Ablation and exercise

Everyone is different. Different history leading up to the ablation, different EP, different technique applied to the affected areas inside the atrial wall, how emotionally touched you have been leading up to the procedure, how anxious you were, how exhausted you are, how much ablation had to be done until you were deemed fully ablated and released from the cath lab...and on it goes...you get the picture.

Your physician is going by rules of thumb, some based on empirical evidence, some based on his/her experience across literally thousands of patients, and some based on keeping in mind what YOU have been through. If I were a cardiologist or an EP, and I hasten to remind that I am not, and you had asked me the question, I would say thusly: You did well during the ablation, and you've had some bother leading up to it, and I find that the patient, him or herself, is most often the best judge in the room about what to do, how early, and to what length or intensity. Let your gut be your guide here. I would advise against resuming hard exercise where your HR rises above 130 typically in the first week, and then add in what you can tolerate, but never by pushing it. Monitor your HR as you add intensity, oxygen demand, and effort. In the first few days, often just going for a comfortable walk is quite doable for many patients, but some don't feel well for two or three weeks after an ablation and they take their time. Your heart has been irritated and is cranky, and that was BEFORE the ablation. Now it has some scaring to do because of what happened to it during the ablation, so it might be that much more cranky. Take it easy, and do what your body says it can do, and do no more!
Some patients are out hiking the very next day, some of them report that it was a mistake, some say it was fine, and they went on an extended bike ride the following day, also fine. Some report that their resting HR for weeks after their ablation was at least 20 BPM over what was normal two/three years ago. This is typical, but it does suggest a bit of duress going on inside the myocardium...wouldn't you think? So, act accordingly.

I had a PFA last July. I took it easy for a couple of weeks and then over the next few weeks ramped up to my previous exercise intensity. I decided to err on the side of caution and had no issues.

Thanks for the comments. After four weeks I did about 15 minutes of strenuous exercise where my HR briefly climbed to 150 BPM. I didn't experience any palpitations or shortness of breath, however I think I will keep my activity level less intense until the eight week milestone, which is when the ablated tissue should be healed.

I think that is reasonable. You want your Holter, when it comes at about the 10-12 week mark, to show a veridical assessment of your heart's robustness-in-rhythm. If you are on meds that might alter that picture, I would hope you have instructions to alter the prescription, including stopping them altogether, at least a couple of days before the Holter. For example, what is the point of taking metoprolol or propafenone while trying to find out if the ablation worked?!?!? No, you want to have been off those, or any others except maybe a statin and a DOAC (Direct Oral Anti-Coagulant like rivaroxaban or apixaban, Xarelto or Eliquis) so that the heart's true performance, unaided, can be shown to the person analyzing the results and thence to you.

Very good points. Thanks.

I waited for about 10 days to resume exercising after my ablation. I really didn’t feel up to it before then. Took another week to get back to normal levels but otherwise I did not experience any other issues.

I had the same PFA in 2023 and went back to the gym within a week with no problems. I’ve been in Sinus Rhythm for 1-1/2 years now and am feeling great. Never had symptoms as my Apple Watch IDed the Afib. No remission except a 2-day period the started and ended by itself.

PFA in 2023…that was early, probably soon after FDA approval. Good to hear that your Afib has been in check.

After cardioversion after ablation, then after another cardioversion, my heart rate is still 100 sometimes over just to do nothing. It’s like really high. I don’t understand what helps this stuff.

I would appreciate help on what to do next not in afib but heart racing on eliquis and 5 gram and diltiazem 180 cant handle this there must be some solution