Atrial Fibrillation and Exercise
For people with atrial fibrillation, the thought of exercising with an irregular heart rhythm can be frightening.
How is it possible to work out safely with your heart rate bouncing all over the place?
There is good news – multiple research studies have demonstrated that it is safe to exercise with atrial fibrillation, it just takes some instruction and supervision from the right health care and exercise-training professionals.
As a clinical exercise physiologist and fellow "a-fibber," I can tell you with confidence that it is a very realistic goal to begin or resume participation in a regular exercise program without the threat of your heart rate getting out of control.
Here are some steps to follow that will help you to get on the right track.
Before You Start Exercising – Talk to Your Doctor
Your cardiologist is the person responsible for overseeing and prescribing your physical activity.
Regardless of whether you exercised regularly or not before your atrial fibrillation, he or she will tell you when you can start or resume activity and to what degree.
- Ask about do’s and don’ts at your follow-up appointment and write all of them down.
- Find out about the exercise-specific activities you want to participate in and when you will be cleared to start them.
- Discuss your goals as partners, and let him or her know what you desire to achieve.
The cardiologist will adjust your medication regimen to ensure the best control of your heart rate.
Once accomplished, he or she will then have the option of ordering an exercise test to measure your exercise capacity, and can also refer you to a medically-supervised exercise program, such as cardiac rehab.
Cardiac rehabs are staffed by certified healthcare professionals experienced in developing exercise prescriptions, and these programs provide activity guidance for people with chronic conditions.
If there are no programs available in your community, or if enrolling isn't possible due to financial limitations, you can ask your cardiologist to write an exercise prescription for you. You can also request a referral to a certified exercise professional for a one-time appointment to obtain a written exercise prescription.
Keep in mind that the exercise prescription depends on the primary conditions that you have, such as:
- Congestive heart failure
- Heart valve disease
- Coronary artery disease
- High blood pressure
- Thyroid issues.
Developing An Atrial Fibrillation Exercise Plan
The following guidelines will help to develop an exercise plan that is right for you:
Your medications are an important part of your exercise routine. Choose a time of day for your activity that is after you have taken your medications, as these will help to keep your heart rate under control.
Your heart rate is irregular, so checking it isn’t an accurate method of gauging your exercise intensity. The Borg RPE scale is a useful alternative monitoring method. You can find it through the link here.
Try to maintain a Borg rating of 11-14 during exercise.
- You are below 11 and are not having any symptoms, and you can push yourself a little harder.
- You are over 14; then you should back off a bit.
- Experiencing short of breath that talking is challenging, you will need to decrease your intensity.
Ease Into Exercise – Don't Push Yourself
Atrial fibrillation reduces exercise capacity by as much as 20%. You will likely tire more quickly because of this and a limited blood pressure rise due to medication control, so it’s important to ease into activity.
Start with 5-10 minutes of aerobic activity, such as walking or stationary cycling, at a low to moderate level.
If you have been inactive recently or are new to exercise, it's wise to try two to four short bouts throughout the day.
Set Achievable Goals
Set a goal to gradually increase your time, intensity, and frequency as you are able. The American College of Sports Medicine has several recommendations:
- Build up to 150 minutes of light to moderate aerobic exercise, spread over three to five days per week.
- Perform strength training on two to three non-consecutive days per week. Start with a light amount of resistance.
- Make sure to include flexibility training, as this will help with the range of motion in the joints.
- Balance training is needed if an individual is at risk of falling.
- For people wishing to “kick it up a notch” and work at a vigorous aerobic or strength training level, consult with the cardiologist first. Recommendations are 75 minutes per week of vigorous activity over three to five days.
You can exercise six days per week if you wish, but it’s a good idea to take at least one rest day.
Keep An Eye On Your Symptoms
If you experience any of the symptoms below during exercise, stop your session and call your cardiologist.
- Increased short of breath
- Feeling faint
- Unusual fatigue
- An exceptionally fast heart rate
- Swelling in your feet, legs, or hands
- Weight gain of two pounds in 24 hours or five pounds in a week
Check Your Heart Rate Daily
If your atrial fibrillation comes and goes, if possible, check your heart rate daily; if it isn’t well controlled, don’t exercise on that day.
There is no standard guide used in designing an exercise plan for atrial fibrillation, as everyone is different. However, exercising with atrial fibrillation is safe when the condition is managed medically so that the rhythm and heart rate are well-controlled.
Exercise has proven to be a valuable form of medicine for treating many diseases, including primary heart conditions linked to atrial fibrillation.
It is vital to work together with your healthcare team; atrial fibrillation can be a scary problem to have, but you can learn to exercise safely with their direction and support.