Exercise and AF

[Coconut8]

Hi everyone,

I am reaching out for advice around exercise and having the condition of atrial fibrillation

I am 35 and was diagnosed with AF last year. I underwent a electrophysiological study as I have an accessory pathway and they wanted to see if that was causing my AF. Long and short of it is that it's not causing my AF and just seems to be an odd pathway connected to nothing.

So I was put on flecanide as my consultant said this can be the better drug to be on whilst exercising.

I have been running for a fair few years now around 5 -10K. Since my AF diagnosis it has seriously hampered my ability to run. It seems to put me into AF, this isn't every occasion and there doesn't seem to be any particular pattern. I recently had an occasion where I went into AF whilst running (only 10minutes!) it passed quite quickly but came back later that day whilst out having lunch, my heart rate sprung to 135 beats per minute and was quite unsettling.

I was just wondering if anyone has any experience with this condition and exercise? has anyone got any tips? Currently I am back running but taking it slow 1 minute run 1 minute walk, this seems to be ok. sometimes going into AF but the breaks in running seem to make it manageable. The problem is I want to get back to my 5K and wondering whether I will be able to, or if I need to change my goals.

My consultant has offered me the surgery of cardiac ablation, but I am hesitant to take it. I would like to avoid surgery where possible and the risk (I know it is small) of a stroke from the surgery has pushed me to want to take the medical route instead. If my AF becomes worse then perhaps I'll change my mind.

I appreciate any advice or shared experience anyone is willing to offer.

Many thanks

Bex

[uzininemm]

Sorry i can't answer your question direct, but were you or have you been offered cardio rehab?

If not try and get it as these are the NHS experts who will be able to tell you how to improve your exercise and also what is safe to do for your circumstances

[Letsallhope1]

hi,

I’d go for the cardiac ablation without any second thoughts.

I’ve had 3 and they have all been successful.

Only Because I have a complicated cardiac situation new formed in my heart hence the 3 times surgery but I have been told that in normal heart it is unlikely to reoccur.

The dangers of stroke is so minimal and normally heparin is given to you to prevent them anyway.

Anti arrythmias Medications are ok but not 100% reliable and it is very much trial and error for which one will be suitable for you. They also cause side effects which are not great (low blood pressure, tiredness, weight gain as metabolism slows down)

If I had the chance to resolve the EF permanently with the ablation and being drug free I would not even question the option so much.

Wish you all the best

[Foxey2]

Hi I too was a runner, regular 5 & 10k and then I was diagnosed with AFib in 2021, had an Ablation but I haven’t run since with advice from my cardiologist. I miss it terribly but I my cardiologist has advised that running can be a trigger for AFib so I have to be sensible 🙁

[Alixia]

I had an ablation aged 38 which has so far been successful. I felt the opposite to you - I preferred to have a surgery that fixed the underlying issue rather than try to treat the issue with meds which never fix the underlying issue. I didn’t want to take meds for an undefined amount of time, possibly forever, which can cause side effects themselves and also become ineffective the longer they’re used.

Is the stroke risk high for relatively young fit people? Or is it more in the older population? Speak to your consultant about the risks.

[Niccco in reply to Alixia]

I am also 38. Had Afib Ablation 3 weeks ago. How was your recovery? I have a lot of PACs since the Ablation. How long are you know afib free?

[Alixia in reply to Niccco]

my recovery was quick - I didn’t think I had ‘symptoms’ from my a-flutter, but I felt much better after the ablation. I’ve not experienced PACs. It may take a while for your heart to settle down? Do you have a post op check up planned?

Have you been diagnosed with anything apart from Afib? I have a genetic heart condition so I have other issues such as DCM and heart block which I inherited from my mother who was plagued with heart issues, but was never diagnosed.

[Niccco in reply to Alixia]

No. No other conditions. My post Op check up is 8 weeks after surgery. I hope the PACs will get better. I got a Pulse Field Ablation for Afib. ( a new thing, should be better, but there is not a lot of Information about it on the Internet

[AAJJTt]

Hi,

I was a fit and healthy 53 year old and had a heart attack (NSTEMI II) 4 years ago. Anyway, after some more symptoms and more investigations, I was diagnosed with PAF. The conclusion being the undiagnosed and untreated Afib caused a small transient clot that entered my heart.

I was prescribed Flecainide and have been on 150mg a day since. I am pleased to say my AFib has been pretty stable with no discernible episodes for over 3 years now. My AFib was always characterised with a high irregular heart beat and RVR along with the tell tale flutterings; it usually reverted itself into NSR in about 4-5 hours. Along with a Kardiamobile and self awareness I have been pretty certain I can detect episodes and the lack of them.

As well as the medication, I also feel exercise has played a key part in my stability and it was encouraged by my cardiologist. I was fortunate that in my area, we have a cardiac rehab program run by a local charity and I was referred there. This has been fantastic for me. Initially they give you a full cardio-pulmonary exercise test (CPET) and from this set a target heart rate for exercise. Following 9 months in their program , a second CPET test is given to see how you are doing.

My target was pretty aggressive and I just jumped into it, “on a mission”. I was determined to get back to my “normal” and do the things I love - climbing, running and cycling. There is research on Afib / exercise and from what I can ascertain, a lot of it promotes it and ‘moderate’ may suppress it. Bearing in the mind the latter, I set a goal of 5k on a tread mill as fast I can while keeping under my target.

That was 4 years ago and it has been brilliant. I routinely run 5-6k 3 times a week on the tread mill as well as all my other activities. Following the heart attack, I did have a slight left ventricle dysfunction but that has now gone. On a follow up echo, the cardiologist said by heart was structurally normal.

As you can see from this website, everyone’s journey with Afib is different. I would confer with your cardiologist and if it is suitable for you and available in your area, give cardiac rehab a try. See if you can build up some tolerance under supervision. My advice would be take it slowly and despite the temptation, keep within any given targets. Also, as well as the exercise itself, you also have access to trained staff in the program, as well meeting others in similar positions.

[AAJJTt in reply to AAJJTt]

I don’t know where my Afib will go and how or if it will progress. I am not anti-treatment of any sort, if it benefits me. However at the moment, it does seem stable with the medication and exercise regime. I have a review next month and the discussion on the table will be whether to drop the daily medication to see if I can maintain NSR without it. The backup being Flecainide as PiP. I am also no longer anti coagulated either.

There is a little trepidation about this, as I do like being ‘Afib free’ for the moment and thought of more episodes does concern me. However, I am prepared to give it a try.

I see all the treatments as an ‘arsenal’ to be used against my Afib. I am at the younger end of the spectrum and for the moment I will try to avoid the ‘heavy weapons’ as long as I can.

[LadyZ13]

Another upvote for the surgical correction here. I've gone into atrial flutter after open heart surgery in June and just want it fixed. The meds don't make me feel great and if there was a day prodecure that corrects it, I'd take that - after OHS anything else feels fairly low key! Yes, there's a risk of stroke with ablation but they'll manage it carefully, and there's also a long term risk of stroke if you're in persistent AF so.... I'd rather do the risky thing in hospital where they can spot it and manage it carefully than carry it around with me for the rest of my life.

I'm booked for a DC Cardioversion in September to try and fix the flutter. I'm 39 and my consultant said 'you're far too young to be left in flutter' so I take that as 'let's not spend the rest of a hopefully long life trying to manage this risk!'. Especially as I was very active prior to surgery, running, cycling everywhere, etc...

I do understand why medical management might feel safer and more managable psychologically, but my local hospital performs 800 ablations a year. They know what they're doing and if it came to it, I'd take it.

Hope that helps

[Huwhuw]

Hi you are too young to give up running unless you absolutely must. It is people like you that usually benefit most from a successful ablation so you dont have to make large changes to your lifestyle. They will put you on an anti-coagulant for a month before the ablation so that, in the unlikely event, you do have a stroke they can deal with it immediately without any lasting harm to you. There is a risk but you're more likely to be knocked down by a bus frankly.The ablation is likely to be successful but if not you may need a 2nd about 3 months later. The likelihood of you being able to regain your previous lifestyle is very high.

As for me - I had a double ablation at the same time ( left atrial atrium for atrial fib, right atrium for atrial flutter) in 2022. The left was partially successful and the right totally successful). They put me back on flecainide (only 50mg morning and night) and I now do long mountain walks with no problem. Previously my AF was successfully controlled by flecainide (100mg morning and night) for 8 years until I got very drunk at a party - doh - hadnt done that for decades - and had a very dangerois AF and atrial flutter event continuously for 48h; 200bpm and AF together.

I am now 68 and had my original diagnoses 9 years ago.

Good luck young man!

[Coconut8]

Thanks everyone for your comments. I hadn't considered cardiac rehab but I will certainly contact my hospital to see if that is an option.Thanks for the comments regarding ablation. It's comforting to see so much support for it and something for me to consider in the future

[Blearyeyed in reply to Coconut8]

They do say in advice that " sooner the better" is the key to success with ablation. It's not guaranteed and you may still need some medication but the whole point of it is to sort of reboot the system back to bear to normal functioning.It may be the best course for you if you want the opportunity to continue the more high cardio activities like running as , unfortunately, for many people with AFib running and power exercise activities can be a trigger.

You are young and don't want to lose the chance to continue these stamina/ stress based sports , that surgical intervention will probably be the best chance for you to get back the performance you would like to achieve.

Good Luck, Bee

[Staffsgirl]

I wish I could be considered for ablation! All the drugs I’ve tried have had horrible side effects, and I can’t tolerate them. My AF situation and age make it too late for ablation. I was asymptomatic when first diagnosed, but the symptoms now are very unpleasant and scary.