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home : columns : ask the doctors January 27, 2021

10/28/2020 8:03:00 AM
Exercise with Afib appears to be a good practice

Dear Doctors: I used to be pretty active, but after a diagnosis of Afib in the spring, I've become reluctant to exercise. My wife is after me to get moving again, and my son says he just read that people with Afib live longer if they exercise. Is he right?

Dear Reader: Your son appears to be up on the latest research regarding people living with the heart condition known as atrial fibrillation, also referred to as Afib or AF. We'll get to that in a moment, but first, the basics. Afib is a common heart rhythm problem, or arrhythmia, in which the upper chambers of the heart aren't behaving properly. Instead of beating in a regular and predictable fashion, the upper chambers, which are called atria, quiver and fail to coordinate with the lower chambers of the heart, known as ventricles. This results in a chaotic and disorganized heartbeat, which interferes with the efficient and orderly flow of blood through the heart. Afib can also lead to the formation of blood clots, which increases the risk of stroke.

For some people, Afib has no discernable symptoms. They may only become aware of the condition when it's discovered during a routine doctor's visit. Others can feel physical sensations, such as an irregular heartbeat, skipped beats or a racing heart. Afib can cause someone to feel dizzy or lightheaded, have chest pains and experience shortness of breath or fatigue that is out of proportion to their exertions.

Treatment typically includes medication to control the heart rate, blood thinners to guard against stroke and lifestyle changes to manage risk factors. Those risk factors include obesity, high blood pressure, diabetes, alcohol use, smoking and hyperthyroidism. Advanced age and certain existing heart problems also raise the risk of developing Afib. In some cases, surgery to shut down the area of heart tissue that is dictating the rogue heartbeat may be recommended.

It's not surprising that, when diagnosed with any type of heart problem, someone might be leery about exercise and exertion. However, a study published earlier this year in the European Heart Journal had good news. Researchers who studied 1,100 people living with Afib over the course of nine years found that individuals who got regular exercise were 45% less likely to have died at the end of the study period than those who remained sedentary. It's important to note that, while observational studies like this can pinpoint a certain outcome, they can't establish the reason it was reached. Exercise was a common factor among the people who lived longer, but the study can only suggest it as a factor in their longevity, and not decisively prove it.

Still, a wealth of existing research links exercise with lower blood pressure, improved blood lipid levels, better blood glucose management and weight control -- each a risk factor in Afib. Our advice is to listen to your family and get moving again. Check in with your health care provider, share your worries, and together you can craft an exercise plan that's safe and appropriate.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to Owing to the volume of mail, personal replies cannot be provided.

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