AF and Exercise

Have returned back to thye gym after quite a while to try and lose a bit of weight and improve fitness. G P keen advocate for this but obviously to pay particular attention to my heart rate. Went yesterday and was very alarmed that my heart rate shot up to 178 and took ages to return to normal ( if there is such a thing as normal with having AF) No palpitations but quite nauseous for nearly an hour after finishing exercise. Don't want to give up the gym as I really enjoy going and know it is benefiting me but then if this is going to happen again could it lead to having an AF attack. Medication at the moment bisoprolol 5mg daily, apixaban 10mg daily and rampiril 5mg daily. Any suggestions.

17 Replies

  • General rule I was told was take your age off 200 . in my case 70 so end up with 130 and do not exceed that HR adjusting effort accordingly.

  • Hi Giddy

    I have the same problem to be honest, using Bob's formulae and it's a common quoted one, then I should exercise to 140, BUT within less than 2 minutes of a warm up I am up at 140 and my EP told me this is typical for an AF heart, (of course I am in AF all the time)

    Honestly I have been pushing to around 160-165 for 30 mins at a time and peaking at 175 or so and feeling no longer term effects other than getting fitter slowly, but please do ask your EP. (My GP said 120 which means no exercise at all for me)

    Be well


  • You max heart rate should be 220 less your age and you should exercise to 85% of that as a rule. Please buy a heart rate monitor and watch and use this when you exercise as it allows you to slow down etc and monitor the heart closely. Your heart should recover quicker and there is some guidance on the Web about this as a sign of fitness. Also on beta blockers you max heart rate should be lower.

  • This is excellent advice. The formula of 220 minus your age is a good general guideline but should be modified based on your cardiovascular condition and history. Some people can work comfortably at their calculated maximum (154 for me, which is no big deal), while others are in trouble if they hit 80%, or even 70%.

    The best way to assess your cardio condition is to exercise at 70-80% of your maximum (or whatever is a sustainable pace for you) and watch how quickly your pulse drops during the first minute. You need a heart monitor for that because your heart rate will decrease while you're counting out the beats. Here's one approach:

    Good luck and have fun!

  • The general rule is 85% of (220 - age): But it's only a "theory" and based on many assumptions about the "average person". I'd be careful to remain within a range that feels comfortable, so "modest" pushing. When I was at my maximum fitness level (squash 4-5 times a week) my heart rate never exceeded 120 bmp even in the middle of an epic match. So going to 85% of [220 minus my age] is simply unnatural for me. The first time I went into AFib was during my first "stress test" when the attending doctor insisted I sprint at full stretch up a steep incline until eventually I finally reached 185 bpm and remained at that crazy level for 10 full minutes. They detected nothing wrong with my cardiovascular system, but the stress test itself brought on AFib for the first time in my life, and I've had it ever since. Sure, I probably had a predisposition, but I can't help thinking it is a mistake to assume that a general rule based on theory is optimal for every single person. So just be careful.

  • Let me get this straight. Your working limit was about 120 bpm and the doc told you to *sprint uphill* until you hit 185? That's 50% higher than your usual exercise heart rate! For some reason the word "malpractice" comes to mind. It sounds like a pretty good way to trigger a serious medical problem - which it did.

    Have you talked with an attorney about this?

  • Sorry to be a Kill-joy but I would give up the gym and consider boring, brisk walking x2 per day for 1 mile, the first BEFORE breakfast ( increases your metabolic rate, I read) and improve your diet. I have had to accept and stop a lot of 'pushing type ' exercises.

    Before I got AF, I got a blood clot in the leg and have done the walking for 10yrs+, better diet 5yrs+ and too much weight/periodic diets has disappeared.

    What do I eat, no diet shakes or other extremes just a lot of good quality organic food including full fat dairy & meat. My view it is a myth these things are wrong for you and when your body gets the right stuff it is quickly satisfied. My cholesterol has been around 7 (high) for 10+ years and heart and carotid arteries scanned recently and all clear.

    Slow phase in with professional advice from medics or an Alternative Practitioner first!!

    Hope something there helps.

  • your heart rate may go up anyway if you have had time off the gym. maybe a bit anxious too???

  • I have had af for past 2 years and kept up various exercise classes at the gym with the guidance of an exercise physiologist. Iver this time i gave managed to lose weight and get my af under control. I have fiund by not over exerting myself i have been zble to improve my overall health

  • I reckon buddje is right. Build up slowly and use the equipment that feels right for you. I'm currently doing the same thing as you and alarmed myself a couple of times at first! However, after 5 visits and being sensible and listening to what my body is telling me, things are getting better. Interestingly, on the treadmill, I started walking at 4.5 kph for ten minutes and pulse rate soon shot up to 140 bpm. Now it increases to a lower 120 bpm for the same effort. Instructors tell me this indicates getting fitter. Don't obsess about pulse rates but do get a good monitor and set yourself sensible targets.

    As in all these things, if something doesn't feel right - get proper advice. Hope you can soon enjoy yourself at the gym!

  • AF isn't the same for everybody especially if you add exercise to the mix. Some of us with a history of AF are happy working in the gym or on the road at 150 - 160 bpm that would see others heading to A&E. Your reaction sounds like you were overdoing it or that you were in AF. Some heart monitors and most gym machines don't give a reliable read out when you're in AF. I use a Polar RS400 heart monitor set to one second sampling and the download to Polar Pro training software clearly shows AF as a spiky trace. You may find that the same exercise with the same power output may produce AF on one day and not on another. If you're you've done cardio vascular exercise for several years then you'll be used to perceived effort and exercising to how your body feels and that could be your best guide. The 220 minus your age might be OK for sedentary people but not much good if you've exercised for years. Although I'm 69, I set the gym machines as though I am 33. I use a formula devised by a Norwegian University. The following example was when I was 67 for 80% maximum heart rate, using a resting heart rate of 52:

    211 – (age x 0.64)

    My calc at 67

    211 - (67 x 0.64) = 168

    Using heart rate reserve with resting heart rate of 52

    168 - 52 = 116

    80% heart rate

    116 x 0.8 = 92.8

    92.8 + 52 = 145

  • I'm very much in agreement with everything that John-Boy has said in the above.

    I'm not entirely sure that I'm "happy with 150-160" when in AF as I know that the effort level producing this should infact see a level nearer to 120-130 but hay-Ho! I'm learning to accept that that is the way it works.

    I particularly agree with the method for working out HRs, that's what I use and find it much nearer to reality than the 220-age formula.

  • The 150 - 160 figure is my target in the gym or on a turbo when I'm not in AF. I've just got back in the gym after a break since May 2014 when I contracted pulmonary toxicity secondary to taking dronedarone, so my resting heart rate and therefore my 80% MHR figure is higher. I'm currently averaging 155 bpm on a Concept 2 when rowing 5km at 120 watts average but, that won't be true for everybody.

    If AF kicks in when I'm exercising I'll be at 180+ average with big spikes in the range of 200 - 230, and that will drop my power output by up to 20%.

  • It's interesting to see just how similar your figures are to mine John-Boy. Cycling and rowing are likely to show differing watt averages and, rather bizarrely, our latest spinning machines don't give wattage achieved but I think it would be of a similar order.

    If I push to that level in AF then I too will see 180 odd to just over 200bpm with a significant drop in output.

  • I have a Cycleops Supermagneto Pro turbo and the road resistance setting equates to 180 watts at 18 mph, so an 80% session at the moment would probably use a 16 rear cog with the 50 front ring. I don't think that I'll be winding it up until next spring.

    I think that Keiser used to do a Spin bike with a power meter but they don't appear to now. If Pure Gym got some Wattbikes I think that I would be in there most days.

  • Well thanks everyone for your replies. Again this is why this site is so good for support and advice. Decided to give the gym a go again this evening. Spoke to the trainer. They failed to tell me that these new style tread mills pick up heart rates from other people using tread mills next to you. Don't think I was having an af attack as I know,what to expect. However have found what could have been the culprit for feeling done in the 3 sets of 20 squats that were on the program. They have now been reduced to 3 sets of 10. What a difference. Feel invigorated rather than completely knackered. Just on the safe side seeing GP in the morning so will get checked out. Again thanks everyone. Plus I know of one Christmas present my wife is going to grte a heart monitor.

  • I was told, and from my research, that most heart monitors (particularly wrist ones) are inaccurate when in AF. Some of the manufacturer's actually say that but most are silent. Be careful what you choose.

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