SVT/AF on Flecainide and level of exercise/training

I am a 67 yr male and had an ICD implanted in July of 2025 due to a diagnosis of Sustained Ventricular Tachycardia. I do not have any serious underlying heart disease. I have been on Flecainide 100mg 2x/day for 11 weeks now. Initially, I thought it was causing constipation but that has resolved. I have had no other significant side effects so far. Others have had more significant reactions, so it depends on the individual. It appears to be controlling my VTach since I have not had another episode since I started taking it.
I was also previously very active with gym workouts, raquetball, hiking, and volunteered doing trail maintenance weekly. I wanted to get back to my previous activity level. There was a wide range of recommendations and restrictions from other patients, doctors, device clinicians. Golf, tennis, and pull-ups have been mentioned as bad activities. The main concern is the leads going to the heart, not just dislodging them, but also long term wear where they enter between collar bone and rib. So some upper body repetitive motions can also be a concern. After surgery, they encouraged walking, and did not place a limit, so I immediately worked my way up to 7 miles a few days per week, while keeping tabs on pulse rate with a smart watch, keeping it below 150. After 2 weeks, I headed back to gym with my wife tagging along to help me build confidence as I learned how the device (or my heart) might react. Started on incline treadmill (walking) again watching pulse rate. After no issues for 2 weeks, I started stair climber which I find more demanding on the heart, but still no issues. Then I started to add weights, legs first, then upper body, lighter than I did previously. I shied away from movements that would cause the leads to be stretched, or did them very slowly. At 4 weeks, I did an easy hike, at 5 weeks a moderate hike, at 7 weeks a difficult hike, at 9 weeks I volunteered for trail work and worked all day including a bunch of upper body work. I did not have any issues during all of this. I think the main idea is to ramp up activity according to your condition and goals. If you have a serious heart condition, of course that will have its own concerns and recommendations. Hope all goes well for you.

@ejstolte thanks much for sharing your experience. Building confidence slowly is key to exploring our limits and scope.

I have had afib for 9 months, have had one ablation and will need another. I have been on Flecanide 100 mg 2 times a day for the last 7 months. I have had no side effects, no restrictions, and have continued my normal strength training 3 times/week, and play pickleball 3 times/week. I am 74 years old. My afib is asymptomatic - I never feel it, and only know when it occurs from my Kardia monitor. My afib does not correlate with exercise or anything else.
If your cardiologist has not given you any restrictions, I would suggest doing whatever is normal for you , and see how it goes.

I am 65 and had a ICD implant in August 2025. I was prescribed Sotolol. About 8 weeks later, I had 5 shock due to VT storm (apparently) that sent me back to the hospital. A lead was repositioned and I was put on Flecainide 100mg 2x a day an Metropolol 25mg 1x per day.

Much better on current meds than Sotolol. Although my HR is typically below 60BPM. For about 2 years before getting the ICD, I was getting episode of what turned out to be occasional short bursts of VT. Most times sitting at my desk or otherwise not doing much activity. I did pass out a few times, which lead to meds and ICD. An EP study did not find anything to ablate.

Now I’m getting back to walking, some light weightlifting, volleyball, and hopefully golf. The meds do seem to limit my exercise capacity. My Dr is worried about side effects of Flecainide so has me also on Metropolol which seem to be keeping my HR low and me sort of listless at times. Thanks for sharing your stories.

@petekj
I could not take Flecainide
It mess up my stomach
Best Wishes

Everyone is different, but I had no problem taking flecainide except for some constipation. I took it for several years and never had any problems with exercise or exercise-induced Afib. Long backpacking trips (3+weeks, several hundred miles); trekking in Nepal to 18,000'.
If your cardiologist is okay with it, go for it.
All the best.