As part of my rehabilitation post heart attack I've been doing under guidance from the cardio rehabilitation nurses the following excericses for the last year.
please note I did a lot more pre heart attack.
3 times a week gym
1) 35kg benchpress 4 sets of 10
2) 28kg should press 3 sets of 10
3) bicep curls 10kg 3 sets of 10
4) lat pulls 15kg 3 sets of 10
5) 2000-3000 rowing
on top of this i do 3 miles brisk walking 6 days a week.
I have stopped the rowing.
The nhs website says don't do strenuous excericses as these can bring on afib.
I spoke to my cardio rehabilitation nurse yesterday and he said its unlikely that excericses bring on afib??
In your experience am I doing too much??
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For some people it most certainly does bring on AF and when we talk on forum it is usually about extreme endurance exercise - pushing for the finish of a long bike ride or a marathon run. For others who find rest can trigger AF a short burst of vigorous exercise can help self convert to NSR.
Very individual so if you are currently doing the above and have never had Af whilst or shortly following your exercise I wouldn’t worry about it.
Personally I found that it can also depend upon many factors the most common is if I have infection, however slight, means there will be inflammation so any exercise will often trigger AF.
Unlike CVD AFib is a bit of a terrorist - doesn’t play by any rules whatsoever.
I have, I've asked a Dr, a cardio nurse, a cardio rehabilitation nurse and they all have different thoughts, hence why I'm asking people with actual experience.
my dad is a heart patient of years of experience and he tells me to contact them and so do I as have PAF. I find the same as you that they all have different points of view. I am proud to say that my dad has heart problems since he was born and he is 70 in April.
At Patient' Day in 2023 an Arrhythmia Nurse specialist advised that exercise was good but you must be able to talk at the same time. If too breathless then back off. There is a great deal of difference between cardiac rehabilitation following a heart attack and dealing with atrial fibrillation.
As with all things AF we are all different and for some it can be a trigger and for others can be the remedy. In my experience it’s never one thing but we all look for the trigger that caused it only to find it was probably an accumulation of several things that coincided. We all have to find our own individual normal in my opinion.
Read as much as you can from the patient resources as knowledge is the key.
I've never done half as much as that so it's hard to tell 😆 However brisk walking for up to 8 miles 6 days a week plus gym 3 days a week may be fine for you but I'd not do it if I had an AF episode
Do you believe your exercise is triggering AF episodes? If so, raise the specific case(s) of it being triggered with your medical professional. If it hasn't then you should be comforted by the fact that it hasn't and that your exercise program is overseen by a medical professional and presumanbly tailored to your specific circumstances.
It’s such an individual thing to be able to comment on. I think you have to live your life the way that is suitable to you. If you feel well, it improves your quality of life and your heart benefits from it then carry on. There are some of us that experience the exact opposite. Mysterious AF. It’s not only difficult for us to understand, but must be even more so for the medical profession. I really don’t think anything compares! You can either laugh or cry!
I think as others have said, it's down to the individual. Your regime here sounds reasonable and is about what I do, save for the walking, I run but fewer times. But I'm in perm AF so it's different. However I have been told by 3 GPs that as long as I feel ok it's ok to do it. It doesn't sound as if it is triggering your AF if you're exercising three times a week and getting an attack every two months.
Lastly, when I used to be properly fit I'd run 80 miles a week, that's what probably got me the AF, I don't think the kind of exercising were talking about here is a concern.
May I ask you one question , Do you monitor your heart rate during your exercise's, if so what is the the range . In my case I was told to keep the HR below 125.
I think if you are keeping the HR in that range with your walks and rowing , you are doing very well I understand for some people rowing is not very suitable and told to be bit carefull
We all have different max HR's. Work to a percentage of max. I saw somewhere to keep to 50% to 70% of max for Afib patients. Very difficult to keep it that easy for some, hard work for others!
I would sincerely hope that someone advising on cardiac rehabilitation would know what they were talking about, my thinking is that everything in moderation and yes, in some cases exercise, especially over exercise can bring on A/F. I really wish all of these professionals would get their act together, it doesn't help when they have differing opinions does it. Another example, I have been advised to wear compression stockings as in heart failure with fluid overload, some say do some say they are of no use so what to do........as they are wretched things anyway I take the choice of leaving them off but I don't know if I am doing the right thing when even my cardiologist says not to bother with them!!!
I've been working on a study with my physio for the last few years trying to create a work out programme for people with Chronic Pain , Hyper mobility and Chronic Dysautonomia ( I also have AF and many people with CD conditions do).I saw your post and asked my physio chum, as I know what I'd answer but I wanted his input.
He said what I thought.
As ever he began with his tag line , "No Pain, No Gain is a Dangerous Myth".
For many people , especially young or active people , heart and pain conditions develop because they don't listen to their bodies and suffer overexertion ( physical stress) too often when they exercise.
I then asked him to be polite in his comments after I saw his eyebrows raise.
His thoughts about weights are,
Personally, I wouldn't recommend that type of weight training or weight lifting to anyone with heart arrhythmia health conditions.
If the person has started to get any AF or arrhythmia like symptoms either during or after weight training that is their body giving them a warning sign to stop before they kick themselves back into regular AF symptoms.
Weight resistance exercises with bands or lighter weights are recommended within your exercise comfort zone with rest days in between ( you can have a leisurely walk on a rest day ) .
Depending on what your body tells you lower weight kettle ball rotations are also useable.
Rowing or stationary bikes ( recumbent for some with autonomic or orthostatic conditions ) are ok at a leisurely to moderate rate and a distance that still feels easy and comfortable to do , it's better to stop while you still feel you could do a bit more with any exercise activities but definitely stop as soon as it starts to feel like you are flagging or straining.
Swimming. Aqua exercises and walking are preferable for a full body workout with less impact on your heart and joints, water creates natural resistance training and you can also choose aqua weights for greater muscle workout.
So you could row but don't row at a speed that could be compared to Boat Race training!
Realistically weight training is a strenuous workout not just on your body but on your heart and it is , alongside running, the exercise that is more likely to cause heart related symptoms and trigger AF ( even in athletes whom have not been diagnosed with AF).
Brisk walks that allow you to continue humming or talking as you go with water to drink on the go are good , running and the triggering effects of jogging is something that most of us should relegate to doing only when being chased by a Mob , a bear or to try to catch the last bus.....that's my view , but my physio agrees.
Listen to your body and find a less weights based exercise regime that you still enjoy us the simple answer.
Give yourself a rest for a week with just leisure walks so that your body can recover from any overexertion that has been causing your symptoms then reconsider your workout regime and begin again at a more moderate level and work your way back up to more intensive activity , attempting to reduce the risk of AF events and bring healthy consistency to your workouts.
Warm up and cool down exercises are more important than before having AF , as is trying not to go from one extreme of temperature to another.
My physio is a Senior Rheumatology and Chronic Pain Specialist Physiotherapist, whom also works on Sports Physio and Massage and Injury Recovery for a local professional football team.
He is also literally the only medical professional person I've met whom actually has real knowledge of Dysautonomia and Arrhythmias and Preventative Care.
Good Advice. My husband and I have recently started using hiking poles when walking - used well they give you a really good overall work out similar to swimming and keep you upright and straight and help with ankles/knees/hip joints. I often have weird stuff happen to my walking, I sometimes have problems walking a straight line or when tired start waddling like a duck, the poles really help
I also have a specialist physio, in my case a neurologist physio because I also have Dysautotomnia and hyper mobility. She used to work solely with Stroke patients but from previous experience I found that only neuro physios (I first came across one at the MS Centre) seem to have the background knowledge - probably because their speciality is nerves rather than just soft tissue. I agree that very few people really understand how hard it is to cope with these clusters of autoimmune/autonomic/arrythmia symptoms, especially re exercise.
Yes, physios, and actually Consultants with real knowledge of Dysautonomia are incredibly rare.When I originally met my physio ( I'd had six before , two of which made me physically ill for weeks from forcing me to do the " one size fits all" basic movements) . I met him because he was in charge of hydrotherapy. He had begun working on Dysautonomia already but had gone to ask the Consultants if they had any more advice for him. Apparently, they said, " Why ask us , you know more about that than we do" ( they swore but I left that out!😆😆😆)
Fills me with great confidence in how they cope with treating me. From then on I learned how to train a Consultant without insulting them and make my own suggestions which are usually taken up.
I think you've been really lucky with your Neuro Physio too, most Consultants and Physics in Neurology don't know much about Dysautonomia either because it's usually dealt with via Cardiology. Basically, I think unless you find a Physiotherapist or Consultant with a genuine interest in Dysautonomia whom has trained themselves or pushed to go to London for training you won't find one that knows how to treat or even test you correctly.
Have you read a book called, ' The Dysautonomia Project ", it's highly recommended to help patients and doctors understand Dysautonomia. Half of it is written by doctors explaining the illnesses in simple terms , the other half of patient cases and patient experience essays. It's really easy to read but I take it to all my appointments and it helps resistant doctors if they see something in print if I want to make a treatment change.
I also use the Nordic walking sticks.
Initially I had them for hikes , but I found they were perfect to use for my walking sticks to prevent me from falling and retaining my balance when I get dizzy or have a sudden attack of vertigo .
I know exactly what you mean about the duck walk , you can be normal one minute then suddenly your walking like a duck going up a rocky hill.
They are a great addition to walking , as you say they help you to exercise your upper body on any walk , but most importantly when set at the right height they ensure you have a proper posture and improve your gait. This helps you to keep your airways fully open and the additional oxygen flow improves how far and how easy your walk can be.
thanks Bee, that's extremely helpful, have been doing 1 hour walks last few days ( we live in a hilly area) and to be honest I've found them more mentally and physically invigorating then being inside a gym.I've got kettlebell, might use the light one and do some of those.
I agree , I much prefer to walk and be outside to exercise. But a city park or walk by a river is just as good. Trees are very helpful for doing stretching and resistance exercises , you keep pushing them and they don't fall down😆😆😆I'm lucky I live on a Welsh island , but I'm also unlucky because it means I have to travel long distances for a gym, physio session or leisure centre which can use up all my energy before I try to workout.
Before moving onto a kettle ball , I did a lot of gentle sessions building up my strength and muscle using resistance bands and exercises first. You can do these outdoors too if you like. People can then build up with light weights , starting weights with floor or chair movement is a good beginning and help prevent falls.
Slowly you can add in a weighted ball ( if you don't have one you can build up the weight of a pilates ball putting part air / part water or sand in it. That's actually really useful to take out with you . Finally I moved onto the kettle bell , I have one that you can increase the weight on with a soft grip handle.
If you are already using exercises kettle bell routines can start straight away but the trick to hold off the AF is pacing things much slower , reducing the time in cardio output to 3-5 mins ( 1 per 20 mins or 2 if you are experienced in a 30/45 minute activity) and building up to and down from a cardio phase much more slowly , not using weights that make you feel strained or tight , especially across the chest and using less rapid movements between leaning down and standing.
There is a difference between the type of exercises and weights that are suitable for use for people after a heart event or surgery whom have no lasting arrhythmias or paroxysmal AF and those that are suitable for people with PAF and Arrhythmias either after another cardiac event or as cardiac conditions on their own. Unfortunately, and oddly, many cardiac physios still don't seem to be aware of this.
It can make the difference between consistent exercise that prevents symptoms ( that people most importantly enjoy ) and erratic exercise that makes you feel ill.
I'm by the coast so I do like to walk on the beach and often put on my water shoes and paddle or walk in calf high water to increase the resistance of my walk it also helps increase your stability.
I only add in the kettle bell and weighted balls once or twice a week for a short time , and only when I'm feeling that my exercise is easy. Floor and chair exercises using weights can help you build your core and upper arms just as well as using weights or gym equipment ( unless you are planning on a body building career), as part of a more relaxed work out they build up muscle mass and most importantly flexibility and balance with more ease than pumping away in a gym.
I invested in my own recumbent bike and on bad weather days I use it in front of the TV and put on a YouTube video of virtual walking or cycling in really nice places , so much more fun than going mad with a peloton trainer screaming at you with all those messages popping up on the screen. I can do it little and often or if I feel good I keep going. Listening to your body is the key.
Hello there, it would seem we are all told something different! Following heart bypass I started cardiac rehab, and was advised to keep heart rate to 110/20. I was closely monitored. Part way through the course I developed afib. When I mentioned this to the rehab team they said I had to stop the sessions until in nsr. They advised only light weights and no rowing. I think it is an individual thing. Good luck, it seems your regime is agreeing with you
I don’t think so. I’m 75 with paroxysmal AF and a heart attack 7 years ago. I do more than your training regimen daily, without any influence on my AF.
I haven’t had a heart attack, so can’t advise on what is or is not appropriate in your case.
My experience of my own PAF episodes is that they were triggered during the resting/cool down period if I raised my max bpm above 150 (I used to do 160-170 bpm). I now monitor my heart rate carefully, and max out between 140-150bpm at the end of my rowing session (4 x 1min 30 secs - approx 500m - interspersed with 1 min 30 sec rests).
I’ve never had any problem with weights (deadlifts 70kg x 5 reps x 5; squats 70kg x 5 reps x 2 and 80kg x 5 reps x 2; chest press 50-55kg x 5 reps x 4). Only squats take my heart rate up to 140bpm on completion and I wait until I’m back at c. 100bpm before repeating. I go to the gym usually twice a week and am 71.
Hope that helps. I now know my usual PAF trigger point and stop before getting there.
Sufferers from AF differ, so I think the NHS site is on the side of caution and is likely intended as help for people who might not have had individual guidance from their doctor. AF can be caused by exercise in some people whereas in some exercise can return NSR.
I would always go with your own doctor's advice, especially where other health issues impact the AF,
mine was the same heart attack. 100% clogged lad. the cardiologist in my review said he couldn't understand why as it was in such a small localised area and the rest of the LAD and all other arteries were absolutely fine and showed no signs of disease. I'm still looking for answers.
Hi, you don't say your age. I got AF working out in the gym at age 67, I'd always exercised and enjoyed it. I have always asked my heart consultants about about exercise and they have always advised agst strenuous exercise as they say it can cause other AF bouts. My understanding is that your HR shouldn't be going above 120 for any long period, rowing would do that. I don't know whether this is age dependent.
Cardiac rehab instructor here. If you are worried than increase the reps to 2-3 sets x 15 reps. This will mean a corresponding drop in the weight you can do but as long as you feel like you are using that muscle it's just as good. Cardio as advised by your instructor. Most cardiac patients coming for rehab are extremely sedentary so we are not used to seeing fitter people. You could also go.over the Cardiac Athletes Facebook page where there is lots of good advice too.Whatever you do, do something. A sedentary lifestyle ruins quality of life for so many...
I can’t help personally however I’ve just received the book The Haywire Heart ( How too much exercise can kill you, and what you can do to protect your heart) which is focussed on high energy exercise and the heart. And previous extreme athletes whom trigger afib. Written by athletes and cardiologists, might be worth a look if you like higher energy output exercise.
Admit we don’t do that level exercise at all but I’m enjoying the heart illustrations and explanations.
Even yoga and standing on a 'wobble' machine set my heart off. The cardiology nurse told me to walk so that's what I do .... at least my dogs are happy.
sorry to be a Job’s comforter, but our friend died on the rowing machine. He had PAF and didn’t always notice when he was in afib
I also believe that just walking or swimming is good but I would definitely steer clear of heavy lifting and putting a strain on your heart. Might build muscles but…..
Just reading what you say you do seems a bit overmuch to me
When I consulted an electrophysiologist about my symptomatic AF 2 years ago I asked him if I could go back into the gym now that I was on beta blockers and Eliquis. His answer was "No exercise". I can think of two reasons why this should be the case. As I am not on a rhythym control drug I imagine any 'heavy lifting' could worsen the rhythym problems associated with AF. Secondly, although bisoprolol is for rate control, in my case, I still have fluctuations if I am doing anything that affects the heart rate. In particul weight bearing exercise can sometimes take the heart rate over the maximum 100 BPM . Any exercise I take is limited to general walking around and household chores.
Me too Rosie. At my age l get enough excercise with household chores, shopping and walking the dog. It’s a fine line not to cross over. Why put extra strain on your heart? Everything should be in moderation and constant listening to your own body. Not to make excercise an obsession or to prove to yourself that you are healthy.
There is far too much obsession with exercise . It's like a cult. Our ancestors had no need for gyms as they got enough exercise in daily life - walking , working in agriculture , doing household tasks that required effort rather than flicking a switch. I try to work at least 2 hours in the garden most days it does not rain and rainy days I catch up with the housework. Even in winter I work outside unless it is very cold and windy . This far south if it is sunny it is usually ok . Even today it was cloudy but mild so I went out. I asked my doctor if this was enough and he said yes. I have found though that doing a lot of upper body work like resetting concrete edging stones can bring on an afib attack.
That' very true Auriculaire. Thank you. I believe in normal exercise throughout the day. Our ancestors had entirely different lives. My family have a history of living in their 90's and that's with heart disease. They were more content, life was at a slower pace, probably lowering BP and HR.
There is far too much obsession with excercise, diet etc., which can often lead to health anxiety and mental stress. Anxiety is my major trigger. One panic attack is equivalent to doing a day's work. I don't have panic attacks, thankfully, just giving a comparison.
It's correct that we should look after ourselves - the human body is a wonderful machine, if you treat it with respect and not keep revving the engine. Rest and relaxation is very important in this "fast forward" world, for mind, body and soul.
"..am I doing too much?" The presentation of AFib can be so diverse between patients that there are no real comparison between individuals.
You've mentioned you have been in a cardiac rehab program where I presume you have been assessed and given that target max HR - 110bpm. It is tempting to push out on your own but I recall the advice I was given. Basically don't, well at least not initially, you won't necessary get better results and improve quicker. Give yourself the time.
My situation is not dissimilar to your own - 53 at the time, active person. Heart attack (nstemi type2) suspected root cause - undiagnosed and untreated atrial fibrillation; it wasn't very conclusive though. Angiogram with no interventions, discharged with medication and exercise. This is now nearly 6 years ago, fully recovered from HA , so far Afib very stable on meds - no discernible episodes for 5 years.
I went through phase 3 & 4 cardiac rehab (and still continue the latter) and have not looked back.
Admittedly rehab programs do seem to vary depending on which part of the country you are located. I felt my local program was very good and thorough. It included 2 x CPET tests, which are considered the gold standard to study a patient's level of exercise limitation and its causes. On both occasions they took me up to my HR maximal and my cardiac output remained normal throughout; no undue stress, maintained NSR. no Afib. Following the assessments, I was given a training target HR (90% maximal), which was a confidence boost.
It took me a little while, there was some trepidation . Built up slowly on a 5k program. Now I regularly 3 times a week (5-6km). This I equate to my base ‘maintenance load’.
I do other stuff, climbing, longer cycling rides at the weekend, strength training and maybe another run - outdoors. Not too keen on outdoor these days, it’s so easy to pick a twist or pull and that then might derail my routine.
I do rigorously monitor my HR during exercise - Polar watch and H10 chest strap. Its convenient that the top of Zone 4 on a Polar equates to 90% maximal. If I breach into Zone 5 for more than a min then I will slow down/stop. Clearly my maximal falls as I age and the target HR adjusts, which I keep to. I also think I am little lucky too in that exercise doesn't seem to be a trigger for my Afib.
I would just say listen to your body and to the medical & health professionals around you; follow their advice.
I live in a town ( city debatable) where it's considered one of the best in the country to have a heart attack with a dedicated cardio rehabilitation centre.
Will take it more sensible and re think my routines, will probably buy a polar strap but not the watch.
Sorry to nag you Casualvisitor, but please, please look after yourself. It’s so hard having to sacrifice parts of our life to AF., but we have all had to do it, in some form or another. Is there ever a good place to have a heart attack? I am saying this with sincerity, because you are worth more than worrying about strenuous excercise. Take it easy, enjoy life and just be happy. All the best.
do you know your target heart rate? when you are lifting are you watching your heart rate? everything I read says its important to maintain muscle. How much rest between sets might be a better question. Do you maintain enough. magnesium that you know of. I am working on maintaining muscle also but I watch my heart rate. I use Apple fitness plus for my exercise routines but I will pause whatever I am doing to allow heart rate to slow if I find it is getting too high. BTW as we age we cannot keep up with these 25 year olds so we modify everything. As so many have already said, we are all different with different levels of strength. our bodies are so intricate that it is hard to understand it all.
Post heart attack! Have you ever considered the benefits of tai chi? and you can do it outdoors in the forest if you prefer. Here's one quote that reflects recent research findings ...
Tai Chi is better than brisk walking in reducing several cardiovascular disease risk factors and improving psychosocial well-being, and can be recommended as a viable exercise for building a healthy life free of cardiovascular disease.
My GP was quite annoyed with me yesterday when I asked for some form of exercise under guidance to give me my confidence back. He said you’re on thinners and rate control you have no excuse not to exercise! It can’t hurt you. No but PAF does! I give up. I’m active and I walk. That will have to do.
Your GP is a moron.Your GP probably reacts like that to anyone whom asks for advice or referral for exercise to help their condition because they know nothing , and have never bothered to learn about the right exercises for different health problems, and their "go to" reaction to the sting of not knowing what to do is to be insulting or snapping comments. Rather like a teenage child.
I've seen it so many times over the years, if you ever get that sort of reaction from a medical professional, don't let it upset you ( as I'm sure it does when you first experience it) , calmly leave and have a big smile when you go out knowing that you've caught them out , and knowing that they aren't the best GP to keep getting your self care advice from.
It’s quite worrying B. You go to the GP to get medical advice to feel better, when in fact they can make you worse. They are not specialists. I have lost all faith in my GP. In fact l have got to the point where l don’t believe most of what she says. I now check and re-check advice and any new medication. It’s those who are incapable of doing this and can’t cope, or are seriously ill, that is most worrying,
I think with more knowledge to hand, with us patients it has upset the apple cart! 🤫
Agreed.It is most worrying for those whom aren't physically up to doing a lot of research or for newly diagnosed patients for any condition , as we all were at one point , whom don't realise that the comments of their GPs aren't god given .
It's shouldn't take so much effort on the part of the patient to get the right diagnosis or the right treatment for them, but I know over the years ensuring I got the help I needed, and most importantly didn't do something that would make me feel worse has been like a full time job.
Most GPs and many Consultants are too focused on finding evidence of the most common illnesses or only have a working knowledge of them , they will often give up looking for equally common conditions or rather ones despite the symptoms more than once because in their opinion something isn't likely. They don't keep up to date with new procedures or treatments and don't bother to learn about what preventative care is available online or in the local area. They prejudge everything based on outdated demographics and prejudiced ideas about age, lifestyle , gender, size so don't test for things that people of your " type" don't get. And they are all obsessed with treating each individual symptom or syndrome someone has in isolation , even if you explain that you have a multi system health conditions, and that method doesn't work if the patient has more than one issue , especially if they can only take certain medications together.
There is the rare gem out there , but you have to fight to see them.
Until you learn to coax them to the right path or test after you've spent more time than they have learning about a less common condition , or combination of illnesses , you can spend years without a full diagnosis and miss out on the NHS treatment that you were entitled to.
Forums like this became a lifeline because it gave the confidence to question things and to educate myself , not just from health mags or blogs on the internet, but from medical research .
I have Health Fatigue, at least that what I call it.
The most common thing I say is , " there is nothing that makes you feel more sick than trying to get well" It's sad but it's true.
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