13 Jun Atrial fibrillation for exercise professionals part 3
Atrial fibrillation and exercise: what some of the literature says
This post is on the topic of exercise and atrial fibrillation (AF) directed for exercise professionals and I’ll be talking about what some of the literature concerning causes and triggers of AF, including in response to exercise. I also recommend that you look at my other videos on AF for exercise professionals. They will give you a grounding on the issues concerning the important factors of rate and rhythm control for people with AF that will help you to design safe exercise interventions.
As a starting point, it is essential that you screen your clients before starting exercise of any kind and I have given advice on what to do if you find “new” (diagnosed) AF in a client when it is not on a referral. After pre-screening, it is important that you assess your clients who have AF for exercise response with a focus on rate and rhythm responses to the range the full range of exercise intensities that you intend to use in your exercise program. In this way you can determine whether the client has adequate rate +/- rhythm control to help to ensure safety before embarking on an exercise design.
Now onto a selection of the literature for this blog: I found some interesting papers on the concept of “lenient” rate control as opposed to “strict” rate control for preventing complications when exercising an individual in permanent AF. It seems that lenient rate control is not inferior to strict right control.
In some interesting research over the last few years, Voskoboinik and colleagues found a positive association between highish levels of regular alcohol intake and AF. Not quite showing cause-and-effect, but certainly a strong association leading to evidence-based advice that alcohol intake should be limited in order to prevent AF from occurring in the first place. Exercise is also a known trigger for AF, as is binge eating and emotional stress.
Patients with AF are at risk of a sedentary lifestyle due to fear of exercise induced episodes of AF. However, there is a merging evidence for lower AF burden in AF individuals who regularly engage in aerobic training.
Patients with AF are at increased risk when engaging in high intensity exercise, including HIIT, but less risk for low intensity or moderate intensity exercise.