Research has shown that
regular exercise and physical activity have numerous benefits for people fitted
with an ICD. These include improving your heart and lung function, increasing
life expectancy as well as boosting your confidence and energy levels. One of
the biggest obstacles to starting exercise is often fear as many people are
worried that it may be unsafe to exercise with an ICD. However, the likelihood
of an arrhythmia occurring during moderate intensity exercise is no greater
than whilst resting providing you warm up and cool down properly and follow a
few simple guidelines.
If you are starting to
exercise for the first time or worried about whether an exercise is safe then
please speak to your GP or cardiologist before you begin. They will be able to advise on how your ICD
is programmed and tell you how high you can safely raise your heart rate. Avoid
exercising if you feel unwell or are recovering from illness. Stop and rest if
you start to feel unwell during exercise.
To get the beneficial effects
of exercise you should aim to exercise or be physically active at least five
times a week for 30 minutes or more. If you can not manage 30 minutes in one
session you can split it up into shorter intervals. You should exercise at an
intensity which gets your heart beating at between 60-75% of your maximum heart
rate (maximum heart rate = 220 minus your age, if you are on beta blockers
subtract a further 30). You can also monitor your exercise intensity by rating
your own effort on a scale of 0-10 with 0 representing how you feel at rest and
10 your maximum effort. You should aim to keep your perceived exertion at 4-6
on this scale. This means breathing hard enough that you need to breath through
your mouth but still have enough breath to talk in full sentences.
An important part of
exercising safely is warming up and cooling down. This involves doing lower intensity
activities and stretching for about 10 to 15 minutes before and after exercise
to allow your heart rate to increase and decrease gradually. You should be able to breath comfortably
through your nose during this period. If you are breathing through your mouth
you are working too hard.
The type of exercise
you do is down to personal choice. Exercises that use lots of muscle groups are
best e.g. walking, cycling, dancing or gardening. Try to choose something you
enjoy as you are more likely to stick with it.
Avoid exercises that involve heavy lifting, lying down or use only your
arm muscles.
The many benefits of
exercise don't just apply to people with ICDs. Most people will benefit from
increasing their physical activity levels so why not involve other members of
the family? Exercise gives you the ideal opportunity to find an activity you
can enjoy together whilst taking a positive step towards improving your health.
If you have recently
been fitted with your ICD ask your cardiologist about a referral to cardiac
rehabilitation. This is a six week
hospital based programme which will show you how to start exercising safely. If you have had your ICD for some time then
community based programmes are available which will enable you to exercise
under the supervision of a specially trained fitness instructor. These programmes are held at Nuffield Health
& Wellbeing in West Byfleet or West Byfleet Village hall (contact Sandra
Cragg 07768 790887) and in Woking leisure centre (contact Suzanne Lawrence
07973 773330) .
More information can be
found on the web at www.heartrhythmcharity.org.uk or in the British Heart
Foundation leaflet “30 mins a day – any way”.
Anna Knott
Senior Physiotherapist
Cardiac Rehabilitation, St Peters Hospital
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