"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

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"


"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013

A-Fib News

A-Fib Patient Conference Sept. 16-18, 2016 in Dallas

The 2016 Get in Rhythm, Stay in Rhythm™ Atrial Fibrillation Patient Conference will be September 16-18 at the Sheraton DFW Airport Hotel in Dallas, TX. For further info and to register, visit the Get in Rhythm, Stay in Rhythm conference website.

StopAfibOrg 200 x 80 pix at 96 resHosted by Mellanie True Hills, Founder and CEO of StopAfib.org, the Get in Rhythm, Stay in Rhythm™ Atrial Fibrillation Patient Conference is designed to give you the tools and information you need to take care of yourself, and to communicate effectively with your doctors and other healthcare professionals. Confirmed topics are listed in the “Agenda”. For presenters, go to the Get in Rhythm, Stay in Rhythm website and hover over each faculty photo.

Costs: Admission is $127–$157 (Early Bird rate) Special hotel rate is $119/night (normally up to $289/night). This special rate is good from 3 days before until 3 days after the conference (so you can vacation in Dallas before/after the conference).

Event Sponsors: The conference is made possible with support from industry sponsors including Bristol-Myers Squibb, Janssen, Boston Scientific and Medtronic. Co-sponsors include Heart Rhythm Society, MyAFibExperience.org and Health eHeart. Promotional partners include Alliance for Aging Research, American Sleep Apnea Association, WomenHeart.org and National Blood Clot Alliance.

A-Fib.com 2016 Top-Rated by Healthline.com For Third Year

A-Fib.com top rated by Healthline.com for the third year.

A-Fib.com top rated by Healthline.com for the third year.

We are proud to announce, for the third year, A-Fib.com has been named to the Healthline.com list of the ‘Best Atrial Fibrillation Blogs’Atrial Fibrillation: Resources for Patients (A-Fib.com) is one of a ten websites selected for special recognition by the Healthline.com Marketing Team.

Of the ten heart health websites, A-Fib.com is one of only four websites dedicated exclusively to Atrial Fibrillation patient education. The other three are ‘Atrial Fibrillation by Dr. John M’ (Dr. John Mandrola),  ‘Living with Atrial Fibrillation’ (by our friend, Travis Van Slooten) and ‘Stop A-Fib Atrial Fibrillation Blog’.

About Healthline: Healthline.com is  the fastest growing consumer health information site — with 65 million monthly visitors. Their goal: “Healthline’s mission is to be your most trusted ally in your pursuit of health and well-being.”

From the Healthline.com article:

“We’ve carefully selected these blogs because they are actively working to educate, inspire, and empower their readers with frequent updates and high quality information…new medical research, personal stories, and helpful advice.”

Visit Healthline’s The 10 Best A-Fib Blogs of 2016 to review all ten winners.

OUR MISSION: A-Fib.com offers hope and guidance to empower patients to find their A-Fib cure or best outcome. We are your unbiased source of well-researched information on current and emerging Atrial Fibrillation treatments.

Did you read…Steve’s A-Fib Alerts: May 2016 Issue?

A-Fib patients around the world are reading the A-Fib Alerts May 2016 issue.

Beat Your A-Fib book cover

Sign-up bonus! Save 50% on my book.

Read the latest issue here. Even better—have our A-Fib Alerts sent directly to you via email. Subscribe NOW.

Our A-Fib Alerts monthly newsletter is presented in a condensed, easy-to-scan format. (There’s no risk! Unsubscribe at any time.) Subscribe NOW.

Special Signup Bonus: Subscribe HERE and receive discounts codes to save up to 50% off my book, Beat Your A-Fib: The Essential Guide to finding Your Cure by Steve S. Ryan, PhD.

TV Doctors’ Talk Shows: Can You Trust Their Recommendations?

Dr Oz Show: 3 Healthy Ways to Use Apple Cider Vinegar, Video frame

Dr Oz Show: 3 Healthy Ways to Use Apple Cider Vinegar, Video still

Most of us have seen an episode or two of a TV medical talk show, like the Dr. Oz Show. Have you wondered if the health recommendations are accurate and fact-based?

A group of general practitioners had the same question. So, they analyzed over 40 episodes of the popular American TV shows, ‘The Dr Oz’s Show’ and ‘The Doctors’, to see if health claims were evidence-based.

Published in The British Medical Journal, the study results were alarming.

Can You Trust the Claims of TV Doctors?

The research doctors were concerned when their patients would say: ‘I was watching TV and I saw a recommendation that I should be taking this medication (or this supplement or have this test).’ Or, ‘I’ve started taking this supplement because it was recommended on this particular medical show.’

Dr. Christine Korownyk, the lead researcher said, as doctors, “we were left scrambling thinking ‘what is the evidence for that? Is this something you should be doing?’ So we thought we should go ahead and systematically look at these shows on television.”

The main goals were to assess the accuracy of the reporting (was it evidence-based), if the recommendations were ‘best practice’ and if the doctors’ claims were unbiased (no conflicts of interest).

The Doctors - Hope or Hype TV video frame 400 x 300 pix at 300 res

The Doctors: Hope or Hype: The Trendiest Foods of 2016, Video still.

Are the Health Claims Evidence-Based?

The findings were somewhat disturbing. One third to one half of what was discussed and recommended on these programs had NO scientific basis.

• For recommendations in The Dr Oz Show, evidence supported 46%, contradicted 15%, and was not found for 39%.
• For recommendations in The Doctors, evidence supported 63%, contradicted 14%, and was not found for 24%.
• On average, The Dr Oz Show had 12 recommendations per episode, and The Doctors had 11 recommendations.

What this Means to Patients

You should be skeptical about claims made on medical talk shows.

The public should be skeptical about claims made on medical talk shows.

Do your own research and talk to your own healthcare professional before making any changes to your health plan.

For a more in-depth look at this study, read the ConsumerAffairs.com article: Study: Less than half of Dr. Oz’s recommendations are actually supported by evidence.

References for this article

Videos: Dr. Carolyn Dean Discusses Magnesium Deficiency

Video: Importance of Balancing Calcium & Magnesium Dr. Carolyn Dean.

Video: Importance of Balancing Calcium & Magnesium Dr. Carolyn Dean.

Magnesium information for A-Fib patients. We’ve two videos to our A-Fib Video Library featuring Dr. Carolyn Dean, author of The Magnesium Miracle, talking about magnesium deficiency and calcium overload:

The Best Way to Supplement Magnesium” with Dr. Carolyn Dean. Getting nutrients through food is not always possible; discusses side effects of too much Mg and how you can tell if you have a deficiency.(3:39) Go to video. From iHealthTube.com.

Importance of Balancing Calcium & Magnesium”. Dr. Dean discusses the importance of balancing your intake of magnesium and calcium (2:1); the benefits of both and why you need to have both in the body; the problem of ‘calcium overload’. (2:30) Go to video. From iHealthTube.com.

What Do We Stand For? A-Fib.com’s Mission

If you visit our “About Us” page, you can read about how Steve started A-Fib.com after researching and finding his own cure.

Among other things, you will also find the A-Fib.com mission statement. It summarizes what we do and why.

The A-Fib Mission

A-Fib.com offers hope and guidance to empower patients to find their A-Fib cure or best outcome. A-Fib.com is the patient’s unbiased source of well-researched information on current and emerging Atrial Fibrillation treatments.

Integrity and an Unbiased Viewpoint

Help support our website

To maintain our independence and unbiased viewpoint and integrity, A-Fib.com is deliberately not affiliated with any medical school, device manufacturer, pharmaceutical company, HMO, or medical practice. We accept no third-party advertising, do not charge for inclusion in our Directory of Doctors & Facilities and accept no fee (cash or other kind) for a listing in Steve’s Lists of Doctors by Specialty.

Not many healthcare websites or patient education sites can make those claims.

Join Us! Support the A-Fib.com Mission

If you would like to support our mission, you can refer others to our website, you can bookmark and use the A-Fib.com Amazon.com portal link to shop, or make a donation towards our monthly publishing expenses.

Every donation helps. Even $1.00

We’ve got it! Largest Glossary of Atrial Fibrillation Medical Terms

Atrial Fibrillation: Resources for Patients Glossary of Terms

Atrial Fibrillation: Resources for Patients Glossary of Terms

Check it out. Bookmark it! Refer to it often!

The A-Fib.com Glossary of Medical Terms and Phrases is the most complete online glossary devoted exclusively to Atrial Fibrillation and is the largest single source online. Each definition is written in everyday language—a great resource for patients and their families.

Bookmark this page and refer to it when reading and studying A-Fib research and literature. (if you have a medical dictionary, make a note of our web address for those terms you don’t find in your dictionary.)

If you don’t find the term you are looking for—email us and we’ll add it to the Glossary.

Fall and Winter Warning: Fireplace Use May Trigger A-Fib

Fall and Winter brings use of many a fireplace and a reminder for those with A-Fib. The tiny particles generated when you burn wood can inflame and damage blood vessels and may trigger arrhythmias, according to Dr. Robert A. Kloner. If you have A-Fib you may want to avoid wood-burning fireplaces and stoves.

In general you may want to also avoid campfires, bonfires, trash or leaf burning, etc.

If you live in communities with a lot of wood-burning stoves, you may want to use a HEPA air purifier in your home. If you are a guest and can’t avoid a wood-burning fireplace, sit as far away as possible or wear a face mask like your dentist wears (mine gave me a bunch for free). If you have a fireplace, consider installing an electric or other non-wood burning insert.

Reference: Kloner, Robert A. ‘Tis the Season…For Heart Attacks. Bottom Line Health, Volume 28, Number 12, December 2014.

Print a free Medical Alert I.D. Wallet Card

Do you carry an emergency medical alert I.D. card? When you have A-Fib and you’re taking a blood thinner or other medications, you may want to carry your medical information.

Free Online Medical ID Wallet Card Generator

MedIDs.com offers a free online generator tool for a fully customized medical info wallet card. Go to Free Printable Medical ID Cards, type in your information and print. (Note: none of your personal information is stored on their website.) Trim the paper and fold to fit your wallet or purse. Add a label, “In Case of Emergency” (ICE). A Few More Tips:

• Laminate your wallet card to prolong its use (an office supply store can help you).
• Why not print a card for each member of your family?
• If you also wear a medic alert bracelet, inscribe it with the message “See wallet card”.

Money clip from Universal Medical Data

Money clip from Universal Medical Data

Additional Ways to Carry Your Emergency Medical Alert ID Information

There are many new styles of Medic Alert IDs bracelets and necklace pendants using different materials like waterproof foam, leather and stainless steel. Don’t carry a wallet? Consider a Money clip with compartment to slide in your emergency contact info.

USB bracelet from Medical Alert Drives

USB bracelet from Medical Alert Drives

Or, if you carry a paper-based day planner or calendar, add the same information to your address book.

For much more information about what and how to carry your emergency medical information, see our A-Fib.com article, Your Portable Medical Information Kit. 

Call for Guest Writers. How About You?

Are you a writer? Are you passionate about an A-Fib topic or issue? Why not share your insights with our A-Fib.com readers? We welcome guest writers!

For examples of guest articles, check out Lyn Haye’s Obesity in Young Women Doubles Chances of Developing A-Fib and Frances Koepnick’s “Patient Review: AliveCor Heart Monitor for SmartPhones“.

If you’re interested in being an A-Fib.com guest writer (or just have questions), send Steve an email. Do it NOW!

Yop Poll Archive


Want to Reproduce an Article? We’ve Updated Our Terms of Use

Do you write about Atrial Fibrillation? Got a newsletter or blog? Want to reprint or quote from one of our A-Fib.com articles? You no longer have to write and ask permission. The content on this website is now licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Creative Commons Atribution Sharealike license

© Steve S. Ryan, A-Fib.com. Some Rights Reserved.

The Creative Commons Attribution Share-Alike license allows re-distribution and re-use of A-Fib.com licensed content on the conditions that Steve S. Ryan and A-Fib.com are appropriately credited, a link is provided to A-Fib.com and that any derivative work is made available under “the same, similar or a compatible license”.

The last part means you can remix, transform, or build upon the material, but you must distribute your contributions under the same license as the original i.e., CC Attribution Share-Alike license. (As a courtesy, email us if you use our A-Fib.com content!)

Help spread the word: A-Fib can be cured!

Recurrence: Odds of Staying A-Fib Free After Ablation

I’ve updated and expanded the answer to a Frequently Asked Question about recurrence of your A-Fib after a successful ablation:

Illustration of catheter ablation

Illustration of catheter ablation

“Since my PVI, I have been A-Fib free with no symptoms for 32 months. What do you think my chances of staying A-Fib free are?”

I think your chances of staying A-Fib free are pretty good.

A PVI is Like a Kind of Immunization Against A-Fib

If your Pulmonary Veins (PV) are well isolated and stay that way, you can’t get A-Fib there again. When the PVs are isolated and disconnected and haven’t reconnected, it seems to be permanent. But it’s too early in the history of PVA(I)s to say this definitively.

NOTE: PVA(I) is a relatively new procedure. I had my catheter ablation in 1998 and I’m still A-Fib free today. However, at that time of my ablation, only one of my Pulmonary Veins was isolated, so in theory, the other veins could start producing A-Fib signals—but that hasn’t happened.

Regrowth/Reconnection of Ablated Heart Tissue

There is a tendency for ablated heart tissue to heal itself, regrow the ablated area, reconnect, and start producing A-Fib signals again. But if this happens, it usually occurs within the first three to six months of the initial PVA(I).

Recent research indicates that for a small number of people, a successful Pulmonary Vein Ablation (Isolation) procedure may not be a permanent “cure.” Dr. Francis Marchlinski of the University of Pennsylvania…read the rest of Steve answer.

FREE Report: How & Why to Read An Operating Room Report

Special 12-page report by Steve S. Ryan, PhD

New FREE 12-page report by Steve S. Ryan

In our new FREE 12-page Report, How & Why to Read Your Operating Room Report, we examine the actual O.R. report of the catheter ablation of Travis Van Slooten, publisher of Living With Atrial Fibrillation performed by Dr. Andrea Natale, Austin, TX.

What is an O.R. Report?

An O.R. report is written by the electrophysiologist who performed the catheter ablation. It contains a detailed account of the findings, the procedure used, the preoperative and postoperative diagnoses, etc.

It’s a very technical document. Because of this, it’s usually given to a patient only when they ask for it.

New Report: How & Why to Read Your Operating Room Report

In our new FREE 12-page Report: How & Why to Read Your Operating Room Report, I make it easy (well, let’s say ‘easier’) to learn how to read an O.R. report.

Along with an introduction, I’ve annotated every technical phrase or concept so you will understand each entry. I then translate what each comment means and summarize Travis’ report.

Read more at: Special Report How & Why to Read Your Operating Room Report

Tip: If you’ve had an ablation, ask for your O.R. Report. If you or a loved one is planning a catheter ablation, make a note to yourself to ask for the O.R. report.

Why & How to Create Your ‘A-Fib Episode Action Plan’

Do your loved ones know how to help you during an A-Fib episode? That’s the topic of this email we received from the spouse of an A-Fib patient:

“My husband’s A-Fib is getting worse. When should I call Emergency and/or take him to the hospital? I’m petrified with fear for him. Our doctors say don’t worry unless he shows signs of a heart attack or stroke.”

For your family’s peace of mind, you need to create an ‘A-Fib Action Plan’. During an A-Fib episode, having an action plan is reassuring to you and your loved ones, and helps everyone stay calm.

Your A-Fib Action Plan

To develop your A-Fib Action Plan, you need to team up with your doctor. Discuss the following. You should know:

• When to contact your doctor’s office
• Your doctor’s cell number and email address for emergencies
• What symptoms or criteria should send you to the emergency room
• When at the ER, if you should call your doctor
• When at the ER, if your doctor will call and talk with the ER staff
• When you should “just ride out” the episode
• How to recognize the signs of stroke

Keep Calm and Follow Your A-Fib Action Plan - A-Fib.comWrite Up and Post Your Plan

Write up the answers to these questions. Add other helpful information, i.e., name of your local Emergency Room, directions, map, and phone numbers, etc. Store the original of your A-Fib Action Plan in your A-Fib binder or folder.

Post a copy in a prominent place your family can find easily. Discuss your A-Fib Action Plan with your loved ones and answer their questions.

Consider: What about your workplace? Should you discuss your Action Plan with your co-workers as well? Should you post a copy at work?

Be Confident & Stay Calm

During an A-Fib attack, an A-Fib Action Plan with specific steps is reassuring and helps everyone stay calm. Your family will be confident they’re supporting you in taking the right action at the right time.

Note: If your doctor is reluctant to develop a specific action plan or your Atrial Fibrillation is getting worse, it may be time to change doctors.

Have a Contribution to Make?

Do you have ideas for other content that should be included in an A-Fib Action Plan? I welcome your input. Send me an email with your thoughts.

Drug Watch: FDA Approves Reversal Agent Praxbind® for the Anticoagulant Pradaxa

The FDA granted “accelerated approval” to Praxbind®, a reversal agent (antidote) to Pradaxa®. Praxbind is given intravenously to patients who have uncontrolled bleeding or require emergency surgery.

The accelerated approval program is designed to provide patients with earlier access to new drugs.

Pradaxa (dabigatran), a novel oral anticoagulant (NOAC), reduces the risk of clots and stroke in patients with Atrial Fibrillation. The new NOACs are alternatives to warfarin (Coumadin).

Patients on Pradaxa Were Bleeding to Death in the ER

Patients on Pradaxa have been bleeding to death in the ER while doctors were powerless to stop their bleeding and could only watch them die. See Stop Prescribing or Taking Pradaxa.

Praxbind - antidote to Pradaxa

Praxbind®, reversal agent for Pradaxa®

In clinical trials, 5gs of Praxbind (idarucizumab) reversed the anticoagulant effect of Pradaxa within minutes (which is significantly faster than the current antidotes for warfarin). In one ongoing trial, the anticoagulant effect of Pradaxa was fully reversed in 89% of patients within four hours. This effect lasted at least 24 hours.

Praxbind works by binding to Pradaxa to neutralize its effect (measured as unbound Pradaxa plasma concentration). The most common side effects of Praxbind were headache, low potassium, confusion, constipation, fever and pneumonia.

Boehringer Ingelheim (a privately-held German company), which manufactures both Pradaxa and Praxbind, will be required to submit additional clinical information after approval to confirm the clinical benefit of Praxbind.

After Praxbind, Get Back on Anticoagulants ASAP!

Boehringer Ingelheim recommends that patients resume their anticoagulant therapy as soon as medically appropriate. In the clinical trials of Praxbind, five patients suffered strokes after reversal. They were not receiving anticoagulant therapy at the time of their stroke.

Other NOACs Will Soon Have a Reversal Agent

Pradaxa was the first NOAC to win FDA approval, but now there are three other new anti–blood clotting drugs available to doctors and patients.

Despite its newly approved reversal agent, Pradaxa’s advantage over the other NOACs will probably be short lived.

• Xarelto® (rivaroxaban) by Bayer Pharma/Janssen Pharmaceuticals
• Eliquis® (apixaban) by Pfizer/Bristol-Meyers Squibb (tested the best with the best safety record)
• Lixiana®/Savaysa® (edoxaban) by Daiichi-Sankyo (newest NOAC to be approved by the FDA)

The other NOACs will soon have a reversal agent, Andexanet Alfa, which has done well in clinical trials and is also on fast track FDA approval. It’s being developed by Portola Pharmaceuticals.

Despite its newly approved reversal agent, Pradaxa’s advantage over the other NOACs will probably be short lived.

References for this article

Steve’s A-Fib Alerts: October 2015 Issue—Ready for You!

The A-Fib Alerts October 2015 issue is out and includes news on Pradaxa’s new ‘Reversal Agent’ getting FDA ‘Accelerated Approval’, case studies about Testosterone curing A-Fib in aging men and medical technology giant Medtronic acquiring CardioInsight Technologies, developer of the ECVUE mapping and ablation system. And much more!

Read our monthly newsletter—Steve’s A-Fib Alerts. Sent directly to your email box, our A-Fib Alerts is presented in a condensed, easy-to-scan format. Read the latest issue. Even better—have our A-Fib Alerts sent directly to you via email. Click to Subscribe.

Medtronic Acquires CardioInsight ECVUE Mapping System

Medical technology giant Medtronic has acquired CardioInsight Technologies, developer of the ECVUE mapping and ablation system. CardioInsight will become part of the Medtronic Atrial Fibrillation Solutions business in the Cardiac Rhythm and Heart Failure division.

Mapping and ablation systems are critical to the advancements in catheter ablation techniques and improving A-Fib patient outcomes.

During a standard catheter ablation, doctors use a special mapping catheter that has to be positioned inside the heart to map and identify A-Fib producing spots in the heart.

CardioInsight Vest for 3-D non-invasive mapping for catheter ablation

VIDEO of CardioInsight 3-D mapping vest

But the new Noninvasive Electrocardiographic Imaging (ECGI) system does not go inside the heart, but instead uses a vest-like device which a patient wears to image the inside of the heart and to pinpoint sites in the heart producing A-Fib signals.

VIDEO: See the animation of the ECVUE vest technology at the bottom of the CardioInsight page (just wait a second or two for it to load).

The ECVUE system has been in trials with more than 1,400 patients, mostly in Europe, (US clinical trials have been limited). It has also been featured in more than 120 peer reviewed journals and presentations. It’s being very carefully tested and slowly brought to market primarily by Dr. Michel Haissaguerre and the French Bordeaux Group.

What Patients Need To Know

It certainly looks like the ECVUE mapping and ablation system will be a game changer for A-Fib patients, especially for those with persistent A-Fib, usually the hardest to cure. See my 2013 AF Symposium report: Non-Invasive Electrocardiographic Imaging (ECGI).
But it’s been frustrating for patients in the US since the testing is being done at multiple centers in Europe. However, one would expect this would change soon with Medtronic buying CardioInsight.
The careful and deliberate testing and marketing approach of ECVUE contrasts with the introduction of the competing FIRM system from Topera Medical. Though FIRM was first on the market and has received great PR in many newspapers and media outlets throughout the US, clinical studies have raised performance issues


I predict that the ECVUE mapping and ablation system will soon be predominate throughout the world.
For more about the two competing mapping and ablation systems, see my 2014 AF Symposium article: ECGI vs. FIRM: Direct Comparison, Phase/Waveform Mapping
References for this article


Anyone in A-Fib is Almost Certainly Magnesium Deficient

Anyone in A-Fib Mg deficient - Lighter poster - 400 pix wide at 300 resWhy? Magnesium used to be plentiful in fruits, vegetable and grains, but decades of industrial-scale farming have stripped the soil of minerals like magnesium.

One study found that the nutrient content of crops has declined by as much as 40% since the 1950s. “It’s now is almost impossible to get adequate amounts of magnesium from food.”

At least 80% of Americans are deficient in magnesium consuming only about 270 mg of magnesium a day. While the Recommended Daily Allowance is 420 mg for adult males and 320 mg for adult females. (The RDAs is the minimum amount for a healthy person, not the recommended amount.)

Anyone in A-Fib is almost certainly magnesium deficient with a substantial cumulative deficiency over months and years.

To learn more about Magnesium, go to our Mineral Deficiencies page. If considering a supplement, read: Low Serum Magnesium Linked with A-Fib, by Lynn Haye; and Natural’ Supplements for a Healthy Heart.

References for this Article

Clinical Trials Results: Watchman Better Than a Lifetime on Warfarin

by Steve S. Ryan, PHD, October 2015, Updated January 26, 2016

According to recent studies, you are better off having a Watchman device installed than spending a lifetime on warfarin.


WATCHMAN device for Left Atrial Appendage Closure

In two randomized clinical trials comparing Left Atrial Appendage Closure (LACC-Watchman Device) to warfarin, 1,261 patients from the PROTECT AF and PREVAIL trials were studied. The follow-up period was around 3.3 years. Patients receiving the Watchman compared to patients on warfarin had significantly fewer:

• Hemorrhagic strokes
• Cardiovascular/unexplained death
• Non-procedural bleeding
• All-cause stroke or systemic embolism was similar between both strategies.

There were more ischemic strokes in the Watchman device group, but this was balanced by a greater number of hemorrhagic strokes in the Warfarin group.

Warfarin - Coumadin tablets various dosages

Warfarin (Coumadin) various dosages

However, the patients in the control group of the PREVIAL trial were considered “unusual” in that, given their risk profile, they had a much lower ischemic stroke rate than ever observed in any clinical trial. See Getting FDA Approval for the Watchman Device.

What Patients Need to Know: Watchman Actually Better Than Warfarin

The Watchman device provides similar protection against having an A-Fib (ischemic) stroke as being on warfarin.

But the Watchman device isn’t simply an “alternative” to warfarin, but rather an improvement or advance or progression. One would intuitively expect that people receiving the Watchman device would also have less hemorrhagic strokes and bleeding compared to those on warfarin, which these studies do demonstrate.

Welcome Alternative to a Lifetime on Warfarin

Warfarin and other anticoagulants work by causing bleeding and are inherently dangerous. The Watchman device is not only a welcome alternative to a lifetime on warfarin, but is actually better than warfarin.

Long-term use of anticoagulants such as warfarin have been known to not only cause hemorrhagic strokes but also microbleeds in the brain which lead to dementia.

Among other bad side effects, long-term use of anticoagulants such as warfarin have been known to not only cause hemorrhagic strokes but also microbleeds in the brain which lead to dementia. See Patient on Anticoagulation Therapy for 10 Years Develops Microbleeds and Dementia.

A 2015 study found evidence of microbleeds in 99% of subjects aged 65 or older, and that increasing the imaging strength increased the number of detectable microbleeds. Microbleeds have been suggested to be predictive of hemorrhagic stroke.

According to current research, you are better off having a Watchman device installed than spending a lifetime on warfarin. (Of course, this assumes that the doctor performing the procedure is beyond his/her learning curve. That is, when operating doctors are first performing the procedure, there is a higher risk for procedural complications.)

What About the New Anticoagulants (NOACs)?

Does this research apply to the new anticoagulants like Pradaxa, Xarelto, Eliquis and Savaysa/Lixiana? Technically no. This research only applies to warfarin. But intuitively one would expect the same general principles to apply. All anticoagulants cause bleeding. That’s how they work.

Caveat—Long-Term Effects of Watchman?

What are the long-term effects of leaving a mechanical device like the Watchman inside the heart? We know that, after a few months, heart tissue grows over the Watchman device so that the LAA is permanently closed off from the rest of the heart.

It seems unlikely that complications would develop after a long period of time as has happened with warfarin. But we can’t say that for sure until enough time has passed. The first clinical trial installation of the Watchman device in the US was in 2009 and in Europe in 2004. So far no long-term complications have developed.

CT Brain scan showing Ischemic Stroke

CT Brain scan showing Ischemic Stroke

Preventing Stroke in the Elderly—Even If They Don’t Have A-Fib!

One of the great potentials of the Watchman device is that it may someday be used to prevent stroke in the elderly even if they don’t have A-Fib. Imagine a world where you no longer live in fear of a stroke as you get older, where 90%-95% of stroke risk can be eliminated by a simple 20 minute procedure. The Watchman device (and other Left Atrium Occlusion Devices such as the Lariat and the surgical AtriClip) may change the way elderly medicine is practiced.

How many people turning 70 or 75 would welcome a device that would almost guarantee freedom from the most severe type of ischemic stroke (a cardioembolic stroke)? The Watchman device has the potential to greatly reduce or eliminate the threat of strokes in the elderly!

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