AF and Exercise talk feedback

[rosyG]

Hi All,

We had a great talk yesterday- it isn't possible to tell you everything but for those who wanted feedback I will try and give a few points that were new to me- i e not general exercise points that we all know already.

I asked , on behalf of those who sometimes mention on here, whether people who cycle at a high level are at risk when they exercise and the EP with us said it's different for those whose extreme exercise is actually causing the AF but that in general people should continue with exercise to the level which they find suits them individually.

They used the BORG scale of perceived exertion i e what an individual feels and they said it's best to start at 11- light exertion ( 20 minutes walk at a moderate pace)- and work towards 15- hard ( a healthy person can still carry on but is very tired)- but not to try to reach 17- very hard

Also you should be able to talk at the same time!

Something else that was useful for us was the warm up and cool down- not related to what we all know about pulling muscles but that one can trigger AF if one doesn't start gradually as one's BP goes up too quickly and the heart muscles isn't prepared, and cooling down- the heart rate etc falls too suddenly and can also trigger AF

I asked other members of health unlocked to try and remember useful points so I hope they will add something to this.

It was also said that one can work through the effect of beta blockers and digoxin ,which cause tiredness , by exercising so not to be put off by the initial feeling of tiredness!

Everything should be gradual and built up day by day. 30 minutes at least 5 days a week- really an hour is you are warming up and cooling down properly but the latter can be done by housework etc.

Hope this is useful- if anyone has a question do put it here and I will let you know if that was touched on

[BobD Volunteer]

Thanks Rosy.

I recall the first ever HRC when we had a talk about risks etc and we were told the one of the most dangerous times for heart attack was straight after a stress ECG. You pound away on the rolling road getting faster and faster and then after 15 minutes you stop and walk back to the changing room at which point you collapse. The heart really doesn't like sudden starts and stops.

[Hidden]

Many thanks for that Rosy.

I have certainly learned how important the warm-up and gradual increase in effort is when trying to excercise without tripping into AF.

Perceived effort is an excellent measure of excercise intensity. If I say that I am hitting 150bpm I know what that means to me but tells you nothing about my effort level. That effort level is different in NSR to when in AF.

For me 150bpm when in NSR is around 17-18 but, when in AF I can hit 150bpm at only perhaps 13-14.

I do wonder what the EP would have said about those whose excercise causes AF.

[rosyG in reply to Hidden]

I think he meant it is obviously unwise to do extreme exercise if that's what happens

[Hidden in reply to rosyG]

I think that I might have quizzed him on that Rosy.

I'm not particularly happy with such "obvious" answers. I recently woke up in AF for no apparent reason, others on this forum have had similar experiences. I would like to point this out to the EP and ask if that meant that we should stop sleeping.

[rosyG in reply to Hidden]

Sorry if I wasn't clear- I too wake up with AF because I have vagal AF that comes on with sleeping. The EP was making the distinction between those of us who have AF for all sorts of reasons and who want to exercise and the special group of athletes who have AF because they exercise to such an extreme degree- that's what I meant by obvious- i e it's obvious the effect exercise has on them as it's the sole cause of their AF.

It is hard to repeat people's talks clearly bur so many asked me to try!

I hope some others who were there will post too and add to the information!!

[Hidden in reply to rosyG]

Understood Rosy. Thanks once again for posting and I do fully understand how difficult it can be to summarise a meeting in just a few words.

In no way do I wishing to criticise your post. My comments aren't aimed at you. I am just expressing my own point of view and that is that if an EP believes that excercising to an "extreme" degree was obviously the sole cause of my AF then I might just as well bang my head against a brick wall.

Other opinions are available.......

[RobertH in reply to Hidden]

In previous posts you have mentioned exercise triggering AF, how long does it normally take you to revert to NSR if this happens? The last time when you couldn't figure out the reason did you revert to NSR in the same time frame? I ask because I will go into AF with strenuous exercise (about 24 - 36 hrs later when I go to sleep) but usually revert within 24 hours. I recently went into AF for no apparent reason while sleeping and am having to have a CV to get me back to NSR.

[rosyG in reply to RobertH]

sounds as if it's vagal AF if it happens during sleep- like me!! I don't get af with exercise but sure some will answer your question

[RobertH in reply to rosyG]

thats an interesting observation. Apart from the obvious 'watch what you eat and spot the correlation' is there anything else you would recommend?

[paulh1 in reply to RobertH]

Robert, I have had afib while on my bike. Usually reverts to NSR within a few minutes of resting. Only one time did I have an afib attack which took longer than a few minutes. It was a bad one. But, I also take Tikosyn which might account for the quick revert.

[RobertH in reply to paulh1]

Thanks I will check out Tikosyn, but I have only ever gone into AF once by exercising, and in fact went out of AF once too! That was weird watching my HR go from 190 to 130 in seconds!

[Hidden in reply to RobertH]

Sorry Robert, I did reply but it seems to have found a black hole....

I'm not sure that there is a norm. My AF can last from a couple of hours upto around 36hrs but will usually be something under 24hrs.

I've not thought about there being a difference in time scale between excercise induced and other, that's a very good question. I don't think that there is any difference but it's worth checking.

[RobertH in reply to Hidden]

Thanks very much, interesting to hear. AF is so individual but it helps to have a few more data points from similar sufferers! Have a good w/e

[Kodaska in reply to Hidden]

That can be arranged. Sleep difficulties are one of flecainide's side effects.

[Jonathan_C in reply to rosyG]

I am interested to know what is extreme is and how relative this.

I would imagine running a marathon, at any pace, is extreme. But is a half marathon run in 2:30 extreme? Or does that depend on the ability of the person...

Is HIIT (high intensity interval training) extreme? The cross fit kind of madness.

[PeterWh in reply to Jonathan_C]

Depends on loads of other things as well including the individual, their conditions (medical and otherwise), prevailing conditions. In my view even 2:30 is excessive.

[SecSpin in reply to PeterWh]

So, 2.30 for a half marathon is excessive? I have very occasional PAF that is not exercise induced. My cardiologist has confirmed mine is vagal but could also be connected to a hear murmur as a result of childhood scarlet fever. My last half marathon time was 1hr 54 mins 13 sec and I am 68. Mind you, I have been running pretty consistently since my school days (cross country) and gradually took up longer distances in my 20s and 30s. My blood pressure is very low 120s/ low 60s and heart rate upper 40s/ low 50s. As is frequently mentioned on this site, we are all very different!

[Hidden]

Thank you Rosy....very interesting , particularly the warming up bit.

Sandra

[Finvola]

Thank you Rosy. That's very interesting information about blood pressure and warming up and down.

[sportscoach]

As a professional swimming coach for the last 20 years with also a several years of coaching track sprinters I have been following the recent posts concerning sport with interest.

Warm up and warm downs in general should last for between 20 to 30 minutes(approx. 1 hour of your session put aside for warm up and warm down) with a properly planned programme increasing heart rate gently but never anywhere near its max HR, a warm up should include a number of different exercises including stretch, skills and technique work, a warm down again decreasing effort gradually and bring the body back to normal operating condition following the advice given in LPAD (Long Term Athletic Development) documentation..... unfortunately, having spent many hours in sports centre's I see this happening only on rare occasions and only where a coach or personal trainer has been involved, in general most people rock up and launch theirselves into the activity they have chosen, with the increasing obesity crisis there is a huge emphasis on exercise unfortunately, a great number of people don't seek advice on how to exercise properly and those who do seek the information do not stick to the advice..... a particularly sad case I witnessed recently in a sports centre a gentleman who had not completed a proper warm up went straight onto the aerobic gym equipment and suffered a heart attack despite all our efforts he passed away.

I have had a number of interesting conversations with my EP whose children swim to quite a high level with their local club about why AF happens in athletes including one on how bad habits when starting an exercise session could be one of many factors that leads to AF in later life.

[PeterWh in reply to sportscoach]

My 10 year old son is doing his gold swimming certificate and their warm up session is 25 lengths of thee pool at a steady pace!!!

[sportscoach in reply to PeterWh]

That sounds good peter 500 to 1000m an easy pace warm up very important to follow the LTAD with youngsters especially with their bodies changing and developing something a lot of schools(not all) do not follow...

I break a lot of my warm up down into 100's with skills ie F/c catch up, finger drag etc to give it a bit of variety.

[PeterWh in reply to sportscoach]

Pardon my ignorance but what is F/c catch up?

[sportscoach in reply to PeterWh]

Sorry Peter not your ignorance I should have explained and not use abbreviations.....Front Crawl Catch up one of my favourite drills have a look at the attached link it will give you the information....

youtube.com/watch?v=NQgMq_7...(Not working as expected?)

Hope this helps but don't hesitate to contact me if you need any further information

[rosyG in reply to sportscoach]

I felt the advice last night was very sound and fits with what you say here- I had always thought warm up was just so one didn't pull muscles and never understood why cooling down was needed!!

[heartmatters1 in reply to rosyG]

I did too Rosy - so now we know - thanks for the info.

[Hardjuice]

I've read John mandro take on exercise and he says putting on your training shoes is better than any medication for AF and you don't need to do iron man stuff just exercise and be mobile

Walking and swimming is two forms of exercise and light weight training combined with weight loss are my own aims this year

[ruuthmo]

As a dance fitness teacher with A/F I completely endorse both the comments and your report. It is so important to keep going. Also Yoga can be beneficial as I can testify, as well as Pilates. So much to choose from!

Enjoy and keep fit,

Ruuth

[dgex2010]

Brilliant, thankyou so much for feedback - it's always reassuring when advice is given by the experts - `onwards and upwards` then - I think many of us consider exercise to be part of our daily routine now - if it helps with our condition, you accept that it is part of your life. Thanks again, had a good day and take care.

[Mrip]

Thanks for that info. Absolutely agree with the warm up part. My af only diagnosed in October 2015 after ignoring it, denying it for several years. Was only triggered by mod -intense exercise initially-i like to do full on step,aerobics classes. . I worked out that if I went too hard too soon it would flip into af. Did a 16 km walk here in sunny Australia today and was mod steady pace and stayed fine. This last month it has happened twice not connected to exercise, prob connected to Xmas late nights - I think bob is right in that af begets af. I am 51 and pretty cheesed off but trying to not be controlled by it

[rosyG in reply to Mrip]

that's interesting - think it's good you are doing so much walking- the experts said that's the best exercise for AF!

[AndyDuk]

Intresting . It seems to backup what I've found when mountain biking with the ride to the trails being 25mins on cycle paths and the same on the way back. These act as my warm up/warm down and even though the distance is longer, I feel better if I do this . I run a Garmin Edge 25 with cadence/speed sensor and use Strava and an IOS tool called ConnectStats which will give me my heart rate colour coded over the course I'm cycling on a map . This helps identify areas where my heart is getting outside of my rate zones, normally long hill climbs . What I do now know is that my heart rate is higher with off-road trail centre mountain biking than with on road cycling .. As with any activity and AF you tend to know the warning signs of an attack, so if it happens stop and rest and ideally don't go out cycling (particularly off-road) on your own .

[Dougsey]

Interesting thread. I've been thinking about whether to introduce HIIT into my swimming sessions, but I am nervous, as the last 2 AF episodes have happened when I have sprinted suddenly. I have done some reading today and there is some evidence that HIIT helps AF (and hypertension). But I am reluctant to try it out - hoping that a decent warm up will reduce or remove the risk of AF....