Is there a risk exercising hard when you have had an AF diagnosis?

Hi

I am a newbie here, just having been diagnosed with atrial fibrillation, and now on flecannide and bispronol. Having been an avid cyclist all my life racing and riding all my life ( I am 47) is it safer to carry on exercising to keep generally healthy or not. When I do exercise my heart rate can peak at my old flat out rate of 160 when the intensity of the exercise would have made it reach 130 before - my resting heart rate is mid 50's.., a bit like driving a car in second gear!

Anyone's experience and thoughts would be much appreciated!

15 Replies

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  • Difficult and quite emotive question there Richard. Exercise is good. Over exercise is bad. Over exercise is a prime cause for AF in younger (sub 60 ) patients alongside binge drinking and being a fighter pilot. Sometimes we have to make choices we would rather not.

    I gave up bike racing when I discovered cars and women and not necessarily in that order so am the last person to advise frankly. My best advice is to listen to your body and act accordingly.

  • These may be of interest:

    Heidbüchel, Panhuyzen-Goedkoop, Corrado, Hoffmann, Biffi, Delise, Blomstrom-Lundqvist, Vanhees, IvarHoff, Dorwarth, Pelliccia:

    Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions

    Part I: Supraventricular arrhythmias and pacemakers.

    European Journal of Cardiovascular Prevention & Rehabilitation 2006 13: 475

    cpr.sagepub.com/content/13/...

    Zipes, Ackerman, Estes, Grant, Myerburg, Van Hare:

    Task Force 7: Arrhythmias

    36th Bethesda Conference

    Eligibility Recommendations for Competitive Athletes With Cardiovascular Abnormalities

    JACC Vol. 45, No. 8, 2005 April 19, 2005:1354–63

    content.onlinejacc.org/arti...

  • Thank you for posting, excellent information.

  • Hi CyclingRichard

    I'm 46, born with TOF(tetralogy of fallot) and it was repaired.

    Diagnosed with AFIB(AF) when I was 24. Many cardio versions and one Ablation.

    Now on bisoprolol and aspirin and AFIB(AF) free for 3 years.

    Played squash most of my life but my DR suggested that I do some sport "less explosive".

    I am now a mountain biker but also do road races like the Cape Cycle Tour (ok it's only one day and 109 km long) and other local races.

    In my case the Dr said the higher my heart rate goes the higher the probability that it would go into AF. With squash I could easily get my heartrate to 185 (it would only be a few sprints on the court to get a ball).

    With cycling I found it difficult to get my heart rate past 160.

    Dr suggested that I keep fit, not compete professionally (not that I could really), rather do it for fun, and keep away from caffeine supplements.

    During a training ride I used someone 's energy drink and did not know that it had caffeine in it. A day later I was in AF. For me the biggest threat is any supplements that have caffeine in them and also not to overuse alcohol.

    I have a blog where I write more about my heart story.

  • Go easy if you are IN AF, I overcooked it and pulse went into a v. odd rhythm which floored me, sucked air out of me. Watch the intensity. For me it has led to pre collapse at high intensity. Steady I guess. Good luck and let know how doing. I am a biker (given up until ablation) but I do run up to 7 miles.

  • Hi

    Like you I have been cycling for many years plus many hard sessions a week at the gym: I am now 50. I was diagnosed with AF 10 years ago. Lived with the symptoms for awhile as they were minor but kept excercising with no real issues: exercise was not a prime AF trigger for me. Had a cardioversion procedure which didn't work so was prescribed flecanide. Continued to cycle, go to the gym and do all the things I wanted to do with no issues as long as I stayed on the medication. What I found was that I could go and cycle etc as long as the AF had ceased i.e. the medication had kicked in. However, the medication became less effective over time (2 years ago) which is normal so I found myself tripping into AF in the middle of the night, whilst walking down the road etc. I eventually decided to have a catheter ablation procedure to sort out my AF permanently - that was last August. So far so good.

    My doctor & consultants never told me to stop exercising 10 years ago, nor did they when I was on the medication. I became acutely aware of my symptoms and managed them accordingly especially when the medication became less effective.

    Enjoy your cycling !

    Julian

  • I am confused. My cardiologist said if my pending cardio version (April 13) does not work, the ablation will likely not work. You still had an ablation although your cardioversion did not work. My cardiologist's take was that many people live in AF and why would I want these "wires in my body?" Almost 8 months later you are saying so far so good about your ablation, Did you insist in getting an ablation or were you discouraged which seems the route my cardiologist is on?

    (As a post script, I wonder if my cardiologist has diagnosed me correctly because my persistent AF began January 13, which is currently close to 60 days, and during this period I did have two very short bouts of sinus rhythm -- the first lasting 1 1/2 days and the second a half a day. He said never mind about those very short sinus rhythm days. His tone was more that the ablation wouldn't work. Plus, he never interrogated me about my AF; his resident MD assistant did. After their private pow-wow, he pontificated his diagnoses to me. )

  • I asked my Dr this question. He said I should push myself to exercise effectively but to stop if I felt any negative effects. I find that when I am in AFib I feel too tired to do too much anyway. Another Dr said that I shouldn't do too much exercise when starting new medication.

  • Hi Richard and welcome. Most of us have different experiences with AF whether or not we are cardio fit. Back in the day I tested my maximum heart rate on a bike by a sustained high speed one mile section - short rest - flat out sprint - short rest - uphill sprint on the big chain ring to failure.

    When I was doing Spin classes we would sometimes do high cadence - 120 rpm - for several minutes. If that kicked off AF I could find that my heart rate would suddenly drop for a few seconds and that felt like riding into a hedge, then it would pick up again. I don't do Spin classes these days.

    Medical text books say that AF reduces power output by 30%. On a rowing machine or turbo trainer my power output dropped by 20% in AF, but as my body adapted that changed to around 10% with the downside that most gym work would trigger AF. Without an HRM and post-exercise download I wouldn't know that I had AF. A fairly easy steady state gym workout would be 12.5km in 60 minutes on a Concept 2 rowing machine. In AF that distance would drop to 12.2km. At 69 years old my heart rate during cardio exercise induced AF would be between 200 and 220. Conversely my heart rate can be really low whilst sleeping.

    Following a stroke last July I'm not cycling on the road - I'm now blind on my right hand side - so I'm working back slowly but the Pradaxa anticoagulant doesn't have an adverse affect. My Consultant Neurologist is happy for me to use a Concept 2 and the turbo trainer. I've been told not to do dips, kettlebell swings and anything that flexes or braces my neck, but that's due to having had a stroke, not because of AF.

    You may find that an EP will arrange a Bruce protocol test for you. You will be on a treadmill that regularly increases in speed and incline, whilst your ECG and blood pressure are monitored. If you do the test be sure to tell them about your cardio fitness so that the test is longer than for a sedentary person. My test was longer and it wasn't until I had passed 155 bpm that AF showed up.

    I'm not sure that seeing my ugly mug will help, but I was filmed in December cutting scrub with vicious looking hand tools, and using my turbo trainer. The two minute film should shortly be circulated to clinicians by a pharmaceutical major, and if the film sponsors give permission I'll post a link to the film.

    Good luck with the cycling; don't give up. I was glad that I hadn't as my fitness pulled me through a life-threatening condition in my lungs in 2014 and the stroke in 2016.

  • I can't really add much to the above, except that I am 78, and when my heart is in af, my performance over 10k runs drops by about 20%. I get no symptoms at all from the af, other than my reduced running performance. However I think if I tried to run at my sinus rate while I am in af, then I would have problems, and could have some difficulties. As it is the HR monitor varies between 120 and 180 over the 10k, with an average around 147. When I am in sinus the average would be around 145. My advice would be to go for it, but be careful and listen to your body. My cardiologist is in favour of me continuing,and says there is little chance of an arrest while I a running.

  • I've had AF for 11 years now and survived to date by continuing pretty hard exercise in the form of badminton, cycling and walking plus fairly strenuous gardening.

    My cardio has always advised me to exercise as much as possible but not to overdo it. Your heart muscles need working at a good level to maintain their form. This would be the case for most folk anyway. Just listen to your body. My AF tells me, in any event, when it can't go on. However, recovery from breathlessness is generally very swift and good. I also have a leaky mitral valve which interferes with my oxygenation.

  • Ive had af for maybe 20yrs.It started off just now and again after a stressful period and drinking.I then took up serious cycling and stopped drinking and seemed to be ok.After a couple of years cycling my af restarted with a vengeance.I was put on beta blockers and eventually had an ablation.I went back to cycling 40-50 mile rides but my af came back so I gave up cycling.Unfortunately I developed rectal cancer and had an operation and treatment over 18 mnths during which time my af came and went although it lasted over a longer period 2-3days.The doctor put me on 100mg flecainide daily which helped enormously but I still suffered bouts.Ive since started cycling again ,not at the same intensity(Im 64 now) I decided Id rather die doing something I loved .My cardiologist informs me Im in controled af the good news being my heart rate doesnt take off on a climb but I stay away from big climbs.Im still waiting to see if another ablation is possible,

  • You would enjoy reading 'The Haywire Heart' by Dr John Mandrola, which considers how exercise affects the heart etc. He is a cyclist, EP, and has AF, so this book will answer lots of questions.

  • Hi. Thank you for all your replies it is really much appreciated. Everyone seems to be affected by AF in different ways it seems.

    I seem to pop in and out of AF on a quite regular daily basis , and may have done for a few years unknowingly, even though I have been on drug therapy for a few months now. I had stopped exercising the last 6 months but still went into AF ( according to my Kardia monitor). So am exercising a bit although carefully as my heart rate did go to 190 a few times - my previous max was low 170's!

    I now know where my washed out feeling comes from - as a avid cyclist it was something I had always associated with cycling and not AF

    I have ordered the haywire heart - it will be an interesting read

  • Having suffered progressively worsening AF for a year, that I know of, before an ablation 8 weeks ago, my experience was that I could still train with AF and strangely it had a positive effect. I have a colleague in the Tri club who had the opposite when on rides he would suddenly struggle and drop out of the back, plodding home to rest.

    I have just finished reading the Haywire Heart and found it very informative but a main finding is that we are all different and we need to find our own levels and what works. That seems unhelpful, but what was helpful for me was some reassurance that training is good in the right levels. Also talking to the EP nurse to get a better understanding and know that training is good and I can start again.

    As said above we have to be careful to what level and I am a big believer in the right ratio of recovery to training, something in my sport, Triathlon, we are notoriously bad at.

    During my run up to the ablation I kept notes of every episode and some of the likely triggers for the episode. That "training diary" has helped throughout as a good reference point to where I am up to. I am not sure yet whether I will start racing again but am accepting what I can achieve, sitting here having come back from my second run, 2.5k and slow, but a boost none the less.

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