Can You Exercise with AFib?
Can you exercise with AFib? And if so, how high can your heart rate go before it is unsafe? We all know that exercise is good for you but does that still hold if you're in AFib? If you or a loved one has AFib, read on to learn more.
Does Exercise Cause AFib?
Most of my patients are shocked to learn that people who run marathons, competitively cycle, or do Ironman triathlons are five times more likely to develop AFib! What is particularly perplexing, however, is that studies have not tended to show higher rates of arrhythmias in athletes who participate in other strenuous forms of exercise, such as boxing, wrestling and weight-lifting.

There is something particular about endurance sports that increases the risk of AFib. One exception to this may be football. Among former NFL athletes, the risk of AFib is six times higher, although this may be due to the use of performance-enhancing substances or the weight these athletes put on to compete at a professional level.

Also, it bears noting that while aggressively competing in endurance sports might put you at a greater risk of AFib, participation in these activities certainly does not guarantee you’ll get AFib. It is reassuring to note that non-competitive recreational participation in endurance sports, even if it is a marathon or triathlon, doesn’t seem to put you at risk of AFib.

I have found over the years that almost all of my athletes with AFib have opted for an early ablation. They simply can't or don't want to exercise with the usual cocktail of AFib drugs that are prescribed. And fortunately for athletes, we typically get excellent results as studies show that the AFib ablation success rates are up to 3 times higher with athletes!
Does Exercise Prevent AFib?
Regular exercise in general isn’t risky at all. In fact, for 99.9% of my patients it’s exceptionally protective. To put things into perspective, for every thousand patients I see with atrial fibrillation, perhaps one may be at risk due to overexercising. The biggest problem, by far, is that most patients aren’t exercising enough.

There is far greater risk to not exercising enough than to exercising too much. People who live sedentary lifestyles are at significant risk of AFib, not to mention all of the other health consequences of not getting enough exercise. Indeed, one study showed that not exercising at all increased your risk of AFib by more than four times!

A big problem for many of my AFib patients is that they want to exercise but either the AFib or their medications make them so tired that they simply can't exercise. And for those people who can't exercise with AFib, we typically end up treating them with an ablation as the health benefits of exercising are too great to ignore.
How High Can Your Heart Rate Go when Exercising in AFib?
As exercise drives the heart rate up, how high can you let the heart rate go when exercising in AFib? For the vast majority of my patients, they are perfectly okay driving their heart rates up to their maximally predicted heart rate. And your maximally predicted heart rate is 220 minus your age.

So if you are 40 years old, I would expect you to hit a heart rate of 180 with high levels of exercise. Of course, if you get chest discomfort or shortness of breath with exercise then you need to notify your cardiologist immediately as your life could be at risk.
How Hard Can You Push Your Heart with Exercise and AFib?
If you love endurance sports, it is perfectly fine to participate as long as your cardiologist is in agreement and your heart feels great during exercise. And if you want to be safe running that marathon, try slowing your running pace. Indeed, among my "plodder" patients, or those who exercise at slow non-competitive speeds, I rarely see AFib.
Dr.