Exercise after Cardioversion

My first cardioversion lasted 19 days, I then went to my GP to get ECG confirmation and he decided to send me to A+E (I also had a chest ache during cycling) at Sheffield Northern General where I was able to get them to do a second cardioversion that night. The chest ache was investigated and not thought to be an issue. I am a keen cyclist who used to do up to 100 mile trips. When persistent AF started in September I cut this back to 60 miles max with no steep hills. After the first cardioversion on the 21st November I took things very steady and gradually increased back to my last ride of 60 miles where I was feeling a bit poor and my heart rate monitor confirmed I was back in AF. I visited my GP the next day. I am now back at home after the second cardioversion, in NSR, but feeling nervous about doing any cycling or exercise for a while. I have decided not to do any cycling for 2 weeks over Xmas, but with no exercise I will be a tetchy old thing! Any advice or comments please. I am 67.

19 Replies

  • Everything in moderation. I would discuss this with your cardiologist rather than your GP as they really are not the experts in AF. We know that excess exercise can be a cause of AF , the problem being what is excess. Endurance athletes are prime candidates for AF amongst younger people as are fast jet pilots (fighting G force) so common sense should prevail where exercise is concerned.

  • Bob, thanks. They all say "do not overdo it". At the back of my mind I know that only I can set my own boundaries, but experience of other always useful. I guess it is difficult to accept the realities of old age! However I still want to do some cycling and have started ablation discussions with an NHS EP.

  • I guess that if you ever get the endorphine rush that you are craving then you are doing too much! I recommend walking with Nordic poles as it gives a full body work out, not just your legs.

  • There have been quite a few comments on this subject recently and so, rather than repeat them here, might I suggest a quick trawl through some of the other posts?

    If you have some space then I can recommend getting a turbotrainer. You can vary the resistance level in order to achieve a very gentle excercise session and then slowly build up without (hopefully!) tripping into AF.

  • Thanks, the turbo is already out and has been used, but it is nothing like the real thing. Deadly boring. Perhaps that is good, as it might stop me overdoing it.

  • Boring yes but I do find it effective. I watch Sufferlandria videos whilst on the turbo. Unfortunately these videos can be counterproductive as they do rather tempt me into pushing too hard and.....AF again!

  • Steady walking might help ease the tetchinesss. It is hard when you have to stop doing something your body is used to doing. I hope you can find something too occupy your mind over the holiday break.

  • What's wrong with good old fashioned walking?!

    I have to say that I've found that I have to take it easy the week following a cardioversion as I can feel my heart trying to get back into AF on comparatively little exertion. I was particularly aware of this happening following my last one a couple of weeks ago.


  • Yes, good advice. Walking not the same as wizzing along on the bike though! It is hard to spot the signs that my heart is going into AF as often happens the day after exercise. How many cardioversions are they prepared to give you?

  • Must agree that walking is not very exciting !

    I don't know how many cardioversions I can have after my last ...15th.....even though this was spread out over 22/3 years.

    Consultant anaesthetist who saw me at AE on my last visit told me I was damaging my heart which is contrary to what I had been told on previous occasions. However I have an appointment with my EP in January and will seek his view.


  • AFCyclist

    I feel for you. As other have already written a history of endurance exercise predisposes to AF. Something like a factor of two. Also, I understand that if your in AF and stress the heart too much you will increase the likelihood of further attacks. Something to do with enlarging and damaging the left atrium and setting up abnormal electrical pathways.

    I also have a history of long distance training (both foot and bike). I look back now and wonder if I overdid it all, especially when I was younger. For me, the AF simply meant that I tried harder - maybe not the most sensible response - but I hope you understand.

    Anyway, I had a maze procedure about a month ago and have been rethinking my exercise regime. Seeing the EP and cardiothoracic surgeon later this week so I'll ask for their advice.

    It seems that any stressful exercise in not wise for a bout three months then moderate exercise (whatever that means) should be OK. It seems that duration as well as intensity are important. Some advise a maximum of 40 minutes. But that's not so long on a bike. I'm hoping that I can get advice re target heart rates.

  • I would be interested to hear what they say. Particularly about heart rates and duration.

    I have asked several cardiologists about cycling when in AF and they have all said it is OK, but do not overdo it. At the AFA Patient Day this year I was told that it is good to exercise an AF heart.

  • The HB when in NSR is a factor as well as age so the actual number is not quite the limiting amount. The have been some formulae in previous posts but don't know how good these are. One aspect that seems to me to be missing is what someone's normal rate is. Also most monitors are inaccurate if you are actually in AF - you need to use something like an AliveCor.

    However as has been said in many posts we are all different and for that matter different consultants can have quite differing views.

    I am in persistent AF and have not done any sports for 25 years because of a car accident. However one thing that I was told was not to be doing things that resulted in me breaking out into a heavy sweat even if it is doing something like a bit of gardening (and I do break out easily now).

  • AFCyclist

    Went to see both the cardiothoracic surgeon and the EP cardiologist yesterday. It is still early days for me as I am only one month out from a minimally invasive maze procedure. Have a look at link if you are interested. Barry was the first patient I was the second.


    Anyway to exercise. I am still on metoprolol so low heart restricts what I can do. However, both doctors said that, all being well, I should be able to return to full exercise over time. They didn't indicate any restrictions or limits.

  • For me the trigger is the intensity of the ride, rather than the length. Another point I watch is hydration and electrolytes, although at present I find a breaking a heavy sweat is too much for my heart and I invariably go into AF (but quite a while after the ride). I have also found cold weather will drastically effect the effort level and trigger AF. I now avoid cold weather (sub 50F) and stay indoors on the trainer.

    You may have pushed the boundaries just a little too fast after the CV. After my CV I have found I can't do what I did before, while in NSR my performance has not returned to 'normal'. Its frustrating to be going slow but better than not riding at all! I am gradually working up way back up and avoiding back to back rides especially if they aggressive rides. I am doing light indoor workouts to keep in tune.

    Hope this helps. Keep riding! Let us know how it goes.

  • Thanks for helpfull comments. I agree it is the intensity. I was using a heart rate monitor aiming for 110 max and stopping if I got to 120. But even this seems to have over done it. Will try 30 mins on the turbo at an easy pace in a few days time. Worried I will bring on persistent AF again. Going to see a private consultant in Huddersfield this week for a second opinion. Happy with NHS treatment plan but it just takes a long time. I agree about cold weather, if I went out with AF I found I could not work hard enough to keep warm and it got dangerous. My AF also used to start the day following a tough ride but sometimes it did not trigger AF. My aim, like you, is to gradually build up so I can do easy back to back rides touring in France. If I go back into AF I know that I can still cycle an easy 50 miles, but I just hope I am not doing damage. All the consultants I have asked have said it is OK to cycle with AF.

  • My consultants have said it is ok to cycle with AF as well. I am not sure I believe them. I have ridden with AF but a lot more gently. I once converted out of AF in the middle of a ride, but only once. Am very surprised that the HR range you speak about is causing problems. Like you I go into AF the next day (if I do) and thats why I avoid back to back rides just in case. Look forward to hearing what the guy has to say about your situation.

  • I don't know what's right or wrong anymore. I am also a cyclist off road and road biking . At the moment I only get two or three attacks a year lasting anything up to two hours . It seems just when I start to get back on my feet wallop !! And I am back on depression street. It's really hard for people who like keeping fit. Plus I am a vegetarian. With a resting heart beat of 46- 50 so tablets are no good for me. I too hAte sitting around .

  • The problem I have is that the amount of exercise it takes to maintain my fitness level is greater than the amount of exercise it takes to make me unwell, so my fitness has been on a long, terminal decline for about five years now. I tried re-training winter 2013/14 and slowly built up my distance, but when I tried increasing my intensity it all went pear shaped again.

    "It seems just when I start to get back on my feet wallop !! And I am back on depression street."

    Yes, that's me. I tried resuming training again last September, at first I improved but then I started regressing again within a few weeks, and had to give up by November. I'm a depressive anyway, and cycling was my way of coping with it.

    Has anyone on here looked into Overtraining Syndrome? I've read quite extensively, and it seems to explain my problems perfectly, particularly the way I suddenly relapse with increased intensity after I'd apparently made a recovery, and the perpetual underperformance despite huge quantities of exercise.

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