What Is Atrial Fibrillation?

Atrial fibrillation (often called AFib for short) is a common cause of an irregular heartbeat. When the heart beats out of rhythm, this is known as heart arrhythmia. Your heart relies on a regular rhythm that comes from an electrical pattern in its chambers. However, with AFib, this pattern doesn’t transmit in an organized way. As a result, the heart’s upper chambers (the atria) don’t contract in a regular, rhythmic beat.

AFib is a concerning condition for several reasons. First, the lack of regular and sometimes effective contractions makes blood pool in the atria. As a result, a person can develop blood clots that can go anywhere in the body, including the brain, causing a stroke, or in the lung, known as a pulmonary embolism. Second, if the heart beats too fast, the rapid heart rate can lead to heart failure. Heart failure means that a person’s heart muscle is unable to pump effectively. Third, untreated AFib can lead to other heart rhythm problems, including chronic fatigue.

Treatments are available for AFib, and a person can live an active life with this condition. However, it’s important to take a few things into consideration when living with AFib, including exercising.

Side Effects of Exercising with Atrial Fibrillation

One of the common symptoms associated with AFib is tiring more easily when you exercise. Others include:

  • heart palpitations
  • dizziness
  • sweating
  • anxiety
  • shortness of breath

These symptoms can make exercising with AFib more difficult.

For some people, AFib can make exercise difficult because the heart may start to race. A racing heart can make your blood pressure drop and cause you to feel faint. This is an example of when too strenuous exercise can be more harmful than helpful.

However, for most people, exercising with AFib can help you live a stronger life. Exercise helps maintain a healthy weight, which can prevent heart failure from getting worse. There are also benefits to physical activity that are especially helpful for people with AFib. Exercising can have some AFib-specific benefits, including slowing your heart rate and lowering your blood pressure. Having a good quality of life is an important goal for those living with AFib, and exercise can help relieve anxiety and stress.

Here are a few tips for exercising with an irregular heartbeat.

Talk to Your Doctor

Make sure to talk to your doctor about what you should and shouldn’t do when it comes to working out. If your AFib causes you to experience symptoms, your doctor may recommend you get the condition under better control before you start exercising. For example, your doctor may prescribe medications to keep your heart in rhythm and/or to keep your heart from beating too fast. Your doctor may also recommend a level of exercise that’s safe for you, given your overall health. If you haven’t exercised in quite some time, you probably wouldn’t want to start with intense, high-impact exercise.

When you exercise with AFib, you may want to start with shorter intervals of low-impact exercise. Then, you can gradually increase the length of time and the intensity of your workouts.

Check Your Heart Rate

You don’t have to engage in overly vigorous activity to enjoy the benefits of exercise. For those with AFib, it might be a better idea to keep exercise at a moderate level at first. Keeping an eye on your heart rate can help you maintain a safe pace during your workouts.

According to the Centers for Disease Control and Prevention, moderate intensity physical activity should be 50 to 70 percent of your maximum heart rate. To measure your heart rate while you work out, place your index and middle fingers on the inside of your opposite wrist, just below your thumb, or on the side of your neck. You can count your heartbeats for a full minute or count for 30 seconds and multiply by two. Here are a few things to keep in mind when checking heart rate:

  • The maximum heart rate is determined by subtracting your age from 220.
  • If you are 50 years old, your maximum heart rate would be 170 beats per minute.
  • To exercise at a moderate level, your heart rate should be between 85 and 119 beats per minute.

If you take medications known as beta-blockers, you may notice your heart rate doesn’t seem to increase as much as you would think. This is because beta-blockers work to slow heart rate. As a result, your heart may not beat as fast, even when you are exercising at a moderate pace.

Consider Cardiac Rehabilitation

It’s normal to feel nervous about exercise when you have AFib. Fortunately, you don’t always have to supervise your own heart rate during a solo workout. Talk to your doctor about cardiac rehabilitation.

Cardiac rehabilitation really just means exercising at a health facility where your heart can be monitored. This can be at a hospital, outpatient center, or at your doctor’s clinic. Staff at the facility can caution you if your heart rate becomes too rapid. The staff is also specially trained to help people with heart conditions like AFib and heart failure. They can provide tips on new exercises to consider and further advice on exercise safety.

Know When to Stop or Seek Help

While many people with AFib can exercise with no complications, it’s especially important that you know which symptoms mean to slow down or stop altogether. AFib can cause you to experience chest pain when exercising. If your chest pain doesn’t subside when you take a short break or rest, call 911 or have someone drive you to the emergency room.

Other symptoms you shouldn’t ignore and seek emergency treatment for include:

  • shortness of breath you can’t recover from
  • shooting arm pain
  • confusion or disorientation
  • loss of consciousness
  • sudden weakness on one side of your body
  • slurred speech
  • difficulty thinking clearly

If you have any other symptoms that cause you to feel uneasy or unwell, call your doctor.

Outlook and Warnings

With the okay from your doctor, you can engage in regular exercise sessions. Ideally, these would be at a moderate exercise level. Knowing the symptoms that could indicate you need to slow down and/or seek emergency medical attention can ensure that you stay healthy when exercising with AFib.

You asked, we answered

  • I have A-fib and a clot in my heart. I’m on Cardizem and Eliquis. Will this reduce the clot?- Anonymous Healthline reader
  • Eliquis is a newer-generation blood thinner that reduces your risk for blood clot formation and associated complications. If you have a blood clot in your heart already, Eliquis will help stabilize the clot so that your body can break it down naturally over time. Cardizem is an anti-hypertensive drug that also has cardiac rate — but not rhythm control — properties. It has no effect, either positive or negative, on the blood clot itself. 

    - Graham Rogers, MD