I was diagnosed with paroxysmal AFib in May 2021 which is being managed by meds (Flec + AC) and I continue to have intermittent episodes lasting between 1 day and 5 days. At the beginning of June this year, I was given permission to return to the gym. I'm 60, male, non-smoker, non-drinker, 68kg, 3 cholesterol, and so reasonably fit apart from the AFib. Since returning to gym, I've had four AFib episodes and in all four cases, while being in AFib, I've done a gym workout and within 20 minutes of starting the workout I've returned to Sinus. The first couple of times I thought it was sheer coincidence but I'm now wondering if this is a way to counter the AFib. The last two episodes I've managed to end within 6 hours - the shortest episodes I've ever had. Has anyone else had any similar experiences? My GP's view is, if it works, then stick with it but I'm waiting for an appointment with my EP to get his view on it too. Thoughts anyone? Thanks.
Returning to Sinus with Exercise? - Atrial Fibrillati...
Returning to Sinus with Exercise?
Many people swear by this . All I wil say is that in my early days I used it quite successfully but was told in no uncertain terms by my EP that I was stupid to do it.
Yes, that works for some. But since you're on flecainide, not an inconsequential medication, I would get clearance from your ep first, before exercising during an afib episode. Are you on a nodal blocker like Bisoprolol or Diltiazem? If not, all the more reason to speak to your ep first. You want to make sure the Flecainide isn't causing too much QRS widening or other arrhythmic issues under stress, which is sometimes does.
But even if you do get the ep's approval, not a bad idea to take an ekg under stress, whether in afib or not. If they don't think it necessary to do it in the stress lab, then as long as they gave you the green light anyway, consider doing it yourself at the gym with a Kardia device, preferably the Kardia 6L. Then email the ekg to your ep, as Kardia has limited interpretations.
.Jim
Thanks Jim. No, I'm not on any other meds. I was on Soltolol but due to some side effects, I've just been moved to Flecainide which so far is going well. Yes, I do have a device to take an EKG (ECG) recording which I will share. My cardiologist is doing more tests in the coming weeks to check the full impact of the Flec so hopefully this will clarify whether there is QRS widening.
I find that I get back to NSR after exercise quite often but it is not gentle exercise. I have to run around 10 k or cycle around 40 miles to get back and sometimes it is a struggle when in afib. Again like some I have been told not to do it as my heart rate is out of control. Sometimes I've been in afib for 14 days and exercise hasn't worked. I don't think there is an easy answer unfortunately
Oh gosh, that's heavy duty exercise to get back to NSR. It usually takes about 20 minutes on the cross trainer in warm-up mode and my heart rate is around 160 and then drops in to NSR at about 100 and once I stop exercising, it settles at a resting rate around 65. But I'm going to consult again with my cardiologist and EP. Thanks for sharing.
I remember reading some information about Flecanaide that it is a rate control drug and it’s effect is proportional to heart rate, i.e., at higher heart rate it is more effective. I personally have similar experience as well, when I was in AFib at HR around 80, if I suddenly standup etc to raised HR to 120, 140, sometimes it converted back to NSR straightaway to around 70 HR. I was puzzled by this and hence did some digs about possible reasons. It did not always work though.
Thanks for this. All adds to the picture I'm trying to paint as to what works, what useful etc.
Hi, I also found the benefits of exercise by chance.
I worked out that in order to self convert I only have to walk around the block for about 3/4 mile, starting off slowly up a slight slope. My pulse then barely gets above 80bpm. Beforehand I listed to a slow heart beat on my computer (entrainment) for 15 mins to really relax. I log this technique and find its 80% effective.
Note that I find my AFib is triggered by adrenaline, which is contrary to the vagal type that most people seem to have. i.e. triggered after heavy meals etc.
For the past 10 years or so I have been getting on my bike the next day and doing a short cycle up a hill to stop my AF. Must have worked over 50 times. I have consulted my EP and arrhythmia nurse who note the effect but have not said don't do it. A couple of times it has not worked and I went to A+E for a cardioversion.
Yep, me.I'm on Sotalol and have a pacemaker. When I go into AF I do 5 or 6 km on my Concept 2 rower. I can't do it when the upper swing is in the 150s as I feel too rough, but when it comes down a bit I get going.
It is not pleasant. When the 'kick' comes my legs feel like jelly and I may have to paddle a bit. But it seems to work.
I was in AF for 3 weeks after a femoral hernia op and just had to sit it out, I was so fed up!
Below is a print out from the rowing log.
Thanks for this. Again really interesting. What I find is I have no difference in feeling when I'm exercising in AFib to normal exercise in NSR - just a higher heart rate but no discomfort or pain or breathlessness other than the same level of heavy breathing one gets from prolonged exercise. But it certainly seems to work after about 20 minutes. Really appreciate your feedback though - makes me realise how variable each individual experience is.
Yes I think it is totally individual and you will identify your solution by trial and error.
Some people might find what works easier because they have vagally mediated PAF; in my case that was gulping down a cold drink from the fridge - I always keep a full carton of coconut water in the fridge for this purpose. At the other end of the Vagus Nerve, the brain can do the trick by relaxing & listening to a steady heartbeat on YouTube
On exercise, I have found strenuous exercise can start AF and to get back to NSR I have found nothing more than a brisk walk for a mile is helpful.
Lastly, you need to get those episodes stopped completely as the more you have the more likely you are to have more and other complications. Your EP will no doubt suggest an ablation but you might ask him about trying a higher dose (not sure how much you are on now hopefully just 100mgs) of Flecainide first over 6 months, whilst waiting. I did that 8+ years ago and have been AF free for that time (bar x2 20 min ones) but have combined it with many lifestyle changes including supplements; ablation still postponed.
‘Lifestyle changes’ can be a bit of a vague notion. Would be interested to know from your experience what lifestyle changes specifically you made and what “supplements” you started taking all of which which seems to have eradicated your PAF. Harry
Hi Harry, there have been many references to Lifestyle changes here, which I guess you can access using the search facility.
In my particular case, as I have been virtually AF free now for over 8 years, my treatment I expect would be categorised by most as a success. However unfortunately, I cannot single out any one Lifestyle change or my only drug Flecainide as being the answer.
From the outset, once I had got over the anxiety/borderline depression, I was determined to use AF as a driver to become healthier overall. I also hold the view that AF, once all the tests are passed and you are categorised as having Lone PAF, is caused for most of us by a multitude of poor Lifestyle choices. I therefore threw the 'kitchen sink' at it.......visiting Alternate Practitioners, spending a fortune upgrading my dental health, reducing business and personal stress, upgrading mental health and spiritual beliefs as well as eating and exercising better. Despite excellent QOL I have not reduced my 200mgs Flecainide, as I suspect it still is playing a role, maybe not every day but on critical days when other actions may have triggered AF.
I started at an early stage and continue taking CoQ10 200mgs & Nutri Mega Mag Muscleze. As I don't take ACs, whether it helps or not, I take fresh garlic, krill oil and a Lamberts (no commercial links just think when mentioning a supplement equally important is a trusted company) multi vitamin daily. I also take Vitamins C 1gm & Vitamins D3 1000iu frequently, more so now with Covid lurking.
Food & drinks is a big area to improve on.......cook from scratch, minimum supermarket meals, if eating out stick to simple meals, less red meat, no alcohol or fizzy drinks especially tonics (quinine), reduce gluten and sugar by 75%.
Hope something there helps.
Thank you so much for telling us your story. You really have “attacked” it head on with determination and motivation. Not all of us have that same drive unfortunately but we can aspire to do more to help ourselves. There are things you have said however which a lot of us can take on board without to much dread. But I suppose there is no “turn key” solution to this that will suit everyone. Many thanks again for posting
Harry
Good for you. Clearly you're fighting it on all fronts. Hope it all works out. I'm interested that you said you've ruled out tonic - is there a particular rationale behind that? Since giving up alcohol due to the AFib, my drink is elderflower & tonic. Maybe that's not good....so your thoughts would be welcome!
Depending on the sensitivity of your Vagus Nerve, any cold fizzy drinks or especially those with quinine can be a problem.
Its all trial and error for each individual. I found cold ginger beer set off an episode and pre AF diagnosis I drank a lot of Indian Tonic Water (with quinine), so believe that may have been an issue, also mentioned awhile back on this Forum.
With no alcohol or fizzy sweet drinks pub visits are less attractive. I usually have tomato juice with a slice, no ice. At this time of year we drink homemade elderflower cordial...very healthy properties!
Many thanks for this. Yes, I think advice from the EP for my specific PAF is what I need. I'm hoping that they will recommend an ablation. My cardiologist feels it's the best route, especially while I'm 'relatively' young. The only lifestyle changes I've made is no alcohol and so caffeine as was advised they were obvious triggers. The episodes seem to happen every three weeks and the longest one has been 5 days, the shortest (more recently ) 5 hours but with no symptoms, just my Apple watch telling me. I'm on 100mg Flec but my cardiologist doesn't want to increase it due to the potential risk to kidney/liver. What supplements are using? Maybe that's something I should consider while I wait.
Hope you find some answers. It's a conundrum sometimes.... Take care.
Thanks Belinda - yes, let's hope so!
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