Exercise; the key to heart disease prevention

There is no doubt that exercise is linked with prevention of heart-related health problems. Exercise modifies multiple risk factors for heart disease and reduces the risk of heart attack.  Dr Saagar Mahida, a respected consultant cardiologist specialising in heart rhythm disturbances, discusses the connection between heart rhythm abnormalities and exercise.

How is exercise associated with the prevention of atrial fibrillation?

Exercise influences the risk of heart rhythm abnormalities, and in particular, atrial fibrillation. Exercise is associated with a positive impact on atrial fibrillation on multiple levels, including prevention, outcomes of catheter ablation procedures to treat atrial fibrillation, and quality of life in patients with an established diagnosis of atrial fibrillation.

Are there certain types of exercises that can help me to prevent atrial fibrillation?

It is important to recognise that there is no ‘one size fits all’ approach to exercise in the context of atrial fibrillation. A personalised approach that takes into consideration previous exercise history, individual exercise capacity, co-existing conditions, and the pattern of atrial fibrillation is important when considering the right type and intensity of exercise.

The good news is that you don’t have to become a marathon runner to achieve significant results. Indeed, there is some evidence to indicate that very high exercise intensity may have a detrimental effect in terms of risk of atrial fibrillation. There is therefore a balance to be struck when considering the level of exercise.

How often do I need to exercise in order to improve my cardiovascular health?

General guidelines from the American Heart Association (AHA) recommend daily moderate-intensity aerobic exercise for 60 minutes to improve cardiovascular health. This level of exercise should be sustained over several months to reduce the risk of cardiovascular disease. The AHA recommendations can reasonably be extrapolated to exercise programmes for the prevention of atrial fibrillation.

As mentioned above, a very high intensity of exercise could increase the risk of atrial fibrillation. Therefore, on rare occasions, moderation of the level of exercise may be recommended in order to reduce the risk of atrial fibrillation.

Can exercise help, even if I have been diagnosed with atrial fibrillation?

AF is associated with a range of symptoms. Fatigue and a decreased exercise tolerance are common symptoms, which can have a significant impact on quality of life. A number of previous research studies have demonstrated that even short-term exercise training programmes improve physical functioning and wellbeing in patients with atrial fibrillation.

Are there specific types of exercises which can improve my atrial fibrillation diagnosis?

In terms of the specific type of exercise, studies have reported that aerobic exercise is associated with superior outcomes in terms of physical functioning and wellbeing in atrial fibrillation patients. On the other hand, anaerobic exercises have been reported to have less of an impact.

Aerobic exercise is any activity that makes your heart beat faster and increases your breathing rate. Examples of aerobic exercise include:

• Walking
• Running
• Hiking
• Swimming
• Dancing
• Cycling

Overall, while your heart rhythm specialist will offer a range of treatments for management of atrial fibrillation, including potentially curative catheter ablation, the role of exercise does not stop with your ablation procedure. The success rates of catheter ablation and future risk of atrial fibrillation are closely related to lifestyle and exercise.