What is heart block?
Heart block is a condition where the electrical signals that control the heartbeat are partially or completely blocked. This results in the heart beating too slowly or with an abnormal rhythm. There are different types of heart block depending on where the blockage occurs:
- First-degree heart block – The electrical signal is delayed getting from the atria to the ventricles.
- Second-degree heart block – Some signals get through to the ventricles while others are blocked.
- Third-degree (complete) heart block – No signals get through to the ventricles.
Heart block can be present at birth (congenital) or develop later in life due to heart disease, medications, or other factors. Symptoms include dizziness, fatigue, fainting, and shortness of breath. More serious cases may require a pacemaker to maintain a normal heart rate.
Is it safe to exercise with heart block?
In many cases, it is possible to safely exercise with heart block. However, there are some important factors to consider:
- Type of heart block – First-degree and asymptomatic second-degree heart block generally do not require exercise restrictions. More severe block often requires moderation.
- Symptoms – People who experience symptoms with heart block need to take more precautions when exercising.
- Fitness level – Those who exercise regularly tend to tolerate heart block better during physical activity.
- Overall health – Underlying health conditions like heart disease require extra care when exercising with heart block.
- Activity intensity – High intensity exercise is riskier than lower intensity activities.
Talk to your doctor about your specific case of heart block and any exercise restrictions. An exercise stress test may be used to help guide safe exercise recommendations. Monitoring your heart rate and symptoms during physical activity is also important.
Precautions for exercising with heart block
If you have been cleared for exercise with heart block, here are some general precautions to take:
- Warm up gradually – Start exercise sessions slowly and build up intensity over time.
- Monitor your heart rate – Use a heart rate monitor to avoid excessive rises in heart rate.
- Know the warning signs – Stop exercising immediately if you experience faintness, rapid heart rate, chest pain or difficulty breathing.
- Stay well hydrated – Dehydration can exacerbate heart rate and rhythm issues.
- Avoid extremes of temperature – Heat and humidity can present challenges for the heart.
- Exercise with a partner – Have someone present who can assist you if problems arise.
- Use prescribed medications – Take medications as directed to help control your heart block symptoms.
Avoid holding your breath during strength exercises. This causes changes in blood pressure and heart rate. It’s also best to avoid sudden bursts of high intensity activity. Build up slow and steady over weeks to months.
Appropriate types of exercise with heart block
The ideal types of exercise will depend on your specific case. In general, moderate aerobic activities and light strength training are appropriate for many people with well-compensated heart block.
Some good options to discuss with your healthcare provider include:
- Walking – Start gradually and work up to brisk sustained walks.
- Stationary cycling – Cycling maintains a steady heart rate and avoids impact.
- Water aerobics – The water provides support and cooling.
- Yoga, tai chi, pilates – Gentle low-impact activities.
- Light strength training – Gradually work major muscle groups with light resistance.
- Seated exercises – Arm raises, marching, knee extensions while sitting.
Activities to typically avoid include:
- Competitive or intensive sports – Such as basketball, hockey, soccer.
- Sprinting, burst exercise – Spikes heart rate rapidly.
- Exercise in extreme heat or cold – Puts additional strain on heart.
- Holding breath during exertion – Causes blood pressure spikes.
- Lifting maximal weights – Can increase blood pressure dangerously.
Having a fitness tracker watch can help you monitor your heart rate response during exercise sessions. Stay below your target heart rate limits.
Creating an exercise routine with heart block
Follow these tips for establishing a safe, effective exercise program:
- Get medical clearance – Consult your cardiologist about appropriate exercise.
- Start slowly – Begin with short, low intensity sessions 1-2 times per week.
- Gradually increase – Add 5-10 minutes per session every 2-4 weeks.
- Include warm up/cool down – Do 5-10 minutes of light activity before and after exercise.
- Add variety – Try different recommended activities to maintain motivation.
- Listen to your body – Stop if you experience warning signs or feel unwell.
- Stay hydrated – Drink water before, during and after exercising.
- Monitor intensity – Use a heart rate or perceived exertion scale.
- Exercise with a partner – For safety and accountability.
A sample routine may include:
- Monday – 30 minutes walking + resistance band arm workout
- Wednesday – Water aerobics class
- Friday – Stationary bike for 20-30 minutes
- Weekend – Rest day or light yoga/stretching
Aim for a gradual increase in your total weekly exercise time until you are able to tolerate 30-60 minutes of activity most days of the week. Always start and end each session with 5-10 minutes of warm up and cool down.
Staying motivated to exercise with heart block
It takes commitment to remain physically active with heart block, but the benefits are well worth it. Here are some tips:
- Find activities you enjoy – You will be more likely to stick with them.
- Vary your workouts – Keep exercise sessions from becoming boring.
- Exercise with a friend – Social support can boost motivation.
- Join a cardiac rehab program – Supervised group exercise with people who understand.
- Focus on how you feel – Notice improvements in energy, sleep, mood.
- Track your progress – Use a journal, app or fitness wearable to follow improvements.
- Set realistic goals – Work slowly toward your next fitness milestone.
- Reward yourself – Celebrate maintaining your routine for a set period of time.
Physical activity is therapeutic for both mind and body. With your doctor’s okay, find ways to incorporate proper exercise into your lifestyle. Listen to your body and you may be surprised how much you can do.
Benefits of exercising with heart block
Despite the need for some precautions, maintaining physical activity provides many important benefits:
- Improved cardiovascular fitness – Exercise strengthens your heart, lungs and blood vessels.
- Better blood flow – Exercise promotes circulation to supply muscles and organs.
- Healthier cholesterol and blood sugar levels – Can help improve HDL, LDL, triglycerides and insulin sensitivity.
- Weight control – Activity helps burn calories and maintain a healthy weight.
- Reduced blood pressure – Even modest exercise can help lower elevated blood pressure.
- Improved mental health – Helps manage stress, anxiety, depression and boosts mood.
- Better sleep – Regular activity promotes deeper, more restful sleep.
- Improved quality of life – Allows you to maintain independence and engage in normal daily activities.
For optimal effects, health organizations recommend 150 minutes per week of moderate aerobic activity combined with 2-3 sessions of resistance training. Work with your healthcare team to determine safe exercise goals.
Risks of inactivity with heart block
It’s vitally important to remain physically active if you have heart block. Insufficient activity leads to deconditioning and a downward spiral of health. Potential consequences of inactivity include:
- Decreased muscle mass and bone density
- Stiffening and weakening of the heart and blood vessels
- Weight gain
- Increased fatigue
- Higher cholesterol and blood sugar
- Higher resting blood pressure
- Weakening of the immune system
- Impaired balance and mobility
- Increased anxiety and depression
- Reduced ability to perform daily activities
- Lowered quality of life
Lack of physical activity can essentially speed up the aging process and progression of heart disease. Do your best to incorporate some form of regular exercise that is appropriate for your level of heart block.
Conclusion
Heart block can present challenges for exercising, but a thoughtful, gradual approach makes staying active possible for many people. Discuss your individual case with your medical providers. When medically cleared, begin a routine of low to moderate intensity aerobic and strength training activities. Listen to warning signs from your body and adjust your workouts accordingly. Exercise is an important component of managing heart disease. With some common sense precautions, you can safely reap the many rewards of staying physically active.