have also found that moderate exercise can send me back into normal rhythm when having a bout of AF. On the past three occasions I have gone onto the treadmill and walked at 7.4 k on a 7% incline for 30 minutes and been back in normal sinus rhythm at the end .

[Hidden in reply to Sumath]

That's very interesting Sumath. I'm trying to understand what level of exercise I can achieve before I trip in to AF and, when in AF, if there is trigger level that can switch off AF.

From what you say it does look rather like you might have found your own "switch off" point. Do you feel that's a realistic assumption and do you use an HRM?

[Sumath in reply to Hidden]

No I just use a sphygmomanometer that can also detect AF. when in AF my heart rate is very erratic but not too rapid , possibly because of the sotalol. I am under Bart's and awaiting first ablation. I also take apixaban .

[Hidden in reply to Sumath]

Sorry, I'm very new to this and have no idea what a sphygmomanometer is and haven't heard of apixaban.

I was just wondering what level of excercise your treadmill equated to when you found your "switch off" point.

[Sumath in reply to Hidden]

It's a blood pressure machine. Apixaban is one of the new anti coagulants. I just set the treadmill at a steady fast walk and go for it.

[Hidden in reply to Sumath]

Thanks, lots to learn! My GP and I agreed that because I cycle, ride a motorbike, sail and do various other things that could end badly warfarin was the better option since an injection can reverse it's effect.

Nothing like thinking positive eh?!

[Cloggie2013]

Over the past few years I have PAF every 1-2 months, almost always starting in the evening and continuing into the next day.

I purchased a small portable ECG monitor/recorder (Prince 180B Easy Handheld Portable ECG Monitor + Software + USB Link) and keep all the occasions stored on my laptop. I have shown the printouts to my GP. As a result I am on Bisoprolol. I am lucky to have a normal to low blood pressure, so no anti coal drugs.

I have noticed that my PAF stops the next morning during or just after doing some physical work, like loading 100 bags of 10 kg each from a pallet onto my trailer, ready for delivery.

So very similar experiences! Have not tried any cycling or running. I do fully agree that further investigations are called for.

[GolfMyrtleBeach]

OB, Exercise is one of my "home remedies" for reverting to NSR. I also bike and I have found that many mornings if in AF it will settle out around the 3-5 mile mark.

[Hidden in reply to GolfMyrtleBeach]

Mention of your experience when cycling reminds me that it has infact also happened to me on several occasions whilst cycling. To be honest I had forgotten about those occasions. It tends to happen around the 25 to 30 mile mark for me though.

[Dadog]

Very interesting post. My quandary is the opposite of this. I've been told, by my GP and INR nurse, to exercise regularly to reduce an increasing cholesterol reading. Fair enough. I'm in NSR but not as fit as I was 2 years ago. HR is 56bpm at rest. I joined my local gym, bought a heart monitor and set off with some trepidation. I was amazed how quickly my HR went up as soon as I warmed up on the treadmill and it reached 140bpm within 3 0r 4 minutes, walking gently at 4.4Kph. Interestingly, it showed signs of becoming irregular anywhere above that HR.

I shall be monitoring results as I go, to see what happens - and stay within these limits on all the equipment I use. I've also found that my BP takes a dive when I stop - down to something around 86/45 - 74 and very dizzy. Not happy with that but hope it will improve as I do.

I'd be interested in anyone else's experiences when exercising, as it is as interesting as you guys who have almost the opposite reaction!

[Hidden in reply to Dadog]

I think that if you read my initial post again you will see that I experience much the same as you describe when I am excercising and in AF.

Although you say you are in NSR what you are describing with higher than expected HR becoming irregular above 140 sounds very much like AF to me.

[Dadog in reply to Hidden]

That's what I'm afraid of and why I ease off when it happens. It feels like I am pushing things too hard and I don't want it to revert to AF. It may not....but I'm not ready to find out. It isn't happening too often so maybe as I get fitter.....?

[Hidden]

On the subject of HRMs mine is the type that uses a chest strap which picks up the electronic impulses that generate the heart beat.

I'm pretty certain that the wayward electronics that are associated with AF sometimes confuse the HRM.

As an example on a recent cycling event a long climb, during which I kept my HR around 140-150 was followed by a long fast descent. During the down hill cruise my HR supposedly went up to 256bpm!!

I rather think that my HRM was seeing double....

[Dadog in reply to Hidden]

They do warn about this in the leaflet with the Pusle kit. Irregularity does throw the readings out.

[paulh1 in reply to Hidden]

My hr monitor does the same. Seems like there is a lag between when you actually are in Afib and when the hr monitor picks it up. Have had similar readings on the downhill. Thought it was pretty strange :-))

[Hidden in reply to paulh1]

Adrenalin rush perhaps?!

[AFCyclist]

Over the past 6 years I have used cycling to get me back into NSR. Most times it worked after about 30 mins, but not always. I am now persistant AF awaiting a cardioversion. Cycling does not now get me back into NSR. I asked my cardiologist, and the experts at the Patients Day in Birmingham, about cycling when in AF. They both said, exercise was good, but do not overdo it. I now try and keep my heart rate down but find I can still do a 40 or 50 mile cycle but at a slow pace. Hopefully they will get me back into NSR soon. I feel fine just sitting around but when I try to do anything strenuous it is like having a motor that only goes at 70%.

[CTG99]

Firstly, it's great to hear your determination that AF is not going to rule your life - keep that one up!

At last year's AF Patients' Day, one of the EPs who has AF himself told us he used to dive for his running shoes when he went into AF as he found he could run himself back into NSR. It seems exercise can both start and stop AF episodes - it just depends on the person which it is.

The advice at this year's AF Patients' Day was that it probably wouldn't be a good idea to start learning to bungee jump, ski or anything else that triggers a whopping great adrenaline rush if you have AF, but that if you are used to doing these activities, there's no harm in carrying on.

I've found that it's just best to listen to my body. You'll get to know when it feels as though you are going into AF and that can drive what you do on the exercise front. Some days I'll do one of my original (pre-AF) gym programmes, other days I know after 2 minutes on the cross trainer that I'm better off just having a stretching session. I also find that using a foam roller can help a lot if it feels as though AF may be on the way.

I avoid Spin at all costs - but that's just because I hate doing it and always have done!!!!!

Caroline

[Hidden in reply to CTG99]

Thanks for the feed back from the AF Patient's Days, good to know.

Do you do any particular excercises with the foam roller or is it more like a massage routine?

[CTG99 in reply to Hidden]

It's massage, or more particularly myofascial release. Using it on my middle / upper back can help to fend off an AF episode (around the T1 / T2 vertebrae) but I use it for legs, IT band (ouch!!!), glutes, back and even arms. NB if you are using it for legs, you should only apply pressure when pushing the blood up towards your heart (i.e. you are moving backwards and the roller is moving up your legs) otherwise you'll be fighting the valves in your blood vessels! Think of it as a one-way movement.

Caroline

[Paul_M]

Without a doubt my AF started when spinning. It all kicked off after interval training. I was 47 and went spinning twice a week and was pretty fit. I went into arhythmia and stayed there until my first cardio version a year or so later. I have not been able to exercise properly since. I have had two cardio version now and a third next week followed by ablation next month.

I really miss the bikes and have put on weight and lost fitness.

Paul.....

[Hidden in reply to Paul_M]

Best wishes for the up coming treatment. Hopefully, in a couple of months you'll be able to get back to some light excercise and then move on from there.

I know just how frustrating it can be to see your fitness drifting away.....fingers crossed for fitter New Year!

[Paul_M]

The Old Buzzard? I used to be in a band called The Buzzards....

[Hidden]

Excellent! "Old Buzzard" (now just called "Buzzard") is a beer from Cotleigh Brewery in Wiveliscombe. It was a favourite of mine and when my local had it on the landlady would alway greet me with "Old Buzzard?" and so it became my nickname which I've utilised for the sake of anonymity ever since!