Can I Exercise with Atrial Fibrillation?

Alright, the question of the week today is can I exercise with atrial fibrillation? Well I’ve got good news, yes you can! In fact, there are several health benefits of exercise for afibbers.

Exercise can…

• Help maintain a healthy weight
• Help slower your heart rate
• Lower blood pressure
• Relieve anxiety and stress
• Improve blood circulation
• Here’s the big one for afibbers, it can reduce the frequency and severity of your afib episodes!

Exercise for afibbers is great, but there are a few things to consider before you start. First, it’s always best to exercise when you’re not in afib. If you have paroxysmal afib, that means your afib comes and goes. With this type of atrial fibrillation it’s obviously best to try to time your exercises when you’re not in afib.

For persistent afib, that is people who are often (or always) in afib, exercising while not in afib might not be an option. That doesn’t necessarily mean you can’t exercise. You’ll just want to apply some of the tips provided below.

Another consideration is that for some, exercise gets them out of afib. That’s usually the case with people who have what’s called vagal afib. With this type of afib, episodes often strike at rest and exercise or activity can actually pop them out of an afib episode. For others, exercise can actually trigger afib or make their episodes worse. That’s usually the case for people that have adrenergic afib.

Before You Start Your Exercise Program
Before you start any exercise program, always discuss it with your doctor. Your doctor may have safety limitations for you to follow based on your specific health situation. Your doctor may also require you to monitor your heart rate during exercise.

In some situations, a doctor may even recommend that you exercise at a health facility where your heart can be monitored and where the staff is trained specifically to help people with heart conditions like atrial fibrillation.

Atrial fibrillation reduces the pumping ability of your heart. When you exercise, your heart naturally pumps harder because of the demands of the body needing more blood. You might be asking, then, is exercise really a good idea if my heart isn’t pumping efficiently to begin with?

The answer to that is yes so long as you can tolerate exercise when you’re in afib. As I mentioned earlier, it’s always best to exercise when you’re not in afib but that might not be an option. If that’s the case, just be sure to pay close attention to the potential symptoms you may experience while exercising when in afib.

If you’re exercising while in afib, you’re likely to fatigue more quickly because of your hearts inability to pump efficiently. Other symptoms you may experience when exercising while in atrial fibrillation include:

• Dizziness
• Lightheadedness
• Excessive sweating
• Extreme shortness of breath
• Chest pain
• Feeling faint

If you experience any of these symptoms when you’re exercising, be sure to listen to your body. Don’t ignore your symptoms!

If your body is telling you this isn’t going to work – stop, rest and adjust. And sometimes “adjust” may mean you’re done exercising for the day.

Exercise Tips for People with Atrial Fibrillation
Here’s some tips you can implement if you have afib and you want to exercise.

1. Always start out slow.
Don’t exercise out of the gate like you’re training for a marathon. Start out with short, low impact sessions to see how you respond and then you can always increase from there. Maybe it’s 10 to 15 minutes of brisk walking every day. You want to ease into your exercise program and then monitor and adjust accordingly. You can slowly increase the amount of time and the intensity. You ultimately want to aim for 30 minutes of exercise, 5 days a week.

2. Light to moderate exercise is the key.
What is light to moderate exercise? It’s 50-70% of your maximum heart rate. Your maximum heart rate (MHR) is calculated by subtracting your age from the number 220. For example, if you’re 55 years old, your maximum heart rate is 165 (220 – 55 = 165). Fifty to seventy percent of that would be 83-116 beats per minute (165 x .50 = 83; 165 x .70 = 116). In this specific example, you would want to keep your heart rate between 83 and 116 beats per minute when you exercise.

3. Set realistic goals.
Your days of training for a marathon are probably over if you have afib. There are studies that show excessive endurance training can predispose you to afib. It only stands to reason that heavy endurance exercise can make your afib worse over the long-term.

4. Be careful if exercising while on blood thinners.
If you’re taking a blood thinner and you exercise, take precautions. If you’re bike riding you probably should wear a helmet in case you get into an accident. You don’t want to get a head injury that could cause you to bleed excessively. If you’re hiking, you might want to be in an area where you have cell phone reception so you can make a call in case of an emergency. And if you’re lifting weights be careful not to drop them on your leg or foot as that could cause a serious bleeding situation too.

5. Be careful if lifting weights.
Speaking of weights, you want to be careful with weight training. Lifting weights can put a lot of stress on your heart, especially when you’re lifting more weight than you should. You don’t want to lift so much weight that you’re holding your breath and grunting just to get through the exercise. You want to be able to lift the weights comfortably. I am not a big weight lifter. I don’t particularly recommend it for afibbers.

I am a strong proponent of resistance bands. There’s actually evidence that resistance bands are far better for you. Take Tom Brady, for example, who is a NFL quarterback for the New England Patriots. He is 39-years-old. The guy is playing better than he’s ever played. He looks younger than he’s ever looked. It’s just amazing what he’s doing at his age. He attributes his ability to stay young, athletic, and competitive not just to his diet, but to resistance band training! That’s all he does. He’s got a whole philosophy on it but I won’t go into it here. Bottom line, resistance bands are highly recommended over weight training!

6. Stay hydrated.
You want to make sure you’re hydrated, but don’t overdo it. You don’t need to be carrying around a gallon jug of water with you, especially if you’re an afibber. You’re not going to be working out that hard. Just stay well hydrated and use common sense.

7. Don’t overheat.
You want to be careful if you’re exercising out in the heat, especially if you’re taking medications that can lower your blood pressure. Low blood pressure can make you more sensitive to heat. People on beta blockers will also be more prone to dehydration. If you’re taking a beta blocker you’ll want to be extra careful about overheating and dehydration.

8. Consider interval type exercises.
This type of exercise is when you alternate between low intensity to moderate to high exercise intensity. A study done in Norway demonstrated the dramatic positive effects of this type of training for afibbers. If you do this type of training, however, make sure when you hit those higher intervals you don’t stay there for more than four minutes. If you experience symptoms such as dizziness, lightheadedness, and gasping for air when you hit the high intensity intervals, you should back off and make adjustments to your training. Listen to your body!

9. Consider yoga and Tai Chi
If you can’t tolerate traditional aerobic exercises like walking, jogging, cycling, swimming, etc. consider yoga and Tai Chi. Yoga is highly recommended for people with atrial fibrillation. There are studies that demonstrate the benefits of yoga for people with afib.

Beta Blockers and Exercise
Afib patients taking beta blockers have to be aware that beta blockers naturally slow their heart rate. That’s how they work, they prevent your heart rate from increasing. Your heart may not beat as fast even during exercise. As a result, checking or monitoring your heart rate while on these drugs may not be effective. A better guide in that situation is to listen to your body.

If you can’t speak a full sentence without gasping for air, you’re pushing too hard. You want to exercise to the point where you’re tired and slightly winded, but can still talk without gasping for air. That’s actually a good guide even if you’re not on beta blockers. Afibbers don’t want to be exercising so intense that they can’t carry on a conversation.

In conclusion, don’t let afib stop you from exercising. In fact, exercising can be very beneficial for people with atrial fibrillation. Just be sure to apply the tips and recommendations outlined here and you should be fine!

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