Saturday, 23. of August 2014
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Exercise and atrial fibrillation - little limitation of physical activity

Atrial fibrillation is a cardiac arrhythmia in which the heart muscle beats very irregularly. The amount of blood expelled from the left ventricle during each beat varies. The patient notices this by virtue of the fact that pulse at the wrist is very irregular and of varying strength when measured with a finger. The pulse frequency (heart rate) also fluctuates widely so the differences may amount to as much as 30 beats per minute.

For the body this means an uneven supply of oxygen when the muscles are working. The fluctuations are also present when the body is under physical stress.

Consequently the stress ECG cannot be used to calculate a training frequency, in contrast to patients with a regular heartbeat.

 

Tips on optimum training

 

Ergometer training:

For ergometer training at home simply adopt the wattage that was calculated for you in the rehab clinic. When adjusting the ergometer, ensure that you enter a constant wattage. Some ergometers have programs in which the load is controlled by the pulse rate.

These do not work for persons with atrial fibrillation.

When buying an ergometer, check that you can set a constant wattage.

Walking, speed walking or running:

As the very irregular and indistinct pulse frequency cannot be used, the walking speed must be set by converting data from the stress ECG to the optimum walking or running speed based on bodyweight. This then gives the walking speed that equates to the training wattage. Then, when walking or running, you only need check your speed.

Swimming:

The changes in heart frequency that occur when the body is immersed in water are of no relevance in the case of atrial fibrillation. Our telemetric investigations in the swimming pool have shown that the load has neither a positive nor a negative effect on the conduction of stimuli in atrial fibrillation, also that there were no additional cardiac arrhythmias. However, the optimum load is not so easy to define as with walking or running. Owing to the changing physical conditions, a conversion cannot be made from the stress ECG to a swimming speed. Decisive here is the individual swimming and breathing technique.

 

Other types of exercise:

With all other types of exercise it is not possible to control the load via the pulse rate. Decisive are the individual exercise technique and the person’s previous experience. However, the following principle applies:

 

The load should only be such that you can still converse with your partner.

 

Technical aids:

There are special pulse meters for heart patients. They consist of a belt for the electrodes so that they can detect the heartbeat and a wristwatch to which the heart rate is transmitted and permanently displayed. These meters continue to show the correct heart rate even under heavy physical load and are an ideal way of controlling the effort being put in. However, these devices are not easily to use if the person has atrial fibrillation, as they show a constantly changing heart rate and thus tend to be irritating.

 

Training effects:

Despite atrial fibrillation, regular physical exercise does produce effects on the organism. They are not only demonstrable, however, as a lowering of the heart rate. Investigations in our hospital have shown that training produces a significant increase in maximum watt output in the stress ECG and in sustained output during ergometer training.

Patients who have become accustomed to the effects of atrial fibrillation experience little restriction on their physical activities.

Author: Uwe Schwan, Graduate Sports Instructor, Clinic Bad Hermansborn, Bad Driburg (Germany)