#362 Can Exercise Triple Your AFib Ablation Success Rate?

Can Exercise Triple Your AFib Ablation Success Rate?

Regular physical activity has long been recognized as a cornerstone of optimal cardiovascular health. Exercise strengthens the heart muscle, improves blood flow, lowers blood pressure, and reduces the risk of obesity and diabetes – all factors that contribute to atrial fibrillation (AFib).

In a recent study conducted by my friend Dr. Oussama Wazni and his colleagues at the renowned Cleveland Clinic, the role of exercise in enhancing success rates for atrial fibrillation (AFib) was examined. The study aimed to explore whether individuals with higher baseline cardiac fitness, as assessed through a stress test prior to the procedure, predicted better outcomes following AFib ablation.

The findings of this study are remarkable and should grab the attention of anyone with atrial fibrillation contemplating an ablation procedure. Specifically, the study revealed that individuals who were in the best physical condition prior to the procedure experienced a staggering three-fold increase in the likelihood of a successful outcome. If you’re living with AFib, it’s crucial to continue reading to discover how you can significantly enhance your chances of a successful ablation.

The Study on Exercise Improves AFib Ablation Success Rates

In this study, the Cleveland Clinic researchers looked at 591 patients who had undergone a stress test within a year prior to their AFib ablation. They divided these patients into three groups based on their level of cardiovascular fitness: low, adequate, and high.

They then followed these patients for an average of 32 months after the procedure to see how often AFib returned and other related outcomes occurred. With regards to their AFib ablation success rates over the following 2-3 years they found the following:

-Low Cardiovascular Fitness: 21% success rate (30% for paroxysmal AFib patients)

-Adequate Cardiovascular Fitness: 46% success rate (55% for paroxysmal AFib patients)

-High Cardiovascular Fitness: 73% success rate (82% for paroxysmal AFib patients)

Additionally, patients with higher cardiovascular fitness levels were less likely to need to go back to the hospital for AFib-related issues or need more procedures to control their heart rhythm. Moreover, patients with higher cardiovascular fitness levels had a lower risk of death compared to those with lower fitness levels. Overall, the study suggests that being more physically fit before undergoing AFib treatment may lead to better outcomes and a reduced risk of AFib returning.

How Did They Define a Successful Ablation in this Study?

In this study, they checked on patients closely after their ablation procedure to see if it worked. Patients had to wear heart monitors afterward. If they had 30 seconds or more of AFib at any time, either seen on an ECG, heart monitor, home ECG, or any implanted device, the procedure wasn’t considered successful.

Dr. Day’s Take on this Study

Firstly, it’s essential to carefully assess how well the ablation worked. In this study, even if someone had AFib all the time before the procedure, finding just one short episode of AFib afterward, like 30 seconds during sleep, meant the procedure wasn’t seen as successful. A better way to measure success would be to look at how much AFib someone had before and after the procedure. From our experience, most of our patients who get an ablation see a big drop in their AFib burden and symptoms.

Secondly, I was surprised by the relatively low success rates seen in this study. One possible explanation could be the differences in the health status of the AFib patients we treat in Salt Lake City compared to those in Cleveland. Generally, it’s widely acknowledged that healthier patients tend to achieve more favorable outcomes with AFib ablation.

For example, Utah boasts notably low rates of smoking and alcohol abuse, both of which are recognized to complicate the elimination of AFib. Additionally, individuals in Utah tend to maintain higher levels of physical activity, facilitating the elimination of AFib. It’s worth noting that in our practice, we seldom encounter procedure failures among our physically fit and healthy AFib patients, particularly when allowing for a touch-up procedure.

Lastly, I’ve seen many patients over the years who decided to get healthier after not getting the ablation result they had hoped for. For instance, after still having some occasional AFib after a second procedure, they then lost weight and committed to going to the gym every day. Quite remarkably, I’ve then seen the AFib often go away completely.

How Does Exercise Help Treat AFib?

Exercise could very well be the best AFib medicine we have as it tackles several key factors that contribute to the condition. Firstly, it helps to lower blood pressure, which is a big risk factor for AFib. When you exercise regularly, it improves your heart health and helps keep your blood pressure in check.

Secondly, exercise can prevent and manage diabetes, another condition linked to AFib. By helping you maintain a healthy weight and better manage your blood sugar levels, exercise lowers your risk of developing diabetes and, in turn, reduces the chance of AFib.

Thirdly, regular exercise can prevent sleep apnea, a common sleep disorder associated with AFib. By keeping your weight in check many cases of obstructive sleep apnea go away.

Lastly, exercise is known to improve mental health by reducing symptoms of depression and anxiety, which are often seen in AFib patients. When you exercise, your body releases feel-good chemicals called endorphins, which can boost your mood and reduce stress. Overall, by addressing these different aspects of health, exercise becomes a valuable tool in treating and managing atrial fibrillation.

How to Start Getting Active?

Getting started with exercise can feel daunting, but it’s essential for managing atrial fibrillation and promoting overall heart health. Start by choosing activities you enjoy, whether it’s walking, swimming, cycling, or dancing. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

Remember to start slowly and gradually increase the duration and intensity of your workouts. Listen to your body and take breaks as needed. Don’t forget to warm up before exercising and cool down afterward to prevent injury.

Consider finding a workout buddy or joining a fitness class to stay motivated and accountable. And most importantly, be consistent – even small amounts of exercise can make a big difference in your heart health over time.

Always consult with your healthcare provider before starting any new exercise program, especially if you have underlying health conditions or concerns. They can offer personalized recommendations and guidance based on your individual needs and medical history.


The information provided in this blog article is intended for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

About the Photo

The accompanying photo captures a serene moment from yesterday, showcasing our family’s ski trail descending from the mountain after sunset. It reflects the joyous memories of a delightful day spent skiing on the majestic 9990 mountain, identifiable as the snow-covered peak in the center of the background, nestled in Park City, Utah.

Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.

  1. Over 65 when I had my first major afib episode. Had the ablation got in a good decade before my second episode. Over that time exercised pretty consistently, really decent diet, no smoking or recreational drug use but, but, drank wine everyday about twice or better than what was healthy. Then about 3 years ago the gout became a major, repeat problem. Had another afib attack but not an ablation. Stopped the drinking cold. Struggled some but now, 80 next year, would say I am better than I have been in five years. Key to keeping on has been steady no frills diet, decent exercise, decent friendships, reduced but satisfying work schedule, a long suffering wife, great canine pets and the good Dr. Day. Your lessons like the one here are entirely helpful
    Reasonable, responsible hope for another five or more years. Maybe just in time to run for president in 2028.

  2. Hi DrDay,I am88 yrs old and a amputee of 54 yrs.i read your book. I have chf and Afib.i started your diet a month ago.i am on Diltiazem and Eliquis. I have to use a walker and the meds leave me very weak and exhausted
    What do you suggest for me to get exercise. Thank you

  3. I was a high school, college, then post-collegiate endurance athlete. I experienced intermittent palpitations beginning in my late 20’s. In my late 40’s I developed paroxysmal AFib treated over the years with anti-arrhythmia meds and three cardioversions. Eventually the meds proved largely ineffective. Last year I underwent an ablation. I continued exercising prior to and following the procedure. Per Dr Day’s findings, it has made all the difference. Post ablation I occasionally experience brief unsustained tachy or palpitations but no AFib/flutter. Accordingly, I classify the procedure as successful. I assume this result may be at least partially attributable to maintaining a physically active regimen over the decades.

    • I was on metropolol for 7 years for my afib(paroxysmal) but afib episodes were increasing so I switched to diltiazem last June and am much better. I have afib continually now but don’t feel it I am active, eat well but find meds make me quite tired. I also have a pacemaker as I used to faint when pulse got too low or BP dropped. What kind of diet works best— so hard to lose weight— like 15 pounds.