A question about exercise!

Dear all!

Great to meet this community and that it exists, even if the circumstances for everyone joining are not initially positive! Wonderful to see so much support and friendly help.

I have a question that I'm hoping the more experienced of you might be able to help with! I'm 40, recently diagnosed with PAF, "lone Attrial fibrillation" as they put it, as no clear cause of it other than lifestyle. I used to be very fit - up until about 10 years ago! - then life and lots of work took over! (Common I'm sure....!)

On the cardiologists advice, I have started to attempt to loose weight (currently 20 kilos above what I should be!) and take part again in exercise - swimming and fast walking.

The question that I'd love your advice on is that exertion - be it physical or occasional emotional, stress, bring on what feel like palpitations and irregular heart rhythms, which i imagine is the PAF kicking in.

The advice is that exercise is good, but if exercise appears to trigger the PAF, is it still good? My dream is to become fitter again and hopefully reduce the symptoms but is this firstly naive? And secondly is exercise really so good if it brings the PAF into action? Is it the case that exercise will help to strengthen the heart to protect it from the electrical signals around it, causing the PAF, or am I stressing out the very organ that is creating the PAF by doing exercise and would be better off not doing any!?...

Your help and experience will be much appreciated! I wish you all well in your AF related journies!

Very best


27 Replies

  • Gentle exercise good. Balls out stupid bad. Listen to your body and let it guide you. Work on reducing stress, try to reduce the amount of meat you eat. ditto alcohol and other stimulants and work on your mental attitude. All these things are said to help slow down the advance of and possibly reduce AF.

    Read all you can from the fact sheets etc on AF Association website and ask questions here.

  • Thank you Bob! I really appreciate your reply, very kind of you.

    Forgive me if I ask one more question! - can I get more fit, cardiologicaly speaking? I used to be very fit but let it go these last years! Is it still possible to build that up?

    Sorry - two questions!! - is it true that the electrical impulses that create the AF come from around the heart, so that by making the heart stronger through exercise, it is better protected against them?

    Thank you again!

    All best to you



  • Trawl through the various posts on this subject Tom, there have been lots of discussions on this topic.

    As Bob so often points out AF is different for everybody and so you must listen to your body. However the basic answer to your question about improving your cardiovascular fitness is YES YOU CAN!

    I have slowly improved my fitness level to the point were I was climbing volcanos in Lanzarote recently AF free. This week I have done 5 spinning classes, this morning two classes back to back totalling 1hr 45. Admittedly I did trip into AF after 1hr 22 but this only lasted till mid-afternoon when I reverted to NSR without taking any drugs. It has taken quite a long time to get back to this level but is well worth the patience and effort.

    Might I suggest Nordic Walking for a starter? This can be as hard or gentle as you wish and excercises the upper body as well as your legs.

  • Thank you so much for your very inspiring reply!! That's amazing that you are doing so well and so inspiring to read that you were climbing volcanos and so active at the gym! Thank you also for the reassuring words that I can also get more fit. Great to read!! I will try the Nordic walking as you suggest! Thank you for this! It also makes much sense about listening to ones own body.

    To get to that fitness level must have taken real dedication! And the feeling to be in great control must be fantastic!

    This may sound like a silly question, but as the heart is a muscle, is it so that the more one trains it, the stronger it becomes and therefor the better it becomes at dealing with AF? My AF lasts very short at the moment but I have the feeling that it is triggered by activity and physical exertion. Walking up a hill is hard work!! Will it cope better the fitter I get?

    Thank you again for your inspiring words! All the best to you!!



  • It's more about how to improve your fitness and learning what is likely to trigger your AF.

    For me it is usually excercising in a particular way that will trigger AF. A rapid change in effort is the most likely trigger for my AF. When spinning I take around 20 mins to slowly increase the effort and that usually then allows me to push harder. Alternatively I can still very quickly go into AF by simply walking too rapidly up a few flights of stairs!

    There are no simple or instant answers but I can now pretty much anticipate when I am likely to trip into AF. I suspect that some might think that I'm being a bit cavalier about it but I just don't worry too much about going into AF. I try not to and don't function quite so well when I do but, hey sh&t happens.....

  • Walking. Gentle and shortish to start with and then building up speed and length.

  • Thank you Peter! I will follow your advice! All the best to you!

  • I should have added if one day you get out of breath or are feeling weak or your heart is racing don't push but ease off or stop (ie as said above and said by my EP "listen to your body". Also, not te3aching yay top suck eggs, if you are paroxsymal and have "PIP meds" then make sure that you take them and also that your mobile reception is OK for all the route.

  • Tom, I don't believe strengthening the heart muscle contributes or detracts from the presence or activity of AF. However, intuitively it seems that the stronger one's heart, the safer one will feel during an AF episode. The matter would best be taken up with a cardiologist, especially one who is also familiar with exercise physiology.

    As for exercise, you don't need to be Olympic caliber to get in good shape. You do need to be consistent about eating right, managing blood pressure (and of course stress), and getting a variety of exercise. Here are a few suggestions:

    - Keep a daily exercise log, including data on miles/km walked or run, time on a treadmill and what pace, heart rate during exercise including average and maximum, and how it felt.

    - Take regular (weekly) yoga classes from an instructor with a background in kinesiology, sports fitness, or such. Ideally, there's a yoga studio near you with someone trained in Iyengar style yoga. The reason I suggest this is that you will benefit greatly - I cannot overstate this - from becoming intimately aware of your body, learning how to use it, how not to use it, and how to increase both strength and flexibility. This should form the basis for your future exercise and will help you stay fit for many years.

    - Learn and practice mindfulness, beginning with basic meditation, which stabilizes the mind and just overall makes you a better person. But don't take my word for it.

    Best of luck.

  • I would endorse the Yoga- worked for me - or Pilates or Yoga -Pilates. You want to have a mix of strength - resistance training, flexibility - Yoga/Pilates and aerobic - swimming & aqua aerobics worked well for me worked well.

    You do not need to do a lot to increase your fitness - just 20 mins brisk walk every day to start as extend as and when you are able.

    Let us know how you get on and especially if you need encouragement,

  • Many people use yoga or a combination of yoga and other forms of bodywork to build strength as well as flexibility. This is fine for those who have developed close working relationships with their bodies. Since you're just getting back on track, I strongly suggest not doing that. What you need now (in my view) is to learn how to work with your body to gradually develop greater awareness of your abilities and limits, as well as to learn proper alignment. Without these two critical elements, you're much more likely to injure yourself by learning the wrong ways to do things. You can adapt correct yoga practice when you know what it is.

  • The advice I was given was exercise so you can walk and talk at the same time, if you can't slow down, if you can continue without being breathless carry on. I guess we will all be at different levels at different times so listen to your body. Moderate Exercising whilst in AF was also considered ok - as long as you were not symptomatic.

    I found some days I could walk ok, even when in AF and other days I couldn't even stand upright because my BP would crash so you just need to listen to your body and ensure you are aware of what your body is communicating.

  • I'm with theoldbuzzard on this one, Tom. When I first had AF, I'd find that a gradual increase in the intensity of the exercise used to keep me from flipping into AF (I'm a runner). When I first went to see my EP, he told me to do whatever I wanted and felt like doing - I used to do short sprints and even if I was in AF this worked for me. Over the course of a couple of years, though, I found that it was getting harder to control and I had an ablation back in May 2014. Since then, I've had no AF and I'm back enjoying my running. Good luck.

  • Hi Tom40,

    I am in a very similar position to you, had my first AF last weekend, so i am interested in everyone's relies regarding exercise.

    How long did it take you feel right again after you first episode? I am feeling better as each day passes, 1 week on, but still tied and not right. I was in AF for 24 hrs.

    Regards GS

  • Lot of good sense here. You do what feels right for you. I joined a gym and got myself one of these heart monitors with a chest strap that links into a wrist watch and also the CV equipment at the gym. I was nervous at first but stuck to a gentle regime of walking, pedalling and upper body work. Interestingly, in my 10 minute walk on the treadmill, my heart rate soon went up to 145 bpm. That was my self imposed level and where I would stop. Now, after 3 months, I am walking slightly faster but heart rate sits happily at 120 bpm after 10 minutes and, importantly, settles back to around 80 bpm within a minute. All very basic stuff but my fitness is improving and my heart is working well and doing something for its keep!

  • I second Nordic walking. I have found this and always leaving a bit in the tank whatever you do works.

  • You say you used to be fit, but you don't mention how much exercise you were doing, if it was a lot then this may be what has caused your AF. A history of chronic endurance training increases your risk of developing AF by about 5 fold, so if it is past training that has caused your AF then you may find that you need to keep the exercise fairly gentle. Just suck it and see.

  • I fear that we are over egging this whole endurance aspect. Most endurance athletes do not get AF and most AF sufferers have never been involved in endurance events. I really don't think that this, rather tenuous, link should ever be used to suggest that exercise is anything other than beneficial.

    What I do find interesting is that several people that I know with AF (no endurance link) have naturally low RHRs of around 50-55. Training for endurance events is likely to lower your RHR to this sort of level. Perhaps the link is more to do with low RHRs than endurance training per se.

  • Most non-athletes don't have AF either, but that's hardly the point. Exercise is like food: enough is good for you, too much is bad. The problem is that couch potatoes who don't like exercise only want to listen to the latter part, and those who enjoy exercise only want to hear the first part.

    Heidbuchel et al found that continuing exercise dramatically reduces the long term success rate of ablation, Calvo et al recommend reducing physical activity, Furlanello et al found that AF may disappear altogether if athletic activity is stopped for an adequate period of time, and Hoogsteen et al found that more than half of athletes with AF are forced to give up sport altogether in the long run.

  • It maybe but the answer still comes out the same - increased likelihood of AF !!!!

    The knowledge about AF has increased significantly in the last 10 to 20 years. There are certain areas where information is lacking and because of the mongrel nature of AF hard to quantify, especially as AF affects different people so differently and for quite a few (including me) it can affect us very differently from one day to the next.

  • Hi there , I too was am a runner my ep seems to think this is what has caused my peroxomol af , although I was never stupid mad just running six miles three times a week and more on a Sunday up to 10 miles ,more if I was training for a half marathon , my episodes started and lasted a few hours but soon progressed to 24 hrs and more regular ,ablation last July still on Medes , my ep and cardiologist both advised me moderate exercise only no running just jogging for now ,I'm hoping one day to be able to run again and get back my fitness feel like I'm just ticking over for now but want to take the professionals advice on this , I do actually enjoy the jogging and also fast walking which is really good for you , try and enjoy a healthy diet with a bit of moderate exercise see how you go cheers Paul

  • Oh good grief.....what prey, do your medics consider is the difference between running and jogging? Only you know what "moderate" excercise is. Your jogging might very well be my sprinting.

    A friend of mine had an ablation 3 months ago and was told to refrain from excercise for 3 months. He is now back to spinning classes and has been given the go ahead to increase his training at a rate that he feels comfortable with. He had his ablation at Harefield, I'm lead to believe that they know a thing or two about heart conditions.

    Sorry Bob, spikyness is catching!

  • My ablation was done at glenfield also a specialist heart hospital , my ep is from there my cardiologist from local hospital funny but they both gave me same advise ,and both think that it's the running that more than likely caused it , to my knowledge I don't go into af whilst running but it's how I discovered my af waking one Sunday morning not feeling too good checked my pulse which I never do to find it bouncing all over the place ,not knowing any better went out for a run to shake it off only to come to a complete halt 1 mile in nothing at all left in the tank unusual has I usually run the six miler every week ,off home keep checking pulse same later that evening hospital ,flecainide in a drip , sent home no melds ,three months later wake again with the same etc etc ablation wasn't thought to have been successful wasn't straight forward apparently this is why I'm still on Meds just take everyday has it comes now cheers Paul

  • "A friend of mine had an ablation 3 months ago and was told to refrain from exercise for 3 months."

    That's the time it takes for the ablation to heal, not a comment on the effect of sport on the long term prognosis.

  • The point being Runcrans, is that you need to become the expert and take responsibility for your own recovery and training regime.

    Ask 10 cardiologists and you will probably get 15 different opinions. On another, related post, we were told about a cardiologist who has AF and when he goes into AF he grabs his running shoes and goes for it.

    EPs and cardiologists are experts in their own field but you are the expert in excercise and how it relates to your own body.

  • Hi Tom,

    The best piece of advice that I was given was to warm-up gradually so there are no nasty shocks for either the heart or the medication. Take your time to warm-up and warm-down and hopefully that will help.

    I'm working with a personal trainer to increase my confidence in the gym (but also to ensure that I don't over-do it). He's done research into AF and spoken to the person who does my Amatsu (osteopathy-type treatment) to make sure he uses exercises that will reduce tension in my chest and improve strength in supporting areas. So far, so good!


  • Hi Tom and welcome. As the "oldbuzzard" writes, most of us have different experiences with AF. Take it easy to start with and losing that 20kg will make a world of difference to you. It probably won't stop incidences of AF whether you're exercising or not, but you'll get used it. You may find that you don't want to exercise if you get AF or, that you can exercise with it but you'll lose 20% - 30% of your power and your endurance will be less. It's suck it and see.

    I was a "gym bunny" until May 2014 when I had a rare reaction to an anti-AF drug. In August 2014 I was apparently "close to death" because of that drug, and on release from hospital I could only walk 100 yards, rest for 5 minutes, then walk back. I returned apprehensively to the gym in November 2105 and I'm now doing reasonable sessions. Sometimes I have AF during exercise and other days I don't. The point to all this is that you and I need patience and, we have to adapt to what are body does now. Above all, don't forget that your body keeps you in this world; don't punish it by working too hard.

    Good luck and keep posting with your progress.

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