should I consider exercising again?

[Fondant]

I went into Af over 18 months ago and had a successful cardioversion in September 2021. Since then (touch wood and 18 months on) I haven’t had a single AF episode. I have had eptopics, palpitations since then but doctor thinks that’s anxiety for which I’m on medication for. I am not on any meds for AF as my specialist said I wasn’t at risk of stoke etc, heart rate resting is below 60 and regulates itself very well. So no need for beta blockers or blood thinning drugs.

so my question is this, I used to be a Kean runner but I stopped once I got AF and was too scared to run cos was worried I ‘might die’

Should I start running again? Starting off slowly at first and gradually building my fitness up? Since I stopped running I’ve put on 12kilos in weight. I should be around 85 kilos and I’m currently 102. Many thanks all

[BobD Volunteer]

Exercise is good but over exercise is very bad. Many keen runners of your age develop AF due to the extra hard work they ask of their hearts so whilst I would encourage you to take some gentle exercise this is not the type that you yearn for I fear. It would be a shame to have wasted 18 months.

Of course it may be that AF returns some time in any case but nobody really knows. AF per se won't kill you but trying to run a marathon on AF might.

[Jajarunner in reply to BobD]

Has anyone ever died running a marathon because of afib? I don't recall ever reading about it. There are rare causes of cardiac events in marathons but usually caused by undiagnosed cardiac myopathies, sadly, not afib. My EP is quite happy for me to do a marathon if I so desire.

[Autumn_Leaves in reply to Jajarunner]

Yes, I think someone here did know someone with AF who died during a marathon. As you say, there could be other factors at play. As you have taken advice from your EP, that’s probably what the OP should do too. You need to look at all the other factors in someone’s medical history, scan results, just in case there is anything else to consider besides AF.

[Banquo]

Hey Fondant,That's awesome you haven't had any recurrences and all is going well! I'm 10 yrs older than you but still 'young' for this condition according to docs, and like you have had a very active lifestyle. Not a crazy or fast runner, but love trail running and the occasional road. So my AFib seemed to slowly progress over a couple years, a day in AFib here and there (though I didn't know what it was at the time)...then three days straight one summer, then a year later it seemed to stick and I went to hospital..ended in Cardioversion after 4 days of failed med conversion. I was discharged and literally did a short hike that afternoon. In my case, and I'm betting yours to, once you are back in sinus rhythm you immediately feel better..truly like nothing has happened. An NFL football player recently underwent Cardioversion and played in a game a week later! So not to sound too cavalier, but by all means return to your activity. If it's like mine..the AFib will come and go mysteriously...my biggest trigger may have been alcohol? But even that didn't prove out all the time.

I just underwent an ablation procedure in the last couple weeks because my AFib episodes started coming back after about a year successfully on a rhythm drug. Once that started failing they sent me off to an electrophysiologist and the decision to have an ablation. We will see how it goes...I look forward to getting off all the drugs in 3 months and see how the heart responds.

The fact that they didn't even put you on rhythm meds is great, and the fact you've been AFib free for that length of time and without any meds! They told me that post cardioversion you are pretty much guaranteed to be on rhythm meds until they also fail. But obviously that isn't true for you and are doing well.

There is some evidence that hard core athletes and especially runners have taxed their heart to point if AFib and other heart difficulties.. but those would be evident to them upon testing. As much as I appreciated them lumping me into the athlete category...exercise had helped my heart, not damaged it...most likely this was all bad electrical, and probably hereditary.

I'm sure it has freaked you out...I know my AFib freaked me out and was nothing I would have ever expected for myself...but here I am. And now post ablation for two weeks..I'm recovering ok and looking forward to a little more intense exercise in weeks to come..not quite yet.

Happy running my friend!

[javo123j]

As Bob says exercise is good and I've been encouraged to exercise from the day I was diagnosed. I was told exercise with afib is better than no exercise with afib. I have paroxysmal AF and attacks can last for over a week and I find that exercise helps me get back into sinus rhythm. Try the couch 25k site on this site. It's a great way to get back exercising. healthunlocked.com/couchto5...

[Lonelytraveller]

Hey. Being an active person before Afib and knowing the value of exercise I asked this question whichever EP I could ask. So, the general answer is : Do exercise but do not do competitive exercise, things like exhaustive team sports. And do not let Afib keep you away from doing moderate exercise (moderate running, brisk walking, yoga, pilates and swimming being most valuables. This I can say was the general counsel.

For me it was kind of hard to accept that I should change exercise profile but what I have been learning for the last 2-3 years says exerting the heart is a no go. On the other hand, weight control comes along with exercise and I assume being over weight would do more harm than exercise would do so, if any. The exercise relief and benefits to other parts of the body does not even mentioning here. I hope this would help a bit.

[secondtry]

Exertion can contribute to tipping you into AF. I say 'can' because if most other lifestyle issues are anti-AF then it may be perfectly OK to start running again as long as you don't overdo it. However.... in my Sixties I found it did cause a problem so I reverted to brisk walking with poles and walking basketball. Such walking undoubtedly will not appeal but I would suggest you do it x2 a day for a mile as I have found it beneficial to reinforce good habits for the heart before gently introducing running again but not back to previous levels.

With regard to weight loss, assuming you have no comorbidities, I have found a full fat organic locally sourced and reputable food supply cooked from scratch reduced me to BMI 23 and I eat what I like and combined with the exercise I don't put anything on.

[KMRobbo]

Were you running when you went into AF? I was not a competitive runner but did 4 or 6 miles twice a week, i did push a bit and it kept me fit and kept the weight off

I never found any triggers for my AF. It just happened randomly. My Afib was always high rate , typical 165bpm resting. Apart from the high rate I was asymptotic. Anyway I never stopped running and never got an AFIB episode whilst running. IN FACT I found out after the 3rd (?).Afib attack that if I went running after 7 or 10 miniutes my AFIB STOPPED, the hr dropped and I carried on running. ,( I did not push hard and stopped if the rate went too high (garmin watch / monitor with chest belt).

I did this for about 18 months but then on my 12th AFib attack the running stopped working.

6 months after this I had an ablation and never had Afib since (almost 5 years ago) . I started running again after that.

Sadly dont do much now as my right knee gives me gyp . This has only developed first year of Covid ( not related) but I did not see this as important as it causes no issues when walking and the health service was busy so never saw a doctor until this year.

So my experience is that everyone is different with AF in terms of the issues and the triggers so unless you try running you wont know if its a trigger or not, or a problem or not . Also the 12 kgs extra weight does not sound like a good thing for your heart if its not muscle!

Not medically trained just my personal experience.

However I should add that my EP was very happy with me running and encouraged me to keep it up.

[kkatz]

I totally understand your fears and have never ran in my life.Except for a bus.And I am 30years older than you.But I regularly went to excercise classes & enjoyed walks & bowling.I have had almost 2 years of persistent AFib.I started with walks & bowls & when I returned to excercise classes I used imaginary weights which can be as heavy as you like.

Start with brisk walks & excercise classes.You will feel so much better.

When Paroxsysmal I never let the worry of an attack stop me excercising.

Good luck.

[Jajarunner]

Of course. A fit heart copes with afib better than an unfit heart not to mention the myriad other health benefits not to mention the weight loss. I'm just starting again after ablation number three, Sunday I did 5 x 2 min run/40 secs walking. Very slow but it's still running in my book.You could wear a heart rate monitor to begin with to stop heart rate going too high. Check with your arrythmia nurses if not sure, I'm sure they will be delighted!

Check out cardiac athletes on Facebook too, very inspiring. Enjoy!

[Speed]

If effects different people in different ways. I’m a 57 year old keen (but not competitive) runner and likely developed AFlutter due to Ironman training ( only for 2 years) on top of genetic predisposition (both parents had PAF in old age). It’s now 6 years since last Ironman and nearly 3 years since 1st symptoms of AFlutter. 2nd Ablation I yr ago sorted AFlutter. I now like to run several times a week and throw in a weekly bike ride and swim.

Have however developed PAF this year with increasing frequency of episodes. Trigger now is during a run / weights. Went from every 3 months 6 mths ago to during last month it has happened every 3rd run. I’m now moderating my running pace to try to keep to a level that does not trigger the AF. This appears to be working. I wear a Garmin with chest strap so have accurate real time HR info. Resting HR in NSR is 50s, in AF is aprox 95. Max measured HR running in NSR is aprox 145, in AF it hits 210.

Generally I take PIP flecainide to get me back to NSR, episodes lasting from 4 to 8 hrs post run. Occasionally I have gone back to NSR (stopped and checked regularity of pulse NOT rate) when slowing in a run but generally it persists.

Interestingly, I don’t know from the running I’m in AF - I always spot it on my HR monitor before I feel any effects.

I now aim to keep HR running below 130 to avoid it triggering AF. Is working so far. FYI I’m on 2x 50 mg Flecainide daily and now also ensure I have taken my scheduled dose an hour before any run having identified that events generally coincide with delaying dose until after run.

I am due to have telephone consultation next week with EP and through arrhythmia nurse, understand this will be a discussion about scheduling in an ablation to isolate the 4 pulmonary veins feeding into the R Atrium.

EP had always emphasised its important to keep exercising for general health of heart but the level / intensity needs to be set by the individual against the risk of progressing the AF / how they feel once in AF and how long it lasts and how important exercise is to them. Much of it is about finding the right balance for QOL and this will vary between individuals.

[Kent2007]

Fondant. As ever, you should be taking advice from medics before deciding a course of action. But, it's always interesting to hear experience of others. That's what this site is about. I'm 67, have suffered paroxysmal AF for 15 years. I take 150mg Flecainide every day and a bit extra if I think I'm going to do something that may push up my risk of getting AF. In my case this may be an 8 hour day walking in the Lakeland Fells. Or maybe an evening out when I might want to drink a glass or two of wine or beer. I also cycle, rock climb and do various volunteering tasks in the countryside. I've had some bad spells (weekly boutd of AF, typically 2-3 hours) but 2022 has been one of my best years - only 3.25 hrs in two sessions. I used to run a lot but the surgeon who gave me replacement hips suggested it was not a good idea to carry on. My cardiologist suggested I try to emulate Hussein Bolt, not Mo Farrah. So, I now do shorter hill walks (6-7 hrs) to which i attribute my better outcome. I hope you find a good way through it all.

[Tryfan]

Won't bore you with my history. But like many on this site, was a long distance runner, cyclist, hill Walker, squash player. You name it I played it. It seems to affect those of us who have been fit and probably pushed ourselves too hard.My only advice. Exercise in moderation. Enjoy fun runs, cycles etc. But keep your heart out of the red zone whenever possible. Enjoy life and don't worry.

[kalgs]

Ask your medics they know your medical history . That’s the safest way to answer your question