Vigorous Exercise brings on AF - Atrial Fibrillati...

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Vigorous Exercise brings on AF

chenstone18 profile image
36 Replies

For the last 8 years I have been enjoying a lot of cycling to a high level and in the last 2 years I have taken up running. Having had AF for about 10 years exercise didn't have an effect upon my condition up until recently. When ever I go for a run or ride I have to spent some time easing my way into it and can no longer push myself to the extreme. Either AF with very high tachacardia kicks in almost immediately if I start out too fast or during the run/cycle and I go up a hill too fast I get it again. Sometimes I have a good run with no over exertion and when cooling down it then kicks in. I thought it was the new blood pressure meds that caused it but coming off them due to bad side effects I still get it. It has really effected my confidence and worry when I am out that AF will kick in. I have managed AF reasonably well by having a very low salt diet, which for me is a real trigger, but now that it is effecting my exercise its depressing. I am on Rampril (blood Pressure 128/86 ave) and Flecianide for when I have AF. I also have a very low resting heart rate of 50 which may be connected. Apparently for men of my age, 57, who exercise it is quiet common so how do you deal with it and keep the exercise going? I can't give it all up as its the only way I keep the weight off. Thank you for your time.

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chenstone18 profile image
chenstone18
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36 Replies

I’m afraid the answer is one you will not want to hear and methinks you already know it. Exercise levels need to be scaled down to a point which causes the least effect or put up with consequences. Even if you embark on a treatment programme which ultimately results in an ablation, AF and extreme sporting activities do not make good bedfellows. Others here may have a different view and there are publications available about AF and extreme exercise written by experts in their field.....

jeanjeannie50 profile image
jeanjeannie50

I used to be into cross country running, cycling and hill walking. They were my life and once AF hit me 14 years ago I realised that I could no longer do these things as part of a group, just in case I had an AF attack and spoilt the event for other members of the clubs I belonged to. A week or so ago I had yet another cardioversion (have had three ablations too) and have now just come to the conclusion that I must not even walk up the steep hill from the town to my house. It's hard, but we have choices in life and more than anything I desperately want to be AF free.

If you look to the right of your post you will see a number of posts about AF and exercise, which may help you decide what to do.

It's a hateful condition AF, but with the right management, healthy eating etc and cutting out artificial additives, it can be kept in check to a certain extent.

Jean

chenstone18 profile image
chenstone18 in reply to jeanjeannie50

That's interesting about artificial additives. Are there any in particular? I have often thought a large part of it is what I eat and that's why I have reduced my intake of salt to less than 1g a day.

jeanjeannie50 profile image
jeanjeannie50 in reply to chenstone18

I think the modern idea today is that salt it not the bad thing it was said to be. I use a little sea salt when cooking and Himalyan pink for the table, all natural salts with no additives. I must admit though that I've never had any problems with high blood pressure.

Artificial sweeteners and additives are a definite no for me and I now avoid them totally. It took a long time for me to suss out that they were one of the main causes of my AF attacks. Alcohol too can be a trigger for some people.

Jean

Vonnieruth profile image
Vonnieruth

I was on Ramipril for both but swapped to Losartan due to side effects

chenstone18 profile image
chenstone18 in reply to Vonnieruth

Did the ramipril cause you to have AF then?

Vonnieruth profile image
Vonnieruth in reply to chenstone18

Bad cough first Then I started with palpitations in a morning when first getting up followed by flushing was fine rest of day till I had them all over weekend Been fine since I changed Hospital diagnosed PAF Went to cardiology appointment and was discharged

AFCyclist profile image
AFCyclist

Yep many of us exercise types find that our exercise history is a contributing factor. A good book is The Haywire Heart by Dr John Mandrola. Having said that some of us are still cycling and running but modify things using a heart rate monitor. The new type of electric bikes that have just come on to the market are also a help in keeping stress levels down.

Ianc2 profile image
Ianc2 in reply to AFCyclist

Excellent book that explains how the whole process works with some very informative case studies. I have a copy on my bookshelf. It is all about balance and being a bit more gentle with yourself- especially with exercise. There are a lot of posts on here regarding lifestyle and diet to try and fine tune your lifestyle. You have already done the hard bit in getting rid of the weight. I take it that you have checked your sugar and chloresterol levels?

chenstone18 profile image
chenstone18 in reply to Ianc2

Thanks, yes all bloods are in normal range thankfully.

Sthrendyle1 profile image
Sthrendyle1

Weight training, and brisk walking /hiking. The Norwegian study pegs xc skiers as 3x more likely to get AF than sedentary folk.

MarkS profile image
MarkS

I used to cycle a lot as well, plus play hockey and do a lot of other exercise. My AF probably started when I was rowing. It gradually got more frequent until I had my ablation in 2010 at age 58. Following the cardio's advice, I then moderated my exercise. I gave up hockey (quite a wrench). I still go cycling but not competitively. The cardio did say also not to compete against yourself so I've ditched my times for various circuits though I still do hills and intervals. I walk a lot more and go to the gym and swim once a week. Touch wood I've been AF free since the ablation.

So I would suggest moderating your exercise a bit. It's still really important to keep exercising though. I don't use a heart monitor, you spend too much time looking at it and stressing!

chenstone18 profile image
chenstone18 in reply to MarkS

Hum that bit about competing against yourself hit a nerve. I think your advise is sound about moderating the effort, I might find I enjoy it more anyway.

redpine profile image
redpine in reply to MarkS

Your story resonates with me. My first few AF episodes began as I was starting out on a run where possibly dehydration and stress were also factors. But, like you, I loved competing against myself with interval training and timed longer distance circuits that I was always trying to improve on. I liked pushing myself (I ran competitively in hs and college) and a hard run might get my HR up to 160 (I was 66 at the time).

About a year ago I did a wind sprint with my dog (not thinking!) and went into permanent AF (previous episodes all spontaneously converted within 12 hours). I was prescribed an anti arrhythmic at that point but could not tolerate the side effects. Hence an ablation two months ago. I have not yet returned to running yet, just fast walking, but intend to try it again. I have already determined that the interval training is not likely something I will do again and certainly not pushing my HR up to it’s max or higher.

I like where you’ve arrived by way of moderation. I will be following in your footsteps. Thanks for sharing your story.

whiteface profile image
whiteface in reply to MarkS

I'm 60 and long ago rowed very competitively (at international level) I've also cycled since a child doing my first one-week cycle tour aged 13. I stopped competition when I was 30 but continued to compete against myself -- however this was only long distance "steady date" effort, so no really high heart rates or stress. Then slightly over 5 years ago I realised I was getting completely knackered trying to maintain my speeds so I ditched the cycle computer and backed off again.

I am very blessed (and it seems unusual) in that my AF has no symptoms. My resting heart rate was 55-60 when in sinus rhythm and is now 50-55 (I'm permanently in AF). So I still carry on as normal (a couple of weeks ago I did a 70 mile bike ride in 5 hours). When on my bike I feel fine (I don't notice my heart) but I don't push it so I go up hills 'fast but steady'.

I met my cardiologist last week and he agrees that I don't need any no medication or any ablations. And after an echocardiogram we know all valves are working fine.

The reason I write this is not to brag or out of some sense of smugness, but to help you understand that there are all sorts of AF's. And to encourage you to believe that that with careful experimentation you may be able to find ways to manage it and live a healthy fulfilled life.

But fundamentally I'm not 25 any more (and neither are you!) and aged 60 things start to noticeably wear out so your lifestyle will have to reflect that. I now have a flock of sheep and volunteer for a local environmental charity. Both of these activities get me out in the countryside and keep me active and have largely replaced the cycling -- although I still do a bit of that every day.

And it may help to remember that a lot of people have a lot worse to deal with at our age.

I hope this helps and happy to share more if you'd like. You may want to take a look at my other posts too.

chenstone18 profile image
chenstone18 in reply to whiteface

Thank you Whiteface, great advise and yes I am very grateful for my life and having so much of it. I am confident that I will be able to continue to live that full life and like you say careful experimentation is the key.

chenstone18 profile image
chenstone18 in reply to chenstone18

So I went out for a run this morning and taking your advise moderated my exertion. I started off really slow and kept my heart rate below 145 and then went up a few short hills without pushing it. Once I found I had confidence I pushed a bit more. My heart rate maxed at 165 for a few seconds but over 6 miles my average was 147 and I warmed down slowly too. Feel great now with no ill effects and have a confidence that if I repeat the process I can look forward to many miles this year. Oh and really enjoyed being out in the winter sun. Thanks again.

whiteface profile image
whiteface in reply to chenstone18

I'd estimate my heart rate during exercise to be around 120bpm although I don't know so to me it looks like you are pushing quite hard.

I read the book "the haywire heart" and I'd suggest you get that straight away and read it so that you can make informed choices about these things.

Ianc2 profile image
Ianc2 in reply to whiteface

If you are in permanent AF have considered anti-coagulants to minimise stroke risk?

chenstone18 profile image
chenstone18 in reply to Ianc2

Thankfully not perminent af and apparently not old enough to need to go on anti coags. But thanks for your concern.

whiteface profile image
whiteface in reply to Ianc2

Yes thanks.

You might want to read this nhs.uk/conditions/anticoagu...

DerekMcAvoy profile image
DerekMcAvoy

Wow

I’ve just read that and thought that I must have written it myself.

Everything is me!

The cycling.

The resting heart rate (good old Fitbit )

Even the age.

I had a Cardioversion a week ago that has stabilised things for the first time in three months after being in persistent AF since October.

I’ve now got a confidence thing going on too. I go on 40-50 mile cycles on my own and am a little nervous about resuming that once the spring arrives.

chenstone18 profile image
chenstone18 in reply to DerekMcAvoy

Ive found that using a turbo in the winter is a good alternative and keeps the fitness up. I have also found that it allows you to warm up the heart slowly before you put any efforts in and allows you to cool down slowly too. This gives the heart time to get accustomed to the load and time to recover without going into af.

KMRobbo profile image
KMRobbo

Have you had an ablation or been considered for one?

If you have had AF 10 years it may just have developed and now be more intrusive. From what you say you are only taking flecainide as a PIP when AF occurs? Maybe a regular daily dose would be better if you are having lots of AF now?

chenstone18 profile image
chenstone18 in reply to KMRobbo

Thank you for the advise. I need to have another appointment with the cardiologist but he has just left. I think an ablasion will be the answer as I hate putting more chemicals in my body due the side effects.

KMRobbo profile image
KMRobbo in reply to chenstone18

Me too , that why I had an ablation. When diagnosed in 2015 I was only put on 120 mg Verapamil rate control. So i had AF 12 times in 20 months. Initially I found if I went running after 5 or 7 minutes I could GET RID of the AFIB and go into NSR so I did not bother about it. But what I am sure of now is that "AFib begets Afib", the more you have it the more you will have it. The 10th and 11th time I got AFIB it took a lot more than 7 mins running to get out of AFib , in fact two runs both times. The 12th time i was running and running over 2 days and my heart would not go into NSR. I was in fast (130-190 resting ) AFIB for 8 days before being chemically cardioverted by flecainide infusion in the CCU of the local hospital. And I was shattered after 8 days of it.

I was then put on 2 x 50Mg flecainide daily rhythm control with 200mg Diltiazem rate control. On that i could hardly run, the max HR i could get was 137 BPM and that was a major effort like the last 100m of a mile race - agony. And I was only going at 6mph! There were other worse side effects as well so I did not exercise so much and I got fat.

Consequently I had an ablation 29th january 2018 and I came off the drugs on the 15th May 2018. Still off them.

If I had my time again, I would have investigated the ablation earlier, so I did not get my heart into AFIB so many times. I would have missed out on a fairly sh*t 10 months, and a few overnights in hospital.

Note I only ran to keep in shape. I only do 10 or 12 mile per week, plus 25 or 50 miles of cycle riding. I did used to try to go as fast as I could do when running but I m not an endurance athlete. I was doing circuit training an hour a week as well prior to getting the AFIB.

Since the ablation i set my Garmin to beep if I hit 155 BPM so i don't get carried away!

I am 58.

chenstone18 profile image
chenstone18 in reply to KMRobbo

I was put on Ditiazem too and it terrible, it felt like I had the brakes on all the time. I also found it made my af worse and even gave me terrible out breaks of eczema all over my body, torture. Since coming off it skin is fine and can exercise properly. Ablation it is then. Thanks

jondeanp profile image
jondeanp

Have you had or discussed an ablation.

In my case I couldn’t run when in AF, which for me once triggered was persistent.

I was extremely reluctant to have an ablation, but since having mine in Feb last year I have been able to return to running again.

Alternatively, I found that even when in AF I could tolerate HIIT type training albeit at my own intensity ie not going at full tilt

chenstone18 profile image
chenstone18 in reply to jondeanp

Yes I have managed cycling with it when I didn't have a choice being 50 miles from home. I took it easy and kept the heart rate as low as it would let me but it wiped me out.

GordonS profile image
GordonS

I too cycle but since having AF have realised that you have to make adjustments to your ambitions. I have had 2 ablations albeit 8 years apart. I was nearly 60 on my first and had probably had paroxysmal AF for 3-4 years with the episodes becoming more and more frequent. I am 3 months post my 2nd ablation and back cycling 40-50 miles at less intensity than previously. I did 2 100 mile sportives last year whilst waiting for the op. I am still in the early stages of recovery so will be taking things steady for a while. I keep a watch on my HR and try to keep it below 170 max, average about 125.

chenstone18 profile image
chenstone18

That's really encouraging thanks

cycleman73 profile image
cycleman73

Good luck chenstone18, I am quite sure you will find a balance with your routines; as I did and indeed as many other athletes have to as they age. I ceased competitive cycling a few years ago having done loads. The warning signs came with the palpitations which took an

eternity to stop. I was diagnosed with aortic stenosis and had a new valve fitted three years ago followed by a new hip later. More or less full recovery now and down the race circuit for a few laps with fellow addicts and daily cycling doing up to 200 miles weekly.

But no competition these days, I feel those days are over although clubmates keep asking,

then they would wouldn't they. Just enjoy being out cycling and long may it continue ! As for AF that very occasionally raises its ugly head but very rarely. I was born in 1943 and have every intention of continuing with this wonderful activity for as long as is possible.

I have in mind one Robert Marchand who recently retired aged 107...……..and why not ?

Best wishes

chenstone18 profile image
chenstone18 in reply to cycleman73

What an inspiration you are and thank you.

Xerxes8840 profile image
Xerxes8840

I’m 78 and was diagnosed with AFIB 3 years ago- walk fast for about hour 2-3 days per week and work out with weights (P90X routine)- 2 ablations- occasionally have flare ups, but exercise usually normalizes heart rate- my docs say exercise is therapeutic- just don’t overdo.

Xerxes8840 profile image
Xerxes8840 in reply to Xerxes8840

You’re welcome-good luck!

chenstone18 profile image
chenstone18

Thanks everyone for your kind advise, it has been amazing that so many people have taken time to offer valuable advise. I replied to a contributer above about the run I had today. I have copy and pasted it below.

So I went out for a run this morning and taking your advise moderated my exertion. I started off really slow and kept my heart rate below 145 and then went up a few short hills without pushing it. Once I found I had confidence I pushed a bit more. My heart rate maxed at 165 for a few seconds but over 6 miles my average was 147 and I warmed down slowly too. Feel great now with no ill effects and have a confidence that if I repeat the process I can look forward to many miles this year. Oh and really enjoyed being out in the winter sun. Thanks again.

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