Hi ,
in response to lamaj545,i would like to emphasise that Physiotherapy management is absolutely contra -indicated in fast AF.but in an acute post operative setting,as in the case of valve replacement most patients are discharged from hospital with AF - slow and controlled.thats where cardiac rehabilitation starts.Even in the ICU we can never give Breathing exercise to a patient with AF if it is uncontrolled.we need to wait till it settles.so right from breathing exercise to simple arm movements we need to chek if his heart rate is acceptable.it will be really dangerous to begin with walking or cycling without cheking on his endurance for simple arm and leg exercises.even walking is also progressed according to his endurance.we need to remember that the cardiac muscle is not the same like the skeletal muscle.we can never encourage the patient to do more exercises as we do with strengthening for skeletal muscle.so instructing the patient to do within his tolerance is the very apt phrase.