A reader with Paroxysmal Atrial Fibrillation wrote me and asked:
“When I’m having A-Fib symptoms, should I go ahead and exercise as I would normally? Can I damage my heart if I exercise while having an A-Fib episode?”
This is a hard question to answer because it depends how A-Fib affects you individually. Ultimately this is a judgment call for you and your doctor. Let me share my thoughts as a former A-Fib patient.
Let’s start with the basics
The general rules or principles you need to keep in mind when making a decision in your own case are:
• An attack of A-Fib, as bad as it may feel, isn’t generally life-threatening (with the exception of a very fast heart rate which can be dangerous and cause you major problems). A-Fib isn’t like having a heart attack.
• A-Fib reduces your overall capacity to exercise, because your heart isn’t pumping properly.
• As much as possible, don’t let A-Fib stop you from exercising and leading a fulfilling life (unfortunately A-Fib often results in much lower activity and exercise levels, in spite of our best intentions).
In some people light exercise helps get them out of an A-Fib attack (Vagal A-Fib). In others (like me when I had A-Fib), exercise makes it worse. When you first start exercising, your heart rate tends to be very rapid and disturbing. If you have A-Fib symptoms, try light exercise for a short time to see if it will get you out of an A-Fib attack. If not, you should probably skip it and rest. Try to exercise when you’re in Normal Sinus Rhythm.
Possible dangers of exercising in A-Fib
When I had A-Fib I used a Polar Heart Rate monitor which you wear around your chest. It transmits your pulse to a wrist watch which you can set to sound an alarm if your pulse goes too high. When I’d run and the heart rate alarm would sound, I’d usually stop running and walk back.
But sometimes I got so mad at the A-Fib that I’d keep on running in spite of the alarm and A-Fib. In retrospect, I don’t think that was very smart.
If running or exercising in A-Fib feels bad, your body is probably telling you that you shouldn’t be doing this. When exercising in A-Fib, you may be pushing your heart into higher pulse levels, putting added strain on your atria, getting your heart used to beating in A-Fib and staying in A-Fib longer, etc. But unfortunately we don’t know this for sure.
Some regularly exercise in A-Fib
I have a friend who is in persistent no-symptom A-Fib. He is an active swimmer. His swimming probably improves his A-Fib compromised circulation. His ventricles during exercise act kind of like a turkey baster sucking more blood down from his poorly functioning atria. He feels better when he can exercise. If you don’t feel bad when exercising in A-Fib, the exercise probably does improve your circulation, in addition to the regular benefits of exercise.
Exercise if you can
In general, do whatever you can to stay active and exercise normally, even though you have A-Fib. If you can exercise without your heart rate becoming too rapid and you feel like exercising, you probably should. But check with your doctor. There isn’t a lot of research and clinical studies on this subject. WebMed.com says, “Take comfort from the experts. They say that physical activity is usually good for people with A-Fib, but it’s still wise to take precautions.”
Bottom-line: If exercising make you feel bad, skip the exercise. No one’s going to hold it against you if you miss a day of exercise.
I don’t think this is the definitive answer to this question. So, if anyone has any suggestions or comments, please let me know.
Note: In the WebMD online article referenced above, Dr. R. Morgan Griffin is quoted saying: “It’s very possible to live a normal life (in A-Fib) for many years.”
I strongly disagree with this statement (I suppose one needs to define “normal” life, and the quality of one’s life.) Leaving someone in A-Fib for many years overworks the heart and leads to remodeling and fibrosis which increase stroke risk and contribute to eventual heart failure. Instead you need to aim for a cure. To read more about remodeling and fibrosis, see “A-Fib remodels your heart and is a progressive disease” on our Overview page.
Last updated: Thursday, July 16, 2015