{"id":25871,"date":"2020-04-20T09:52:28","date_gmt":"2020-04-20T16:52:28","guid":{"rendered":"https:\/\/medfitnetwork.org\/public\/?p=25871"},"modified":"2020-05-18T12:53:56","modified_gmt":"2020-05-18T19:53:56","slug":"exercise-for-atrial-fibrillation","status":"publish","type":"post","link":"https:\/\/medfitnetwork.org\/public\/all-mfn\/exercise-for-atrial-fibrillation\/","title":{"rendered":"Exercise for Atrial Fibrillation"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Here are some things to look for when working with a client with Atrial Fibrillation (A-fib).<\/span><\/p>\n<h4><b>FIRST&#8230;<\/b><\/h4>\n<p><span style=\"font-weight: 400;\"><strong><img fetchpriority=\"high\" decoding=\"async\" class=\"alignright wp-image-25878\" src=\"https:\/\/medfitnetwork.org\/public\/wp-content\/uploads\/2020\/04\/trainer-and-senior-on-ball-766x1024.jpg\" alt=\"\" width=\"400\" height=\"535\" srcset=\"https:\/\/medfitnetwork.org\/public\/wp-content\/uploads\/2020\/04\/trainer-and-senior-on-ball-766x1024.jpg 766w, https:\/\/medfitnetwork.org\/public\/wp-content\/uploads\/2020\/04\/trainer-and-senior-on-ball-224x300.jpg 224w, https:\/\/medfitnetwork.org\/public\/wp-content\/uploads\/2020\/04\/trainer-and-senior-on-ball-768x1027.jpg 768w, https:\/\/medfitnetwork.org\/public\/wp-content\/uploads\/2020\/04\/trainer-and-senior-on-ball-1148x1536.jpg 1148w, https:\/\/medfitnetwork.org\/public\/wp-content\/uploads\/2020\/04\/trainer-and-senior-on-ball.jpg 1179w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/>What types of medications are they on?<\/strong> Calcium Channel Blockers, blood thinners (Coumadin)? These may have an effect on the intensity and type of exercise performed. You know that people who have A-fib are at increased risk for strokes, and may have hypertension and get dizzy more often. The medications \u2013 while they may help with some factors \u2013 may preclude a well-designed exercise program just because they may not tolerate some types of exercise.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><strong>What are the exercise goals?<\/strong> Are they wanting to tone up? Lose some weight? Get stronger? Train for a tennis match or 5K? This would help in structuring the program. The type \/ intensity \/ duration are all dependent on what the client wants. If they are just coming off surgery or a new prescription \u2013 this is important to build the foundation (which you know).<\/span><\/p>\n<h4><b>SECOND&#8230;<\/b><\/h4>\n<p><span style=\"font-weight: 400;\"><strong>Does the doctor have any contraindications for exercise?<\/strong> Usually, it\u2019s not to \u201coverdo\u201d, which means building up a program. I read a <a href=\"https:\/\/drbillsukala.com\/tips-for-safe-exercise-with-atrial-fibrillation-af-or-a-fib\/\" target=\"_blank\" rel=\"noopener noreferrer\">good article<\/a> by Dr. Bill Sekula on a program for A-fib. It\u2019s essentially a \u201cstep down, time up\u201d program, where patients go from a few minutes of exercise a few times per day \u2013 to building up to an hour of exercise one time per day.\u00a0\u00a0However, I am going to recommend more of an ITP (interval training program) that concentrates on moderate strength programs (using the 40-50% rule similar to cancer patients), so they don\u2019t use the Valsalva maneuver while lifting, but still use a progressive resistance approach.\u00a0<\/span><\/p>\n<h4><b>THIRD&#8230;<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Monitoring with a HR monitor, and having good hydration status are both important. Of course, you probably have them using the smart water bottle. Because of the heart dynamics and possible Coumadin Rx, the hydration is important. I assume you do a HR variability test with your client. This may be a very important test to do, as over time it may be instrumental in reducing A-fib occurrences.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I like the <a href=\"http:\/\/www.drjohnm.org\/2014\/05\/exercise-over-indulgence-and-atrial-fibrillation-seeing-the-obvious\/\" target=\"_blank\" rel=\"noopener noreferrer\">article<\/a> by Dr. John Mandrola on the amount of exercise. He states that A-fib is completely controllable through specific lifestyle changes. He states that low inflammation exercise (high intensity endurance \/ triathlon, etc.) training needs to be modified, as do other lifestyle issues. I really like the discussion on inflammation, which may be one of the biggest issues in cardiac care of late. He talks about the \u201cJ curve\u201d of exercise and that the more intense actually increases the odds ratio (OR) for sudden cardiac events and other abnormalities related to A-fib.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I think he is on to something, and you should look into some other lifestyle aspects such as meditation and heartbeat regulation through mindful breathing and relaxation. I know that excess stress, lack of sleep and poor diet have effects on the electrical system, including SA node and conductivity. Regular relaxation may do a LOT to improve the normal sinus rhythm and reduce resting HR to a more manageable level.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Mandrola also recommends regular monitoring of BP, keeping the use of warm exercise clothing due to peripheral circulation issues, and not overheating.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I like the issue of ITP and progression.\u00a0\u00a0I also am more of a fan of modified strength training for most clinical conditions.\u00a0\u00a0I think it would work for AF because if you think of the strength of contraction during exercise (even moderate) \u2013 it will have a strong steady beat during exercise (in most cases).\u00a0\u00a0<\/span><\/p>\n<hr \/>\n<p><i>Eric Durak is President of\u00a0<a href=\"http:\/\/www.medhealthfit.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">MedHealthFit<\/a>\u00a0\u2013 a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.<\/i><\/p>\n<p>&nbsp;<\/p>\n<p><b>References<\/b><\/p>\n<ol>\n<li><a href=\"https:\/\/www.everydayhealth.com\/hs\/atrial-fibrillation-and-stroke\/afib-exercise-safety-tips\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">https:\/\/www.everydayhealth.com\/hs\/atrial-fibrillation-and-stroke\/afib-exercise-safety-tips\/<\/span><\/a><\/li>\n<li><a href=\"https:\/\/drbillsukala.com\/tips-for-safe-exercise-with-atrial-fibrillation-af-or-a-fib\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">https:\/\/drbillsukala.com\/tips-for-safe-exercise-with-atrial-fibrillation-af-or-a-fib\/<\/span><\/a><\/li>\n<li><a href=\"http:\/\/www.drjohnm.org\/2014\/05\/exercise-over-indulgence-and-atrial-fibrillation-seeing-the-obvious\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">http:\/\/www.drjohnm.org\/2014\/05\/exercise-over-indulgence-and-atrial-fibrillation-seeing-the-obvious\/<\/span><\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Here are some things to look for when working with a client with Atrial Fibrillation (A-fib). FIRST&#8230; What types of medications are they on? Calcium Channel Blockers, blood thinners (Coumadin)? These may have an effect on the intensity and type of exercise performed. You know that people who have A-fib are at increased risk for strokes, and may have hypertension and get dizzy more often. The medications \u2013 while they may help with some factors \u2013 may preclude a well-designed exercise program just because they may not tolerate some types of exercise. What are the exercise goals? Are they wanting to tone up? Lose some weight? Get stronger? Train for a tennis match or 5K? This would help in structuring the program. The type \/ intensity \/ duration are all dependent on what the client wants. If they are just coming off surgery or a new prescription \u2013 this is important to build the foundation (which you know). SECOND&#8230; Does the doctor have any contraindications for exercise? Usually, it\u2019s not to \u201coverdo\u201d, which means building up a program. I read a good article by Dr. Bill Sekula on a program for A-fib. It\u2019s essentially a \u201cstep down, time up\u201d program, [&hellip;]<\/p>\n","protected":false},"author":66,"featured_media":23164,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[98,198,82,101],"class_list":["post-25871","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all-mfn","tag-cardiovascular-disease","tag-fitness-professionals","tag-heart-disease","tag-stroke"],"jetpack_publicize_connections":[],"_links":{"self":[{"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/posts\/25871","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/users\/66"}],"replies":[{"embeddable":true,"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/comments?post=25871"}],"version-history":[{"count":0,"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/posts\/25871\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/media\/23164"}],"wp:attachment":[{"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/media?parent=25871"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/categories?post=25871"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medfitnetwork.org\/public\/wp-json\/wp\/v2\/tags?post=25871"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}