Exercise can make your heart pound. But what if it’s already racing before you start? Will working out make it worse? What if you have had AFib in the past but are currently in a regular rhythm? Will exercise trigger another AFib episode? The answers may not be straightforward, but we are here to set the record straight! But so many people want to know…can I exercise with AFIB?

Exercise makes the heart stronger 

Exercise is one of the best things we can do for a healthy heart. Not only does exercise strengthen the heart directly, but it also reduces or eliminates some of the risk factors that can lead to heart disease. Exercise causes the heart to beat faster, opening the blood vessels and improving oxygen supply to all the organs- including the heart. Following a regular exercise routine can:

• Keep body weight in check
• Lower blood pressure
• Slow the heart rate
• Lower inflammation 
• Improve blood flow 
• Improve cholesterol ratios
• Reduce the risk of heart attacks and stroke
• Lower stress hormones in the body 

The type of AFib matters 

Atrial fibrillation causes a rapid and irregular heart rate due to electrical misfiring of the heart’s upper chambers. When a person is in AFib, they can feel dizzy, light-headed, weak, and tired. In addition, AFib may diminish the ability to exercise.

Before beginning an exercise routine, it’s important to determine what kind of atrial fibrillation you have and decide what triggers your AFib episodes. Understanding how AFib impacts you personally will dictate the best exercise approach. So first, determine which of the following types of AFib you have: 

• Paroxysmal AFib, also known as intermittent AFib, produces symptoms that come and go. Individuals with paroxysmal AFib can typically perform most exercises, so long as they feel well and don’t experience additional symptoms.

• Persistent or chronic AFib produces symptoms that are nearly always present. Individuals with this type of AFib may need to modify their exercises and stick to low-impact, gentle movements. 

While the mechanism by which AFib occurs is still not widely understood, many people can determine what triggers an AFib episode for them. Consider speaking with your doctor to find out what triggers your AFib. Together you might be able to determine if you have one of the following:

• Vagal AFib occurs due to a malfunction of the vagus nerve, the largest nerve in the body. Individuals with vagal AFib notice that symptoms are exacerbated with eating, resting, or sleep. Studies show that exercise improves vagal tone and can often be helpful for those with vagal AFib. 

• Adrenergic AFib results from an imbalance of stress hormones in the body, namely adrenaline. Adrenergic AFib tends to be triggered by stress or exertion, meaning exercise can exacerbate symptoms.

However, keep in mind that some individuals may have a combination of vagal and adrenergic mediated AFib. In addition, others may be unable to identify the root cause of their heart arrhythmia. 

Is it okay to exercise with AFib?

Atrial fibrillation reduces your heart’s ability to pump blood effectively. Since exercise causes your heart to pump faster, it stands to reason that additional stress on the heart may not be helpful. However, since the heart is a muscle, the best way to strengthen it is through exercise. 

In most instances, it is perfectly safe for AFib patients to exercise. In fact, exercise may be good for AFib patients, helping to prevent additional episodes. For example, a recent Norwegian study followed 51 AFib patients, half of whom ran or walked three times a week for 43 minutes, and the other half who did not. Those in the exercise group saw significant improvements in their AFib symptoms, cutting their time in AFib in half. 

While it’s best to exercise when you are not actively in AFib, individuals with persistent or chronic AFib may also benefit from exercise if done right. No matter the kind of AFib that you have, the type of exercise matters.

What is the best kind of exercise with AFib?

The best kind of exercise with AFib is the exercise you love. When you enjoy what you are doing, you are more likely to continue. Great activities include tennis, yoga, biking, open-water swimming, or hiking. 

When thinking about exercise, it’s best to attempt to mimic the movements of our ancestors. Thousands of years ago, our ancestors were not at a spin class or running a marathon. Instead, they participated in “burst” activities, such as running from a tiger, climbing a mountain while hunting, or carrying water long distances.  

These short spurts of exercise elevate the heart rate temporarily and then quickly bring it back to baseline. For example, walking is an excellent activity for AFib. One way to get a great burst of movement while walking is to alternate a brisk walk with a casual stroll, one minute on and one minute off. 

It’s best to choose an exercise that can be enjoyed outside. Most gyms are toxic environments that should be avoided. It’s hard to heal when working out under fluorescent lights, breathing in poisonous cleaning chemicals, and surrounded by electromagnetic frequency. Nature is healing, so exercise outside whenever possible. 

Is weight training safe with AFib?

Experts once thought that aerobic exercise is best for the heart, and while it certainly has its benefits, strength training is gaining steam. Multiple recent studies have illustrated the positive relationship between weight training and heart health. For example, a recent study found that resistance training reduced fat tissue around the heart by as much as 31 percent compared to those who did not exercise. 

Now, this does not mean that you should go out and buy a weight lifting set. On the contrary, strenuous activity, such as lifting heavy weights, should be avoided by AFib patients as it can strain the heart. However, lifting relatively light weights, such as 2-10 pound dumbbells, is reasonable. Recent studies have shown that lifting lighter weights is just as effective as lifting heavier weights to build strength and muscle. Better yet, resistance band training is an excellent way to maintain or build muscles without heavy straining.

Slow and steady wins the race

Shockingly, high-level athletes have the highest risk of AFib. A major study published this year concluded that athletes face more than twice the odds of developing AFib than non-athletes. Interestingly, the study found that younger athletes were at higher risk. 

Movement provides excellent benefits for the heart, but only to a point. If exercise becomes too intense, it can actually contribute to atrial fibrillation. Years of intense training may cause irreversible changes to the heart and nervous system. 

For patients with AFib, it’s best to begin slowly and work up to a moderate level of exercise as tolerated. Consistency is key. It’s much more beneficial for AFib patients to exercise regularly at a slow to moderate pace than to exercise vigorously but sporadically.

Perhaps the most important thing you can do when exercising with AFib is to listen to your body. You may need to adjust your workouts based on your physical symptoms, and that’s okay. Show kindness to your body and be patient with yourself. No matter what kind of exercise you’ve decided on, be sure to stay hydrated. 

Next steps

Atrial fibrillation can be a life-changing disease, but it doesn’t have to be! Don’t let your diagnosis stand in the way of a consistent exercise routine. Not only is working out regularly good for your health, but it may actually help to reduce or even eliminate AFib. Talk to your doctor about the best ways to incorporate exercise into your daily regime and get moving!

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Medical Review 2022: Dr. Lauren Lattanza NMD