Exercise versus A Fib

[dogsneedwalking]

Hello everyone. I was wondering if anyone could advise me on exercise as I took myself for a long walk which included up and down steps and quite a steep hill. Felt brilliant afterwards and really pleased with myself so I took myself another walk the following day - not so far but again felt fine. However by the evening I was having recurring AF which lasted several days. Everything settled again but now worried it'll set off again if I do it again. Are there gyms out there that can monitor my heart, etc so I can learn how to pace myself better but keep fitter at the same time. I am currently on 40mg of Sotalol twice a day - the downside of it is my Pulse sits around 43/47bpm resting so thinking my heart didn't like all that exercise. Thanks.

[JulianM]

I work in a big gym and as a personal trainer, one of the courses I took was on working with people with health conditions. We were told that training people who are exercising on beta blockers is a particular challenge because you can't rely on heart rate as a way to assess intensity of exercise, so you have to go on fatigue/tiredness instead.

A basic principle is to understand the effects of the medication people are on, so I've looked up sotalol and I have also read your other post about your SVT to understand a little about why you're on it. This also tells me you are living in a rural area which sounds great but obviously has challenges in terms of accessing anything. Sotalol is (clearly) a very effective beta blocker and anti-arrythmic which needs to be taken regularly at the same time of day and at the same dose. You don't say what your blood pressure is like, but it seems unlikely that there's scope for the doctors changing your dosage.

You might have trouble accessing a regular gym because the staff may be scared by a condition they're not familiar with and start asking for doctors' letters which may be hard to get. However, you might be lucky: if there is a gym that you can access, it would be worth asking if they have any links to cardiac rehab specialists who could advise and support them to give them confidence in helping you with a programme.

For me, the biggest advantage of working out in a gym is that the equipment - treadmills, bikes, cross-trainers - allows more control of effort levels and that there is help available, including trained staff and hopefully an AED too, if the worst happens while exercising. But for exercise to be sustainable, it's vital to do something you enjoy and can access easily; getting outdoors with the dog(s) sounds like an equally good plan.

The approach I would expect them to take is based on what you have said: make a plan based on regular exercise that starts gently and progresses in terms of distance and intensity and allows for recovery, for example, by alternating 'hard' and 'easy' days.

Running programmes might raise the distances by 10 per cent a week; this might also be a rough guide to how the longest walk in your week might progress.

In terms of intensity, start by choosing flat routes even if it means some repeat loops - and save the hills and steps, if you can, for later.

The other place to go for help, apart from a gym, is obviously back to your cardiologist - but ask if there is a trainer or physiotherapist in their team who can advise you, perhaps on a Zoom call (which everyone has got better at in the last couple of years) on whether these suggestions are appropriate for you and how you can ensure your safety going forwards - and when you may need to go back to the cardiologist and look at other treatment options.

Hope this all makes sense and is helpful - and I'll be very interested in what others have to say, too.

[dogsneedwalking in reply to JulianM]

Many thanks for your reply. I forgot to add that I have since moved back to Aberdeen as the DVLA revoked my licence so I had no option but to give up my job because of my rural location and no public transport. My blood pressure 'fluctuates' from normal to high and when it scoots up it makes me feel unwell. I mentioned this to my Cardiologist but he said he wasn't worried about my blood pressure but when it goes up over 157/123 like it was yesterday for a short period of time it's difficult not to be worried. I think I'll get in touch with my local surgery to see if they can make any recommendations as a starting point for me. Thanks again and I'll let you know how I get on.

[JulianM in reply to dogsneedwalking]

Aberdeen should have some options available; the other advantage of exercising indoors may be that it's a little more weather-proof. In any case, working on getting a network of people to support you in staying active and maintaining your physical and mental wellbeing as far as possible is definitely the right the way to go. Best of luck!

[Yellow26]

Hi thereI’ve had AF for 11 yrs, I also have good days and some bad. My heart rate goes up to 178 bpm, then seen it down to 38 bpm, blood pressure is the same, been on the usual medication for 11yrs. Exercise can be difficult sometimes it’s no problem and others I have to rest for a good while. I must live with this condition, cardiologists tell me to manage the best I can, but I still live a normal life to my standard.

It will take time but you will manage on how much exercise you can do and control your symptoms, good luck ,,,,,

[dogsneedwalking in reply to Yellow26]

Thanks for your advice. It's only been a year since I was first diagnosed with SVT then after Cardiology consultation it was confirmed its A Fib. I need to lose weight and am getting frustrated to my limitations with the condition/medication. I know now that long walks/hills/stairs are out for now so will be trying flat walks for a while to see how I go. Take care

[Summerlily]

Hi,I was on Sotalol when first diagnosed with Afib and experienced similar reactions to you.

My pulse went so low that they halved the dose but then, soon after, the Afib came back

I am now on Flecinide which, for the moment, seems to suit me much better

I have two Springers that I walk every day and other animals that keep me busy, so I am active most of the day

I find I can walk for miles on the flat, but do try and avoid steep hills.

Hope this helps, good luck