Exercise as a Cornerstone of AFib Management
Living with AFib: How exercise and lifestyle changes help
Lifestyle practices are the ground rules of managing AFib (atrial fibrillation). Maintaining a healthy weight, controlling blood pressure, reducing alcohol, quitting smoking, and improving sleep quality all support heart rhythm stability. Importantly, exercise for AFib is not just safe, but a cornerstone of AFib management, when it’s properly scaled.
Exercise guidelines for AFib
Aerobic guidelines
Moderate intensity
“Zone 2”
Avoid extremes
Moderate intensity
Current clinical guidance emphasizes moderate-intensity aerobic exercise as part of AFib care. Aerobic activity such as brisk walking, swimming, or cycling for about 150 minutes per week (or a mix of moderate and vigorous activity to equal ~150–300 minutes) is associated with lower AFib risk and reduced symptom burden.
“Zone 2”
This moderate zone—often referred to by fitness professionals as Zone 2—is a level where your heart rate is elevated but still allows comfortable conversation. It builds aerobic capacity and improves metabolic health without the strain of high-intensity effort. Consistent practice helps with weight management, blood pressure control, and cardiovascular resilience, all of which reduce AFib burden.
Avoid extremes
While moderate exercise is protective, research indicates that extreme, high-intensity, or long-term endurance training may increase the risk of developing or worsening AFib.
Strength training guidelines
Light weightlifting
Gradual progression
Light weightlifting
Perform light weightlifting to build and maintain muscle strength without straining the heart. Use hand weights, resistance bands, weight machines, or body weight (for example, kitchen counter push-ups or chair sit-to-stands).
Gradual progression
Start with light effort and gradually build to medium (about 60-80% of full effort). Begin with 10-15 reps for each major muscle group and progress over time to 2 sets of 8-12 reps. Avoid straining or holding your breath.
Do strength training exercises 2-3 times a week on non-consecutive days.
Flexibility and balance exercises
Stretch key muscle groups for 10-30 seconds (or longer) most days of the week and especially after workouts. Yoga and Tai Chi help with flexibility and balance while calming the nervous system.
Safety precautions for AFib workouts
Warm up before and cool down afterwards: Start gradually and decrease the intensity gradually so that your breathing returns to normal before you stop.
Start slowly: Begin first 5-10 minutes of the session slowly to gauge your response.
Heart rate: Because your pulse is irregular, monitor how you feel rather than relying on heart rate monitors.
Intensity check: You should be able to hold a conversation while exercising. If you lose your breath quickly, stop or reduce intensity.
Avoid heavy lifting and stop immediately if you experience dizziness, fainting, or severe palpitations.
Symptoms of AFib during exercise
A resting heart rate that is unusually high or erratic
Dizziness, lightheadedness, or feeling like you might faint
Severe exhaustion or extreme breathlessness
Fluttering in the chest
The Bottom Line
For most people, moderate activity (“Zone 2”) is protective of your heart rhythms in both aerobic and strength training. Avoid extremes of intensity and endurance. Strength and flexibility work can complement aerobic fitness and further enhance overall health.
This is the 2nd post of a 2-Part article. For the first, please see AFib: How Lifestyle Supports Healthy Heart Rhythm.
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Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.
For expert guidance on strength training techniques, step by step photos depicting how to perform the exercises, and a selection of well-rounded workouts please check out the book Strength Training Exercises for Women by Joan Pagano.