I'm hoping someone can help me with the answer to this please. I have paroxysmal atrial fibrillation and one of my main triggers is exercise. However, exercise is also recommended lose weight, get healthy and reduce episodes. How can I increase exercise if it's a trigger? I am even reading The AFib Cure and I can see no answer to this 😔 All the doctors seem to say is to build it up gradually which is obvious really. I am also on bisoprolol which makes it difficult to raise my heart rate. I am a walker now reduced to shorter slower walks and so sad and frustrated 😔
Exercise: I'm hoping someone can help... - Atrial Fibrillati...
Exercise
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Spj57
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BobDVolunteer
You need to be able to walk and talk at the same time is a good guide.
I got on a Phase III heart fitness course run at my local gym with the hospital physio and cardio nurse in attendance. If you can find one of these in your area then I advise you to try and get on it. Remember exercise does not lose the weight but regulating your intake of calories reduces the weight most increasing exercise along with diet will help keep the weight off.
If you can't get on a Phase III heart rehab course then ask at your local gym if they run any other types of rehab courses they run as it may be suitable for you to join another - At the start I joined a respiratory rehab course before getting on the heart rehab course.
If Bisoprolol is causing you such problems with breathlessness and fatigue it may be worth having a talk about changing to another medication that may not. I tried all sorts of medication beta blockers, calcium channel blockers and various other types of rate and rhythm control medication all of which made me feel worse than the AF so in the end stopped all of them and am now just on apixaban anticoagulant.
Thank you 🙂 I can walk actively for a couple of hours, but I'd like to get back to longer, hillier walks. I can manage at a slower pace but I never know when it is going to kick me into AF. I just don't really understand how they can say exercise is a main trigger and then at the same time tell you to exercise more... 😟
"🙂 I can walk actively for a couple of hours"
You are doing brilliantly, keep doing it!
My experience is that whenever I do too much exercise I can be vulnerable to AF, doesn’t always happen, but often does especially if I am under par anyway. Any incline I get breathless and I’m not on any drugs, but walking on the flat I’m fine but do find I need to go a bit slower these days, partly age and other conditions, not just AF.
Some people find resting triggers AF and exercise promotes NSR and for many it’s the other way around. Suggest you read up on vagal AF and Vagal tone - balancing sympathetic and parasympathetic ANS.
Hi there, if you are walking for two hours you should congratulate yourself. I was in paroxysmal AF for 14 years have now gone into Persistent AF just recently but that’s another story. I have moved to Derbyshire and it is all hills. I have never been able to walk up a hill since being in AF without stopping. I have lost 2 stone which I know has helped a lot.. I think you will find things will settle down for you in the future. I am 73. I was on bisoprol and I couldn’t walk on the flat when walking my dogs I felt as though I couldn’t get any air in my lungs. So I asked to change to verapamil which I have found a lot better.
Goid zlucj
If I could walk for one hour I'd be made up! Honestly that's great!Perhaps walk for a while ,but with a planned rest and then continue?
Combination of diet and exercise is key,but doesn't have to be all cardio/ aerobic based
I think we all mourn pre AF life really.
Bisoprolol is a powerful drug,I'm only on 1.25 mg and HR hovers around 50/55 .
Best wishes xx
Goodness I would be happy if I could walk actively for 200 yards or 10 minutes. That your “actively for 2 hours” sounds wonderful reminds me when we snd friends used to go for 8 mile walks with a picnic so yours seems good to me, but I understand we all want what we used to have and be like.
Hi,
As the previous poster suggested, I would try cardiac rehab, and see what services are available in your area.
In my locale,
Phase 3 - this is run by the NHS with cardiac nurses and some trainers from a local charity. It was a 12 week program, starting and finishing with a walking/jogging beep-test; to show progress. Predominantly this was low intensity circuit program designed to get you moving again after discharge and build confidence. You also have the opportunity to discuss things with the staff, emotional support is important too.
We also have Phase 4 - this is run by a local charity with their trainers. This was a 9 month program starting and finishing with full CPET tests (treadmill/Bruce protocol). The test ramps up the workload, while you are monitored - ECG, BP and respiration (walking, jogging, running with a mask on). It is a clinical investigation of your tolerance and response to exercise. On completion of the tests, the results are analysed, discussed and you are given a target heart rate to work to. You then follow the program, twice a week, circuit training or gym, working to your target. The staff are there (to monitor, support you and to show you how to work safely to your desired intensity.
For me, I started this nearly 5 years ago and rehab was brilliant. I still attend the weekly rehab sessions; it’s part of my ‘maintenance routine’ and it certainly helped me to suppress my Afib to a point where I am now titrating my anti-arrhythmia medication.
Are you 100% sure you are in Afib after exercise? Apologies for being blunt. We are all very different with our Afib presentation. It took me a while to figure out what was going on. I was given a high target after my CPETs and regularly exercise to 90% of my maximal. My heart is beating fast and hard, some days I notice it, others I don’t. In the past, after exercise, while it was fast & pounding, I wondered if I’d entered into Afib. I have a Kardiamobile 6L and experiment with it, after a session like this, it usually determines Tachycardia. No surprise there, it’s after hard exercise but it doesn’t detect any Afib. My heart then slows down, recovering to its normal RHR, about 55 bpm.
Best
Thank you for your reply 🙂 i will do a walk in the early morning and then later in the afternoon AF will start. I have a Kardia 6l that identifies it and I've kept a record for the last 18+ months which shows this pattern. The rehab sounds really good, I will look into it 😊
You are clearly monitoring yourself, which is good, gaining an understanding of your condition.
Sorry to hear that it looks like exercise is tripping you; that must be difficult. Are you medicating daily at all, to stop Afib or just using a PiP? I was going to say, if it was the latter then I might ask your doctor about a maintenance dose maybe. See it that can help.
I started out in May 2019 after diagnosis, with daily Flecainide (150mg) and bar a blip in May 2020, this has kept me stable and ‘Afib free’ since then. As I mentioned earlier, I’ve now started to titrate the meds, my cardiologist was ok with this due to factors like my stability and exercise tolerance. I have a PiP plan too as backup.
I asked if I could go along to a cardiac rehab in my home city of Leeds but I was told afib doesn’t qualify you to join up with any of the courses. I am assuming they were meant for people who had heart attacks only.
Hi, my Afib journey did start with a heart attack. I don’t know about the initial phase 3 but phase 4 can be joined (including self referral) by anyone with a number of conditions - Afib, heart attack, angina, diabetes, PAD …… I am in Lancashire.
Leeds run sessions at local health centres called Leeds Active.You can self refer.I am unsure if it is a requirement for the classes I attend but I self referred some time ago.There is keep moving beginners,Keep moving & gentle exercise.Contact them & they will advise.
I have been on one of those Kkatz a few year ago but was told your only allowed to attend the one course. Thanks for info though .
Not a course .there are regular classes .Best to just contact them as to what level to start.But maybe the info could be useful to other members.
It was a six class course of exercise I did Kkatz. I was looking for something a bit more intense but with a professional health advisor present to check over heart rate blood pressure etc. Those classes are for heart attack patients Apparentley.
Sorry to hear this.
Maybe try yoga if you can’t manage the normal yoga there are seated yoga classes which are beneficial to your health.
Good luck in finding something that works for you. 🙂 x
I really feel for you as I have a similar situation. I'm a walker - I do at least 10,000 steps most days and multiple times a week will go for a good 2 hour walk at a reasonable lick. This doesn't bother me at all. I also use a trampoline for cardio and can do a very energetic 20-30 minutes without any problem. My general cardiac fitness is high, according to my Apple watch + health app.
But I've joined a walking group that I really enjoy - they're a very friendly bunch and the walks are great. 5-6 miles and I experience no difficulty, can and do chat the whole time with no shortness of breath or tiredness. Yet the first two times I went on these walks I went into AFib a couple of hours later. The third time I went I took a preventative dose (50 mgs) of Flecainide as soon as the walk ended, which seemed to head any AFib off at the pass. But it has made me a bit leary of the walks - especially as I just don't understand why they would be triggering my AFib given that I have no difficulty at all while on the walk.
I have Flecainide as a PiP - like you, I suffer from PAF - and take 200mgs at the onset of an episode - so I feel pretty safe taking 50mgs and the one time I've done that it seemed to do the trick.
There seems to be increasing discussion around beta blockers not being the best approach to AFib (I think I'm right in saying that) so perhaps you could take that back to your doctor/cardiologist for further discussion?
Thank you, that's really interesting. I'll try to have the discussion with them again! I take bisoprolol. When I tried flecainide as a pip the AF stopped but returned two hours later much worse so they've taken me off it. The beta blockers haven't stopped the episodes either but I am on the waiting list for an ablation so 🤞🙂
I was just about to ask if they have mentioned ablation to you. I wonder if the walking/exercise is actually a trigger or just coincidence if you walk every day and have the required disposition for AF to kick in. I had very little success identifying triggers but after I started a small dose of bisoprolol then all my episodes came while resting in bed about 20hrs after taking 8am the day before. When they doubled my dose I split it am and pm and my episodes were more random again at different times of day.
There also appears to be a lot of us have slow resting heart rates and some believe the AF takes over when the heart rate gets low at rest. I wonder how much bisoprolol you are on, what time you take it and what your resting HR is.
No science, Just my thoughts.
Best wishes
Ohhh, that's too bad. I hope you get your ablation soon then. This condition is so frustrating! ❤️
Maybe a discussion about ablation with your Cardiologist?
what is your diet like?
I am currently trying to lose over 15lbs which I have gained since my diagnosis, being on bisoprolol and reducing exercise. I don't eat ready meals or fast food. I am a home cook though who makes too much traditional comfort food! I have now cut out most sugar and carbohydrates are reduced. I haven't had caffeine or alcohol for 18+ months. I'm getting there, slowly.
I find the more I “behave” when it comes to the types and quantities of foods I eat the less exercise triggers episodes. If I ever eat something that gives me indigestion I might as well forget jumping on my mountain bike. It may have something to do with the Vagus nerve but you would need to ask some of the regulars on here about that - they know far more than I do about it. Alcohol is a definite trigger for me and many others I believe, however, I am not triggered by caffeine. I think there was a study that said it did not find a link between caffeine consumption and the onset of afib. Again, others on here may be able to cite that study. I currently eat a diet high in cruciferous veggies and lots of fruit. I believe fiber is vital. I have dieted for most of my life and I have decided that a new approach was needed - I decided to add good foods (the things I mentioned above) to my current diet rather than start by eliminating some food group or starving myself. Down about 12 pounds now. Back to my original reason for posting - figure out the optimal way-of-eating for you and you may find you can exercise more without episodes. Good luck!!🙂
Good morning. I too have PAF and hypertension and was prescribed Bisoprolol for 4 years. I decided 3 years ago I needed to help myself, lose weight and exercise more. I know exactly how you feel because I too was stuck at the first hurdle. Walking made me breathless and gave me a rapid heartbeat on the slightest exertion. I mentioned this to my GP who eased me from Bisoprolol to Adizem over a period of weeks. After a full week on the alternative to Bisoprolol, my breathlessness at walking short distances grew to be minimal. Suddenly I realised I could walk further and further at a moderate pace without exerting myself. It wasn’t all plain sailing though. I had flutters (I do still have them but not as many) and a weird sensation of a mild faint (I don’t have these anymore). I have lost nearly 3 stone in weight, walk daily for 90 minutes plus (I also try to avoid the car whenever I can) and eat more healthily than ever. I’m pescatarian, don’t drink alcohol and on advice of my GP cut down on the caffeine. I now drink Barley Cup and herbal teas if I need a hot drink in place of coffee and ordinary tea and I also drink around 8 glasses of water daily. My medication is Adizem 120mg and Edoxaban 60mg daily. It can be a long haul to create a balance that suits you but eventually you wake up and AF isn’t constantly at the forefront of your mind. The medication is necessary but finding your own equilibrium is in your hands and it’s no quick fix. Good luck, I hope you get there very soon. 🐝
Thank you. It's encouraging and I am glad you have found a way that works for you 😊
such a nuisance and I feel for you. Mine kicked in on 2 occasions when I did weight training in the am…had a shower..then went for a walk..only 40 mins or so..sat and had a light lunch then boom it started..so drank a glass of water with Zero tablet and took my evening flecaniden with lunch…seemed to send it away or rather it didn’t kick off into an episode….coincidence..who knows. Worked on 2 occasions. Now I will walk in the afternoon, weights in the am.
Like many others i eat home cooked..healthy..plenty of veg and probably too much fibre(according to my bottom ) and drink 2litres a day( causing 2 wee trips at night) .also eat a lot of protein in chicken, eggs and protein powder. Alcohol only one one’s social occasions altho that doesn’t appear to be a trigger and have gone caffeine free, unless out and there’s no other option.
I think AF is a sneaky devil and just when you think you’ve sussed it…boom..hey..don’t forget me!. I don’t worry about it now. Good luck xx
Sounds like you need to work on other lifestyle factors while keeping up moderate exercise that you can tolerate. Also suggest a private cardiologist appointment to discuss different drug options.
11yrs ago I was given Flecainide and in the early days I remember being unable to walk very far at all without feeling unwell. However in time that disappeared and now my walking for a 70yr old is probably above average.
Hi, it may be that Bisoprolol isn't the best medication for you if it's limiting your walking. I found my legs ached walking up a flight of stairs and at 63 (4 years ago) I didn't want to feel like that. So, maybe ask about alternatives. Bisoprolol is the first port of call for most of us with AF.
Re weight loss most nutrition researchers think now that changing the way you eat is what helps most with weight loss (as opposed to exercise). But walking etc is good for your blood pressure as well as - in my experience- mental well being.
Have a look at you tube channels bio the Zoe people and Dr Tim Spector to start with to find out more about changing dietary patterns. Also The Dr's Kitchen. Quite a few members here have reported success with these approaches. You won't need to eat less, just differently.
For me, the main trigger is HR. If I go over about 145- boom, AF. I run, but aim to stay below 140. My resting HR is high 50s. As I have got fitter, my HR has lowered for the same pace / effort and so now I’m regularly keeping below 135 but getting faster. If your AF is triggered by hitting a specific HR, then if you can monitor it (I use a Garmin watch whilst runnig), then you can avoid whist maintaining exercise. I appreciate for most, it is not so simple. I’m on Flecainide 50mg, 2x daily. Dropped the Bisoprolol because it trashed my max HR and made any meaningful exercise impossible/ miserable.
Another thing to watch is dehydration, I believe if I allow myself to become dehydrated, it increases the probability of having an episode.
Having said above, I had a spontaneous episode last night! Thankfully these uncontrolled episodes are relatively infrequent.
I was used to exercise before my heart event. To get my fitness back after it I’ve found I’ve had to change the type of exercise. I’m swimming a lot of lengths, iv taken up Pilates, I walk and do a bit of gym. Ohh Ive more recently added badminton and spin. But it’s taken a long time to improve things. Now it’s a slow nudge but things are still improving. I don’t know how long you’ve been trying to increase your exercise but it will take time. Good luck.
I understand exactly what you say and there is a difference between AF which is 'under control' when heart rate is controlled by a drug successfully and AF which is uncomfortable and alarming with racing heart beat. For example, though I have permanent AF, my betablocker controls the rate so exercise is possible most of the day (at 77) and only becomes uncomfortable if I try to move too quickly or don't rest. Any excitement like chasing the dog and throwing sticks for him can trigger an attack. But a steady walk around the forest for 45 minutes is, if not comfortable, perfectly normal apart from a little breathlessness.
You perhaps need to consult your doctor and cardiologist about whether bisopropol is the best thing for you if you are still suffering episodes of AF which prevents exercise. Working up very gradually is of course essential.
I have to careful, no yoga!
Tai Chi (demos on YouTube) is amazingly good. Even though it is so slow it has been shown to improve fitness and has other good effects which should be helpful for AF. As has been said, exercise doesn’t help with weight loss unless combined with suitable diet. The simplest one I know is ‘Eat food, not too much, mostly plants’.
Yes, Tai Chi, as good as or better than walking for cardio fitness apparently (who would have believed that!), and especially suitable for those of us who can't walk at all for cardio fitness. In my case, because of motor neuron degeneration due to childhood polio.
And me who has got spinal problems and a worn hip and has a 20 minute max walking tolerance 😕
Yes, all the talk of "hours walked", "miles covered by foot and bike", obviously makes me a little envious. But what can you do? it is what it is.🤔
Even your "20 mins" has me dreaming of "better times".
Hi there, you mention a worn hip. I am 74 have had AF for 14 years or so. Do you get pain down the front of your thigh down to your knee by any chance? It’s like toothache. I know my hip is wearing out but this pain is awful at bedtime.
I get pain down the side of my leg ending with a sharp pain in my knee. It is hard to tell how much pain is from my hip and how much from my spine, but when my hip is playing up I can’t lie on my side because on my left I get pain like toothache down my leg and on my right an ache inside my hip. I’ve bought an adjustable bed and that really helps.
hi, I can’t lie on my bad hip side or on my back. Have been wearing an Amazon brace off Amazon this week and it supports everything. Been better. Are adjustable beds quite expensive?
That was supposed to say an amazing brace !!!
I’m afraid they are but been worth it for me. I have a brace left from when I had a spinal op and if my back is feeling very unstable I still wear it occasionally. It was fantastic when I fell and fractured my ribs!
Ummm......sorry for being nitpicky (why change a lifelong habit I hear people say 😂) but the actual wording from the study I believe you're referring to is:
"Tai Chi was superior to brisk walking in reducing some cardiovascular disease risk factors ...." which is certainly a good thing but not the same thing as being better for cardio fitness. The wording is interesting...and is very specific.
Without reading the whole study I believe that some of the benefit is coming from it being essentially 'mindfulness in action' so reducing blood pressure through stress reduction probably...? That's just an example of how it might be reducing cardio disease risk.
I could be wrong - stranger things have happened.
Yes, makes sense. I perhaps misremembered in an attempt to guild the lily, but that's no excuse because I need to be accurate. However, I warn you 🤣, if I do find this missing connection between "better for cardio fitness" and tai chi, I will get back to you.
In the meantime can you please send me a link to the "whole study" to which you referred.
bob
I expect nothing less! 😀
I've sent you the link via Chat to circumvent having to ask permission from the powers that be.
And I'm still envious of your "olympic" level of fitness training. I suspect, even in my better younger days, I would have struggled to keep up with you.🤸♀️🤸♀️🤸♀️🤸♀️ 🤸♀️
Such is life! (which incidentally, is the title of a famous Australian novel)
There are many studies on the effects of Tai Chi and it seems to be a general conclusion that Tai Chi does improve cardiovascular fitness - in the study I saw on TV the Tai Chi group beat the ‘exercise’ group but neither were aiming for a high level, just improvement.
I know that someone on here recommended that book but a lot of the stuff it recommends is crazy! I have never been overweight in my life so do not need to loose weight and have chronic fatigue so cannot manage all the walking and exercise I used to do. I haven’t had an episode of AF for over a year now that I take 100mg of Flecainide twice daily. I can’t contemplate much exercise but you might be able to! We are all different and have to find what works for us as individuals. And the lowest dose (1.25mg) brought my heart rate down dangerously low!
Same boat here, 69, but I workout daily. 4-5k morning hikes, cycling 25-40k and medium weights/resistance training 3 days a week. The HR rate is frustrating at first, but your metabolism adjusts. First step is to get to an optimum weight. You calories burned must exceed calories in, no matter what you eat. Portion control is paramount. Always consult a physician before upping your workout. Finally, ask if you can get a stress-test so you have a good baseline for your heart health.
Hi
I have had PAF for several months having in the past had atrial flutter. I kept exercising (stationary bike) and was worried about heart rate spikes. I have gradually got going again within different parameters. For me PAF comes and goes randomly without triggers. Some AF exercisers even claim to get back into normal rhythm through exertion. I have some good days but I see the problem with Bisoprol. I would stick to your walking as long as you are not getting presyncopic. Forget the triggers.
I've had the exact same problem for the last 6 years. It's very hard to build up your exercise tolerance when any increase at all sets off the afib! The experts just shrug their shoulders and offer nothing apart from the ablation waiting list.
The only clues as to what is happening for myself is that according to my smartwatch I get an awful lot of ectopic beats when I'm moving around - and the more quickly I move the more ectopics I get. I sometimes also get a slight twinge in the heart when putting more effort than usual into something. These both make me think that there may be some (small?) ischaemic blockage going on which wasn't picked up on the chemical stress test that I had last year. Apparently microvascular artery disease is very hard to diagnose with the normal tests.
Have you had a stress test? If not, it may be worth pushing for one, if only to rule out a major coronary artery blockage.
Just a few suggestions. I also have PAF and have had a couple of episodes of tachycardia. In all cases, episodes (4 over the past 5 years) have occured after vigorous bike rides. I rode 4-5 days a week, 14 mph, and 25 miles a ride. And…my favorite time to ride was early afternoon when the temps were hot. Now, while also saddened a bit, I’ve changed my routine substantially. My cardiologist is comfortable with my running my heart rate to 120 BPM. After my last PAF I decided that was too high for my comfort since I only take Flecainide and take it twice daily 100mg each. So…now I try and walk 2 miles a day, and have changed my cycling routine to keeping my speed to 11-12 mph, given up any hills, and when my heart rate hits 100 bpm, I cut my speed, increase my peddling cadence and try and keep my bpm below that level. And…ride late in the afternoon when temps drop, and dress much lighter to keep my body heat lower. Not quite as much fun, but certainly happy to enjoy the outdoors. Always wear an Apple Watch and/or a Polar strap to track your BPM when exercising. Keep it below whatever comfort level works best for you, and keep your body temp lower. I am hoping I am able to continue at those levels. Wishing you the best in making adjustments that work…and keep you enjoying life. I am 74.
My motto is still "exercise is always good". Bob's comment is spot on. I've found that when walking (especially uphill) I go slower at first because the bisoprolol has prevented my heart rate from increasing as expected during exercise, but it then catches up after maybe ten minutes and I can increase my walking/climbing speed.
I felt lethargic and avoided exercise until I checked with my cartiologist about maybe reducing my bisoprolol.I was taking 5mg to reduce my heart rate.
I tried at 2.5mg and normal heart rate didn't rise above 80, so continued.
Have more energy and riding stationary bike much more.
I live in a dry climate and when, during the summer, I spend hours working in the garden, I often am hit with afib later (often during the night). At the same time, I can cycle for 50 miles in hilly terrain and do not end up in afib within the next 8-12 hours. For myself, I wonder if the difference is hydration. When cycling, I am always attentive to hydration and electrolytes. . . it goes with the cycling culture. With gardening not so much. So, as far as my gardening -afib connection, I suspect the trigger is an electrolyte/hydration issue. Just a thought.
do what you can do. Any exercise is better than none.👍
Swimming is very low impact which might be something you might want to consider. Tai Chi also.
I just wanted to thank everyone for all your supportive, interesting and in depth replies. I have a clearer idea of a way forward now 😊x
I have had paroxysmal AF for over twenty-five years now medicated with a daily 5mg of Bisoprolol, I have been weight training since I was seventeen and I am now in my eighty-second year. I warm up with 3 x 8 free standing squats followed by various exercises with a pair of seven pound dumbells three times a week. Regular resistance exercises along with daily walks keep my muscles strong and lift my mood if I'm feeling down. I have never found that exercising triggers my AF.
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