AFib, exercise and meds

[Lyndylan]

I was diagnosed with symptomatic persistent AF about 18 months ago. I had one cardio version but only stayed in NSR for 24 hours. After a decline and short stay in hospital, I was put on bisoprolol and amiodarone which has kept me in sinus rhythm for the last year with only a couple of minor AF episodes.

My EP has told me to lose weight in order to have an ablation. I lost initially but this has become a real struggle for me as the amiodorone has triggered hypothyroidism. I have got a rowing machine and have started to enjoy exercise for the first time ever.

My concern and question is about heart rate when exercising. I know I should exercise at 100-105 to burn fat. My resting heart rate is 50. Despite working very hard and becoming quite hot and breathless, I am unable to get my heart rate above 80-85.bpm Is this due to the medecine limiting my heart rate or is just a sign of being unfit and overweight?

Any feedback and suggestions are very welcome.

[Hidden]

Hi! Interestingly, your and mine values for HR are almost the same. My resting HR is 48-52. When exercising, it never goes above 90. I do not remember my HR being above 90. I always imagined that it is because I was very keen to exercise when I was young, so having the heart of an athlete... Maybe not so...

[Lyndylan in reply to Hidden]

I’m no athlete-I think it’s caused by the bisoperol. But at 90 do you feel you are doing a good workout? I feel I could not do anymore without doing myself some harm. So I will or push it as advised by @doodle68.

[Lyndylan in reply to Lyndylan]

Sorry I meant I will not push it

[Hidden in reply to Lyndylan]

I found it for interesting, that the numbers for resting HR and the HR under the load were almost the same in our two cases. Yes, I can give a very good output when at 90 BPM. It may be that it is the consequence of my training when I was young, but it also might be that I have a little weird heart. For instance, when on my feet and working, I never go into AF, but when I go to sleep, I have AF bouts almost every night, maybe for the whole night, but almost without any symptoms.

In my opinion, what matters a lot, is the relation between the heart capability to pump the blood and the demands the body puts before the heart. I am slim and have been slim all my life. When the heart is "large" and the body is small, as mine is (72 kg), than even going into AF (despite the flow-rate going down to 60-70% of normal) does not make significant problems. Hence, reducing the weight would be a very good approach for all people suffering on AF! Cheers!

[doodle68]

Hello Lyn some betablockers like Bisoprolol are intended to lower the heart rate so during excercise they can prevent the increase in heart rate that usually occurs with exercise.

I would start off with gentle excercise little and often just to the limit of breathless so as they say 'you can still talk but not sing' then gradually increase it as your stamina builds. I think this is better than concentrating too much on your heart rate when exercising, how you feel is more important.

[TracyAdmin Partner]

Hello, for some advice on exercise - you may find our A F Fact File booklet helpful? Just follow the link to download heartrhythmalliance.org/afa...

[Hidden]

Being unfit and overweight would increase your heart rate., so likely it’s your beta blocker assuming your thyroid tests are ok now

[The_Lord_is_with_Us]

I'm 67 and have had 4 ablations. I do a lot of long distance walking of 60 to 70 miles per week.

I just had an AFIB ablation on OCT 23. Shortly after Halloween I was nearly back to the same walking program.

A nice 6 to 8 mile daily walk will solve your weight problems nicely. All you need are good walking shoes with a thick sole. I pick up Sketchers Brand at a deep discount.

For boredom ... load up an MP3 player with your favorite music, podcasts, and YOUTUBE audio and away you go ... learning while you walk.

I wouldn't worry about heart rate while walking. The weight will drop off no matter what it is.

[Lyndylan in reply to The_Lord_is_with_Us]

I’ll give it a try, thanks for the advice

[Sewnknit]

I can relate to this. I love my rowing machine.I had a pacemaker fitted last August for Tachybrady. From June I had been back on my rowing machine and was doing very well. The cardiologist told me to wait 6 weeks before I started again and then I went very slowly - building up in 5 minute increments per week until I got to about 30 mins.

My PM stops my HR going too low and is set to 60 bpm. I'm on Sotalol which keeps it from going too high.

The exercise is part of my weight management programme - my dearly beloved and I have his'n'hers Concept 2s. Anyway I was really frustrated to find how he tries to keep his HR down to stay in the fat burning zone and also because he had a series of heart attacks last year.

I have come to the conclusion that lower and slower works. I have managed to maintain my almost 4 1/2 stone loss starting from July 2019. I can't sprint - I tried the 1000m challenge and failed totally at 312m. Go longer and slower.

I'm 64 and have managed over 1million metres since I got back to it last year.

Good luck!!!

[Lyndylan in reply to Sewnknit]

Congratulations on the weight loss and particularly on maintaining it. IMO that’s much harder than losing it. When you row as slowly you say you do, what is your HR that enables you to maintain your weight loss? I am just concerned that I am not working hard enough to fat burn. How did you manage to lose so much and do you have any thyroid problems?

[Sewnknit in reply to Lyndylan]

Long post - sorry!I've put my rankings below so you can see how I do.

2020/2021 Ranked Workouts

May 1, 2020–April 30, 2021

Indoor Rower

Distance Time

5,000m 23:55.5 2:23.5 72 of 248 03/06/21 64 Hwt

6,000m 29:01.8 2:25.1 39 of 114 03/15/21 64 Hwt

6,214m 30:00.0 2:24.8 53 of 162 03/11/21 64 Hwt

10,000m 48:18.1 2:24.9 42 of 161 02/19/21 64 Hwt

5000m is probably the shortest workout for me, I can go up to 10,000m but i find the PM pocket gets a bit tender by the end.

I've managed to get up to 120 bpm when I last wore a monitor, but it was more 95-100. During the cold weather I gave up using it as it took so long to register I was freezing before I started.

Like I said I can't sprint as I just run out of battery power - probably due to the beta blockers. Accepting that has made things easier. I try to row everyday and join in the Concept 2 challenges as they come up. We also joined a team called the Diamonds. i thought it was because we're all hard, but it is because we're all over 60.

My weight loss started in July 2019 as my knees were so bad and I knew any decent surgeon would tell me to shift some lbs before they would look at me so I thought I'd get in first!

I had lost over 7 stone 20 years ago with slimming world and running (won an award as well!). However that gradually crept up. This time I went low carb high (healthy) fat on the basis that doing the same thing over and over again wasn't doing anything. I'd also gone through the menopause by then so was a rather different person.

Some people throw their hands up when you mention it but I now bounce round a 5lb band (since Christmas) and have decided that this is my ideal weight. With the target i had with slimming world I got there, but I couldn't maintain it. I stopped going when I seeded to stick at the weight I am now. My BMI is still 'overweight' but I am very broad and feel good (so there!).

No thyroid issues that have shown up but I do have a lung issue which is being monitored and I think the rowing gave me my good results at lung function 2 weeks ago.

Take care.

x

[john-boy-92]

Hi;

I would say that the bisoprolol is limiting your heart rate. A rowing machine is great for exercising the majority of muscles and, for cardio fitness. The rowing machine settings will vary with the make of rowing machine that you have. When I used to go to the gym, I used to put the damper setting on the Concept 2 rowing machines to maximum (10). It wasn't until I had a second hand Concept 2 at home and looked at the online videos, I realised that cardio only required a setting of 3 or 4. I can row easily or hard on a setting of 3. Even if you don't have a Concept 2, their online videos are worth looking at to get the right rowing action.

[Lyndylan in reply to john-boy-92]

Thanks I have a water rower - so there are no settings , just the water.I’m following a Youtube trainer called Rowaway who uses a concept 2. I’ve found he gives great advice on technique, sessions and motivation too.

[Steve101]

I was in persistent AF. In the last 12 months I have lost 50 pounds. Touch wood I have been in NSR for over 6 months. The only way to lose weight is to eat less. Exercise of course does help, but you have to do many hours on an exercise bike even to lose a pound. I also gave up alcohol (one glass of red wine a week I allow myself) that helps a great deal as evidence would suggest that alcohol doesn’t help AF and it also contains lots of calories.

Stick at it, you will get there!

Best wishes

Steve

[Lyndylan in reply to Steve101]

Thanks. I agree on the wine. I have cut it out completely except for birthdays and holidays.

[harrigate1]

Bisoprol is a beta blocker usually prescribed while you're in AF to slow your HR. When you're in SR why are you on this? HR of 50 is a bit bradycardia. I have a BP issue. I looked up amiodarone combined with valsartan, good results. Check it out.

[Lyndylan in reply to harrigate1]

That’s is a very good point. I have aching legs often which I think is a side effect of Bisoprolol. I will talk to my cardiologist as he is about to take me off amiodorone and put me on flecanide- I will ask if we can try dropping the Bisoprolo too.

[Maagaa]

Hi, was on heavy dose amiodarone before my second conversion. First one worked one week. After second worked three years but back in full blown AFIB with a pacemaker. My feet are numb from neuropathy and the side effects I have experienced have been terrible. My thyroid has been fouled up and been on meds ever since. My advice to you would be if you don’t have to take it don’t. Good luck 🍀