Arrhythmias and exercise


Quite often the question comes up Fitness for sport with existing cardiac arrhythmias. This mainly depends on the exact shape the arrhythmia, but above all whether a structural heart disease exists or not.So you cannot generalize whether you are fit for sport or not. Only one can do this Cardiologist determine after appropriate examinations.

Preliminary examinations

Does the Suspicion on a Cardiac arrhythmiaso should a Cardiologist should be visited, who should carry out the following examinations when asked about fitness for sport:

  • a electrocardiogram (EKG), an EKG during exercise, e.g. by pressing on the Exercise bike can be triggered
  • a Echocardiography (Ultrasound scan of the heart) and
  • a long-term ECG over 24 hours.

In this way, the cardiac arrhythmia can be better localized.
In addition, the long-term EKG can be used to find out whether a context between the Cardiac arrhythmia and certain Everyday activities such as the sport exists. If the cardiac dysrhythmia intensifies during exercise, one should be aware of the presence of a structural heart disease such as the coronary artery disease (KHK) think.


The fitness for sports with cardiac arrhythmias depends on the exact form of the arrhythmia.

If the cardiac arrhythmia causes a sudden onset Loss of consciousnessso are certain Avoid sports. This includes things like:

  • Diving
  • To ski
  • To go biking
  • Riding or also
  • Motorcycling

Understandably, swimming can also involve certain dangers and should only be done under supervision. Swimming in lakes or the sea should be avoided whenever possible. Sports such as walking are available.

Was able to get a structural heart disease are proven, the probability during exercise is one Cardiac arrhythmia to get increased.

In general, however, it should be noted that there are few cases in which the risk of exercise is higher than that positive health effects of sport. This means that it is usually beneficial to regularly expose the body to light sporting activity, because physical activity has many beneficial effects in the body.

Exercise for structural heart disease (for example, coronary artery disease)

Is there a structural heart disease before, so can after thorough preliminary examinations and with no complaints a light physical exertion recommended. Exceptional loads and competitive sports, however, should not be exercised.

competitive sport

In competitive athletes, so-called bradycardiac arrhythmias, i.e. slow cardiac arrhythmias, can be observed. This is conditioned by a structural adjustment of the heart to the heavy burden. As part of the structural adjustment, a increase of the Heart muscle mass and des Volume of the heart (also known as so-called Athlete heart). That's how it is Cardiac output, i.e. the volume of blood that the heart moves into the Body circulation is sent, elevated. This means an improved supply of blood and thus also oxygen to the body during exercise. The cardiac output is general depending on the Blood volumewhich is poured out from the heart and from the Heart rate. The cardiac output should be reduced again at rest. To achieve this, the heart rate is lowered. This explains why in competitive athletes you can sometimes relax Heart rate of 40 beats per minute can determine. This form of cardiac arrhythmia is general harmless and usually not hazardous to health.

Sudden cardiac death

One speaks of one sudden cardiac death in sports if this while one physical exertion or up to an hour later of the effort entry. The following things make sudden cardiac death more likely:

  • male gender
  • advanced age
  • bad training condition
  • highly stressful sport and
  • existing risk factors for atherosclerosis, like that Smoke.

Young people are significantly less affected than people of older age as follows. The risk of sudden cardiac death can be with older age about that 20 to 100 times increase. In young age are mostly previously unknown anomalies, so Malformations, Cause of sudden cardiac death. In old age, the trigger is largely an existing atherosclerosis of the coronary arteries, which is also known colloquially as Hardening of the arteries referred to as. Sudden cardiac death triggers the sports that are also very popular and are therefore most often practiced. To be mentioned here are above all Football, swimming, cycling and to jog.

Cardiac arrhythmia after exercise

Certain cardiac arrhythmias occur especially after exercise.

A common example is what is known as paroxysmal atrial fibrillation. This arrhythmia is triggered by high blood pressure or intense endurance sports.
After exercising, the irregular heartbeat is perceived, the affected person experiences heart stumbling, palpitations or inner restlessness.
In addition, symptoms such as shortness of breath, dizziness, sweating and chest pain can occur due to the arrhythmia after exercise. The arrhythmia usually ends by itself after a certain period of rest and the symptoms also disappear. For this reason, paroxysmal atrial fibrillation can often not be diagnosed by an electrocardiogram (EKG) at the doctor, as it is not always there.

One possible diagnostic option is a long-term ECG, in which the heart rhythm is recorded over several days, for example. An attack of the arrhythmia can often be recorded. Paroxysmal atrial fibrillation is not necessarily life-threatening, but it can turn into permanent atrial fibrillation, which in the long term can lead to cardiac insufficiency (Heart failure) can lead. An early diagnosis and treatment of cardiac arrhythmias that occur after exercise is therefore of great importance.

Please also read: Symptoms of atrial fibrillation, can you do sports with atrial fibrillation?

Arrhythmia during exercise

With physical exertion, the heart rate increases from normal 60-100 beats per minute up to 200 beats per minute on.

In healthy people, the pulse remains regular, the beats occur at equal intervals one after the other. Under normal circumstances, the heart rate increases gradually rather than by leaps and bounds during exercise. After exercising, it falls off slowly and not suddenly. This fast heartbeat during exercise is completely normal, as the body has to supply more blood and more oxygen when it is stressed.
If, instead, a sudden palpitations occur, if the heart rate rises suddenly during exercise, a rapid (tachycardia) Underlying cardiac arrhythmia. An arrhythmia with a slow heartbeat (Bradycardia) manifests itself during exercise by an insufficient increase in heart rate. The heartbeat rate normally increases to more than 100 beats per minute during exercise.
If there is little or no increase, the person concerned is significantly impaired in their performance and must end the sporting activity early due to exhaustion or shortness of breath.

Cardiac arrhythmias that occur during sport should definitely be examined by a doctor before exercising again.

Cardiac arrhythmia and exercise - is it dangerous?

The risk of sudden cardiac death in athletes in connection with cardiac arrhythmias has been discussed a lot in recent years. This also raises the question of whether exercise is dangerous if you have cardiac arrhythmias. In principle, physical activity and sport protect the heart from many diseases and also from cardiac arrhythmias.

In particular, the risk of new cardiac arrhythmias and atrial fibrillation is greatly reduced by regular, light to moderate physical activity. Especially when sport is carried out well into old age, it has a protective effect on the health of the heart. Even light endurance sports (e.g. brisk walking) are beneficial to health, while too intense strength training and endurance training do not necessarily have a positive effect on the heart. Why exercise can help prevent cardiac arrhythmias is not yet fully understood. One possible explanation is that exercise contributes to weight loss, a slower heartbeat, improved fat and sugar metabolism, and lower blood pressure.

So sport is not inherently dangerous, it even promotes heart health. However, in individual cases with a previously unknown or recognized heart disease, intense sporting activity can lead to life-threatening cardiac arrhythmias. Fortunately, this happens very rarely. However, if warning symptoms are known that indicate a heart disease, a medical evaluation should be carried out before intensive sport is practiced.

In the case of a known cardiac arrhythmia, exercise at the right frequency and intensity can also be beneficial in promoting heart health. Here it depends on a good individual consultation with the attending physician which types of sport are suitable and which intensity should be aimed for. Some tachycardiac arrhythmias can be treated with the help of modern therapy methods such as catheter ablation. As a rule, sporting activity is possible and desirable again after a certain period of time after such a treatment. If a cardiac arrhythmia is treated with medication, the effects of the medication may lead to a reduction in performance. Here, too, the right type of sport and the intensity level of physical activity should be discussed with the doctor individually.

Sports activity should always be stopped if symptoms such as dizziness, severe shortness of breath or palpitations occur during training. In this case, it is imperative to see a doctor.

You might also be interested in our next article: Heart stumbling during exercise


People who do a lot of sport tend to have low heartbeats, so-called Bradycardias. Usually the Heart rate (Pulse) between 50 and 80 beats per minute. However, especially in endurance athletes, the heart rate can drop to up to 30 beats per minute at rest.

For some endurance athletes, electrocardiography (EKG) certain cardiac arrhythmias due to the slow heartbeat (AV blockages I and II degrees).
The cause of these cardiac arrhythmias lies in the fact that the heart and the conduction pathways of the heart are trained by sport to beat efficiently with a lower heart rate under high stress. These bradykarden (slowed downCardiac arrhythmias can lead to various symptoms, ranging from a brief circulatory collapse with loss of posture control (vasovagal syncope) to severe dizziness and brief loss of consciousness (syncope).