Exercise

[Rachelanx50]

Hi everyone hope you are all well. This episode of afib started around mid November and I am so frustrated as I'm getting more communication from a tea bag than my cardiologist!! I have a resting pulse rate between 80 to 100bpm Still waiting for my son to set up my new Kardia device. The trouble is that i am a do,er i hate not exercising or flitting around doing something but i dont know how much is too much will i make my AF worse if i get out of breath? Sometimes I,m to scared to move

[jeanjeannie50]

What is your normal heart rate Rachel?

[Rachelanx50 in reply to jeanjeannie50]

Hi Jean, when not in afib around mid 70s

[jeanjeannie50 in reply to Rachelanx50]

So your heart rate, although out of rhythm, is not beating at an overly high rate. Most importantly, how does it make you feel?

[Rachelanx50 in reply to jeanjeannie50]

Worn out Jean mainly when I've eaten a meal it seems to go up to around 120bpm i think the anxiety of it all affects me more than anything if i could "get a grip " and understand how to cope i would feel much better I'm sure

[jeanjeannie50 in reply to Rachelanx50]

My heart rate used to be around 62bpm and I'm now in constant AF between 60 to late 90's - it's up and down constantly. For many years I had attacks of high rate AF that would totally floor me and I would spend time in hospital. I had three ablations and numerous cardioversions, then after about 14 years was told they would offer me nothing more. My body is now used to the higher rate and I lead a fairly normal life. I wonder if your body could get used to it as mine has. However, we are all so different and many people on this forum have said how poorly a heart rate like yours can make them feel.

I would do gentle exercise, such as walking, don't push yourself too much, but get out and about in the countryside.

I live on my own and there have been times when feeling quite poorly with AF I would have to cut my lawn. Full of self pity, later when I felt sore in my chest, there were many times when I suddenly went back into normal rhythm. Many people here have said that they can put themselves back into sinus rhythm by exerting themselves. I don't think I would voluntarily do that myself, but sometimes there are things you just have to do.

I think you need to ring your doctor's surgery when your rate is particularly high and say you are afraid and would it be possible to have an ECG (most doctors surgeries have them now). On second thoughts wait and see if they suggest that first and if not come right out and ask.

When you have a meal make it a small one and sit for at least half an hour afterwards. I snack on nuts and fruit between meals so that I can have smaller main meals. If you are carrying any extra weight, do your best to get rid of it - you will be amazed at how much better that will make you feel. I lost a stone in weight and can tell you it works. I guess you know already to avoid caffeine, alcohol and any foods containing artificial additives?

Are there any plans for you to have a cardioversion or ablation?

Jean

[Rachelanx50 in reply to jeanjeannie50]

Thank you Jean for your reply and sound advice it's so comforting to hear from fellow sufferers and their experiences this can be such a lonely condition. I asked about an ablation while in hospital over Christmas with an attack but they refused because I'm not on blood thinners they say I'm not at risk of stroke because I only scored one on the at risk scale. I will object when i get my cardiologist appointment through. I'm really careful with my diet it was originally red wine that started it I don't drink anymore no caffeine plenty of heart healthy foods but i do need to lose weight I'm going to do my best to get this sorted out in the New year

[Boudica_HD in reply to jeanjeannie50]

Dear Jean - may I ask how long was the transition period between you becoming permanently in AF and your body acclimatising to that regular state sufficiently for you to lead a normal life? … and many thanks for sharing your experiences.

[jeanjeannie50 in reply to Boudica_HD]

In October 2019, I had my last cardioversion, had had one earlier that year too. It only lasted for about 6 weeks and as I'd had numerous cardioversions before. I was told I wouldn't be offered any more. I didn't feel too good for a few months, but tried to carry on with my life as usual and my body slowly got used to my heart rate. I get days when I may feel more tired when I exert myself e.g. climbing up a particularly steep hill. Oddly that's when I go up just one local hill where I live. I can now do that route and climb to the same height via a different route with no effect! I live in an unusually hilly small coastal town.

You ask how long it took my body to get used to constant AF. I would say several months.

Jean

[mav7 in reply to jeanjeannie50]

Great advice for everyone, jean !

May I ask what medication you take for heart rate control ? And have you had to try more than one type ? Thanks !

[jeanjeannie50 in reply to mav7]

I take Flecainide 1 x 100mg +12.5 of Metoprolol mornings and Flec 75mg + 12.5 Metoprolol at night. I've tried all sorts of medication, Metoprolol on it's own, Sotalol, Digoxin and Amiodarone. Flecainide is what I think of as the miracle cure drug.

[mav7 in reply to jeanjeannie50]

Thanks for the reply !

Doctors in the US (at least in my area) don't often recommend flecainide. They 'luv metoprolol or an antiarrythmic drug like the ones you mention.

I need to press for an answer. Thanks, again !

[jeanjeannie50 in reply to mav7]

Flecainide is the favourite medication for AF by most of the members on this forum, but my EP didn't appear to like it much either.

[Diver2]

I asked my doctor to give me the parameters when I should go to the emergency room when I go into Afib. I also bought a blood pressure cuff and check my blood pressure when I’m in Afib or Flutter. Since Afib or flutters can be cause by stress you need to develop coping skills so your stress is much less! I use education… thus the request to my doctor about how high my blood pressure can get and for how long before I need to go.Also I listen to Weightless buy Marconi Union which was developed by a music therapy class at a University in the UK. It is designed to lead your heartbeat back to a steady 60 beats per minute. You can download from ITunes for about a dollar. When I first go into a bad session if “flight or fight” Afib. I put earbuds in and lay down. If I can sleep my Afib and flutter calms down or stops……. Sometimes in 20 minutes other times it may take longer.

I listen to it all night long when I sleep so usually stay in sinus rhythm

[Pigleywigley]

Hi Rachel exercise was my biggest question to the cardiologist. I run, swim, walk & cycle all moderately & not to extreme. He reassured me I was fine to exercise. To not push myself too much & listen to my body is v v important. We are all individual. My anxiety in year 1 stopped me a lot!

I am currently in remission/episode free.

Rachel

[Rachelanx50 in reply to Pigleywigley]

Thanks so much and I agree that it's my anxiety that's holding me back i think I need to try to push myself through the fear barrier try harder to peel myself from the sofa easier said than done though

[FancyPants54 in reply to Rachelanx50]

You can do it. Just pretend it's not happening and do what you would do. When I went into permanent AF I was in a right state. Panicked and frightened and so stressed by it. But eventually I calmed down and realised that most of the time I had no idea I had a high heart rate. I still don't really. My Apple Watch shows me that it is but I'm used to it.

They all tell us to loose weight. It's a doctor's holy grail. I'm fat because they have been utterly useless in helping me with my hypothyroidism. I'm having to try to solve my own difficult case myself. When I saw the cardiologist this week for a check-up, first in 2.5 years, he started off on that tack. No one who is hypothyroid and under medicated will ever loose a pound. That's why I'm fat in the first place. But as I always point out to them, and they always ignore, I was slim, fit and very active when AF started. I'm not fat and slow and not active for the other reason and my AF is just the same. I wish they would listen to what comes out of their mouths sometimes. It could demoralise a lesser person. I just ignore most of what they say. I've had to read so many books and articles and medical papers to try to help myself that I know I have more idea than them in the thyroid field.

So don't be afraid. Don't stress over weight. Just concentrate on getting back into the swing of your life. If you know certain foods or alcohol trigger you, avoid them. I don't have food or alcohol triggers, which is lucky. Some of us just inherit this condition.

[Izzle]

I'm a longtime sufferer of PAF so in and out of rhythm regularly. For a long time I've been doing basic yoga (3-5 times weekly for flexibility, breathing and balance) and daily walks (1/2-1 hour). The beta-blocker I take keeps my pulse down generally below 100. Only treadmill at my specialist gets it higher.

During the first 9 months of 2021 my AF worsened, lasting an average of 6 days. But one thing I'd noticed was quite often I self reverted during exercise, walking (up hill), easy cycling, even mowing the lawn. I decided to increase exercise and introduced twice daily 'exercise snacking' (Google has many entries).

3 months later my AF is lasting just over 3 days, so nearly halved. And yes, I do it during periods of AF at 80-90% of normal, BUT I listen to my body, particularly breathing comfort.

I hope this might help you and some other sufferers.

[Rachelanx50 in reply to Izzle]

Thanks so much izzle feel so much more confident after reading yours and others responses this morning going to be getting off my bum more and work through my anxiety about exercise

[KMRobbo]

I used to go running to stop an AF episide when I first had it. My resting HR was 165 ish in afib. My max recorded was 243 when running. I am not medically trained but unless you have other Co morbitities esp heart issues you will be fine. If you get very breathless then stop. I was 57 when I was diagnosed.

[Rachelanx50 in reply to KMRobbo]

Thanks for much appreciated advice

[saulger in reply to KMRobbo]

I am not medically trained but would say that running at 165 BPM is too high, bearing in mind that the atria are quivering at 400 BPM or so, which I've read will lead to enlargement of the atria and heart muscle weakness, possibly leading to reduced blood perfusion.

[KMRobbo in reply to saulger]

In 7 to 10 mins of starting the run I was back in NSR. That was why I did it, running converted me to sinus. Unfortunately as my AFib progressed this trick stopped working.

I am not medically trained but I doubt that excercise had much effect on the rate my atria were quivering , that was already likely to be well above my sinus rhythm.

As I converted during the run then it actually reduced the average time that atria was quivering.

For me pre afib, 165 bpm was not unusual when running anyway eg top of a hill. ( did not average that rate ) .

Shortly after being diagnosed with AFib and given a 24 hour monitor, I went running with it on. I was not in afib at the time as it was after my first occurrence.

When my cardiologist reviewed this he was supportive of me running.

However I was nor recommending that anyone in particular exercise at that particular rate.

I was just using myself as an example to say that you should not fear excercise if you are otherwise healthy and have a healthy heart.

The person worrying about stated they have a rate of 100 in AFib.

[saulger in reply to KMRobbo]

KMRobbo, I was worried for you in case you were not aware of the training heart zones, and you wrote that your HR went up to 243 BPM, which sounded too dangerous and to be avoided.

I read/heard that some people convert to NSR during aerobic exercise and tried it, but instead of the 100-120 HR typical for me during AFib, it shot up to the 140's, so I don't try any more. Weirdly, it seems to be more uncomfortable at the higher HR than when it is slower...

We react differently to stimuli, and our AFib is also uniquely sensitive, it would appear.

Can I ask what medication you are taking that would allow you to train at high intensity?

I used to row in a boat and also indoors at home, but even low intensity now will bring on an episode a few hours later.

All the best, Saul

[KMRobbo in reply to saulger]

I had an PVI cryoablation ablation 4 years ago and so currently take no meds at all. I was not compatible with beta blockers, so was on 120mg extended release verapamil with a supply of 40mg normal release to take in case of AFib attack.

After 20 months and 12 afib attacks the running trick stopped working and the Verapamil became useless. It always struggled to control the high AFIB rate anyway. When it kicked in it was 165 resting. Sometimes the extra 40mg held it up a bit. After an attack lasting 8 days in afib at 130 to 195 resting hr I was cardioverted by flecainide infusion.

I then went onto 50 mg flecainide x 2 and 200mg Diltiazem times x 1 . When running I could not get my HR above 137bpm. It was agony if I tried. The only time I was in afib on this combination was the day after I missed my evening flecainide dose, but when it happened in was back in the 160s in afib.

However post AFIB ablation I developed reentrant atrial flutter in the right atria. The Diltiazem rate controlled this at 140bpm almost constant. I did not like the Diltiazem, it had side effects ( verapamil had none). I would not have taken it long term, but I organised a PVI cryoablation following my 8 day AFib session, so it was always a temporary drug. However it did its job with the flutter as I had to have a second ablation to stop that and was at 140bpm for a month until it could be organised. Without the Diltiazem it could have been higher rate.

I think the issue you maybe asking about, is that my AFIB was not related to/ caused by excercise. I was 2 times 4 or 6 miles runs, a 25 to 50 miles bike ride and for a period a 1 hours circuit training session weekly . Not too much exertion, but enough to offset fitness decline. Not competitive running although I always pushed myself a bit and did go on a couple of organised runs Inc the Chester half marathon but they were pretty rare.

I decided to run against the afib because when I ran I did not warm up I just ran . The effect on my heart as recoded on my garmin was a fairly quick rise in heart rate up into the high 160s , and then after a short period it would drop down to 140 to 150 depending on how hard I was trying.

So on my 3rd or 4th afib attack , rate has gone up, and looking forward to another few days wasted in A&E/ MAU while the medics struggle to control the rate. It was weekend and I was pissed off! I just wondered if I went for a run whether the high exertion rate would overtake the afib rate and take back control somehow . No medical knowledge of this , no idea if it could work, just fed up enough to try anything.

But it did work. So that's what I did for the next 9 ot 10 times until it stopped working.

I understood well from early days, that AFIB begets AFIB so I was always in a panic to stop the AFIB ASAP. But i was sure my AFib was not caused by excercise. ( i never found any triggers) .

Looking back I should probably have organised the ABLATION after the 4th or 5th attack as it was clear by then it was not going away. But I was against ablation initially and I was not sure how my afib woukd develop.

[saulger in reply to KMRobbo]

KMRobbo, thank you for your wonderful reply. It really helps to feel what you were going through.

You are a super-fit individual and very brave for not letting the AFib get the better of you.

I believe that mine started way before it was diagnosed in 2018. When I was training for the Great River Race in 2004 (age 58), several hours after a 20k steady-state row, then 30mins of static bike, followed by a 1k swim (much more than I usually trained), I could feel the heart to be irregular but just slept on it.

This seems to be the pattern with me, after exercise, but there is also a digestion / bowel connection, I believe.

For the past year, or so, I've been following the WMM (Wolf Mini Maze in US) FB group of past patients with first-hand testimonies. This procedure ablates several areas of nerves outside the heart but it is more invasive than a catheter ablation.

I am waiting for some info on a surgeon in Brighton who performs this same method.

A 69 year old ex-Afibber who has not been able to ski for two years just skied a whole day at 12,000 feet, 7 weeks after his WMM. Just incredible and I want that !!!

All the best and thank you for caring enough to share your experiences.

I will keep re-reading and maybe there is a solution there for me. HNY. saul

[KMRobbo in reply to saulger]

No sure about the brave! One day I am happily running then I get afib, high rate, but asymptomatic otherwise. The medics give me beta blockers which make a fast walk impossible, (with bisop max hr 117 plus lots if other side effects) but they do echos / etc and say structurally my heart is fine and I am only paroxysmal . So I deduce the drugs are the problem not the afib. So I get my GP to change drugs until I find one I can tolerate and run with. It's logic not bravery. Because I never stopped running (only for a few weeks) I just followed on the same logic. Until I have a good reason I can't excercise then I will excercise. So if I could run yesterday I can run today. After I got the ablations I started running again, my EP was in agreement, and early the year after I was almost as quick as before AFib/Aflutter. the difference being I try to keep max HR to 155 ( before afib I didn't bother) , so I was slower up hills. Sadly I hurt my right knee in early 2020 whilst running. Running now makes it hurt badly but if I don't run it heals up. But walking is not a problem, even up mountains, so just currently don't run. I have not tried to sort it out as our UK health service is swamped owing to Covid, and and I can do everything but run, ( even been backpacking) , so its not that important. but if we ever get on top of this Covid I will get it sorted and get back to running!

Best wishes.

[saulger in reply to KMRobbo]

Cheers again. I live in a hilly part of Athens Greece now (Lykabettus), and walk an hour a day. My rowing machine is gathering dust. About to wean myself off Flecainide (2 x 50mg), which does not much, and might go for a different channel blocker after I see how I will feel.The Bisoprolol (1 x 1.25mg) was also too draining and as I am low HR (53 resting and less) and low BP, no real need for heart rate control.

I still believe that there is a treatment out there for long-term remission, and we will keep searching. All the best and that your knee gets better. Saul

[Ppiman]

I can't add much to the excellent responses you've had here. Isn't HealthUnlocked such a useful website?

My own feelings are that whether you can do anything safely depends not on your heart's rhythm but on its general overall condition. Have you had an echo or MRI to determine this? If so, then from what I have been told, AF isn't going to do much harm at all, even over the long term, assuming two things: any persistent tachycardia is controlled and the blood clotting risk brought on by AF is dealt with. I have an elderly friend of 88 who has had permanent AF for a long time, and he is in good shape for his years.

Like you, I get tachycardia after breakfast that easily spirals up to 85 > 105 > 120 > 130bpm, fortunately never any higher than that, and rarely that, in fact. On the Kardia, this shows as NSR with Wide QRS, or with PVCs or as Unclassified. It makes me feel anxious, a little breathless and gives me some chest discomfort. It seems to be gastric in origin, and I do have a small sliding hiatus hernia, but that idea didn't impress my cardiologist overmuch. If it doesn't go away or if it makes me feel especially anxious, I take 1.25mg of bisoprolol. That takes about an hour, maybe more, to bring it down and seems to last for a day, maybe two.

It makes for a difficult life because of the anxiety of it being so focused on the heart and of not knowing where things will lead. You have my sympathies.

Steve

[Rachelanx50 in reply to Ppiman]

Thanks so much Steve for your very informative advice I've read these amazing replies with a new view on life with afib I'm off for a well needed walk this morning I will be having an echo when my appointment comes through always a waiting game especially these days

[Fullofheart]

Hi there

I've had af for about 17/ 18 years. I was in my late 20s when it started and late 30s when it went persistent.

I've always just got on with things exercise wise. There are times/ periods when I just don't have the energy because of af (and now cos of thyroid issues) and times when I feel up to it so I work with the energy. I used to run, go to gym, box, swim etc. Nowadays I do more walking, cycling, yoga, pilates etc so a bit more gentle but all useful to keep active.

I've always been advised to keep exercising as long as not overdoing it.

Best of luck to you.

[Rachelanx50 in reply to Fullofheart]

Thank you for replying to me it's much appreciated

[Diver2]

My doctor told me my body will tell me when to not exercise. Dr Mandrola is a long bicycle and after he got Afib he still rides long distances . He has a blog on Afib for other doctors, but you can listen to it