Can Exercise Cause an Arrhythmia?

This is a fascinating question and one that requires an in-depth explanation. We know from decades of research that exercise and movement are keys to preventing heart disease and staying physically and mentally healthy into old age. To that end, it may seem clear that exercise would be a protective mechanism against cardiac arrhythmias like atrial fibrillation (Afib) and other rapid heartbeat. However, the type of exercise and the patient’s age are the differences between protective activity and one that may induce atrial fibrillation or atrial flutter.

Exercise- vs. Afib-Induced Heartrate

Before we get into the details, we must discuss the difference between a rapid heartbeat induced by an arrhythmia and one caused by exercise. Both involve an elevated heart rate, but the main difference is that the increased heart rate caused by exercise is not only expected but also beneficial. As the heart rate subsides post-exercise, many benefits follow, including lower blood pressure in the long term. Indeed, exercise is the only way to strengthen the heart and keep it beating well long into the future.

On the other hand, atrial fibrillation and other arrhythmia can create a heartbeat so rapid that it causes problems. This fast heartbeat is disorganized, putting additional strain on the heart and creating circulation problems and long-term structural damage to the heart. To that end, the elevated heart rate associated with an arrhythmia does not lower blood pressure; in fact, it may worsen blood pressure in the short and long term.

The Protective Benefits of Exercise

As with any activity, moderation is key. To that end, exercise is cardioprotective and an excellent way to reduce the risk of atrial fibrillation and other arrhythmias when performed within the bounds of the patient’s physical ability. For patients carrying excess weight, moderate exercise can help them lose weight and reduce the risk of obesity and excess weight-induced arrhythmias. Exercise can strengthen the heart and ensure continued heart health for patients with a normal BMI. Ultimately, moderate exercise, up to 15 minutes daily, a few days a week, benefits most patients. In addition to cardiovascular exercise, everyone should be performing strength training, whether lifting weights, performing bodyweight exercises, or anything that strains the muscles. These exercises are crucial to building muscle, which ultimately burns additional calories at rest and ward off future cardiac-related issues.

When Exercise May Cause an Arrhythmia

Interestingly, sustained vigorous exercise, including endurance sports like long-distance running or other endurance exercises, may increase Afib risk, especially in younger patients. A study estimated that for every ten years of endurance exercise, which in this case was defined as 30 minutes of exercise three or more times per week, the risk of atrial fibrillation increased by 16%. The risk of atrial flutter increased by 42%.

You may wonder why we see these trends; the answer is relatively straightforward. Just like any other muscle, the heart can be overworked, and when it is, it has a deleterious effect on its long-term health. A tired heart does not have time to rest like other muscles in the body—the result can be an arrhythmia. Of course, young athletes should be aware of this.

The Bottom Line

Don’t be afraid of inducing or worsening an arrhythmia due to exercise. However, patients must understand that everything, including exercise, must be performed in moderation. Overdoing it can overwork the heart and ultimately induce an arrhythmia. Speak to Dr. Osorio or your local electrophysiologist to understand more about managing any possible arrhythmias associated with exercise and develop a workout plan that minimizes your risk and maximizes your results.