Exercise

[JK5AEO]

I need some information about safe and effective types of exercise for people with a history of heart attack and atrial fibrillation.

My heart attack was six years ago and was treated with one stent. I have had two emergency admissions with fast AF; the first was one year after the heart attack and induced by a respiritory tract infection; the next four years later and unexplained. Both were treated with IV medicine at the hospital; cardioversioning failed. I am prescribed small doses of the standard medications, including bisoprolol and ramipril.

In August I started experiencing some mild chest pain which is difficult to diagnose because I have quite severe IBS which often results in sharp pain in random parts of the torso. I rang the GP and explained that I am a heart patient experiencing chest pain but was told they had no appointments. I persisted and eventually was referred to a cardiac nurse at a small facility in the next county; she'd like me to have an echocardiogram, but that will probably not happen unless I can pay a private provider, (which I can't).

So, I am trying to enhance my self-awareness and self-treatment without becoming paranoid and fearful. Part of that awareness concerns exercise. I asked my GP if he would discuss this with me, but he said "it's not medicine" so he is "not able to comment". (Yes, I know...change to a better GP, but that is no longer an option due to the Government-sponsored destruction of the NHS).

I have never been a sportsman; I don't jog, I am not a member of a gym or sports team. The last and only time I was in a gym was during my 10-months of cardio-rehab; I enjoyed the benefits, but it's not a natural setting for me. I do perform some of the exercises at home but not in a very organised or regular fashion.

I live in a rural area that has no public transport, so I have to walk regularly. The village bus service was scrapped 8 years ago, (the nearest town is 4 miles, the nearest village with a shop is also 4 miles).

Ironically, since lockdown I have walked much less often and have become quite confined to the house. Being self-employed in a reserach role am able to achive a great deal of my work at home, and it is tempting to stay indoors now that there are no public health control measures to restrict Covid-19, (my wife is clinically vulnerable with a neurological condition and I don't really want to kill her by bringing something home).

I am a 56-year old man with all the usual aches, pains, and fears. My regular exercise is 5 km of static cycling over a 15 minute period at an average speed of 20km/h. My heart rate rises to about 100bpm, but if I get above 110bpm I start to feel slightly unwell, so I reduce speed or rest. Since starting bisoprolol I find it very difficult to get my HR above 100bpm in any case. If I push myself to achieve a faster HR there is a danger of me going into AF

I assume that this level of exercise is viewed by one and all as pathetic, but I'd be interested to know if it is of any value whatsoever? I'm sure I should be jogging 10km a day and entering sponsored marathon races, but that's just never going to happen.

Any advice would be most welcome - I do not want to clog up the BHF helpline as I am sure the excellent nurses are overwhlemed by people who would in normal times/places have access to public health services.

Thank you.