Is exercise a good idea with AFib?

If you have the heart rhythm disorder atrial fibrillation (AFib), you may be confused as to whether it’s a good idea for you to exercise. And it’s no wonder.

While some studies have shown that exercise can help reduce or prevent AFib, other research has identified exercise as one of the triggers in AFib.

As researchers continue to examine the impact of physical activity on AFib, they’re finding that a lot depends on the type, frequency and intensity of exercise, as well as the severity of the person’s condition.

But, as the results of a very recent study have shown, a carefully structured and moderated exercise program may help some people with AFib better manage their condition…

Six months of exercise did the trick

While exercise-based rehabilitation is recommended in patients with coronary heart disease and heart failure, not many studies have investigated its benefits in AFib patients.

So even the experts were all ears when results were presented at the European Society of Cardiology Congress 2021 about the effects of such an exercise program.

The ACTIVE-AF trial examined the effect a six-month exercise program combining supervised and home-based aerobic exercise had on AFib recurrence and symptom severity, both during the intervention and after another six months of follow-up.

The study included patients with paroxysmal AFib, which are short AFib episodes, as well as those with persistent AFib, longer episodes that needed intervention to restore normal heart rhythm. Patients with permanent AFib where normal heart rhythm cannot be restored did not participate.

The program included weekly supervised exercise for the first three months, then every two weeks for the remaining three months, along with a customized at-home weekly exercise plan. The goal was to increase the patient’s aerobic exercise up to 3.5 hours a week.

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The supervised sessions usually involved higher-intensity exercise designed to strengthen cardiorespiratory fitness, while the home-based program allowed the participant to choose a more moderate aerobic activity like walking, indoor cycling or swimming.

Participants in the usual care group were given exercise advice but no active intervention.

At the 12-month mark, AFib recurrence was 60 percent in the exercise group, compared with 80 percent in the regular care group. Researchers defined recurrence as AFib episodes lasting longer than 30 seconds, undergoing an ablation intervention or requiring ongoing anti-arrhythmic drug therapy.

“The ACTIVE-AF trial demonstrates that some patients can control their arrhythmia through physical activity, without the need for complex interventions such as ablation or medications to keep their heart in normal rhythm,” says study author Dr. Adrian Elliott of the University of Adelaide in Australia.

Tips for exercising safely with atrial fibrillation

Since AFib significantly raises the risk of stroke and heart failure, it’s important to bring the disorder under control. And if exercise can help you do that without procedures or mountains of medication, it may be worth giving it a try — as long as your cardiologist gives you the go-ahead.

Hopefully, based on the details and results of the ACTIVE-AF trial, more cardiologists will be able to develop exercise plans for their patients. For instance, your doctor might suggest going for a 5- or 10-minute walk every day and increasing the time by one or two minutes each week until you hit a total of 3.5 hours. High-intensity exercise is not something you would want to jump into.

Speaking of which, be aware that not all exercise is good when it comes to AFib…

Research has shown that high-intensity, extreme endurance activities like marathons or triathlons can raise your risk of AFib, particularly if it’s your first time participating in such an event.

Finally, if while exercising you experience pain, extreme shortness of breath or exhaustion, stop immediately and talk with your doctor. They may need to check your heart function before you can resume your workouts.

Sources:

Exercise maintains normal heart rhythm in patients with atrial fibrillation — European Society of Cardiology

Can You Exercise With Atrial Fibrillation? — WebMD