Difficulty exercising after aFIB and SVT ablation

Posted by mikeneverwired @mikeneverwired, Jun 15 2:48pm

I just had a procedure (6/10/25) to address my recurring rhythm issues including SVT and ablation. My heart seems to have calmed down quite a bit relative to pre-surgery but I am wondering how long it takes to get back into a normal exercise routine. I have been walking daily but am finding myself winded and tired. I hope this is transient but am not sure. I want to get back up into the mountains to hike some tall rocky mountain peaks (it is summertime after all)!

Thoughts?

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Some people have minor bouts of arrhythmia now and then during the 'blanking period.' Some don't. Some have so much ectopy that their ablation obviously didn't work and they'll have to go back for a re-do.
Some people are biking and hiking literally two days after their ablation. Some report that they still haven't recovered full functionality months later.
Some report that their hearts calmed down very soon and they have felt great ever since. Others report high resting heart rates in the high 80's for literally months and months afterwards, although almost every one of those that have reported this undesired outcome have later come back and said their heart returned to its normal rate after about a year.
From this you should take that we all naturally deal with what has been done to us and what we have experienced that got us there, meaning the disordered heart. Your system is dealing with your operation normally, as much as that may seem unfortunate or unwanted. I think you should keep doing what you are doing, but don't push it. If you're tired one day, or even a whole week, give it a rest! You can resume your regimen the following day or week. What you don't want happening is a return to high amounts of ectopy or arrhythmia. That would be a sign that your operation was probably not going to be successful ultimately. The research suggests that this is especially true later in the blanking period. Those who have short runs of ectopy in the first four or five weeks have a better prognosis than those who think they're home free for the first couple of months and then suddenly they get breakthrough arrhythmia again...that's a bad sign. The idea is that your heart 'should be' calming and repairing itself as time goes on, so ectopy after several weeks suggests the calm heart is welcoming the pre-ablation conditions of unwanted electrical signaling.
Honestly, don't fight this. Decide you're going to enjoy puttering and letting your system climb down from off the wall. A day will come when you'll bounce out of bed and you'll know you're ready to start reclaiming normalcy again.

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I'm with you! I also want to be hiking in the Rocky Mountains (like I've always done -- I live in NM). But I had a Watchman device and second ablation done on May 1, and now at 6 weeks I'm finally able to do some short hikes with minimal elevation gain (below 9,000 feet). I'm probably older than you (75) and Covid started this whole story just about two years ago.

The other person who commented mentioned ectopic beats which I have been having during this "blanking" period. They are finally easing off. I've been doing Japanese acupuncture and it's helping!

Good luck to you -- don't push it -- everyone's different and our bodies need time to recover.

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@gloaming

Some people have minor bouts of arrhythmia now and then during the 'blanking period.' Some don't. Some have so much ectopy that their ablation obviously didn't work and they'll have to go back for a re-do.
Some people are biking and hiking literally two days after their ablation. Some report that they still haven't recovered full functionality months later.
Some report that their hearts calmed down very soon and they have felt great ever since. Others report high resting heart rates in the high 80's for literally months and months afterwards, although almost every one of those that have reported this undesired outcome have later come back and said their heart returned to its normal rate after about a year.
From this you should take that we all naturally deal with what has been done to us and what we have experienced that got us there, meaning the disordered heart. Your system is dealing with your operation normally, as much as that may seem unfortunate or unwanted. I think you should keep doing what you are doing, but don't push it. If you're tired one day, or even a whole week, give it a rest! You can resume your regimen the following day or week. What you don't want happening is a return to high amounts of ectopy or arrhythmia. That would be a sign that your operation was probably not going to be successful ultimately. The research suggests that this is especially true later in the blanking period. Those who have short runs of ectopy in the first four or five weeks have a better prognosis than those who think they're home free for the first couple of months and then suddenly they get breakthrough arrhythmia again...that's a bad sign. The idea is that your heart 'should be' calming and repairing itself as time goes on, so ectopy after several weeks suggests the calm heart is welcoming the pre-ablation conditions of unwanted electrical signaling.
Honestly, don't fight this. Decide you're going to enjoy puttering and letting your system climb down from off the wall. A day will come when you'll bounce out of bed and you'll know you're ready to start reclaiming normalcy again.

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Gloaming,
I very much appreciate your commentary on this site. You speak the truth good or concerning with encouragement. While I’ve not had an Ablation or a Pacemaker yet, I’m more than likely heading that way. In the meantime, I’ll pay attention to my Cardiologist (also an Electrophysicist) on dealing with my AFIB and LBBB. I recently learned the hard way about not “overdoing” exercise and yardwork with a trip to the ER and overnight stay, but got back in Sinus Rhythm quickly once there. I too have realized the entire heart health journey requires patience, slowing down and building back what you’ve lost with patience and diligence. Of course we all have to adjust our lifestyle to “heart healthy” too. Thank you very much for your insight and wisdom.

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@gloaming

Some people have minor bouts of arrhythmia now and then during the 'blanking period.' Some don't. Some have so much ectopy that their ablation obviously didn't work and they'll have to go back for a re-do.
Some people are biking and hiking literally two days after their ablation. Some report that they still haven't recovered full functionality months later.
Some report that their hearts calmed down very soon and they have felt great ever since. Others report high resting heart rates in the high 80's for literally months and months afterwards, although almost every one of those that have reported this undesired outcome have later come back and said their heart returned to its normal rate after about a year.
From this you should take that we all naturally deal with what has been done to us and what we have experienced that got us there, meaning the disordered heart. Your system is dealing with your operation normally, as much as that may seem unfortunate or unwanted. I think you should keep doing what you are doing, but don't push it. If you're tired one day, or even a whole week, give it a rest! You can resume your regimen the following day or week. What you don't want happening is a return to high amounts of ectopy or arrhythmia. That would be a sign that your operation was probably not going to be successful ultimately. The research suggests that this is especially true later in the blanking period. Those who have short runs of ectopy in the first four or five weeks have a better prognosis than those who think they're home free for the first couple of months and then suddenly they get breakthrough arrhythmia again...that's a bad sign. The idea is that your heart 'should be' calming and repairing itself as time goes on, so ectopy after several weeks suggests the calm heart is welcoming the pre-ablation conditions of unwanted electrical signaling.
Honestly, don't fight this. Decide you're going to enjoy puttering and letting your system climb down from off the wall. A day will come when you'll bounce out of bed and you'll know you're ready to start reclaiming normalcy again.

Jump to this post

Wow, this is really a useful response. I will be patient but will attempt to push it physically with no expectations. If I go on an 8 mile hike and make it only 3 miles, I will consider this a good thing and try again in a few weeks. I appreciate the very thoughtful response.

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@mikeneverwired

Wow, this is really a useful response. I will be patient but will attempt to push it physically with no expectations. If I go on an 8 mile hike and make it only 3 miles, I will consider this a good thing and try again in a few weeks. I appreciate the very thoughtful response.

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I'm glad if it helps at all. Note, I'm not a health expert, not a coach or mentor...I have had two ablations, all the workups to get me to where an EP was willing to take me on as a case, and I have read hundreds of research articles and watched videos on YouTube by EPs. Some of those videos are incredibly useful.

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I understand. I'm going up on a 6 mile+ hike at about 9k' this thursday (June 19). That will tell the tale... I'll go until I don't think I can make it back but I think I might make it at least 4 miles... the bonus would be to make it all the way to balanced rock (6+mi RT). It won't be overly hot at that altitude...

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@mikeneverwired

I understand. I'm going up on a 6 mile+ hike at about 9k' this thursday (June 19). That will tell the tale... I'll go until I don't think I can make it back but I think I might make it at least 4 miles... the bonus would be to make it all the way to balanced rock (6+mi RT). It won't be overly hot at that altitude...

Jump to this post

I would control my pace, keep an eye on HR (if it climbs much above about 130 when walking, you might wish to slow or pause). You can push it later when you 'know' or feel it in your bones that you're ready for a greater effort. That may be a month from now. Also, keep an eye on electrolytes if you're going to be sweating some, and of course keep the fluids up. Also, keep a snack with some carbs so you don't 'bonk' and maybe encourage a cranky heart.

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Thank you Gloaming for the thoughtful and thorough analysis of recovery process. As a CCRN in cardiology and as a SVT and Afib patient I am frustrated at the lack of explanations from the Electrophysiology team. They are crazy busy yes but also typical lack of communication skills and a narrow focus excluding often the person in the bed.
I have had a paroxysmal Afib ablation last year with pretty good success now that it has been 1 year post and SVT ablation this past March.(so far so good but remain on Sotalol for now) The exercise tolerance is compromised however and there is no guidance for that. Kind of on your own to figure it out.

REPLY
@gloaming

Some people have minor bouts of arrhythmia now and then during the 'blanking period.' Some don't. Some have so much ectopy that their ablation obviously didn't work and they'll have to go back for a re-do.
Some people are biking and hiking literally two days after their ablation. Some report that they still haven't recovered full functionality months later.
Some report that their hearts calmed down very soon and they have felt great ever since. Others report high resting heart rates in the high 80's for literally months and months afterwards, although almost every one of those that have reported this undesired outcome have later come back and said their heart returned to its normal rate after about a year.
From this you should take that we all naturally deal with what has been done to us and what we have experienced that got us there, meaning the disordered heart. Your system is dealing with your operation normally, as much as that may seem unfortunate or unwanted. I think you should keep doing what you are doing, but don't push it. If you're tired one day, or even a whole week, give it a rest! You can resume your regimen the following day or week. What you don't want happening is a return to high amounts of ectopy or arrhythmia. That would be a sign that your operation was probably not going to be successful ultimately. The research suggests that this is especially true later in the blanking period. Those who have short runs of ectopy in the first four or five weeks have a better prognosis than those who think they're home free for the first couple of months and then suddenly they get breakthrough arrhythmia again...that's a bad sign. The idea is that your heart 'should be' calming and repairing itself as time goes on, so ectopy after several weeks suggests the calm heart is welcoming the pre-ablation conditions of unwanted electrical signaling.
Honestly, don't fight this. Decide you're going to enjoy puttering and letting your system climb down from off the wall. A day will come when you'll bounce out of bed and you'll know you're ready to start reclaiming normalcy again.

Jump to this post

Thanks, Gloaming - good information!

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As gloaming says, be patient with your healing. I had an ablation in 2021 and my heart rate was on the high side,, and highly variable, for a number of days. My cardiologist said that was expected and that I was "just along for the ride." I started hiking and cross-country skiing about 10 days after the ablation, up to about 6 miles. Worked up to 10+ miles carrying weight about 1-1/2 months after. I was completely out of A-fib except for occasional blips after 2 months. About 4 months after my ablation I went to Nepal for two months of trekking, hiking up to 18,250' without any problem.
So, have patience and take it as it comes. Everyone is different, but it sounds like you are in good shape and can expect a successful recovery. All the best!

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