Atrial fibrillation (AFib) is the most common kind of irregular heart rhythm, where the upper chambers of the heart, the atria, beat chaotically instead of contracting normally. This disorganized electrical activity causes the atria to quiver, meaning the heart cannot pump blood effectively to the rest of the body. AFib can lead to symptoms like palpitations, shortness of breath, and fatigue, and it increases the risk of stroke. Although physical activity is recommended for cardiovascular health, exercising with AFib requires specific medical guidance and precautions to ensure safety.
Medical Evaluation Before Starting
A comprehensive assessment by a cardiologist is a necessary first step before an individual with AFib begins or changes an exercise program. The goal of this evaluation is to establish safe exercise parameters and identify any underlying conditions that could make certain activities unsafe. This process often involves testing for structural heart disease, such as with an echocardiogram, or evaluating the heart’s response to exertion.
A physician will often recommend an exercise stress test, also known as an exercise tolerance test, to see how the heart performs under strain. This test monitors the heart’s electrical activity and blood pressure to assess the adequacy of rate-controlling medications during physical activity. The results help determine the appropriate and safe limits for heart rate and intensity during exercise. The evaluation also screens for other health issues, such as uncontrolled high blood pressure or coronary artery disease, that could complicate an exercise plan.
Safe Exercise Types and Intensity Limits
Once medical clearance is obtained, the focus shifts to selecting appropriate low-to-moderate intensity aerobic activities that allow for controlled exertion. Recommended activities include walking, swimming, cycling, and gentle yoga, which are easily modified to match the individual’s current fitness level. Light resistance training is also safe and beneficial.
Activities that involve sudden, intense bursts of effort, such as high-intensity interval training (HIIT) or competitive sports, may be discouraged. Heavy weight lifting that requires holding one’s breath—the Valsalva maneuver—should be avoided, as it can cause sudden changes in blood pressure and heart rhythm. Because rate-controlling medications can make maximum heart rate calculations unreliable, intensity is best measured using the Rate of Perceived Exertion (RPE) scale. Exercise should typically target an RPE of 11 to 14 on the 6–20 scale, which corresponds to a feeling of moderate exertion.
Monitoring Your Body and Recognizing Red Flags
Self-monitoring is a necessary part of exercising with AFib, requiring close attention to how the body feels and what the heart is doing. Individuals should learn how to check their pulse rate and rhythm before beginning an activity, noting if it feels erratic or too fast even at rest. Monitoring devices like smartwatches can provide supplementary data, but they should not replace listening to the body’s internal signals.
Knowing the specific warning signs that require immediate action is paramount for safety. Individuals must stop exercising immediately if they experience sudden dizziness, lightheadedness, or feeling faint. Other red flags include chest pain, severe shortness of breath disproportionate to the activity, or a prolonged, rapid, or fluttering heart rate that does not slow down with rest. Seeking emergency medical attention is necessary if symptoms like chest pain or severe shortness of breath do not subside quickly after stopping the activity.
How Physical Activity Impacts AFib Management
Consistent, safe physical activity is an important component of long-term AFib management. Regular, moderate exercise helps address several risk factors, such as reducing body weight and improving blood pressure control. Maintaining a healthy weight lessens the burden on the cardiovascular system, which can positively influence AFib symptoms and recurrence.
Physical activity also improves overall cardiovascular fitness, which is associated with a lower frequency and severity of AFib episodes. Research indicates that exercise can reduce AFib recurrence and lessen symptom severity. These positive outcomes are linked to a more favorable electrical environment within the heart and better control over the autonomic nervous system. Even small increases in activity are beneficial, suggesting that some physical activity is better than remaining inactive.