6 Rules for People With an Irregular Heartbeat

Atrial fibrillation (AFib) is a heart condition in which the heart pumps irregularly. It’s a type of arrhythmia, or irregular heartbeat. "AFib is one of the most common arrhythmias cardiologists take care of," says Donald Orth, MD, a cardiologist with Lourdes Health System in Voorhees, New Jersey.

Arrhythmias are caused by abnormalities in the heart's electrical system. They can stem from medical conditions that affect the heart, such as coronary artery disease, high blood pressure, infection, or sleep apnea. Sometimes, we don’t know why they happen. Medications, surgery, and electrical cardioversion (shock therapy) are used to treat arrhythmias, including AFib. If AFib goes untreated, it can lead to complications such as blood clots, which can cause a stroke.

Treating any known underlying cause of your AFib is the first thing a healthcare provider (HCP) will seek to do; treating the AFib itself is the second. Once your AFib is under control, it can take some time to jump back into normal life, and doing so can be a little scary. The good news is that it’s typically safe to resume many of your favorite activities.

Here's what you need to know about living with an irregular heartbeat.

Once AFib is controlled, Dr. Orth recommends resuming normal activities. "Sex is fine, running is fine, gym work is fine. All these things are perfectly acceptable," he says.

There are proven health benefits to being intimate, too. Sex can help alleviate headaches and improve sleep, and it may be especially helpful for longevity. An observational study of 15,000 adults published in The Journal of Sexual Medicine in 2020 found that those who had sex more often were at a lower risk of death from any cause. 

Another 2020 study—this one published in the European Journal of Preventative Cardiology—determined that having sex at least once per week was associated with a 10 percent drop in heart disease mortality and a 44 percent drop in non-heart disease mortality. 

Despite what you've seen in the movies, there’s little evidence to suggest that sex is linked to cardiac-related deaths. In fact, a 2018 study published in Circulation found that just 17 of the 3,000-plus cases of sudden cardiac arrest studied occurred during or within an hour of intercourse.

Physical activity can help control weight, protect your heart, and boost your mood. If you have AFib, exercising can improve your cardiovascular strength, but you may need to take precautions when working out.

Some people with AFib may want to avoid taxing exercises like hiking and running. "Sometimes, patients have to avoid too much strenuous activity if their heart rate is not well-controlled," Orth says.

To reduce their risk of stroke, some of those with AFib take anticoagulant drugs. These increase the risk of bleeding, so people using them should be especially careful to avoid bumps, scrapes, and bruises. “The medications significantly reduce the chance of blood clotting and embolization of clots,” Orth explains.

Speak with your HCP about the best exercises for you before beginning any fitness routine. And if you experience a fluttering or pounding in your chest, fatigue, or dizziness during activity, stop and report signs to your HCP.

Stress is a normal part of life, but people who experience stress often or whose stressors never seem to go away may be at an increased risk of high blood pressure and heart disease, which can increase their risk of developing an irregular heartbeat.

One stressful experience may not be a danger to your heart. But if you have AFib, it's worth looking into techniques to manage the mental, physical, and emotional effects of stress. Regular exercise, adequate sleep, and relaxation practices like meditation and yoga can help keep stress under control.

Tracking your stress using apps like Sharecare (available on iOS and Android) can also help you pinpoint—and ultimately avoid—stressful activities.

You may have heard that it’s possible the change in air pressure during a flight can provoke an irregular heartbeat. But it’s not likely. For the vast majority of people with heart conditions, including arrhythmia, flying is safe.

Here’s how to be prepared for any eventuality when flying:

• Pack your medication and keep your HCP’s name and phone number handy.
• Research and locate medical facilities at your destination in case an issue arises.
• Get up and walk when possible during your flight, since prolonged sitting can increase your risk for blood clots.
• To reduce your risk of becoming ill, wash your hands frequently, make sure your vaccinations are up to date and follow all official COVID-19 recommendations for travel.

Eating a well-balanced diet rich in fruits, veggies, whole grains, lean protein, and healthy fats is a good idea for everyone. Focusing on heart-friendly foods—and limiting saturated fats, sodium, and sugar-sweetened treats and drinks—is especially important for someone with a heart condition. Even if you have an irregular heartbeat, the occasional indulgence is okay.

“Some people are sensitive to certain beverages, like alcohol or too much caffeine,” Orth says. Before pouring yourself a glass of wine or cup of coffee, speak with your HCP about how they might affect you.

Vegetables rich in vitamin K, like kale and spinach, can alter the effects of the anticoagulant warfarin, so consult with your HCP if you’re prescribed the drug. Orth also recommends being cautious around the holidays. "What we call holiday heart syndrome, where people are drinking more alcohol than they're used to, may trigger AFib," he says.

Maintaining a healthy weight is beneficial for people with AFib. According to a 2018 study published in Europace, obesity is linked to AFib progression, and weight loss can reverse it. While the study looked at different weight loss ranges in people with obesity, those who lost 10 percent or more of their baseline bodyweight had the best result, with 88 percent of the patients reversing the severity of their AFib. 

Keeping a food journal, limiting your snacks to healthy choices, and making an effort to get more physical activity throughout your day can help you achieve a healthy weight. So can keeping track of your weigh-ins. College-aged women who weighed themselves daily over a two-year period decreased their body mass indexes more than those who didn't, according to a 2017 study in the Journal of Behavioral Medicine.