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.
Running/Exercise After Ablation
snowshoedude
It has been 25 weeks since my long post ablation flutter episode and over seven months since my first and only ablation. As an avid runner, I had recovery questions going into the ablation that many fellow afibbers kindly helped answer. So while things are still fresh in my head, here's a recounting of what I learned post ablation to return the favor for others who might have the questions I had. My last run before my ablation was a brisk 11miler. 2 days later, as they put me under for my ablation, I wondering if running would change for me for the better or for the worse. So I figured I would put this information out there for someone who might come here like me seeking information about running and exercise, post ablation.
So what happened? 2 days after the procedure, I went into Aflutter. I was just sitting around when it happened and I was SOOOO Discouraged even though this forum and others and my EP warned it was possible. Fellow afibbers here advised me to relax, after all, I was still in the so called blanking period. It went away in a couple of days and I was relieved!
Three weeks later, my runners brain getting the best of me, I decided I would start back into running gradually. I wanted to test things see how things felt. My curiosity was getting the best of me.
I ran a 3 mile trail run on a Monday and then repeated the same run a couple days later. It was doable. I felt OK but my heart felt like someone was squeezing it from the inside. I attributed it to the Flecainide (a drug I grew to hate). Then 2 days later, I went out for the same run and exactly 1 mile into it, I went into Aflutter. I was SOOOO Discouraged. OK I figured I would ride it out. After all, before the ablation, I had always converted on my own and never needed cardioversion. My EP agreed. Well days went by and I was still in Aflutter. When I was approaching the 2 week mark, I was SOOOO SOOOO Discouraged because I could not shake it on my own. My EP and I decided to cardiovert. It was my first ever. My thought was, MAN, I am WORSE OFF after the ablation because now I can't convert on my own any more and running now throws me into aflutter. So I went through the conversion the worst part was the lunch they served me after I did not eat it though.
OK, I decided to take a break from the running and allow for more recovery time. My plan: to start running 7 weeks later once I was off the Flec and well out of the blanking period. The Flec really made me feel weird, especially during the running I tried. In fact, I blame the Flec more for my post ablation aflutter than the procedure (but note that I am a drug hating left wing outdoorsy funloving person who doesn't like feeling chemically or socially suppressed :-).
So 14.5 weeks after my ablation, I went for a 1.5 mile run. I was SOOOO encouraged. No more squeezing heart feeling! I ran a 3 miler the next day and a 3 miler that day after that. Then a couple weeks later, going on about 17 weeks after the ablation, I went to 5 mile runs and then 6 mile runs. No issues. Happy. Happy. Happy. By 21 weeks after the ablation, I was doing up to 8 milers and stretched those to 10 milers over the next couple of weeks but limiting my mileage to around 30 a week. So my training strategy was run real short on recovery days and stretch out the long run and periodically combine short runs into an extra long run as I slowly got my endurance back. My heart really didn't feel any different than it did before the ablation.
From week 23 through week 26 after, I was unable to run at all because I was traveling in Asia in places I did not want to push my luck because of the pollution. BUT I think this was a good break for me. Give my body some time to repair from the wear and tear I had introduced it to. But got back into running at week 27 after the ablation and pushed it from 5 mile at the beginning of the week to a 10 mile run at the end of the week. I felt good. Not great and effortless but like my heart and body were able to handle it. Then over the next couple of weeks, I pushed my long runs to 11 miles, then 13 miles, and then 14 miles. I was I was SOOOO encouraged. Note that I am running slow and steady (8.5 to 11 minute miles depending on how flat or hilly the course is I am running and how energetic I fell but happy to be still running given my mid fifty-sh age.
So that brings me to the last 3 weeks. During that time, I have started to run hilly routes. As you might guess or know, running hilly routes is completely different from running flat routes. It puts way more cardio stress on you. I felt it was time to test that out. I was able to get up to a 13 mile run with some good hills yesterday. But wow, when I ran my first route with good hills over a week ago (about 5 miles), it was SOOO hard. But here's what I thought about. I've got scar tissue around where my pulmonary veins connect to my atrium to prevent the afib. Worst case, over time, I can get abnormal narrowing which can effect my performance and health.
So far, from what I can tell, I have acceptable wind doing the hills but can't tell yet whether my uphill performance will be effected. I have only done about 550 vertical gain on the steepest run I have done so only time will tell.
So 7.5 months after ablation, I have gotten through 2 disappointments but seem to be improving since. Once in awhile, I might feel a second or 2 of flutter but it goes away as fast as it comes. The things I used to do that would trigger afib (sudden posture changes, eating late etc) aren't causing me any issues. I am hoping Afib stays away for awhile but realize that ablation is considered a treatment, not a cure. The question that remains in my mind from a running perspective is whether I will be able to obtain the level of fitness before the ablation. Only time will tell. And finally, I have not started weightlifting again. Being very cautious there since in the months leading to the ablation, my weight training sessions almost always were followed by Afib episodes which started while I slept the night after a training session. I will start that again at some point but don't want to push my luck. Upper body exercises really put stress on the heart so taking my time there. Everyone is different and this is just what I have experienced. But hope this provides a good example of one person's experience....so far. Thanks again to all who provided me advice and encouragement.
So what happened? 2 days after the procedure, I went into Aflutter. I was just sitting around when it happened and I was SOOOO Discouraged even though this forum and others and my EP warned it was possible. Fellow afibbers here advised me to relax, after all, I was still in the so called blanking period. It went away in a couple of days and I was relieved!
Three weeks later, my runners brain getting the best of me, I decided I would start back into running gradually. I wanted to test things see how things felt. My curiosity was getting the best of me.
I ran a 3 mile trail run on a Monday and then repeated the same run a couple days later. It was doable. I felt OK but my heart felt like someone was squeezing it from the inside. I attributed it to the Flecainide (a drug I grew to hate). Then 2 days later, I went out for the same run and exactly 1 mile into it, I went into Aflutter. I was SOOOO Discouraged. OK I figured I would ride it out. After all, before the ablation, I had always converted on my own and never needed cardioversion. My EP agreed. Well days went by and I was still in Aflutter. When I was approaching the 2 week mark, I was SOOOO SOOOO Discouraged because I could not shake it on my own. My EP and I decided to cardiovert. It was my first ever. My thought was, MAN, I am WORSE OFF after the ablation because now I can't convert on my own any more and running now throws me into aflutter. So I went through the conversion the worst part was the lunch they served me after I did not eat it though.
OK, I decided to take a break from the running and allow for more recovery time. My plan: to start running 7 weeks later once I was off the Flec and well out of the blanking period. The Flec really made me feel weird, especially during the running I tried. In fact, I blame the Flec more for my post ablation aflutter than the procedure (but note that I am a drug hating left wing outdoorsy funloving person who doesn't like feeling chemically or socially suppressed :-).
So 14.5 weeks after my ablation, I went for a 1.5 mile run. I was SOOOO encouraged. No more squeezing heart feeling! I ran a 3 miler the next day and a 3 miler that day after that. Then a couple weeks later, going on about 17 weeks after the ablation, I went to 5 mile runs and then 6 mile runs. No issues. Happy. Happy. Happy. By 21 weeks after the ablation, I was doing up to 8 milers and stretched those to 10 milers over the next couple of weeks but limiting my mileage to around 30 a week. So my training strategy was run real short on recovery days and stretch out the long run and periodically combine short runs into an extra long run as I slowly got my endurance back. My heart really didn't feel any different than it did before the ablation.
From week 23 through week 26 after, I was unable to run at all because I was traveling in Asia in places I did not want to push my luck because of the pollution. BUT I think this was a good break for me. Give my body some time to repair from the wear and tear I had introduced it to. But got back into running at week 27 after the ablation and pushed it from 5 mile at the beginning of the week to a 10 mile run at the end of the week. I felt good. Not great and effortless but like my heart and body were able to handle it. Then over the next couple of weeks, I pushed my long runs to 11 miles, then 13 miles, and then 14 miles. I was I was SOOOO encouraged. Note that I am running slow and steady (8.5 to 11 minute miles depending on how flat or hilly the course is I am running and how energetic I fell but happy to be still running given my mid fifty-sh age.
So that brings me to the last 3 weeks. During that time, I have started to run hilly routes. As you might guess or know, running hilly routes is completely different from running flat routes. It puts way more cardio stress on you. I felt it was time to test that out. I was able to get up to a 13 mile run with some good hills yesterday. But wow, when I ran my first route with good hills over a week ago (about 5 miles), it was SOOO hard. But here's what I thought about. I've got scar tissue around where my pulmonary veins connect to my atrium to prevent the afib. Worst case, over time, I can get abnormal narrowing which can effect my performance and health.
So far, from what I can tell, I have acceptable wind doing the hills but can't tell yet whether my uphill performance will be effected. I have only done about 550 vertical gain on the steepest run I have done so only time will tell.
So 7.5 months after ablation, I have gotten through 2 disappointments but seem to be improving since. Once in awhile, I might feel a second or 2 of flutter but it goes away as fast as it comes. The things I used to do that would trigger afib (sudden posture changes, eating late etc) aren't causing me any issues. I am hoping Afib stays away for awhile but realize that ablation is considered a treatment, not a cure. The question that remains in my mind from a running perspective is whether I will be able to obtain the level of fitness before the ablation. Only time will tell. And finally, I have not started weightlifting again. Being very cautious there since in the months leading to the ablation, my weight training sessions almost always were followed by Afib episodes which started while I slept the night after a training session. I will start that again at some point but don't want to push my luck. Upper body exercises really put stress on the heart so taking my time there. Everyone is different and this is just what I have experienced. But hope this provides a good example of one person's experience....so far. Thanks again to all who provided me advice and encouragement.
From what I've learned and have blogged about on my afib blog, inflammation of the system can be a contributing factor to afib. Rigorous exercise, particularly weight lifting, can be a major contributor to overall inflammation of the body.
To that end, I question one's efforts to continue a rigorous running and/or weight lifting regiment after an ablation. Why risk it?
I was a hardcore runner and weight lifter for years (which I think was a major contributor to my afib). I have since cut way way back. I now only do a modest 20 minutes on the elliptical every week day and I have given up weight lifting completely. Sure it sucks, but it is what it is. If you were a smoker and were diagnosed with cancer, wouldn't you quit smoking?
It's as if you were "cured" of your cancer but now you're started to smoke again. It just doesn't make sense to me.
I think if I had an ablation and it worked...I would be extremely reluctant to push things at all. I'd count my blessings and do extremely modest exercising.
From the outside looking in, it seems you're pushing things and are likely a candidate for a second procedure if you keep pushing.
Please don't take my comments as being offensive or critical. I'm just reading your comments and thinking, "Awesome. This guy had a successful ablation. It seems to have worked." But then I continue to read how you're trying to get back to exercising like you used to and I think, "Why? Consider yourself fortunate and don't push things at all. Just chill and keep the inflammation down!"
Travis
BTW...don't let me influence you, I have minimal life responsibilities, so I may be inclined to take more risks than some. ... I can be a bit of a nudge.
After I had my ablation Xmas eve, my EP told me no hard exercise for 3 months, only walk on flat trails. He knew I was a hiker and I could NOT wait to get back on the trails. So, I sort of listened to him since I don't want another ablation. He told me I should wait until the scars in my heart heal.
Also, in the hospital, a nurse was telling me that her husband got back to mountain biking 3 weeks after his successful ablation and he went back to hard afib. He had to get another ablation. Also, the EP gave him a beta blocker to take indefinitely. So, he can not really compete any more because o f the beta blocker.
I have been hiking on moderate trails and I make sure I don't push myself (my luck). So far. my ablation has been successful for most parts. However, if I over eat greens (too much potassium?), I go to flutter (not afib). I take 50 mg of Atenolol (a beta blocker) when I go to flutter. Then , the flutter stops after 30 minutes or so.
Snowshoedude -
As far as taking Flecainide if you go to flutter, it is a "NO, NO" according to my EP. He told me if you tend to go to flutter, Flecainide makes it worse. So, I have to agree with you that your episodes after your ablation probably were caused by Flecainide.
Also, I am very impressed by the amount of running that you are doing, more power to you. But, just be careful. I am surprised that your EP did not advise about how much you could push yourself after your ablation. Good luck to you.
Paul -
Good luck to you on your upcoming ablation. Also, I am surprised that your afib for the past 40 years had not bothered you in your weight lifting. I always had to abort my exercise routine if I went to afib. I would get out of breath while lifting if in afib. That is great that the afib did not interfere with your lifting.
jall53 -
Good luck to you for your ablation on Thursday. I am sure it will be successful and you will be very happy with the results and what you can do without afib, it is really liberating.
Scott
"Usually you can return to your normal activities within 48 hours after the procedure. For one week after the procedure, you cannot lift anything that weighs more than 10 pounds. You should wait at least three weeks before you resume intense exercise."
If I had an ablation at my current age, 65, I would NEVER go back to heavy lifting. I would do low weights with more reps. I wouldn't go heavy at 3 weeks either.
petey
Christine
I like Travis's comparison to a smoker who can't stop smoking and I must admit, yeah I love running, climbing, and hiking - it's hard to give up the stuff you love. So indeed, there is a risk for me doing this due to the inflammation it causes. It would be very interesting for a study to be done on the recurrence of afib after ablation as a function of exercise. While I am aggressive with exercise, I am still conservative in other ways: avoiding triggers like MSG and red wine for example. But indeed, I could end up needing another procedure. I could also ramp down and still need another anyway. Travis is taking the conservative approach which I completely understand. Yes I agree, I could be opening myself up to some inflammation which could cause issues in the future. AFIB though is so darn contradictory.
I like Paul would almost always convert on my own by running. And it was virtually guaranteed it would work for me - run 2 days in a row and on the second day, during and right after, Voila, back to NSR. Sleeping on the full stomach, sudden posture changes, and then over the past year, weight training were my triggers with 3AM being the typical start time. Of course, Afib runs higher in runners so indeed there is a connection. But I could personally associate the weight lifting directly with AFIB over the past year. Paul, if you are still doing 200s, WOW. It will be interesting to see how you approach training after the ablation. I think I am going to go with the low weight/hi rep approach per Petey when I start lifting again -- although its always tempting to go up 5 pounds on dumbells when you see them sitting right next to those ones you have been wearing out. Have to tamp down that impulse.
Petey, it is interesting what the clinic says...and I agree with your comments. And heck there is no way I felt like going back to intense exercise 3 weeks later. And normal activity after 2 days...They should define normal. But perhaps they mean walking the dog... In retrospect, I would have gone cold turkey on running until the blanking period was over 3 months or maybe more which is exactly what Scott says. On the Flec - Scott, interestingly, I never had Aflutter until AFTER the ablation (only Afib). And per your comment, again I must concur, 2 weeks in Aflutter! I really think it was the Flec talking!
My EP told me that I could do whatever I wanted post ablation after the mandatory rest period. He seemed pretty confident about it and I knew he had treated other runners. I asked him if I could still hike above 8000 feet, run up hills etc and he said yes. So I have been very curious to see if he was right. - yeah I am testing his theory. But having fun doing it.
Jall, you will have your own impression on the post ablation experience. Will be interested to hear how things go. Best wishes on that. Axiom, good luck with the first day of the rest of your life after you get off the drugs - hope you feel as good as I felt!
Thanks again to all for the interesting and spirited dialogue.
Just to keep the record straight, my 200 lb weight work is on some of the Hammer machines. It's not like free weights, I'm a lot lighter on free weights, nowhere near that.
The reference to Long's Peak brought back lots of memories. I climbed it as a teenager. I went back a few years ago and could only get as far as the key hole. I still recall trudging up the trail and being passed by two guys who ran to the top several times a week.
Excellent point. You MUST exercise post ablation to get your heart back to "normal." As I have stated in the past, I was afraid to exercise post ablation cuz of my greatly increased resting heart rate (from 58 pre to 85 post ablation)...but this put me way behind the 8 ball, and led to some other bad stuff (metabolic syndrome). So while you MUST exercise, I guess the big question is - how much? And I also agree that the reason to have an ablation is to get back to doing what you enjoy most in life. If that is running, then why not? Of course, NOBODY wants to do something that will contribute to ablation failure. This is a tough call. I guess each person must make their own decision.
Bill
Bill yes it is a tough call! Ironically, to do the things I like to do, I have to train but that very training could end up preventing me from doing what I want to do! Longs Peak is the kind of thing I am talking about. Or doing a Grand Canyon Rim to Rim hike in one day the hard way (South to North) or doing the Paintbrush Divide Loop in the Tetons in one day - these are experiences you never forgot. Well to meet the challenge of altitude changes, thinner air, long climbs and bashing downhill stretches, you have to train. The training could lead to Afib which could ultimately prevent you from doing the activity you are training to do. Alternatively, you could avoid the training and decide not to do the longer endurance activities but with the same outcome - you are depriving yourself of the activity versus having Afib do that for you. You could slack off on training and do these hikes and climbs in "survival mode" but that's no fun either. You could stretch them out into 2 or 3 day affairs. Even a 2 day with a pack over 20+ miles with lots of climbing is tough. So maybe that is a compromise. But there is a satisfaction from beating a trail in one day and seeing so much in one day. That satisfaction might also be gained by though-hiking the Pacific Coast Trail or the Appalachian Trail - which involves a large commitment in time and endurance over the long hall.
I might have mentioned this before but I met a guy who was in his late 70s who was solo hiking across the Grand Canyon around mile 14 - and I asked him what is secret was. And he said, "you know, you just have to just keep on doing it. Keep on doing it."
I modified the dialogue a little to fit AFIB:
Curly: Do you know what the secret to managing your AFIB is?
[holds up one finger]
Curly: This.
Mitch: Your finger?
Curly: One thing. Just one thing. You stick to that and the rest of what you read on AFIB support groups don't mean shit.
Mitch: But, what is the "one thing?"
Curly: [smiles] That's what *you* have to find out.