Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
This whole thing with endurance exercise is a bit confusing to me. I went back and re-read some of the posts on the subject and went to Dr. Mandrola's web site. When I went in 10 days ago, I was told I could do all the running I wanted as long as I kept my heart rate down to 130. That's a very arbitrary number and quite frankly makes no sense to me.
First, my big episodes, one 17 hours and one 26 hours, were both on slow runs, on a cold night. This last one was worse than the first but a small dose of metoprolol seemed to do the trick and I've been NSR ever since. I was told not to take the beta blocker if my heart rate is below 50, which is usually the case when I'm at rest. It's usually about 40, give or take 4 bpm. If I run slow, my hr is usually lower than 130, especially if it's cold.
Yesterday, I ran a half marathon. My pulse at race pace is usually about 155-160. But I kept it down to under 150 and tried to keep it at the mid-140s. No problems despite cool weather and even some rain.
Now I understand that the concern isn't about a single exercise, but instead is about the continued effect of exercise on the heart. The studies have said that "self-reported" moderate exercise was beneficial and self-reported high intensity exercise can be harmful. I'm just not sure what that's supposed to mean.
The cardiac nurse practitioner that I saw indicated that exercising at a high pulse could lead to a fibrillation that couldn't be controlled, beats in excess of 300 bpm and I could have heart failure. Okay. That got my attention but I haven't found anything to back that up.
So, does anyone have some good info on how I can continue running and know that I'm within the appropriate norm for my heart? And where is an article that I can read that backs up the assertion that exercising at or near 90% max can lead to unstoppable and fatal fibrillaton?
Thanks,
Todd
First, my big episodes, one 17 hours and one 26 hours, were both on slow runs, on a cold night. This last one was worse than the first but a small dose of metoprolol seemed to do the trick and I've been NSR ever since. I was told not to take the beta blocker if my heart rate is below 50, which is usually the case when I'm at rest. It's usually about 40, give or take 4 bpm. If I run slow, my hr is usually lower than 130, especially if it's cold.
Yesterday, I ran a half marathon. My pulse at race pace is usually about 155-160. But I kept it down to under 150 and tried to keep it at the mid-140s. No problems despite cool weather and even some rain.
Now I understand that the concern isn't about a single exercise, but instead is about the continued effect of exercise on the heart. The studies have said that "self-reported" moderate exercise was beneficial and self-reported high intensity exercise can be harmful. I'm just not sure what that's supposed to mean.
The cardiac nurse practitioner that I saw indicated that exercising at a high pulse could lead to a fibrillation that couldn't be controlled, beats in excess of 300 bpm and I could have heart failure. Okay. That got my attention but I haven't found anything to back that up.
So, does anyone have some good info on how I can continue running and know that I'm within the appropriate norm for my heart? And where is an article that I can read that backs up the assertion that exercising at or near 90% max can lead to unstoppable and fatal fibrillaton?
Thanks,
Todd
If you're at all like me, you take pride in being aerobically fit and enjoy the outdoors. I'm having to scale back--not that I'm done with the outdoors by any means! Acceptance is hard.
Others may have a different perspective.
Oh and since doctors don't know--not their fault, the condition is perplexing!--you end up having to draw your own conclusions.
I hear you. I think you should discuss this issue with your cardio and/or EP. They should be able to give you the right time of the day on your HR limitations (while running).
For my part I don't run. I never liked running cuz I was never good at it. But my thing is Jiujutsu and long walk (hiking) in the woods. Walking is a no brainer for HR but combat sport can be pretty demanding on the old ticker (at 53 years old). Never the less, my cardio never gave me any limitations on physical efforts, HRs and duration or intensity of exercise sessions. Not sure what he would say while in afib like your episodes but he seemed pretty unconcerned about afib and exercise limitations.
Once in afib, I would simply not do sports that day or stop what I was currently doing and go to casual walking mode while in afib but I will not restrict myself as long as my afib remains paroxysmal (with or without meds).
Unlike yours, my afib is always at night for a few hours then I go back in NSR early morning or on my next dose of Sotalol. According to Petey, doing exercise while in afib is not that big of a deal if you don't feel it....and that guy is always in afib.
From what I have read in recent studies, exercise intensity should be kept to an acceptable level if you are very often in afib for long periods, enough that you heart muscle could be enlarged due to very long afib burden. Other than that, I think the sky is the limit if you can get the green light from your Cardio, have at he!
I think each individual is different and what could be only a limitation for you (like slowing down on a marathon) could mean death for me a guy who never runs. The way you have described your self, you are not the average guy and you should not follow general guidelines.
Cheers
Scooby
Scooby, I'm 65 and prefer ultramarathons because I never have to run fast. There's a lot of walking in most ultramarathons. If you push too hard in an ultra, you don't finish.
I really felt that I did back off in this last race. I didn't redline it at any time. Since 2010, I've had to back off due to a variety of other injuries including sciatica, achilles tendonosis, pulmonary embolisms, and minor aches and pains. I've been doing a lot of walking when I can't run. I only run, on average, one day a week and even that is not hard unless it's a race.
As for 150 bpm, yeah, that's a little high so I'm trying to keep it below that. It's hard unless I'm running alone or with someone and we're socializing, not competing. 15 years ago I raced at 170 bpm so racing at less than 140 is more than just hard.
Well, I'll try to figure this out.
Thanks hegel and scooby.
http://www.everydayhealth.com/hs/atrial-fibrillation-and-stroke/afib-exercise-safety-tips/
http://www.healthline.com/health/atrial-fibrillation-exercise#2
http://www.ismaap.org/index.php?id=68
Okay, now that you are back to reality, talk to your doctor and enjoy your exercise. Interval exercise is probably the best.
Paulh, thanks. I like hearing from others that walk (or bike or run or swim) the talk.
I'll contact my doctor again and see if I can get some better answers.
Todd