I am new to AF. Is exercise good and if so how much and what are the limits? I am on blood thinners.

I am used to doing quite a lot of exercise - hiking, mountain biking, ski touring, scuba diving kind of thing. I am 66. I have recently had my tendons reattached on my left shoulder - due to wear and tear - so exercise is limited but my Doctor / surgeon has recommended that I restart exercise after two months of limited exercise. So has my EP.

How much exercise is too much and what are the limits?

As of now I go to the gym 4/5 times a week - I spend 30 mins on a bike and / or a cross trainer. We live at 1550 metres. I am currently varying the watts between 114 and 130. When at 130 watts I pretty quickly reach 145 bpm on the bike and 165 bpm when on the cross trainer. These are high point not averages. Average for the bike would be in the low 130's and for the crosstrainer in the mid 140's. Before I had AF I very seldom exceeded 145 bpm with much lower averages.

My EP has asked if I can live with this? But this is another topic.

I am keen to get back being fit etc but would like to know what the training parameters should be. For the moment I am constrained to using a gym.

I have read quite a few blogs and have noticed that there a quite a few people who are doing quite a lot exercise and wondered what there get fit experiences have been.

Was the exercise post successful AF treatment such as Ablation?

Thanks in advance?

.

18 Replies

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  • Oh this is such an old and emotive question Blaine and you will get lots of different answers. I do understand the need for some people to punish their bodies in the name of sport but all things in moderation. There is ample evidence out there to connect over exercise with being a cause of AF so you pays your money and takes your pick My only advice is to listen to your body and slow down when it protests. Exercise is good. Over exercise is bad.

    [Edited by HealthUnlocked]

  • i would love to work with my GP to contain my AF but he is never available as the surgery I belong to should have 6 full time GPs but has 3.25 (two of whom work part time, so one full time, 2 part time and one brand new just qualified). I will therefore keep listening to BoB D (volunteer) for moral support.

  • Hi BobD,

    Sorry if the question is old and emotive - it is though new to me. Without AF I knew what my heartbeat limits were? (in your words, overexercise) Also, my heartbeat was consistent and any increases or decreases were directly linked to the intensity of my activity.

    With AF, have these limits changed? According to my heart beat monitor, my heartbeat seems to vary a lot without changing the exercise or the intensity of the exercise. Also, I do not notice / feel the variation in my heart beat. While reducing exercise intensity, the higher heart rates become lower (eg 160 to 140) but the variability continues for any single level of intensity.

    Given the wide variability of my bpm, how should one think about establishing limits?

    As one of the others recommended, I will address the question to my EP but it might take awhile to get a response and I thought if others had had similar experiences then their insights might be helpful.

    cheers

    BT

  • Hello Blaine,

    I am interested in the fact that you live at 1550 meters and whether this is significant.I also think that excessive exercise may have contributed to your AF.

  • Hi Francis - your body / heart works harder at altitude than at sea level. A lot of top class athletes train at high altitude training camps. When you come back down to sea level you feel as if you can run etc faster and / or longer than before the altitude training.

    cheers

    BT

  • Bob's nailed it as usual. I was quite sporty but not at your level. My cardiologist said go back to tennis and my EP said don't!

    I self prescribed a period of de-training with just Nordic walking x2 miles/day. Who knows whether it, the Flecainide or the 101 other diet/lifestyle changes did the trick but I haven't had AF for 3 years. The level of measures you take are in direct proportion to the urgency you want to deal with the matter and there are many positive outcomes....starting walking basketball this week.

  • Hey Blaine,

    I do a few Ironman races, I am now 55

    Since I was first diagnosed with AF, I got cardioverted, then over 2 years completed about 6 more Ironman's, then went in to AF during an event, had about 10km's of run to go so just walked to finish.

    I then got cardioverted again, started training but if heart rate got above about 160 would slow down, had an ablation about 3 months later, that was 2 years ago, have completed another 3 ironman, cardiologist tells me I can do as I please, but I try to keep my heart rate below 170 now, just because I feel happier, about 5 years ago I had a max heart rate of 186.

    Have had no further episodes for over 2 years, am on only aspirin now. even though I have been told I can do as I please I have cut down in both intensity and and time.

    I don't know if thats useful or not but thats my story :)

    Nick

  • Hello Nick

    We would be very interested in sharing your story on our website. If you are happy with this, would you kindly mind emailing it to me in around 500 words with a recent photo to r.harris@heartrhythmalliance.org

    Many thanks, Rachel - AF Association

  • well done

    this is good news and helpful

    i understand your heart neat limits - i try to keep below 160 now

    I used to do loads of marathons and more recently ski touring across the alps

    best

    BT

  • The advice I picked up was that the amount of exercise that is appropriate varies for each individual but a good indicator is whether you can talk during exercise. If you can just about talk, maybe a little breathless but you can manage, then that is an appropriate intensity. If you can hardly gasp a word then you're doing a bit too much.

    If you are measuring effort externally, for example power output, you might find the point at which you can exercise and talk will vary day by day. The advice I received was not to focus on the external measurement but on how you feel - that is the important indicator of what is going on in your heart. So don't assume that, because you can manage 130 watts one day, it is good to push yourself to that power output every day.

    That seems reasonable, if a little disheartening (sorry!) sometimes.

  • I'd (in fact I do) get advice from healthcare professionals. The trouble with the forum is too many views and too little evidence. Work with your consultant an EP and develop a personalised exercise plan.

  • You can read other people's stories of exercising with AF on the AF Association website. heartrhythmalliance.org/afa... I'd like to particularly draw your attention to Paul's story. Paul competes in triathlons. The advice we give, is do what your body allows you to.

    Regards,

    Rachel - AF Association - Patient Services

  • many thanks

    makes loads of sense

    it is a relief

    cheers

    BT

    I was worried about putting too much pressure on the heart as i have done for years and then ageing the heart too quickly

  • that's why a lot of us on this forum have A F, we push are body's to limit with over exercising,

    you can get away with it when your young, but as you get older got to pace your self. i never slowed down on hard training and hard working, never thought i would get any thing wrong with my Heart. bit at 58 years old got A F, so now pace my self, a bit late but you live and learn the hard way.

  • I am 61 and have always been quite fit, with cycling, jogging and hiking, including hill-walking, mainly in UK. I have not ever run marathons or done iron man etc., so though I was exercising 5-6 times a week, I did not think it was extreme, sessions were usually ave. 1.5 hours.

    I went into persistent AF about January 2015, and had ablation January 2016, after cardioversion was ineffective. My EP has said there is an association with exercising for about 2 hours at 70% of max pulse rate, three times a week, but it is not a hard and fast rule and there is a gradation; it seems we all react differently. My theoretical max. pulse is now 159, based on age.

    I use a Polar RC3 GPS fitness monitor with chest strap which I use always when exercising. My response to exercise has steadily improved over the past year, cycling works particularly well, up to 50 miles on road, walking pretty good too. Jogging has taken longer to settle down and I have had periods of high and erratic pulse, but usually it settles after first 20 minutes, and this is also improving. I try to build in some rest days and use the Polar readings to look at Training Load, which indicates when rest days, or moderate days are needed, and several consecutive heavy days can cause issues.

    I recommend monitoring pulse during exercise and building up gradually, incorporating rest days etc. Good luck! P.S. suggest also reading "The Haywire Heart".

  • Fantastic. Really appreciate your time and effort.

    I do monitor my heart beat all the time during gym exercise.

    With AF, my heart beat has a very different pattern than before AF. Much more volatile. Even though I slowed down.

    It is trial and error but I feel like I am getting there. I look forward to my gym sessions as I always feel energised post exercise

    Thank you again

    BT

  • I asked about setting training zones after I was diagnosed, but all I got was "You can't expect your heart rate to be the same", so I'm none the wiser.

    These are the eligibility guidelines, but there's nothing in there about training zones:

    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 very much. Interesting - esp. the JACC doc.

    cheers

    BT

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