Doctors & patients are saying about 'A-Fib.com'...


"A-Fib.com is a great web site for patients, that is unequaled by anything else out there."

Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."

Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
Baltimore, MD


Doctors & patients are saying about 'Beat Your A-Fib'...


"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su,
Cavanaugh Heart Center, 
Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA


Patti Ryan

Steve's wife, Patti The story goes that when Steve Ryan started planning his website for A-Fib patients (A-Fib.com), the top priority was presenting up-to-date medical and research information but in layman’s terms, not medicalese. That’s where Patti Ryan enters the picture. With a background in corporate communications, she pledged to fight tooth ‘n nail, if needed, to represent the patients’ point-of-view and drum out as much medical jargon as possible. And, yes, there were many heated “discussions.” Patti also contributes her graphics and photography savvy to both A-Fib.com and and the publishing of the book, Beat Your A-Fib: The Essential Guide to Finding Your Cure (BeatYourA-Fib.com). Patti has earned a B.F.A. in Fine Art, a B.S. in Communications, and university certificates in business management and corporate training. Her professional experience ranges from graphic design and digital photography to corporate video production, and business management. In the past few years she has focused on creative project design and writing for the craft and home décor magazine/book publication markets. For more background information, see Patti J Ryan at LinkedIn.

For A-Fib Patients: An Updated Review of Medic Alert ID Products

When you have A-Fib and you’re taking a blood thinner or other medications, you may want to carry details of your specific medical history.

From the simple printed card to products with an integrated USB drive, there are many ways to carry your emergency history with you these days.

Beyond the familiar styles of metallic Medic Alert ID bracelets and necklace pendants, there are products using newer materials like waterproof foam, Duro silicone and plastic. And products linking to centralized, password protected data storage services.

We’ve reviewed dozens of products to offer you an updated sampling of the available options. (For each product, we’ve included a hyperlink so you can easily get more information.)

A Few of Our Favorite Wearables

These are a few items that caught our eye. An Apple Watch slip-on ID band with multiple lines of custom text, an athletic shoe with medical ID card holder which attaches with velcro. And a sports helmet warning decal for 911 responders, with registered data service and built-in medical ID pocket.

Apple Watch strap add-on stainless steel medical ID from Road ID

Athletic shoe ID pocket with Velcro attachment by Vital ID

Helmet warning decal for 911 EMTs with ID card pocket from Vital ID

USB Drive Equipped Products with Medic Alert Symbol

These products all display an emergency symbol or label and includes an integrated USB drive. Data can be registered or entered by the owner. A few items are a Duro silicone, latex-free bracelet with pop out USB drive, a stainless steel key chain with the USB built into the fob, and credit-card size data wallet card with a hinged USB drive.

Duro silicone bracelet with integrated USB drive by CARExcel Medical History

Key ring fob with integrated USB drive by Key 2 Life® EMR Medi-Chip

Emergency Medical Information USB Card – The size of a credit card! by 911 Medical ID

Keeping it Simple: Print Your Medical ID Wallet Card

Printable Med ID Wallet Card from AllenLawrence.com

If you want the low-tech version, here are three free online sources for printing your own wallet cards:

Printable Emergency Medical ID Card (online form) by AllFreePrintable.com
• Print Your Own Emergency Medical I.D. Card (online form) by AllenLawrence.com
Emergency Contact Card (in PDF format) from the American Red Cross

Follow the online instructions to enter your information. Then print, trim, fold and add to your wallet or purse. (Or print the blank form and fill-in by hand.)

Money clip from Universal Medical Data

Don’t carry a wallet? Consider a Money Clip with medical symbol and a compartment to slide in an emergency medical ID (left); from Universal Medical Data.

Review and Update the Contents Regularly

Whichever method(s) you use to carry your emergency medical information, don’t forget to review and update the contents regularly. For example, when you change doctors, when you start (or stop) a medication, or if you have a medical emergency or surgical procedure.

Knowing you have up-to-date medical information will give you peace of mind.

Additional thought: Consider your spouse and other family members. Should they also carry their medical emergency ID information?

What Emergency Medical Info Should You Carry?

For information about what emergency medical information to carry, see our article, Your Portable Medical Information Kit.

Update: A-Fib and Dementia & My Top 5 Articles

This article was first published on Apr 26, 2017. Last updated: March 14, 2019

There’s a growing body of evidence linking atrial fibrillation with early onset of dementia. New cases of dementia are diagnosed every four seconds. The number of people with dementia is also expected to triple worldwide to an estimated 140 million by 2050.

Most Feared: When 65+ year olds were asked what disease or condition they were most afraid of getting, 56 percent cited memory-robbing dementia.

Good News: A bit of good news is that the prevalence rate of dementia has declined in some countries, including in the US. And researchers think it may in part be due to increases in levels of education, which seems to protect people from getting dementia.

For a disease many of us fear, the message is hopeful: Dementia is not necessarily inevitable.

While both Atrial fibrillation and dementia have been linked to aging, neither is a normal part of growing older.

Reducing Your Risk of Developing Dementia

You CAN influence or avoid developing dementia. Review these articles to learn more about the link between Atrial Fibrillation and dementia:

1. Anticoagulants, Dementia and Atrial Fibrillation
2. Increased Dementia Risk Caused by A-Fib: 20 Year Study Findings
3. FAQ: “I’m scared of getting dementia. Can the right minerals help? I’ve read about the link with A-Fib. What does research reveal about this risk?”
4. Leaving Patients in A-Fib Doubles Risk of Dementia—The Case for Catheter Ablation
5. FAQ: I’m concerned because Vitamin D deficiency has been tied to both A-Fib and Dementia. What is a normal level of Vitamin D

A-Fib Patients & Strategies to Prevent Dementia

Atrial Fibrillation and Dementia: Neither is a normal part of growing older.

What doesn’t work: current drugs, even statins, don’t work or have mixed results in preventing dementia.

What does work: Catheter ablation to eliminate your Atrial Fibrillation. Patients who get a catheter ablation have long-term rates of dementia similar to people without A-Fib. (This result holds regardless of their initial CHADS2 score.)

Don’t Settle. Seek your A-Fib cure: To decrease your increased risk of dementia, your goal should be to get your A-Fib fixed and get your heart beating normally again. We can’t say it enough:

Do not settle for a lifetime on meds. Seek your A-Fib cure.

Reference for this Article
Americans Rank Alzheimer’s as Most Feared Disease, According to New Marist Poll for Home Instead Senior Care; November 13, 2012 http://www.businesswire.com/news/home/20121113005422/en/Americans-Rank-Alzheimer%E2%80%99s-Feared-Disease-Marist-Poll

Prince M, et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dementia. 2013;9:63–75. [PubMed]

I Couldn’t Believe the Drugs He Was On; How to Ask Questions About Your A-Fib Prescriptions

03/15/2019 5 pm: Corrected a missing link below to the Free Worksheet, Ask These Questions Before Starting a Prescription Drug.

I received a very distressing email from a reader, Kenny, who was worried about his prescribed medications. He wrote that he just had a cardioversion a week ago and is back in A-Fib (unfortunately that’s not uncommon). Alarm bells went off in my head when I read:

“My doctor just prescribed me amiodarone 200mg, 4x a day…I’m a little concerned about the amiodarone and all the side effects!”

“I’m also on Digoxin…Xarelto and aspirin… .”

“I can’t get my doctor’s office or doctor to call me back! Reluctant to start amiodarone until I can talk to someone!” 

Drugs Therapies Concerns - capsule of heart molecules at A-Fib.com

Drugs Therapies Concerns

Ding, Ding, Ding! I am deeply concerned for him. The doctor prescribing these drugs is in internal medicine, not a cardiac electrophysiologist. While Kenny and I continue to exchange emails, here’s some highlights from my first reply:

Amiodarone is an extremely toxic drug, and this dosage is 4x the normal dose.
You must get a second opinion ASAP! (consult a cardiac electrophysiologist)
Digoxin is also a dangerous drug not normally prescribed for A-Fib patients.
It’s very unusual to prescribe both Xarelto and aspirin.

Time to Change Doctors? And lastly, I wrote him that if your doctor or his office isn’t calling you back, that’s a sign you should look for a new doctor (don’t be afraid to fire your doctor). You need good communication when you’re in A-Fib and trying to find a cure.

I’m glad Kenny reached out to me so we can get him on the right A-Fib treatment plan for him and his treatment goals.

Ask These Questions Before Starting a Prescription Drug

Download the Free Worksheet

Before starting any prescription drug for your Atrial Fibrillation, you should ask what it’s for and why you should take it.

Download our free worksheet, 10 Questions to Ask Before Taking Any Medication’ and use as a guide to ask these questions of your doctor or healthcare provider, and note their responses:

1. Why am I being prescribed this medication?
2. What are the alternatives to taking this medication?
3. What are the side effects of this drug?
4. Are there any precautions or special dietary instructions I should follow?
5. Can it interfere with my other medications?.
6. How long before I know if this drug is working?
7. How will I be monitored on this drug? How often?
8. What happens if this drug doesn’t work?
9. What if my A-Fib symptoms become worse?
10. If I don’t respond to medications, will you consider non-pharmaceutical treatments (such as a catheter ablation)?

Research and Learn About Any Prescription Drug 

You can do your own research about a specific medication and if it’s the right one for you.

An excellent prescription database is the U.S. National Library of Medicine Drug Information Portal. (For an example, see the page on Warfarin [Coumadin].)

Decision Making Time

Download our free worksheet: ’10 Questions to Ask Before Taking Any Medication’. Take a copy to your office visits.

Your research and the answers to these 10 questions should help you decide about taking a new prescription drug. Remember, it’s your heart, your health. Taking medications is a decision you should make in partnership with your doctor.

Note: File your completed worksheets in your A-Fib binder or file folder to use for future reference and follow-up.)

Why You Should Learn to Live with Your Atrial Fibrillation—Not!


“Don’t let anyone—especially your doctor—tell you that
A-Fib isn’t that serious…or you should just learn to live
with it…or to just take your meds.”

From Beat Your A-Fib: The Essential Guide to Finding Your Cure


Research studies tell us the longer you have Atrial Fibrillation, the harder it can be to cure it. A-Fib patient Daniel Doane, Sonora, CA, shares his insights:

Daniel D.

“I didn’t realize how continued A-Fib so drastically remodels your heart. ‘A-FIB BEGETS A-FIB’ was the phrase that brought it home to me. 

Every instance of A-Fib changed my heart, remodeled the substrate, and made it more likely to happen again. Get your A-Fib taken care of. It won’t go away. It may seem to get better, but it will return.”

Lessons Learned: After eight years with A-Fib, Daniel had a successful Totally Thoracoscopic (TT) Mini-Maze operation. In his personal story in Beat Your A-Fib, he offers this advice to others with A-Fib:

“Get a catheter ablation or a mini-maze procedure, whichever best suits your situation. I wish I had had this done sooner. I personally think that the sooner a person has a procedure, the better off they are.”

For more from Daniel, a patient now free from the burden of Atrial Fibrillation, see: “I Have Gotten a Lot of Bad Advice From Various GPs”. 

“Don’t let anyone tell you that A-Fib isn’t that serious.

To be cured of your A-Fib, you may need to ‘fire’ your current doctor, see Is This the Year You Fire Your Doctor? and Finding the Right Doctor for You and Your A-Fib.

Medical Marijuana: A-Fib Patients Offer Personal Experiences

Due to the increased use of medical marijuana in California and other states, we should soon be getting more data on marijuana’s effects on Atrial Fibrillation.

Several readers with A-Fib have emailed me to share their experiences and observations with marijuana. There seems to be a lot of interest every time I write about this topic.

How about you? I’d love to get more first-hand feedback from A-Fib users. Please email me.

First-Hand Experiences: A-Fib and Medical Marijuana

Jim, an A-Fib patient, has kindly shared his personal use of marijuana and how it helps him. He has tried various meds, cardioversion, and had a failed ablation. He owns his own business in California and is under a lot of stress.

♥ JIM: “Because of all of this, I was having trouble sleeping and was getting very stressed out. But instead of taking something pharmaceutical, I turned to medical marijuana. It changed my life. I come home at night, have some marijuana edibles, and the stress goes away. I sleep wonderfully at night, waking up fresh and ready for another day.

I told my doctor who understands. He says that marijuana edibles shouldn’t have anything to do with A-Fib, and that I can continue to take them.”

On the other hand, John writes that:

♥ JOHN: “99% of his A-Fib attacks occurred while under the influence of marijuana.”

And others add their experiences:

♥ JONATHAN: “I tried a tiny bit of brownie for the first time since being diagnosed with A-Fib (occasional episodes). It was OK until about two hours later. I went into A-Fib and, a bit later, came the closest I ever have to blacking out. I don’t think it’s for me anymore.”

You can join the discussion, too. If you have used marijuana to help with your A-Fib symptoms, email me and share your experience.

♥ WILLIAM: “The A-Fib ablation has been very successful, except the two times that I went into A-Fib after smoking marijuana. I’m a lifelong recreational marijuana smoker, also smoke to relieve the pain from six surgeries on my right arm. Both times that I’ve gone into A-Fib since my last ablation have been after smoking marijuana. After the latest episode I’ve quite smoking marijuana because of the evidence that it can lead to A-Fib.”

♥ SCOTT: “I am currently 55 years old and have been through 15 cardioversions due to A-Fib. I smoked marijuana pretty much daily and noticed that, when I smoked, my heart rate went up. So, I stopped smoking altogether. Since quitting smoking marijuana 7 years ago, I have not had a single case of going into A-Fib. I’m positive that the two are related.”

Scott added that he also stopped drinking which helped. He used to drink a six pack daily.


PODCAST: Marijuana—Good, Bad or Ugly for Patients with A-Fib?

For my most recent report about A-Fib and Marijuana, listen to my Podcast with Travis Van Slooten, publisher of LivingWithAtrialFibrillation.com. (About 18 min. in length.) Includes transcript.

PODCAST

Marijuana—Good, Bad or Ugly for Patients with A-Fib?

With Steve Ryan and Travis Van Slooten (18 min.)

Go to Podcast

References for this article
Korantzopoulos, P. et al. Atrial Fibrillation and Marijuana Smoking. International Journal of Clinical Practice. 2008;62(2):308-313.

Petronis KR, Anthony JC. An epidemiologic investigation of marijuana- and cocaine-related palpitations. Drug Alcohol Depend 1989; 23: 219-26.

Rettner, R. Marijuana Use May Raise Stroke Risk in Young Adults. LiveScience.com, MyHealthNewsDaily February 08, 2013. Last accessed Nov 5, 2014. URL: http://www.livescience.com/26965-marijuana-smoking-stroke-risk.html

How to Cook up Your A-Fib Plan for a Cure

At A-Fib.com we encourage you to become your own best patient advocate. Here’s our “recipe” to help you look beyond common drug therapies and nourish you on your path to an A-Fib cure or best outcome for you.

We hope the ingredients in our “recipe” will help you in your journey to a life free of the burden of Atrial Fibrillation. At A-Fib.com we can help you, and many of our A-Fib.com readers have written their personal stories to help you, too.

A-Fib Patient Stories: Listed by Topic

It’s encouraging to read how someone else has dealt with their A-Fib. In our 99+ Personal A-Fib Stories of Hope, A-Fib patients tell their stories to help bolster your determination to seek a life free of A-Fib.

Pick an A-Fib story by Theme or Topic: You may find it helpful to read a specific type(s) of stories. For example, about A-Fib patients in your age group, patients with the same symptoms as yours, or perhaps patients who have had a specific treatment such as a cardioversion, catheter ablation or a mini-maze surgery.

Select stories by theme or topic

How to Choose an A-Fib story: To help you select a personal A-Fib story, we’ve cross-referenced them by five major themes and topics:

by Cause
by Risk Factor
by Symptom
by Age group/Years with A-Fib
by Treatment

Each category has several subcategories. To browse stories on a specific subject, see Personal A-Fib Stories ‘Listed by Subject’.

At A-Fib.com, we can help you to
Whip up your Resolve to
Seek your Cure. 

Why am I Angry at Some Doctors Treating Atrial Fibrillation Patients?

I can’t tell you how angry I am at cardiologists who want to leave their patients in Atrial Fibrillation.

It doesn’t matter even if a patient has no apparent symptoms. Just putting a patient on rate control meds and leaving them in A-Fib can have disastrous consequences.

Silent A-Fib Discovered During a Routine Physical

Discovered during routine exam

I corresponded with a fellow who had just found out he was in “silent” Atrial Fibrillation (no symptoms).

I told him he was very lucky (and should buy his doctor a present in gratitude). His doctor discovered his A-Fib during a routine physical exam. If his silent A-Fib had continued untreated, he might easily have been one of the 35% who suffer a debilitating A-Fib-related clot and stroke.

I would normally commend his cardiologist, but his doctor just put him on the rate control drug, diltiazem, and left him in A-Fib.

That is so wrong for so many reasons!

Rate control drugs aren’t really a “treatment” for A-Fib. They leave you in A-Fib.

Rate Control Drugs Don’t Really “Treat” A-Fib

Rate control drugs aren’t really a “treatment” for A-Fib. Though they slow the rate of the ventricles, they leave you in A-Fib.

They may alleviate some A-Fib symptoms, but do not address the primary risks of stroke and death associated with A-Fib.

Effects of Leaving Someone in A-Fib

A-Fib is a progressive disease. Just putting patients on rate control meds (even if they have no apparent symptoms) and leaving them in A-Fib can have disastrous consequences. Atrial Fibrillation can:

Infographic at A-Fib.com A-Fib is a Progressive Disease

• Enlarge and weaken your heart often leading to other heart problems and heart failure.

• Remodel your heart, producing more and more fibrous tissue which is irreversible.

• Dilate and stretch your left atrium to the point where its function is compromised.

• Progress to Chronic (continuous) A-Fib often within a year; Or longer and more frequent A-Fib episodes.

• Increase your risk of dementia and decrease your mental abilities because 15%-30% of your blood isn’t being pumped properly to your brain and other organs.

What Patients Need to Know

For many, many patients, A-Fib is definitely curable. You don’t have to settle for a lifetime of “controlling” your Atrial Fibrillation.

Normal Sinus Rhythm: The goal of today’s AHA/ACC/HRS A-Fib Treatment Guidelines is to get Atrial Fibrillation patients back into normal sinus rhythm (NSR) and stay in sinus rhythm.

Unless too feeble, there’s no good reason to just leave someone in A-Fib (see note below).

Don’t let your doctor leave you in A-Fib. Educate yourself. Learn your treatment options.

Always Aim High! No matter how long you’ve had A-Fib, you should aim for a complete and permanent cure. Shoot for the moon, as they say, and you’ll find the best outcome for you and your type of A-Fib.

Note for this article
A rebuttal: A cardiologist may cite the 2002 AFFIRM study to justify keeping patients on rate control drugs (and anticoagulants), while leaving them in A-Fib. But this study has been contradicted by numerous other studies since 2002.
References for this article
• AHA/ACC/HRS. 2014 Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2014; 130: e199-e267 DOI: 10.1161/CIR.0000000000000041.

• AHA/ACC/HRS 2014 Guideline for the Management of Patients With Atrial Fibrillation. Circulation. published online March 28, 2014, 4.2.1. Antiplatelet Agents, p 29.doi: 10.1161/CIR.0000000000000041 Last accessed Nov 23, 2014.URL: From http://content.onlinejacc.org/article.aspx?articleid=1854230

I’m off to Boston: Attending the International AF Symposium 2019

To stay current about advances in the treatment of Atrial Fibrillation, each year I attend the annual International AF Symposium. The AF Symposium is one of the most important scientific conferences on A-Fib in the world. This year the conference is January 24-26, 2019 in Boston.

This intensive, highly focused three-day symposium brings together more than 50 of the world’s leading medical scientists, cardiologists and cardiac electrophysiologists (EPs) for a thorough and practical course on the current state of the art in the field of atrial fibrillation.

My goal is to offer A-Fib.com readers the most up-to-date research and developments in the treatment of A-Fib that may impact their treatment choices. 

This meeting has become a major scientific forum for health care professionals to learn about advances in research and therapeutics directly from many of the most eminent researchers, scientists and investigators in the field.

Reports for A-Fib.com: I usually attend all of the over 65 presentations, live procedures via video, and panel discussions. I then select the topics of most importance from a patient’s point of view and write summaries for patients with Atrial Fibrillation.

My goal is to offer A-Fib.com readers the most up-to-date research and developments that may impact their treatment choices. Look for my reports in the coming months.

My 2018 Summaries: In the meantime, you can review my reports from the 2018 AF Symposium.

AF Symposium participants with large presentation screens

Q&A: Natural Therapies & Holistic Treatments For Atrial Fibrillation

You probably have a long list of questions about your Atrial Fibrillation. At A-Fib.com, we have answered thousands of patient questions—perhaps some of the same questions you may have right now. We’ve organized these questions and answers into several topics and treatment groups.

CC use credit - Nikodem_Nijak

Complementary and Natural Therapies

Under FAQ about Living with A-Fib, we discuss Natural Therapies & Holistic Treatments.

Here we focus on topics such as naturopathic doctors, complementary or integrated medicine as well as mind/body practices such as chiropractic, acupuncture, yoga and meditation.

Some of the questions we answer: How do I find a doctor with a more “holistic” approach?,  Is there any evidence on Yoga helping with A-Fib symptoms? and Do A-Fib patients find chiropractic adjustment useful?

We also answer questions about whole food or organic diets, A-Fib and supplements, and the vagal maneuver’.

We invite you to browse through the lists of questions. To read more, just ‘click’ on the question to be taken to the answer page.

Go to Q&A: Natural Therapies & Holistic Treatments

From the U.S. National Institutes of Health (NIH):

“Most people use non-mainstream approaches along with conventional treatments. The boundaries between complementary and conventional medicine overlap and change with time.”  

5-Year CABANA Trial: Compares Catheter Ablation with Antiarrhythmic Drug Therapy

The catheter ablation procedure for Atrial Fibrillation has been around for 20+ years.

In a randomized controlled trial, the 5-year CABANA study is the largest to compare the A-Fib treatments of catheter ablation (PVI) and antiarrhythmic drug therapy (AAD).

CABANA stands for Catheter Ablation versus Antiarrhythmic Drug Therapy.

CABANA Trial Design

Worldwide, 2,204 patients with new onset or undertreated Atrial Fibrillation were randomized between two treatments: catheter ablation (PVI) or antiarrhythmic drug (AAD) therapy. Patient participants were followed for nearly 5 years.

Patients details: Many patients had concurrent illnesses with Atrial Fibrillation: cardiomyopathy (9%), chronic heart failure (15%), prior cerebrovascular accidents or TIAs (mini-strokes) (10%).

Over half of participants (57%) had persistent or long-standing persistent A-Fib [i.e. harder types of A-Fib to cure].

Drug details: Antiarrhythmic drug (AAD) therapy was mostly rhythm control (87.2%), some received rate control drug therapy.

Anticoagulation drug therapy was used in both groups.

CABANA Trial Results

Crossover a Major Problem: Many in the AAD therapy arm decided to have a catheter ablation instead (27.5%). And some in the ablation arm decided not to have an ablation (9.2%). [One can not blame patients or their doctors for making these life-impacting choices.] 

The CABANA results showed catheter ablation was significantly better than drug therapy for the primary endpoint (a composite of all-cause mortality, disabling stroke, serious bleeding or cardiac arrest). [See Additional Research Findings below.] Mortality and death rate were also significantly better for catheter ablation.

CABANA Findings: Ablation vs AAD Therapy

▪ Catheter Ablation significantly reduced the recurrence of A-Fib versus AAD therapy.

▪ Catheter Ablation improved ‘quality of life’ (QofL) more than AAD therapy, though both groups showed substantial improvement.

▪ Catheter Ablation patients had incremental, clinically meaningful and significant improvements in A-Fib-related symptoms. This benefit was sustained over 5 years of follow-up.

▪ Catheter Ablation was found to be a safe and effective therapy for A-Fib and had low adverse event rates.

Take-Aways for A-Fib Patients

Ablation Works Better than Antiarrhythmic Drugs: Rather than a life on antiarrhythmic drug therapy, the CABANA trial and other studies show that a catheter ablation is the better choice over antiarrhythmic drug therapy.

For related studies, see CASTLE AF: Live Longer-Have a Catheter Ablation and AATAC AF: Catheter Ablation Compared to Amiodarone Drug Therapy.

In an editorial in the Journal of Innovations in Cardiac Rhythm Management, Dr. Moussa Mansour, Massachusetts General Hospital, wrote about the CABANA trial:

“It confirmed our belief that catheter ablation is a superior treatment to the use of pharmacological agents, and corroborates the findings of many other radomized clinical trials.” 

Lower Recurrence: What’s also important for patients is the lower risk of recurrence of A-Fib versus AAD therapy.

Reduced Ablation Safety Concerns: Ablation significantly improved overall mortality and major heart problems.

Immeasurable Improvement in Quality of Life! Perhaps even more important for patients on a daily basis, catheter ablation significantly improved quality of life.

Don’t Settle for a Lifetime on Drugs

Over the years, catheter ablation for A-Fib has become an increasingly low risk procedure with reduced safety concerns. (Ablation isn’t surgery. There’s no cutting involved. Complication risk is similar to tubal ligation or vasectomy.)

An ablation can reduce or entirely rid you of your A-Fib symptoms, make you feel better, and let you live a healthier and longer life (for people who are older, too). A catheter ablation significantly improves your quality of life (even if you need a second “re-do ablation” down the road).

For many, many patients, A-Fib is definitely curable. Getting back into normal sinus rhythm and staying in sinus rhythm is a life-changing experience, as anyone who’s free from the burden of A-Fib can tell you.

See also:  Does a Successful Catheter Ablation Have Side Benefits? How About a Failed Ablation?

Additional Study Findings
Primary endpoints: Results of the primary endpoints were not significant. This is probably due to the crossovers and the lower than expected adverse event rates (5.2% for ablation versus 6.1% for AAD therapy).

Deeper Analysis of Data: The researchers performed sensitivity analyses on the primary results using “treatment received” and “per protocol” rather than “intent to treat”.

Research Terms: Primary endpoint—specific event the study is designed to assess. Intent to treat—all assigned to the AAD group compared to the assigned ablation group (even though 1/4 crossed over to the ablation group). Treatment received—compared all who received an ablation to all who received AAD therapy.
References for this article
• Packer, Douglas. CABANA trial provides important new data on clinical and quality of life effects of ablation for atrial fibrillation. Cardiac Rhythm News: October 18, 2018, Issue 42. P. 1.

• Mansour, Moussa. Letter from the Editor in Chief. The Journal of Innovations in Cardiac Rhythm Management, June 2018. DOI: 10.19102/icrm.2018.090609.

Is 2019 the Year You Fire Your A-Fib Doctor?

Consider this question: “What would you tell your healthcare providers about living with A-Fib?”

That’s the question Mellanie True Hills, StopAFib.org, posed in 2017 to A-Fib patients on several online forums. Around 1,000 A-Fib patients and caregivers from around the world responded.

(How would you answer her question?)

A Top 10 List from A-Fib Patients to Their Doctors

After culling the patient comments, Ms. Hills distilled them into a top 10 list: 5 things A-Fib patients do not want to hear from their doctors and 5 things they do want to hear. She shared these insights with an AMA audience of doctors and later in a journal article for Electrophysiologists. For the full article with the accompanying explanations, go to her journal article.

Five Things A-Fib Patients Do Not Want To Hear

Ms. Hills’ survey results and several research studies tell us that some doctors underestimate the impact Atrial Fibrillation has on a patient’s quality of life. Many doctors treat A-Fib as a benign heart ailment. But patients report how A-Fib can reek havoc in their lives.

Responding A-Fib patients in this survey have said they do not want their healthcare providers to say:

  1. “A-Fib won’t kill you.”
  2. “Just get on with your life and stop thinking about your A-Fib.”
  3. “Stay off the Internet and only listen to me.”
  4. “I’ll choose your treatment, not you.”
  5. “You’re just a hysterical female.”

How Does Your A-Fib Doctor Measure Up?

Did anything on this list sound (or feel) familiar to you?

Think about your doctor’s manner and personality. Is this someone who works with you? Someone who listens to how A-Fib makes you feel? Does this doctor inspire confidence? Is this someone you’re comfortable with and trust with your health care?

Even if a doctor is the best in their field and an expert in your condition, that may not help you if they don’t communicate well with you and they don’t respect you.

If your doctor is condescending or dismisses your concerns, you’re getting poor care. If a doctor is too busy to talk with you and answer your concerns, he’s probably too busy to take care of you properly.

It may be time for you to change doctors.

Five Things A-Fib Patients Do Want To Hear

Those doctors who recognize the serious effects atrial fibrillation can have on patients will foster meaningful and productive partnerships with their patients. To bolster the doctor–patient relationship, here are five things A-Fib patients do want their healthcare providers to say:

  1. “I respect you and will listen.”
  2. “I want to be sure you understand.”
  3. “Let’s customize a treatment that works with your lifestyle.”
  4. “I understand your values and preferences.”
  5. “Here are some resources about A-Fib.”

Is 2019 the Year You Fire Your Doctor?

Your relationship with your doctor is important. Do the comments on this second list sound like your doctor?

If you don’t have this kind of rapport with your current doctor(s), it’s worth looking elsewhere for a new doctor (even if they’re “the best” in their field).

When your doctor respects you and listens to you, you’re more likely to collaborate on a treatment plan tailored to you and your treatment goals.

Developing a good relationship helps you feel comfortable asking questions and getting feedback in a give-and-take environment. And you’re more likely to accept and follow their advice.

Changing Doctors Can Be Scary

The researcher in doctor-patient communication, Robin DiMatteo, of U. of Calif.- Riverside, says of changing doctors: ”I really think it’s a fear of the unknown. But if the doctor isn’t supporting your healing or health, you should go.”

We can help you. Learn more about how to Find The Right Doctor For You and Your Treatment Goals.

Helping Doctors Understand A-Fib from the Patients’ Point-of-ViewRead about my own experience talking to over 200 cardiologists and surgeons about the emotional stress of A-Fib from a patient’s point of view.

Resources for this article
Mellanie True Hills presentation, 2017 American Heart Association Scientific Sessions in Anaheim, California, November 11-15, 2017.

Recognize AFib Patient Values by Mellanie True Hills. PowerPoint Presentation. From Improving Outcomes for Patients with AFib. American Heart Assoc. Non-CME Webinar. May 3, 2018. https://www.heart.org/-/media/files/health-topics/atrial-fibrillation/improving-outcomes-for-patients-with-afib-ucm_500972.pdf?la=en&hash=CDE25CF86D94CE01B9D5662E45E86619F20FF809

Hills, M T.  The transformative power of understanding and trust in AF care: How doctors can provide better treatment by understanding the hearts―and minds―of AF patients. Journal of Cardiovascular Electrophysiology. Point of View. Volume 29, Issue 4, April 2018. Pages: 641-642. https://doi.org/10.1111/jce.13443

‘A-Fib-Zebub’ Whispers in your Ear …”A-Fib’s not that Bad”

That little voice has a name: A-Fib Zebub.

This little character is called “That Demon A-Fib-Zebub“. He’s that tiny voice that’s whispers in your ear…“You don’t look sick! A-Fib’s not that bad. You can live with it”.

Don’t Listen to A-Fib-Zebub!

Any time A-Fib-Zebub pops up in your head, it’s time to remember that A-Fib is not benign, but a progressive disease. It’s not a “nuisance arrhythmia” as some doctors consider it.

And don’t, as one doctor told his patient, just “take your meds and get used to it”.

Don’t Settle for a Lifetime on Meds: Aim for a Cure

Who wants this demon on their shoulder for the rest of their lives? Don’t listen to A-Fib-Zebub! Instead seek your A-Fib cure like I did (see my personal A-Fib story: Finding my Cure).

For many, many patients, A-Fib is definitely curable.

Always Aim High! If you have A-Fib, no matter how long you’ve had it, you should aim for a complete and permanent cure. Shoot for the moon, as they say, and you’ll find the best outcome for you and your type of A-Fib.

Personal Stories of Hope and Lessons Learned

To help bolster your resolve, seek encouragement from other patients. Other A-Fib patients have been where you are right now and have shared their personal experiences (starting with story #1 by Steve Ryan).

Each story is told in their own words. Some stories are told in a few paragraphs while other stories are longer, spanning years, even decades. Symptoms will vary, and treatments choices run the full gamut.

Browse through our list of over 99 Personal A-Fib stories of Hope. Look for patients with similar symptoms or situations as your own. Many writers have included their email address if you want to contact them directly. Read a story or two to learn how others are dealing with this demon we call Atrial Fibrillation. Their hope and courage is contagious.

Do not learn to live with Atrial Fibrillation.
Seek Your Cure!

For Inspiration: ‘A-Fib’s Demise’ a Poem by Emmett Finch, the Malibu Poet

At the beginning of this new year, we offer you a poem written for A-Fib patients by our friend Emmett Finch, the Malibu Poet. We met Emmett when we researched his personal A-Fib story for our book, Beat Your A-Fib (“40-Year Battle With A-Fib Includes AV Node Ablation With Pacemaker”).

Emmett F.

Emmett honored us with a special poem ‘A-Fib’s Demise’. It’s for people of faith who look for hope and help from the Divine but also see doctors, medicines, supplements, etc. as manifestations of the “creative power we call God.”

We hope A-Fib’s Demise will inspire you during this coming year to seek your A-Fib cure!  (Note: You can download and print the PDF.)

Emmett's Poem - A-Fib_s Demise

Wishing you a blessed year to come
filled with good heart health.

It Takes Time to Find the Right Treatment Plan for You: Learn all Your Options

A-Fib begets A-Fib. The longer you have A-Fib, the greater the risk of your A-Fib episodes becoming more frequent and longer, often leading to continuous A-Fib. (However, some people never progress to more serious A-Fib stages.)

Most Atrial Fibrillation patients should look beyond the typical antiarrhythmic drug therapy. These drugs don’t cure A-Fib but merely keep it at bay. According to Drs. Irina Savelieva and John Camm of St. George’s University of London:

“The plethora of antiarrhythmic drugs currently available for the treatment of A-Fib is a reflection that none is wholly satisfactory, each having limited efficacy combined with poor safety and tolerability.”

Educate Yourself: Learn All Your Options

A-Fib is not a “one-size fits all” type of disease. You need a personalized treatment plan. To begin, first educate yourself about Atrial Fibrillation, and then review all your treatment options. See Overview of A-Fib, Find the Right Doctor for You and Treatments for Atrial Fibrillation. A-Fib treatments include both short-term and long-term approaches aimed at controlling or eliminating the abnormal heart rhythm associated with A-Fib.

Next, you can move on to the guidelines we’ve posted: Which of the A-Fib Treatment Options is Best for Me? You are then prepared to discuss these treatment options with your doctor. Keep in mind, this should be a ‘team effort’, a decision you and your doctor will make together.

Build a Support System: We Can Help

You are not alone. Many, many others with A-Fib have been where you are now and are ready to share their experiences and insights.

Our A-Fib Support Volunteers: Having someone you can turn to for advice, emotional support, and a sense of hope that you can be cured, may bring you peace of mind. Our support volunteers offer you one-to-one support through exchanging emails and sharing their stories. To learn more, go to our page A-Fib.com’s A-Fib Support Volunteers.

Positive Thoughts/Prayer Group: At A-Fib.com we believe in healing through hope, belief, prayer and in the power of positive thoughts. To learn more about our group and how to send in your request, go to our A-Fib.com Positive Thoughts/Prayer Group.

Build Your A-Fib Treatment Plan: Know All Your Options

Resources for this article
Savelieva I, Camm J. Update on atrial fibrillation: part II. Clin Cardiol. 2008 Mar;31(3):102-8. Review. PubMed PMID: 18383050. URL Retrieved Nov 17, 2011. http://www.ncbi.nlm.nih.gov/pubmed?term=PMID%3A%2018383050

Give the Gift of Hope: Steve’s Guides to A-Fib-Related Products

Give the gift of hope this gift-giving season with our ideas for family members and patients with Atrial Fibrillation. We’re often overwhelmed when we shop for A-Fib-related items.

Steve’s Shopping Guides help you sort through the vast array of products of interest to those touched by Atrial Fibrillation. These brands and products are available from many online and other retailers.

We invite you to browse our page with the following shopping guides from books to supplements and heart rate monitors. Go to Steve’s Steve’s Shopping Guides to Recommended A-Fib-Related Products including:

A-Fib Survival Kit for the Newly Diagnosed
A-Fib Reference Books and Guides
Magnesium & Potassium Supplements for A-Fib patients
Seven ‘Natural’ Supplements for a Healthy Heart
DIY Heart Rate Monitors (HRMs)

Support A-Fib.com When You Shop Amazon.com

Amazon.com portal link for A-Fib.comUse our Amazon.com portal link and support A-Fib.com at the same time (at no extra cost to you). Your purchases generate a small fee which we apply to the costs of publishing this website. Bookmark this link. Use it every time!

“Hi Steve and Patti, I just spent $200+ on Amazon and used the A-Fib.com portal link [to generate commissions for the website]. I, too, want to keep the A-Fib.com website independent and ad free.

I bookmarked your portal link and will continue to use it for every Amazon purchase.” 

Barbara Cogburn, Renton, Washington, U.S. 

 

Help Keep A-Fib.com Independent and Ad-Free

http://tinyurl.com/Shop-Amazon-for-A-FibEach purchase you make generates a small commission for us (at no extra cost to you.) We apply it towards the monthly costs of publishing A-Fib.com.

Our goal is to make A-Fib.com a self-sustaining site and maintain our ‘no third-party advertising’. No distracting Google or product ads that interrupt your reading.

Your support is needed and much appreciated. Bookmark this link (http://tinyurl.com/Shop-Amazon-for-A-Fib). Use it every time you shop Amazon.com.

After using the A-Fib.com portal link to shop Amazon.com, Mary Jo Hamlin, Liverpool, NY writes:

“I’m happy to donate [to A-Fib.com]. Steve has always been very helpful answering my questions. You guys do a great job for a good cause! God bless.”

VIDEO: Compares Apple Watch 4 EKG to Hospital 12-Lead EKG

Image from C/NET video

C/NET.com has posted a very informative short video featuring Dr. Gregory Marcus at the UCSF Medical Center who compares a 1-lead ECG from the Apple Watch Series 4 to the results of a traditional hospital 12-lead electrocardiogram (ECG/EKG).

Hooked up to a traditional electrocardiogram monitor, C/NET Senior Editor Vanessa Hand Orellana uses an Apple Watch 4 app to take her 30 second ECG reading.

Compare ECGs: See comparisons of Vanessa’s readings from her 12-lead electrocardiogram (ECG) monitor and her Apple Watch ECG.

EKG monitor from C/NET video

Learn the technology of how the Apple Watch captures the heart beat.

Dr. Marcus talks about appropriate uses of the Apple Watch ECG and the role of the electrocardiogram. (Note: Other wearable devices also let you take an ECG outside the doctor’s office.)

Go to video: Animations with location footage and on-camera interview. 4:26 min video. See the video–> Apple Watch EKG tested against a hospital EKG

Personal Update: Surviving the Woolsey/Malibu Fire

For our earlier posts and fire photos, see On a Personal Note: Malibu Fires and Mandatory Evacuation and Personal Update on the Malibu Fires.

Wow! The last 30 days have been an experience I hope you never have to live through.

The left sign post was burned, but not the right.

We evacuated our Malibu, CA, home on November 9th due to the Woolsey brush fire that was burning its way toward us and the Pacific Ocean. We were in a motel for 11 days. Then we got word our home was okay. When road blocks were lifted, we returned home but without electricity, no heat, spoiled food in the frig/freezers, no phone landline and no internet access (FIOS). But we had water and our cell phones worked.

Fire damage: The fire did come down the land on either side of our home, singed the trunks of our palm trees near the street, but only burned a few isolated spots (see our Island sign). Our structures were spared but the soot and ash were throughout the house, even the closets (despite closed windows).

Making do without and filing claims: First came treks to the library to charge our devices and get on the internet. Cold drinks were out of a styrofoam cooler, hot food from a drive-thru. We burned a lot of candles at night. Next, came insurance, FEMA, SBA disaster claims paperwork. After about two weeks without power we bought a gas powered generator. Over several days (and lots of industrial extension cords) I got power for our devices, hot water heater (and satellite TV) then furnace and laundry. But it required daily trips for gasoline (Patti could now use her CPAP at night).

The green brush and tree mark our property line; The rains caused the hill side erosion next to us.

Then the mud slides. Then came the dreaded rains. We had been advised where to place the free sand bags from the fire station to protect our property and propane tank. We had little mud but you can see the erosion next door where the fire burned the brush that had been securing the soil.

Thank God for Friday: This weekend was a big one for us. Friday, after 28 days with no power, the electric company discovered and replaced a fried transformer next door and restored our electricity!

About 12 cleaners descended on our home and started three days of cleaning. Our insurance paid for us to move out while Service Master cleaned our entire house (inside and out), frig and freezers, closets, rugs, etc. to get rid of the soot and odors (and will pay to wash or dry clean the clothes in our closets). On Saturday, surprise! our phone service and internet access were restored.

Home sweet home after 30 days: When you read this, we will be back in our freshly cleaned home. We still have a bunch of work to do, but we now have everything we need in one place.

Thoughts and prayers: We thank God our home was spared and the disaster center services and our insurance claim agent were there to help. Blessed be all the firefighters, first responders, evacuation center volunteers and all the utility company workers.

Please keep all those who lost their homes in your thoughts and prayers. No matter your income level or the size of your home, the loss is still devastating.

Blood Thinner Myths Debunked by Healthcare Monitor Guide to AFIB

Every Atrial Fibrillation patient has to deal with the increased risk of clots and stroke and that often includes taking a blood thinner or anticoagulant.

At my doctor’s office I came across one of those “free take home copy” publications about Atrial Fibrillation. Healthcare Monitor Guide to Living with AFib 2018 had an interesting sidebar with a few myths and truths about blood thinners. I’d like to share a few misconceptions they list:

Guide to Living with AFib 2018

• “I’m afraid of shaving because I hear it’ll take forever to stop bleeding.”
• “Blood thinners will make me feel tired.”
• “It seems I bruise much more easily now-and that can’t be good.”

Do any of these ring a bell with you? Are you concerned with the same issues? Healthcare Monitor debunks these as myths and explains way.

Blood Thinner Myths Debunked

“I’m afraid of shaving because I heart it’ll take forever to stop bleeding…If bleeding while shaving is a problem, consider using an electric shaver. And remember: Even if you seem to bleed more easily now, suffering a stroke could cost you your life.

Blood thinners will make me feel tired. There’s no evidence that blood thinners cause or worsen fatigue. In fact, fatigue has not been identified as a problem in numerous studies done in thousands of patients. Of course, several things can effect your energy levels, including other medications you’re taking and lack of sleep. If you’re feeling more exhausted than usual, bring it up with your doctor.

It seems I bruise much more easily now-and that can’t be good. It’s true that bruising may be somewhat increased while you’re on a blood thinner. Although this can be a nuisance, it is important to remember that you are taking this medication to lower the risk of stroke. So the trade-off—accepting a slight increase in bruising—is worth the protection from dangerous clots.”

An Alternative to Blood Thinners

Catheter positioning the Watchman occlusion device at the mouth of the Left Atrial Appendage

Catheter placing Watchman in LAA

But blood thinners are not like taking vitamins. They have their own set of risks and side effects. However, preventing a stroke is for most people a welcome trade-off for any bad effects of anticoagulants.

If you can’t or don’t want to take blood thinners, an option is to have a device installed to close off the Left Atrial Appendage. The LAA is a small pocket of heart tissue located above the left atrium where 90%-95% of A-fib strokes originate.

To learn more see my articles: Watchman: the Alternative to Blood Thinners or LAA Occlusion for A-Fib Patients: The Lariat II Versus the Watchman Device.

Or watch the 3:28 min. video: The Watchman Device: Closure of the Left Atrial Appendage.

Resource for this article
Blood thinner myths debunked. Healthcare Monitor Guide to Living with AFib. 2018. print publication, p 21. healthmonitor.com.

How Wide-Spread is Silent Brain Damage in A-Fib Patients?

A-Fib patients are at increased risk for cognitive problems and dementia, even in the absence of stroke. But why?

Swiss researchers devised a study to determine what causes A-Fib patients to experience more cognitive dysfunction.

Mechanisms of A-Fib Cognitive Decline

The Swiss-AF research is an observational study designed to identify the mechanisms of cognitive decline in A-Fib patients. The study enrolled A-Fib patients between 2014 and 2017 from 14 centers in Switzerland.

Analyzed were 1,389 A-Fib patients with no history of stroke or transient ischemic attack (TIA)

All patients had standardized brain magnetic resonance imaging (MRI). Analyzed were 1,389 A-Fib patients with no history of stroke or transient ischemic attack (TIA). The average age of the A-Fib patients was 72 years. Most (89%) were being treated with oral anticoagulants.

Study Findings: Types of Silent Brain Damage

The MRI scans showed that 569 (41%) had at least one type of previously unknown (silent) brain damage.

 15% (207) had a cerebral infarct (dead tissue resulting from a failure of blood supply)
 19% (269) had small bleeds in the brain (microbleeds)
 16% (222) had small brain lesions

41% had at least one type of previously unknown (silent) brain damage

Oral Anticoagulants and Silent Brain Damage: In this study the researchers couldn’t determine if the cerebral infarcts and other brain lesions occurred before or after patients started taking oral anticoagulants.  But the researchers did state:

“The findings nevertheless raise the issue that oral anticoagulation might not prevent all brain damage in patients with atrial fibrillation.”

Additional analysis incomplete: The patients in this study underwent extensive cognitive testing to determine if patients with silent brain damage also have impaired cognitive function. But this analysis hasn’t been completed.

What A-Fib Patients Need to Know

The Swiss-AF research was a small study in one country over four years with 1,389 A-Fib patients. The risk of silent brain damage was found in 4 of 10 A-Fib patients. But the findings are alarming and worth continued research.

For A-Fib patients these findings can be frightening―especially for older patients. On top of that, it’s likely further analysis will show ‘cognitive decline’ as well in patients with these types of brain damage.

So, what can you do?

• Aim to get cured of A-Fib as soon as practical, such as by a catheter ablation. (Don’t let anyone tell you that you’re too old to have an ablation. People in their 90s have successful ablations.)

• Seek ways to avoid taking oral anticoagulants, if possible. Intuitively one suspects that anything that causes or increases bleeding in the brain like anticoagulants can be risky and dangerous for older patients. Consider installing a device to close off the Left Atrial Appendage (LAA) where 90%-95% of A-Fib clots originate.

Learn More About Risks for Cognitive Problems and Dementia

To learn more about how A-Fib patients are at increased risk for cognitive problems and dementia, see my articles: Anticoagulants, Dementia and Atrial Fibrillation and Increased Dementia Risk Caused by A-Fib: 20 Year Study Findings.

Also see my answer to this FAQ: “I’m scared of getting dementia. Can the right minerals help? I’ve read about the link with A-Fib. What does research reveal about this risk?”

Resources for this article
Conen, David. The Swiss Atrial Fibrillation Cohort (Swiss-AF). A presentation at the European Society of Cardiology Congress 2018, Munich, Germany. August 2018. As reported in the Cardiac Rhythm News, October 18, 2018, Issue 42, p. 14.

Conen, David. Hidden AFib Risk. Bottom Line Health. Volume 32, Number 12, December 2018, p.1.

 

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