Sport is essential for good cardiovascular health. But when our heart fails, can we really continue physical activity? Should certain sports be favored over others? Answers from Dr. Claude Kouakam, cardiologist.

Can you do sports when you suffer from cardiac arrhythmia

The practice of a regular sporting activity is beneficial for the mind, but also for the body. And that goes for everyone: with a few exceptions, most patients with cardiac arrhythmia are encouraged to take up exercise. "However, this sports practice must be very supervised, because zero risk does not exist", specifies Dr Claude Kouakam, cardiologist, specialist in the management of heart rhythm disorders and responsible for the Syncope unit and the Non-invasive rhythmological technical platform at the Institut Cœur Lung of the CHU Lille.

The benefits of physical activity for the heart and arteries of athletes

Physical inactivity is  a major cardiovascular risk factor.  Physical activity in the broad sense promotes the proper functioning of our heart and the arteries that feed it.

From a medical point of view, as detailed by the French Federation of Cardiology (source 1), physical activity:

  • improves the performance of the myocardium . In short, the force of contraction of the heart increases, which allows it to provide less effort to propel blood through the body;
  • helps fight high blood pressure  ;
  • protects the arteries by improving their vasodilation , which limits the risk of clot formation;
  • and promotes the maintenance of a good glycemic balance and participates in the prevention of type 2 diabetes .

In addition, it also greatly improves the quality of life of patients suffering from cardiac arrhythmia:

  • it makes it easier to perform everyday tasks , such as climbing stairs or carrying shopping bags;
  • it reduces stress and anxiety levels  ;
  • it increases enthusiasm and energy on a daily basis;
  • it improves the quality of sleep  ;
  • and it helps to gain self-confidence .

"The key to success is regularity," insists Dr. Kouakam. Indeed, the beneficial substances secreted by our body after physical activity only take effect for 24 to 36 hours. Hence the importance of regularity.

Can you do sports when you suffer from cardiac arrhythmia (tachycardia, extrasystole, atrial fibrillation)? At what pace?

"Contrary to popular belief, yes, most patients suffering from cardiac arrhythmia can practice physical activity - even if they wear a pacemaker , answers Dr. Kouakam. But the type of activity must be discussed with the cardiologist , depending on the type of pathology of each patient". As a reminder, there are several types of cardiac arrhythmia, which can themselves be declined to varying degrees: tachycardia , bradycardia, atrial fibrillation, ventricular fibrillation,  atrial flutter , extrasystole and disorders of conduction.

Before you start, it is therefore essential to seek the advice of your cardiologist or your doctor . He will make you pass a battery of tests (see below) which will allow him to assess the risks and recommend the type of activity best suited to your situation. To limit the risks, he will also tell you the ideal frequency, duration and intensity  for your sessions.

Note: sporting activity at a professional level is totally prohibited in the event of cardiac arrhythmia. Because ? The high risk of sudden death of the athlete. “For physical activity to remain beneficial, patients must be able to practice it safely,” insists Dr. Kouakam.

Can you exercise after a heart attack?

The answer is yes.  Physical activity is even encouraged, since it allows for example to reduce mortality by 30% after a myocardial infarction . Exercise re-training is an integral part of post-operative care and most patients continue with gentle and moderate, but regular physical activity throughout their lives. 

What precautions to take?

As indicated above, patients wishing to embark on a new sports activity are strongly encouraged to seek the advice of their doctor. Once the necessary operations have been completed and the treatments implemented, the professional can prescribe several additional examinations:

  • an electrocardiogram (ECG), or even wearing a Holter ECG for a few days or weeks;
  • echocardiography;
  • and/or a stress test (the patient engages in physical activity under medical supervision).

Have you received your doctor's approval? Stay tuned to your symptoms!

No risk does not exist. Even if your cardiologist has given you the green light, you must follow certain common sense rules:

  • stay hydrated (within reason) for the duration of the session);
  • don't forget to warm up properly before and after exercise;
  • avoid outdoor exercise when temperatures are too hostile (too hot or too cold) or when pollution is too high  ;
  • in the heat of the moment, stay tuned to your symptoms and do not hesitate to regularly check your heart rate using connected tools;
  • follow your treatment to the letter and consult regularly to reassess your abilities and the effectiveness of your treatment.

The warning signs: 

Stop all physical activity if: 

  • your heart races more than usual;
  • you are abnormally short of breath
  • you feel feverish and/or dizzy
  • you have nausea and a feeling of being sick

And if one or more of these symptoms persist, contact the emergency services (15, 112, 18) 

Can you exercise with a Holter?

The Cardiac Holter is a portable medical device that measures the electrical activity of the heart over an extended period of time in everyday life. It is therefore recommended that you continue with your usual activities . However, avoid water sports and excessively strenuous activities that may cause the electrodes to come off as a result of shock or excessive sweating.

What is the best sport to do if you have heart problems? Are endurance sports suitable?

Physical activity should in no way endanger the patient's life. This is why not all sports are recommended for people with cardiac arrhythmias . We generally favor gentle endurance sports (especially if the people are not very athletic at the start). The most recommended sports are:

  • walking,
  • jogging , _
  • cycling,
  • and/ or swimming .

It is possible to split the effort, for example two sessions of about fifteen minutes during the day, or four sessions of five to ten minutes.

The list of sports generally contraindicated in case of cardiac arrhythmia (because too violent or intense) is longer:

  • climbing ;
  • boxing ;
  • tennis ;
  • soccer  ; _
  • volley ball ;
  • rugby ;
  • diving ;
  • basketball ;
  • etc