How to train with AF/AT

So 7 weeks post implant (Abbot Assurity), that was put in for Brady and early stage heart block with Afib. 
Brady solved with PM but I have 21% of it switching into AMS because of AT or AFib. AT has been measured at 640bpm but can't say how long they last? Anyway I am an active fit guy, mostly sure that hasn't helped over the years now! 
Today I walked for 10k at a good pace but my heart rate wouldn't climb to what I would expect . Came home and sat down and the PM went into AMS. I gave it an hour or two and was going to jump on the spinning bike for a little bit but it was jumping to 140bpm just turning the legs over on the bike warm up. 
I checked the pulse manually against the Fitbit and that seemed about right although difficult to be sure as it was irregular. So my question is do I push on and train ignoring the numbers and go by breath (train till just about still maintain a conversation) or just trust the numbers and don't train when in AMS. I am on no meds or thinners etc so curious on how you fine people manage it.
 

2 Comments

I would continue to exercise but not to push beyond your comfort level

by Gemita - 2024-10-21 17:36:33

Welshblood, let your symptoms be your guide as to a safe level of exercise for you during any atrial tachy arrhythmia.  Your body will soon tell you when it is time to stop.  I get symptoms like breathlessness and chest pain if I try to push through during a symptomatic arrhythmia.  I don't watch those numbers if I am symptom free, but if symptoms are difficult to tolerate, then I will want to know why and will quickly check blood pressure and heart rate and take action if I need to.

I find exertion during Atrial Fibrillation (AF) difficult mainly because of the irregularity of heart rhythm.  I can cope fairly well with an intermittent high atrial heart rate as long as the rhythm is regular but I absolutely hate the irregularity of rhythm during AF and find it extremely hard to push through with exercise.  I can walk without difficulty during AF, although struggle to go uphill or to run.  

When I am in AF and my heart rates surge and my Automatic Mode Switch (AMS) activates and stops tracking my atrial tachy arrhythmias, I lose a lot of strength.  I do not like being in any other pacemaker mode other than my atrial mode.  The AMS puts me in DDI mode which is a ventricular-based pacing mode, for the duration of the tachy arrhythmia.

I think you are really strong.  You say you are on no meds and yet your heart rate has been hitting unbelievably high levels at times.  What did your doctors suggest?  Did they recommend any rate control medication or discuss anticoagulation or perhaps you don't yet need anything?  Perhaps this is a good sign that all is well, for the moment?

All the time you are feeling okay, I wouldn't stop exercising.  Your AMS and a rate control medication will take care of high atrial heart rates and prevent these from affecting your ventricles, allowing you to get on with your life.  However during an arrhythmia like AF, I don't think we can ever expect to reach our peak exercise capacity, even though many of us can be completely asymptomatic when in AF. 

Thanks

by Welshblood - 2024-10-22 08:02:40

I don't score on the Chads score so not really going down then anticoagulant route. The NHS here is so backlogged my urgent cardiologist referral means two months wait probably to see the next stage. 

i am a passenger but hoping for a cardiac MRI so I can ensure that they are treating the problems and not the symptoms. Just did the bike and ignored the bpm.. still alive so will probably continue until told otherwise.. let's be honest I won't make 100 so better just keep going until I can't..

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