Have PAF, 63 year old female. Used to love jogging for mental and all round fitness. Still keep fit but stopped jogging since AF diagnosis over a year ago.Had ablation 3 months ago. May have worked, may not! I still get occasional heart rhythm disturbances when i lie down to sleep.
I want to get back to jogging so i went for very slow one yesterday, slower than walking pace. My fitbit showed my HR was super high during the entire time, even though i wasnt breathlessor even sweating.
Average HR was 148
Peak HR was 178
Resting HR is 55
I still hope to jog, but am i being unwise?
Sorry for long question!
Any advice from this forum would be great.
Thanks
Written by
intheweeds
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At Patients Day in October last year we were advised that any excercise you need to be able to do and talk at the same time. If too out of breath then slow till you can.
Thanks Bob. I was hoping you would reply. I have followed your advice before so thank you.I will keep that in mind. I jog so slowly that i can easily chat to someone. So perhaps i must not be a slave to my fitbit, or worry about HR do you think?
BobD: At Patients Day in October last year we were advised that any excercise you need to be able to do and talk at the same time. If too out of breath then slow till you can.
Terrible across-the-board advice that can turn many otherwise healthy individuals unnecessarily into an overmedicalized version of themself. I therefore wonder if you're quoting out of context.
Yes, the "walk and talk" rule may be best from some, but again, absolutely no reason to limit more vigorous exercise, if medically cleared.
There is no one size fits all optimal exercise program for anyone, including those diagnosed with afib.
I have AF and my consultant positively encourages exercise, he says just be sensible, if you get chest tightening stop. But he was not worried if I was breathing heavily.
Just take it very easy and work up slowly. You are only a short way from your ablation. I got on a Phase III heart rehab gym class with my local hospital and gym where we spent a couple of afternoons a week with a physio and cardio nurse being given helpful information and exercises. After about 6 months we graduated into the gym proper and were supervised by a Physical Training Instructor to get us back into good exercise habits. I have always been fit and still go to the gym at least 4 times a week - more often every day. When I started off back on my own in the gym my wife purchased a Polar heart monitor with chest strap and wrist worn read out so that I could keep a close eye on my heart rate whilst I exercise. I try and keep my heart rate down to 130 or under during exercise. It's hard for me because I am old school and believe in the no pain "no gain attitude " No reason why you can't get back to jogging as you used to just take it easy and listen to your body.
Thanks, thats really helpful advice and i will try that. My worry is that when i really am going so slowly i am barely doing the exercise in my opinion, my heart behaves otherwise, as if i am going full tilt!
You will get back to your usual routine at some stage just take your time. If there are no Phase III courses near you ask at your local authority gym if there are any rehab courses run for people getting back into exercise after illness or operations or an instructor with experience with this type of exercise who can help you.
Of course start easy after an ablation, but down the road, unless medically contraindicated, or shown non productive, there is absolutely no reason you cannot incorporate some higher intensity exercise into your life such as jogging.
In fact, some studies show it to be beneficial, especially interval traning that incorporates some anaerobic work at higher heart rates.
My concern given your stated exercise heart rate is whether or not you were in normal rhythm or in an atrial fibrillation. If you don't have a home monitoring device like the Apple Watch or Kardia, this might be a good time to get one.
Thanks for your words. I am pretty fit but i agree the high HR is concerning. I did not think i was in AF and my Fitbit showed no AF notification. But i will now think about getting more useful device.The benefits i get from higher intensity exercise are immense and it has been hard to take it easier since getting ablation.
I am stuck between rock and hard place. Damned if i do and damned if i dont!
Do you have any data on the sensitivity and specificity of the latest Apple Watches with updates, in the detection of supraventricular dysrhythmias including atrial fibrillation?
99.3% specificity in classifying sinus rhythm and 98.5% sensitivity in classifying AFib per Apple Health web site.
Unlike the Kardia, The Watch does not classify any other SVTs.
That however, does not mean that the ECG tracing themselves cannot reveal other SVT's by someone experienced, or trained to read them.
Like all automatic detection systems -- be at the Apple Watch, the Kardia, or even the 12 lead at your doctors office -- sometimes the machines AI get fooled and give wrong readings and therefore are not a replacement for ekg diagnosis by a trained EP.
The numbers initially given are based on comparison readings of a 12 Lead EKG. I would imagine them to be slightly lower if they were compared to readings by an ep. Still highly accurate, but not perfect.
Personally, after many years of use, I don't remember an incident where Apple Watch said that afib was normal rhythm. And only a few times vice versa, but that was probably due to.multiple PAC's.
I'm not sure if I'm following your thought process. EKGs are generally taken during rest, not during intense exercise. The exception would be an exercise stress test, which is a different animal altogether.
I start my boxercise session in sinus rhythm. After 5 minutes my heart rate is 180 according to my Apple Watch, which is not reporting AFib. Can I be confident this is correct?
I have never had an Apple Watch, and have only a limited understanding of it’s capabilities.
It's most probably correct per the specificity and sensitivity, above. That doesn't mean it's not another arrhythmia such as aflutter, but it could just be your hearts normal response to Boxersize. The definitive way to find out is to send the EKG to an EP for analysis.
I'm assuming you're taking an actual EKG with the apple watch right after or during a break in exercise, by pressing the crown, as opposed to just looking for an afib notification? The notification functions are not real time and often miss episodes because they don't look for them all the time, nor during exercise.
The only live function is when you press the crown and actually take an EKG reading. So you could do that when you're finished with Boxersize, or you could just take a brief break so that your wrist is still, and take an EKG during the workout.
Jim
• in reply to
I have not seen any reason to doubt the accuracy of my Apple watch HR measurements. I would add though that it does have a weird glitch that it will often record one very high peak when I go from low activity to sudden higher level activity, which I'm sure is not accurate - and I've heard this also from other sources. You can see it if you look at the overview of HR. There'll be just one tall, narrow spike and then it comes down to appropriate levels. Other than that it's pretty spot on.
Hi intheweeds
“The benefits i get from higher intensity exercise are immense”
Is that the endorphins kicking in, the “runners high” or a more sustained physical benefit?
Your Fitbit readings under such a low physical stress are alarmingly high. Is the Fitbit really accurate?
3 months out from an ablation I would be more cautious. Maybe research Polar and Garmin watch and chest strap combinations.
Many thanks for your reply. I agree with you that the HR is too high and i really was not exerting myself on the jog.I will look into the tech you suggest and also stay off jogging for a while longer i guess.
Rather than jogging straight away, have you considered the NHS couch to 5k app? I have used that when injured and it is a gentle way to get running again, starting with walking and small running intervals. I use a frontier x chest strap which monitors my rhythm continuously so you can see what your heart is doing in more detail, and also identifies heart strain, ie when your heart isn’t getting enough oxygen, which might kick in at higher heart rates. The Frontier X is not cheap but I have a 20% off voucher code if you decide to go down that road.
If you aren’t sure, then they are very happy to talk. They are a relatively small company, still developing the product, so eager to please. I have found the customer service to be excellent.
I agree with Bob and many others here. Start out slow and let your heart tell you when to increase your exercise routine. Three months is typically not long enough.
I had my PVI ablation about 7 months ago. I am almost back to my regular exercise level but not quite. I ride an elliptical duo and use weights for upper body. I started back at 3 months for 15 minutes a day then increased as I felt able to easily. Now I am up to 40 minutes on the elliptical and another 10 or 15 on weights. This along with household chores keeps me in decent physical shape.
In the beginning my heart rate would increase dramatically but over time it has adjusted and rarely goes over 110. Best of all still in sinus rhythm 😊
I feel your pain, it’s hard not to be able to get the mental benefit of exercise when you need it most.
Thanks for this. It sounds like I should have asked the question before I went jogging! I feel bad that I may have set back my recovery but maybe there is hope if I calm my exercise down for a while longer.
Congrats on your sinus rhythm! I still get short bursts of palpitations and what seems like a few seconds of AFib, so I am not even sure my ablation has worked. Time will tell I guess…
Just in case you haven’t considered this, I wonder how accurate your device is while jogging, some of these wearable devices can give false highs and lows as they are only relying on the optical sensor seeing the blood pass by under the skin. If you move your arms a lot while jogging the sensor can see the blood move twice or three times for one heartbeat. Making sure it’s a snug fit can help accuracy but still can be unreliable in my experience.
The devices are much more accurate when you do an ECG if the function is available as then you are using electrical sensors in a circuit to monitor the heart beat electrically instead of optically.
Since my ablation in December my resting HR has been elevated but is settling back towards where it was and my walking HR is about the same as it was but still restricted by bisoprolol I feel.
Buzby62: Just in case you haven’t considered this, I wonder how accurate your device is while jogging,
Great point. Reminds me of the story I heard about a man in a hospital, who is hooked up to an EKG for observation. Somewhere along the way, he had been trained to read EKG's .
All of a sudden the ekg alarm goes off and he looks up to see that his EKG is flat lining, which, according to his training means he is dead.
In shock, he simultaneously keeps pressing the alert, button and yelling at the top of his lungs, "HELP!!!".
Nurses and doctors soon arrive, and indeed his EKG was flatlined. Apparently a couple of the ekg leads had fallen off of his chest. They calmly reattached the leads and left the room.
The man looked again at the ekg monitor and saw he was in normal rhythm and therefore alive.
In many cases with medical devices, we also have to use common sense.
If your Dr will allow a stress test (a true one that puts you at an incline and increases difficulty), it should help know your hearts performance. Some ppl are hypertensive when exercising, and may benefit from a calcium channel blocker or similar. My experience is each Dr is different. Some encourge all but marathons, others stay at 3 miles a day...in my own experience.
Thank you for the great idea. I would love to do a stress test. Unfortunately where i live its hard to get to even see a doctor. Still haven't seen one, even when i got diagnosed with PAF. Had to get ablation done privately.Perhaps i will be able to ask for a stress test.
Many thanks for this idea. I have been perhaps too trusting of my cheap Fitbit…I will do more research and possibly I will find out what is happening to my heart when it ramps up and I feel fine…when I have had a rare AFib attack with fast HR, I felt tired and faint. When out jogging I felt fine with an apparent 177 HR!
Hi BuzbyThanks for this great reply. I am thinking also it could be my cheap fitbit, because honestly i was not even breathless i was jogging so slowly. I had no idea my HR was so high while i was jogging along, chatting with myself to prove i wasnt out of breath.
I am worried that if i am rulee by the fitbit, i will not get back to my happy exercise level!
Two years ago I began to make a change to my life to increasing my activity levels. At first it wasn’t easy and some days I was easily exhausted and had some AF in the evening as a result. I then became very mindful of how I felt before I exercised and if I felt the least bit tired I missed the day of exercise and maybe went for a short walk instead or even worked in the garden.
Gradually those off days decreased and now I can manage alternate days in the gym with some quite hard stuff for my age. Occasionally I forgo the gym and go for a long high speed walk with my wife and we’re working up to a half marathon for a charity event in September.
For me, walking or jogging (if you can) in the open country is a treatment for so many things .. heart, head and body I feel so fortunate that I’ve managed to do it.
It took time and being mindful of how I felt .
My ambition is to be very fit and the ideal weight by the time I die!!
Thats fantastic and i agree really important for all round well being. I also hope to get to your level, if i can stop worrying about HR getting too high., even though i feel fine at the time. I am hoping its the Fitbit thats wrong and not my heart misbehaving...
I had a Fitbit or similar device once but I became too obsessed with the numbers. If you’re not like me I guess they’ll have a value but I’ll drive myself mad if I got it out again.
I allow myself to be slightly obsessive on my bp checks … I’ve got to have something to play with !
I think 178 is pretty high for your age but that wasn't the resting. 148 - have you checked recommended rates for us in our 60s? Overall, I'd say- yes- you might be able to return to jogging but with caution. I'm coming up to 68 and recommend interval walking. Start slow, stop for 2 mins, hurry along, stop for 2 mins, jog, stop for 2 mins. That way you still get a little buzz but don't over tax your heart. You also encourage HR variability.
It's still early days yet post ablation for you. I think I waited a bit longer to restart my interval walking but after 3 months I was certainty able to do regular 40 minute brisk walks and get back to gardening.
I think it's wonderful you felt so well. And you're talking to a woman who joyously climbed St Michael's Mount in a headwind one month after ablation, so I know how it feels. I only clocked 120 but boy was I tired later! Think of it like recovering from a virus- you get a burst of wellness and them overdo it. And wonder why you feel lousy afterwards. You have time to do all the things. Give yourself that time. Many of us notice changes even 12 months after.
That HR seems far too high for a gentle jog from someone who used to jog regularly. Presumably you used to wear the Fitbit when you jogged before AF and you have comparative readings showing much lower HR whilst jogging?
First thing would be to confirm that the readings are accurate - do you have / can you borrow another device that gives real time readings?
If confirmed, it would be very unusual during light exercise, for your HR to be that high without there being an arrhythmia / tachycardia and further investigation is required.
At this point I would highlight just how important it is, subject to other co- morbidities to exercise to maintain as far as possible, a healthy heart. The foundation of a healthy heart is eating well (that’s quality not quantity!) and reasonable exercise. Hope it all settles and resolves.
I don't want to sound like a broken record, so I'll ask you to see if to can see postings I've done before... one in the past month, about how I've had marvelous restoration following my cardioäblation. At age, 63, six months shy of my 10th anniversary of surviving a massive heart attack, I was struck down by AFib. Before then, I roamed up and down the 10,000-11,500 ft / 3,000-3,500 m peaks that rimmed the Santa Ana River Valley in the San Bernardino mountains. I would take photos and ECGs on mountain tops for my cardiologist.
Overnight, I developed AFib that raced at over 200 bpm lying in my bed and I started fainting climbing 10 ft/3 m of stairs. I was a strapping 6 ft 3 in/188 cm, 230 lb/16 st/105 kg man who'd spent his life on the football gridiron, soccer and rugby pitch, pressing my body to do what I demanded. And all of a sudden, I'd lost my prowess. I went into a deep depression and felt my life as I knew it was over and was spent shell of a man.
Happily, I convinced my cardiologist to prescribe a course of telemetered cardio exercise at the facility I'd done my heart attack rehab at where I caught ECG recordings of my heart racing to 240+ bpm under light loads and my cardiologist was able to use that to convince the insurance company to let me be referred to an EP.
A month later, in Feb, after consulting with Drs Alan Goldhamer (yes, that Dr Goldhamer) and Caldwell Esselstyn (yes, that Caldwell Esselstyn), I had my cardioäblation. It went so quickly and successfully. I followed Dr Esselstyn' s wise counsel to bathe my endothelium and traumatized heart in nitric oxide by eating leafy greens + balsamic vinegar six times a day, and started gentle walking again after about a week. I gradually was able to return to my daily 5 mi/8 km regimen in 80-90 min and by August, a year after my cardioäblation, I was back working as a camp cook at 7,000 ft/2,100 m and on top of Mt San Gorgonio, the tallest California peak South of Mt Whitney. A month later, I summited San Gorgonio again, this time beating two U.S. Marines, literally half my age, to the top (they took a bit of a detour, but, fact of the matter is, this 64 yr old geezer got their first!).
So, as you can see, given a chance, I can talk the hind leg off a mule... but what I want you to know is that if you listen to your body and cardiologist(s), there's every reason to hope that you'll return to where you were before your detour.
A couple of weeks ago, I was shoveling 12-15 tons of snow a day by hand for four days at my camp in the San Bernardino mountains and it looks like I'm gonna do it again this weekend.
I have only sincerest hopes that your recovery can be as satisfying as mine, though I hafta offer the disclaimer that 'your mileage may vary'!
I read your reply with my mouth open. I am agog at your story! And yes it is fantastic that you are back as you should be on top of mountains and taking life by the horns.Hopefully i will be able to get back to the old me soon as i find it hard to not go full on with ky running etc.
Trouble is over here where i live i cannot get any testing done unless i pay a lot!
You most certainly can. Given a successful ablation there are almost no limits to what exercise you could do.
I’ve run many races, set pb’s and regularly train hard post my ablation in 2016.
As others have said, wrist based heart monitors are notoriously unreliable. When I started back I used to check my Garmin constantly. I would start running really slowly and within 50 metres it would say 160bpm! I would stop and actually measure my heart rate manually which would show that the monitor was way off. Indeed looking at a post run trace of my heart rate on Strava would show massive instantaneous changes which were simply wrong. I have a feeling that they confuse cadence with heart rate somehow.
Since swapping to a chest strap with the same watch I’ve had no such issues.
Regarding training progression. The Couch to 5k suggestion is excellent. It’s a fantastic structured way to build up at a manageable rate.
Given a cautious start and a little good fortune it’s entirely possible in time to get back to running how you will. Don’t get stuck constantly running so slowly that you can talk all the time. Unless you run massive mileage that’s a poor way to build fitness. Equally, don’t go out and run hard every day.
What a brilliant reply! Thanks so much. As you and others have talked about chest straps, i may just get one and it will help me feel more confident about my exercise. I am doing exercise but holding myself back regarding the running.And its running that i really find helps my overall fitness.
I have been running (jogging 🤣) again but I did get clear from my EP first. He was all for it as it strengthens the heart and never triggered my afib. He also said exercise can cause afib in individuals who do lots of high volume, high intensity work over years ie Tour de France cyclists which isn't me!!! Studies into the link between exercise and afib are not as clearcut as sometimes reported and there is no link found between afib and exercise in females! A far greater risk for afib is obesity, lack of fitness and age, apparently. Best wished
Thank you so much for this helpful reply. I am getting the feeling from this thread that possibly my wrist Fitbit may not be entirely accurate. Your comment certainly helps me feel more confident and purposeful. Thanks for taking the trouble to help me here.
I went back to jogging after OHS which triggered atrial flutter, for which I had a successful cardioversion six months ago. I did couch 2 5k to build back up, and my HR quickly got up to 160-170 while running at my normal pace, which didn't feel like I was out of breath or exerting myself especially - I could still talk etc. I discussed with with Cardiac Rehab and jogging uses all your largest muscles so your HR does spike quickly. It's not a huge concern, but they did a fitness assessment on me after that and a HR training range of 130-150 for 90% of my exercise, so now I jog slowly for 4km and then do the last 1km at my normal pace which puts my HR into the 160s+. Maybe a conversation with a cardiac exercise specialist would be helpful? They're mostly used to 'typical' heart patients I find (i.e. older men who were not fit before their heart attack) but it was still reassuring.
There really is no hard and fast rule . Although more strenuous activities like running , jogging , high impact cardio and weights are more common triggers.What exercise you can get back to depends on the individual.
The "walk and talk" rule is a good one , generally speaking, but some people , particularly those whom were physically fit and active before their diagnosis can often do this easily at higher exercise rates and still, therefore, have taken the heart rate levels too high in the process. It looks like you could be in that category.
I always suggest the wise words of the Physiotherapist I'm working with on exercise programmes for people with less common heart and nerve conditions.
Start gradually well inside your activity comfort zone , this can be quite frustrating at first but it does the job. When each activity feels very easy add a little more , go a little further , try a different terrain or speed , but not too much, get used to that and then try another step up until you find your optimal rate. You should always feel invigorated , happy and like you could still do a bit more at the end of any exercise session.
Always warm up with gentle stretches before you start and drink water before , during and after the activity. Don't forget to cool down with relaxed stretches too.
Keep an eye on your heart rate. If you are in cardio rate only stay at this level for 2-5 minutes for one period of your exercise activity. If you are consistently in cardio heart rate output it is more likely to trigger an event during your activity or within hours after you finish, so slow down , do some relaxing breathing , even stop and just stretch.
You may have jumped from one exercise to another too quickly. All higher impact needs to be worked up to gradually if you want to get it right.
Try Moderate walking on a flat surface, then moderate walking with a easy hill or less even terrain. Then moderate walking with a period of brisk walking two thirds of the way through Move to brisk walking on the flat, then to less even surfaces. Add in a couple of minutes jogging pace at two thirds of the activity. Then a few intervals of two minutes jogging.
Build up a pace that then suits your heart with intervals of jogging , brisk walking and occasionally a minute of slower deep breathing pace.
Start for shorter runs of 5-10 minutes and build up at 5 minutes a time to get the duration of the activity right.
Drink regularly as you go.
If you find your heart rate is remaining too consistently in your own cardio rate , reduce your pace and get used to slower states.
Make sure the last three minutes if the run involves winding down the pace to a a walk with deep breathing to help the heart adjust to the change.
It's actually the impact through the body of the jogging step that can increase the heart rate as much as the speed itself, the vibration causes heart increases because of your autonomic nerve system response.
Recent studies actually show that mixed pace activity and low impact steady state activity ( L.I.S.S) with just 1-2 minutes in cardio rather than constant high impact cardio is better for your heart , and can improve your fitness and weight management better than going for the burn.
So , there's the answer , you may be able to jog as part of your routine but you may need to alter your jogging style or speed to exercise consistently without injury or triggering your symptoms.
Thanks Bee, very useful info you have shared with me here. I am sure you are right. I can certainly jog on the flat easy terrain where I live and take more breaks. I guesss I must retrain myself to a new way of doing it. This forum has been so helpful to me and I am grateful to you for taking time out to share advice.
Everything I read and listen to regarding heart health, jogging and long distance running is out. Exercise yes but not anything that is considered extreme sports. You say jogging but how long and how far, is the better question. Something I have learned and keep repeating on this forum is we can stress our own bodies when we do things that create cortisol to rise. My understanding is that all joggers and long distance runners will end up in AFib or other heart issues. this is something you will have to figure out for yourself. I would encouge you listen to you body and not advise from anyone even a doctor.
I know what you mean. For me, jogging and exercise like that feels right. But I agree what I think and what my heart thinks may be at odds. I have to find a way that keeps me and the heart happy!
Your view is in total contrast to that of my EP. Subject to co-morbidities, the best support for a healthy heart other than eating well (that’s quality not quantity) is reasonable exercise. Jogging and running fall within reasonable exercise for AF patients as long as you don’t do High Intensity Interval Training or run for longer than about 2hrs. Jogging and running are not extreme sports. The vast majority of joggers / runners will not end up in AFib but will actually avoid or delay other heart issues.
Ok then, why did you ask if you already made up your mind? You asked I answered end of story, I don't need a debate about it. Doctors don't have all the answers either.
I did not ask anything. I’m not the original author of this post. I responded to your post because it makes claims that contradict all the professional advice I’ve ever heard as well as stating your understanding and sweeping statement on joggers & long distance runners which is controversial and not backed up by any evidence. You also advise not to listen to anyone even a doctor.
For these reasons, and for the sake of balance, I responded with my experience and understanding. I hope you can appreciate this and respect other’s points of view. No debate necessary.
I responded to the wrong person and i did not make claims, I said everything I have read or listened to is saying that jogging is not exactly the best type of excercise. I am sorry if I offended any one but you all offend me at times because this is a forum of discussion, yet the push back is not appreciated. you are causing me stress. I am done and possibly with this forum as well.
I am sure all the members here will offer their support and advice based upon their own experiences, however, if you would like any advice from our Patient Services Team, please feel free to contact us: info@afa-international.org
How long since your regular jogging ?Your stats are eay to high . You need to establish your Z2 hr. Dont go over that. It will mean just walking at the moment. Its a long process and disciplined. Keep in touch. I am an x athlete and have been involved in coaching.
It us mist likely a problem with the fitness level you have at this time. Your simply not fit enough to train at the level your mind is wanting your body to be. It is a slow progress forward. Non impact excersise like walking, cycling, swimming.Treat your max hr as 150 so Z2 would be 90 to 105 Stay at 90 for a while gradually working up to 105 over a few months. See how you go. Just 30 mins a day to start even less if necessary. I use an uoright cycling macine plus some walking to get to our gym.
interesting and informative, I’ve had ablation 2 weeks ago and not given much guidance as to what I should and shouldn’t to or when.
I’ve exercised for many years and my preferred is swimming and aqua exercise. I know swimming is a good all round exercise and some written direction says to wait 2 weeks if you did strong manual work!
Thanks for your story. I know how you feel...its like we have to decide ourselves when we can get back to our exercise habits. Someone advises here to listen to your body. Good advice i think?
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