Atrial fibrillation (AFib) is the most common heart rhythm disorder, characterized by an irregular and often rapid heart rate originating in the upper chambers of the heart. This chaotic electrical activity causes the atria to quiver rather than contract efficiently, leading to fatigue, palpitations, and an increased risk of stroke. Exercise does not cure AFib, meaning it will not make the condition “go away” permanently as a singular treatment. However, physical activity is a highly effective, non-pharmacological strategy for managing the condition, reducing symptom severity and lowering the overall burden of the arrhythmia.
Exercise as a Primary Management Tool
Regular, moderate physical activity significantly benefits individuals diagnosed with AFib by improving cardiac function. Consistent exercise can reduce the frequency and duration of AFib episodes, lowering the overall AFib burden. Improved cardiorespiratory fitness is directly associated with a lower risk of recurrence following procedures like catheter ablation.
Exercise promotes beneficial cardiac remodeling, stabilizing the heart’s electrical and structural environment. This activity enhances the heart’s efficiency, allowing it to pump more blood with fewer beats. Patients in structured exercise programs often report a better overall quality of life and less severe symptoms compared to those who remain sedentary.
Modifying Underlying Risk Factors
The positive effect of physical activity on AFib is largely due to its ability to address common coexisting health problems that fuel the arrhythmia. Obesity is a major risk factor for AFib, and exercise promotes weight loss, which reduces the number and length of AFib episodes. Losing weight can also make treatments, such as ablation, more effective.
Regular physical activity is highly effective at lowering high blood pressure, a condition closely linked to AFib development. Exercise also improves lipid profiles by managing cholesterol levels and helps regulate blood sugar control for individuals with diabetes. Furthermore, consistent movement can reduce systemic inflammation, which plays a role in the onset and persistence of AFib.
When Exercise Intensity Becomes a Risk
The relationship between physical activity and AFib risk indicates that the benefits of exercise diminish and eventually reverse at extremely high levels. While moderate activity is protective, prolonged, high-intensity endurance training can paradoxically increase the risk of developing AFib. This elevated risk is commonly observed in elite endurance athletes who engage in years of intense training.
The repeated strain and volume overload from extreme exercise can lead to structural changes in the heart, including enlargement of the left atrium, which may create a substrate for electrical instability. For the average individual, the health benefits of moderate exercise far outweigh the minimal risk of AFib development.
Establishing Safe Exercise Guidelines
Before initiating any exercise regimen, individuals diagnosed with AFib must consult with a cardiologist to ensure their heart rate is adequately controlled and to receive personalized recommendations. The standard goal for heart health is to aim for at least 150 minutes per week of moderate-intensity aerobic activity. Moderate intensity means the activity causes your breathing and heart rate to quicken, but you can still comfortably hold a conversation, often referred to as the “talk test.”
Monitoring for symptoms during exercise is important, and any activity should be stopped immediately if dizziness, chest discomfort, or unusual shortness of breath occurs. Since AFib causes an irregular pulse, using a heart rate monitor may not accurately reflect the intensity of the workout, making the “talk test” a more practical guide. Aerobic exercises like brisk walking, swimming, or cycling are recommended, as they allow for better control over intensity.
Strength training is beneficial for muscle health, but patients should use lighter weights with higher repetitions (typically 10 to 15 reps per set) and avoid holding their breath or straining. It is advised to start slowly, perhaps with 5 to 10 minutes per day, and gradually increase the duration and pace over time. For individuals taking blood thinners, avoiding contact sports or activities with a high risk of injury is a necessary safety precaution.