Exercise and Atrial Fibrillation: Finding the Right Balance
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Atrial fibrillation, or AF, is a heart rhythm problem that affects millions of people worldwide. It happens when the heart’s upper chambers beat irregularly, which can lead to symptoms like palpitations, shortness of breath, and tiredness. AF also increases the risk of stroke and heart failure.
Exercise is known to improve heart health, but for AF, the relationship is not so straightforward. Research shows that the type, amount, and intensity of exercise matter a lot.
Why Exercise Helps With AF
Moderate, regular exercise offers many benefits for people with AF. It helps control weight, lowers blood pressure, and improves cholesterol and blood sugar levels. All of these reduce the strain on the heart.
Exercise also improves fitness, which has been linked to fewer AF episodes. In one study, people who improved their fitness by even a small amount had a much lower risk of AF coming back. Exercise can also lower inflammation and improve the way blood vessels work, making the heart’s electrical system more stable.
The Risk of Too Much Exercise
While moderate activity is good, too much intense exercise—especially over many years—can have the opposite effect. Long-term high-intensity endurance sports, like marathon running or competitive cycling, can sometimes increase AF risk. This is more common in younger men, but women can also be affected.
The reason is that intense training can stretch and scar the heart’s upper chambers, change how the nervous system controls the heart, and cause inflammation. All of these changes can make AF more likely.
What the Guidelines Say
Medical guidelines recommend that people with AF aim for about 150 to 210 minutes of moderate aerobic exercise each week. This could be brisk walking, cycling, or swimming. Doing 30 minutes on most days works well for many people.
For people who are overweight, combining aerobic and strength exercises can help with weight loss, which can reduce AF symptoms. Those with conditions like high blood pressure or diabetes may need to start slowly and increase gradually.
High-intensity interval training (short bursts of hard effort with recovery in between) can be helpful for some, but should be done with medical guidance, especially if other health issues are present.
Tips for Exercising Safely With AF
- Get checked first: Before starting or changing your routine, talk to your doctor to make sure it’s safe for you.
- Choose heart-friendly activities: Walking, swimming, cycling, and light-to-moderate gym workouts are usually safe.
- Watch your heart rate: Many experts suggest keeping it below 80 beats per minute at rest and below 110 during moderate exercise.
- Increase slowly: Add just a little more time or intensity each week to avoid overloading the heart.
- Listen to your body: Stop and seek medical help if you have chest pain, dizziness, unusual shortness of breath, or your heart races unexpectedly.
- Avoid extreme training: If you have AF, very long or very intense endurance workouts are best avoided unless you are closely monitored.
The Bottom Line
For most people with AF, moderate regular exercise is not just safe—it’s an important part of treatment. It can reduce symptoms, improve quality of life, and lower the risk of other heart problems. The key is balance: enough activity to gain the benefits, but not so much that it puts extra strain on the heart.
By working with your healthcare team and paying attention to your body’s signals, you can enjoy the benefits of being active while keeping AF under control.