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


Treatments

Apple Watch 4: Do ECG Readings Give A-Fib Patients a False Sense of Security?

We received a couple of emails about the new Apple Watch 4. As many A-Fib patients may be aware, recently Apple unveiled the next generation of Apple Watch which includes a second generation optical heart sensor.

Among several interesting features, it can generate an ECG tracing similar to that of a single-lead electrocardiograph.

In her Sept. 14, 2018 editorial on Medscape.com, ECG Readings From the Apple Watch? This Doctor Is Leery, Dr. Hansa Bhargava gives her perspective of this feature for those diagnosed with atrial fibrillation. She writes that she finds the Apple Watch’s ability to do a one-lead ECG interesting but has some reservations.

“…Here’s what I worry about: the false sense of security that a person could have.

Apple Watch 4 screens

Being able to do a one-lead ECG is definitely interesting, but does it always help? Here’s a scenario. A 40-year-old runner starts feeling dizzy, lightheaded, and has chest pain. He worries but remembers that there is an ECG function on his watch. He proceeds to do the ECG which then reads “normal.” Because of this he decides to continue to run.
What he doesn’t know is that this is only a one-lead ECG, and even though it seems normal, it is an isolated data point; more information is needed to diagnose what is going on. What if he is having angina? In fact, 30% of cardiovascular events happen to people under the age of 65. One lead on an ECG could certainly miss this; in fact, even a 12-lead ECG, if the only isolated data point, could miss this.

Dr. Andrew Moore, an emergency department physician at the Oregon Health and Science University is also skeptical of the Apple Watch 4 ECG feature:

“The ECG thing is a little bit overhyped in terms of what it will really provide. …The tech that Apple is working with is very rudimentary compared to what we’d do for someone in a hospital or health care setting.” 

While the watch can detect changes in the patterns of a person’s heart rate such as too fast, too slow, or beating irregularly—signifying A-Fib, the watch doesn’t diagnose a medical issue.

Apple Watch and Other DIY Heart Rate Monitors

Guide to HRMs and Handheld ECG monitors

Keep in mind these doctors’ concerns apply to all consumer heart rate monitors (HRM), those with optical heart sensors and those with electrode-containing monitors.

Wrist vs. Chest Bands: Wrist-band optical heart-rate monitors (like Apple Watch 4) may be more convenient or comfortable and have advanced over the years. But researchers found that electrode-containing chest-strap monitors were always more accurate than their wrist counterparts and more reliable and consistent. To learn about this research, read When Tracking Your Heart: Is a Wrist-Worn Heart Rate Monitor Just as Good as a Chest Strap Monitor?

Blue-tooth chest-band with smartphone app

As an A-Fib patient, when monitoring your heart beat rate is important to you (while exercising or doing heavy work), you’ll want to stick with an electrode-containing monitor (chest band-style, shirts or sports bras with built-in electrode pads, etc.).

For help selecting a HRM, see our article: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I). Also take a look at Steve’s list on Amazon.com: Top Picks: DIY Heart Rate Monitors for A-Fib Patients.

Keep in mind: None of these DIY heart rate monitors are diagnostic tools. But they can be helpful once you know you have A-Fib, A-Flutter or suffer from PVCs, PACs, etc. Just don’t make medical decisions based on their readings. See your doctor if you have any concerns or symptoms.

Remember: None of these DIY heart rate monitors are diagnostic tools

Resource for this article
Hansa Bhargava, MD. ECG Readings From the Apple Watch? This Doctor Is Leery: The Apple Watch Gets ‘Medical’. Medscape/NEWS & PERSPECTIVE.  September 14, 2018. https://www.medscape.com/viewarticle/902001?src=wnl_edit_tpal&uac=159481AX&impID=1739393&faf=1

Hauk, C. Data Collected by Apple Heart Study Used to Obtain Apple Watch Series 4 ECG Clearance from FDA. Mac trast.com. Sep 14, 2018.
https://www.mactrast.com/2018/09/data-collected-by-apple-heart-study-used-to-obtain-apple-watch-series-4-ecg-clearance-from-fda/

Has My A-Fib Returned? I Get an Insertable Wireless Monitor to Find Out

Update 5 pm (see below): During a recent medical exam, one of my doctors (not a cardiologist) detected an irregular heart beat. I didn’t feel any symptoms before, during or after the appointment, so I wasn’t alarmed. But I did make an appointment with my EP.

Medtronic Reveal LINQ ICM

When I met with my EP, he took an ECG but didn’t find A-Fib (thank goodness). But, just to be sure, he recommended implanting a tiny wireless heart monitor so he can review my heart activity over time.

I Get a Reveal LINQ Insertable Cardiac Monitor

So yesterday, as an outpatient, I had a tiny cardiac monitor implanted just under the skin near my heart. The minimally invasive procedure took the doctor about 2 minutes to do. (Most of my time at the hospital was spent doing paperwork).

My doctor used the Medtronic Reveal LINQ Insertable Cardiac Monitor (ICM)—one of the world’s smallest cardiac monitors—the device is approximately one-third the size of a AAA battery.

MyCareLink transmitter

The Reveal LINQ System includes a bedside unit that collects heart rhythm data from the ICM and wirelessly sends it to my doctor every evening.

The device allows my cardiologist to continuously monitor my heart for up to 3 years.

Setup to transmit: I got it all set up and it’s working. But I don’t expect to get any feedback from my EP any time soon. I’ll publish an update when I have something to report.

My incision for the ICM

Update 5 pm: I forgot to mention that I had no pain with this procedure. They used some numbing agent on the incision area, but I’ve had no pain afterwards (it’s now about 36 hours since the insertion). No sutures. They applied a clear bandage that holds the tissue together while healing.

There’s no visible sign of the device. If I press the area I can barely feel the outline of the ICM. It’s possible this will diminish with time as the surrounding tissue encases it.

I’ll write more:  I’ll talk with my EP in a couple of weeks when he has reviewed some of the data received via the MyCareLink wireless transmitter. (I assume he has some data processing feature that will alert him before that if the readings are outside normal specs.)

VIDEO: The Insertion Procedure

An animated video (music, no narration) by Medtronic, shows how the Reveal LINQ ICM monitor is inserted through a tiny incision just under the skin near the heart. Special tools are used to make a small incision and another to hold the ICM and “plunge” it under the skin. About 2:45 min.

To enlarge video: click and start the video. At the lower right, click on the frame icon. To exit, click again.

Diet and Nutrition: ‘The China Study’ and Other Diet Plans With Dr. Joseph Mercola

After Saul Lisauskas of Encinitas, CA was diagnosed with Atrial Fibrillation, he was disappointed by doctors who offered only drug therapy with no advice about improving his symptoms through diet and nutrition. He decided to educated himself on the topic: In his A-Fib story Saul wrote:

Saul Lisauskas

“I read a few books on the subject of food and the interaction with our body. The best book was The China Study. It will give you an education about food, its sources and dangers.”

The China Study Book and its Critics

The China Study by T. Colin Campbell & Thomas M. Campbell II was first published in 2004. The book’s title comes from the China-Cornell-Oxford Project, a 20-year study that began in 1983 and was conducted jointly by the Chinese Academy of Preventive Medicine, Cornell University, and the University of Oxford.

By Campbell & Campbell II

Conflicting opinions: There has been criticism of some of the conclusions drawn in The China Study (mostly focused on data collection, collection bias and data analysis).

Publisher of Cholesterol-and-Health.com Christopher Masterjohn, PhD has written: “Only 39 of 350 pages are actually devoted to the China study…[The China Study] would be more aptly titled, A Comprehensive Case for the Vegan Diet, and the reader should be cautioned that the evidence is selected, presented, and interpreted with the goal of making that case in mind.”

The Cornell-Oxford-China Study: A Critique (Jesse and Julie Racsh Foundation) states: “After performing regression analyses, the data does not justify the indictment of all animal foods as risk factors for chronic degenerative disease.” Read the report online or download the PDF.

A Critical Look at ‘The China Study’ and Other Diet Plans: Dr. Mercola Interviews Denise Minger

Dr J. Mercola

A jam-packed, up-to-date article for those interested in improving current health problems and long-term health through diet and nutrition.

Denise Minger

Published in July 2018, natural health expert and Mercola.com founder Dr. Joseph Mercola interviewed Denise Minger, most noted for her comprehensive rebuttal of “The China Study” (The China Study: Fact or Fallacy?) some eight years ago. She’s heavily vested in the vegan versus omnivore battle, having cycled through vegetarianism and raw veganism, finally coming full circle to being an omnivore.

Topics covered in a Critical Look at ‘The China Study’ and Other Diet Plans:

• Raw Veganism Took a Toll on Health
• Debunking ‘The China Study’
• The Case for Lowering Protein Intake
• Protein Cycling
• Macronutrient Cycling — An Overlooked Component of Optimal Health
• Cyclical Ketogenic Diet Is Ideally Combined With Cyclical Fasting
• Focus on Nutrient Density
• How Minger’s Diet Has Changed Over the Years
• Critiquing the Blood Type Diet
• Awesome Omnivore
• Plant-Based Paleo
• Lifelong Learning Is Key to Staying Ahead

Go to A Critical Look at ‘The China Study’ and Other Diet Plans.

VIDEO: Highlights from Dr. Joseph Mercola’s interview with Denise Minger (2:28)


YouTube video playback controls are located in the lower right portion of the frame: closed captions,
speed/quality, watch on YouTube website and enlarge video to full frame.

Additional Resources About Diet and Nutrition

Download the full transcript of Dr. Mercola’s interview with Denise Minger. Read Debra Minger’s The China Study: Fact or Fallacy?.

Read The China Study for Free: The 2006 edition is available to read online or download.

The 2017 edition of The China Study is available at Amazon.com and other bookstores.

See my article: The Effect of Diet & Nutrition on Your A-Fib: My Top 5 Articles.

Resources for this article

• The China Project: Studying the Link Between Diet and Disease. Study room provides a general overview and introduction to the Cornell-China-Oxford project. Accessed August 7, 2018 URL: http://www.cornell.edu/video/playlist/the-china-project-studying-the-link-between-diet-and-disease

• Cornell-Oxford-China Study: A Critique. Jesse and Julie Racsh Foundation. Accessed August 7, 2018 URL: http://www.raschfoundation.org/wp-content/uploads/Cornell_Oxford_China-Study-Critique.pdf

• Masterjohn, C. The Truth About the China Study. Cholesterol and Health.com Accessed August 7, 2018 URL: http://www.cholesterol-and-health.com/China-Study.html

• Mercola, J. A Critical Look at ‘The China Study’ and Other Diet Plans. Mercola.com, July 08, 2018. URL: https://articles.mercola.com/sites/articles/archive/2018/07/08/the-china-study-and-other-nutrition-plans.aspx

• Minger, D. The China Study: Fact or Fallacy? July 7, 2010. DeniseMinger.com. https://deniseminger.com/2010/07/07/the-china-study-fact-or-fallac/

Drugs Don’t Cure Atrial Fibrillation But Merely Keep it at Bay

Advice from Patients Now Free from the Burden of Atrial Fibrillation

Daniel Doane, Sonora, California, USA, shares his mistake:

Daniel D.

“Don’t think that the medication is a long term solution. Don’t put up with nasty side effects.
That was the mistake I made. I thought I could tough out the medication as long as I stayed out of A-Fib.
Terry Dewitt at A-Fib.com

Terry D.

Terry DeWitt, Massachusetts, USA, advises act sooner than later:

“I knew I could continue on medication for several years, but I was concerned about the remodeling of my heart. …I would need an ablation…and sooner seemed better when my heart was still strong.”  

 

Max Jussila, Shanghai, China, says meds are for the short term:

Max J.

“Do not listen to your doctors if they suggests medication as a long-term solution!
The doctors who see medication as a solution commit serious negligence and are ignorant of the terrible nature and consequences of Atrial Fibrillation.”

Don’t Just Manage Your A-Fib with Meds. Seek your Cure.

According to Drs. Irina Savelieva and John Camm of St. George’s University of London, London, UK:

“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.”

In general, don’t expect miracles from current medications. Antiarrhythmic drugs are only effective for about 40% of patients; many can’t tolerate the bad side effects. When they do work, the drugs become less effective or stop working over time.

In his, personal A-Fib story, Dr. Sam T. MD, from Tennessee, USA, shares:

“At this time when all medicines and cardiac procedures have their risks and limitations, finding a way to get to NSR [Normal Sinus Rhythm] and staying in NSR is most important.”

The goal should be to end your A-Fib episodes not manage them. Learn more at: Drug Therapies. Always Aim for a Cure!

Drugs Have a Role, but Other Treatment Options Target a Cure.

Resources for this article
CAMM, J, MD. Medical Management of Atrial Fibrillation: State of the Art First published: 03 August 2006 https://doi.org/10.1111/j.1540-8167.2006.00581.x

Savelieva I, Camm J. Update on atrial fibrillation: part II. Clin Cardiol. 2008 Mar;31(3):102-8. doi: 10.1002/clc.20136. PubMed PMID: 18383050. URL: http://www.ncbi.nlm.nih.gov/pubmed?term=PMID%3A%2018383050


From The Top 10 List of A-Fib Patients’ Best Advice’ , a consensus of valuable advice from fellow Atrial Fibrillation patients; Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Go to Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

Updated Article: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors

We’ve updated our Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I) with new models of chest bands/wristwatches sets, Bluetooth versions and wearable technologies.

A consumer heart rate monitor (HRM) is useful when Atrial Fibrillation patients want to monitor their heart rate and pulse when exercising or when performing physically demanding activities.

To our section on handheld real-time ECG monitors, we added the Contec PM-10. Our recent review read in part:

Illustration: Three ways to hold the Contec PM-10 when taking an ECG scan at A-Fib.com

Three ways to hold the Contec PM-10 when taking an ECG scan

“The Contec PM10 (about $79 on Amazon.com) is a very easy-to-use small 4 oz. unit that can track a single channel ECG waveform. You can observe the scan live, then download the recordings (up to 30) to your computer or smartphone for review and print to share with your doctor.” Read the full review.

Also updated: WEARABLE TECHNOLOGY WITH WIRELESS SENSORS

From Sensoria Fitness

“Wearable technology” offers a new option for those who find a chest strap uncomfortable or chafing. Instead of the chestband, these workout clothes have sensors built-in. Just snap on your heart rate sensor from your chestband. Starting at $75.

♥  Sensoria Fitness Men’s T-Shirt with standard sensor snaps (no heart rate sensor)
♥  Sensoria Fitness Sports Bra with standard sensor snaps (no heart rate sensor)

To read the updated article, go to: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I)

Not to be Confused with Optical Fitness Wristbands

Optical LEDs on inside of fitness wristband

The HRM sensors/monitors in our guide work by being in contact with the skin. Don’t confuse DIY/consumer heart rate monitors with fitness bands like Fitbit or running/sport watches.

This group of fitness wristbands use an optical sensor to shine a light on your skin illuminating your capillaries to measure your pulse. Optical sensor wristbands are not accurate enough for A-Fib patients.

For more, see my article: When Tracking Your Heart: Is a Wrist-Worn Heart Rate Monitor Just as Good as a Chest Strap Monitor?

Don’t Delay. Get Your A-Fib Taken Care of. It Won’t Go Away.

Advice from Patients Now Free from the Burden of Atrial Fibrillation

Daniel D.

Daniel Doane, Sonora, California, USA, A-Fib free after Totally Thoracoscopic (TT) Mini-Maze surgery:

“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. 

Roger M.

Roger Meyer, Columbus, Ohio, from three generations of A-Fib, had the Cox-Maze surgery:

“I can now say, first hand, that there ARE bad effects from A-Fib and especially from A-Fib that is not treated early. I now wish I had had some of the today’s more aggressive A-Fib treatment options which weren’t available to me in my younger years.
My best advice: Don’t let A-Fib wreak its havoc untreated!” 

Joan S.

Joan Schneider, Ann Arbor, MI, from Pill-in-the-Pocket therapy to A-Fib free after catheter ablation:

“My advice to other AF patients: Know that paroxysmal AF becomes chronic. Drugs only work for so long. Heart modification will occur, and options will become few. Get with a great EP  and/or AF clinic and find your cure.” 

Don’t Delay—A-Fib Begets A-Fib. 

Do not remain in A-Fib indefinitely if possible. Your A-Fib episodes may become more frequent and longer, often leading to continuous (Chronic) A-Fib. (However, some people never progress to more serious A-Fib stages.)

Controlling symptoms with drugs, but leaving patients in A-Fib, overworks the heart, leads to fibrosis and increases the risk of stroke.

Drug therapies are never curative. Don’t just manage your A-Fib with medication. See Editorial: Leaving the Patient in A-Fib—No! No! No!

Don’t delay—Seek your Cure.


From The Top 10 List of A-Fib Patients’ Best Advice’ , a consensus of valuable advice from fellow Atrial Fibrillation patients; Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Go to Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

No Way Am I Having an Ablation! Seeks Alternative Treatments

Saul Lisauskas of Encinitas, CA, was 62 years old when he first detected something wrong with his heart. After his A-Fib was diagnosed, he started to note his episodes were associated with stress and getting angry, along with dehydration, too much caffeinated coffee and foods containing MSG.

Saul Lisauskas

He was disappointed by doctors who offered only drug therapy with no advice about nutrition and the benefts of an improved, healthy diet. He decided to educated himself on the topic: Saul wrote:

“I read a few books on the subject of food and the interaction with our body. The best book was The China Study. It will give you an education about food, its sources and dangers.”

Looking for Alternative Treatments: A Vegetarian Diet

While avoiding his A-Fib ‘triggers’, he decided to go vegetarian but eating fish (a pescetarian) to reduce exposures to foods laced with unhealthy chemicals. (As a bonus, he lost 20 pounds in 3 months.) He was feeling better, but his A-Fib was still active. In his A-Fib story, Saul shares:

“The cardiologist explained to me that the real solution lay in having an Ablation procedure. I was willing to do anything to avoid that surgery.
“I was willing to do anything to avoid that surgery [catheter ablation].”
But with time, my A-Fib episodes increased along with longer periods of activity and stronger symptoms.”
During my ordeal leading up to my Ablation procedure, I was taking various meds in order to control my A-Fib.
However, the meds would make me dizzy and slow down my heart rate to dangerous levels to the point that such levels in fact were counterproductive. My system would compensate by sudden increases of adrenaline and consequently place me in A-Fib mode.
Consequently, I had a pacemaker installed to prevent low levels of heart rate.”

After nearly 8 years since his A-Fib diagnosis, Saul writes about his decision to have a catheter ablation:

“I was getting tired of and frustrated with all these meds.
After too many episodes of A-Fib forcing me to go to the ER, I capitulated against the Ablation surgery and had it done.
Today I am feeling well and doing my daily activities. …I feel that I may be cured well enough not to have to have another ablation.”

― Saul Lisauskas, Encinitas, CA, A-Fib free with pacemaker and catheter ablation

Since his ablation, Saul writes that he remains cautious not to run the risk of stress, dehydration, too much caffeinated coffee or getting angry.

To read more about Saul’s story, see No Way Am I Having an Ablation! But Diet and Meds Disappoint—A-Fib Free After Ablation.

Lessons Learned

When asked if he had any ‘Lessons Learned’ to share, Saul offers these insights:

”Doctors do not have a solution for everybody with A-Fib…We need to carefully educate ourselves as we follow the doctor’s recommendations and observe how our body reacts. Do not follow blindly the doctor’s recommendations.”

Saul certainly did everything he could to avoid having an ablation—identifying what triggered his A-Fib, a vegan diet with fish and all kinds of meds.

Saul certainly did everything he could to avoid having an ablation.

His experience with meds was unfortunate. The meds Saul was taking slowed his heart rate to the point where his doctor had to insert a pacemaker to keep his heart rate normal. It’s crazy to think about it. If this happens to you, talk to your doctor about changing meds (or change doctors).

Unfortunately, once the heart starts to produce A-Fib signals, it’s hard to turn them off. Saul faced the decision that many people have to make. He bit the bullet and had a catheter ablation―with successful results. He’s now A-Fib free!

What’s the Best Treatment Options For You?

A-Fib is not a one-size-fits-all disease. Your Atrial Fibrillation is unique to you. Along with various treatments, you may need to address concurrent medical conditions (i.e, hypertension, diabetes, obesity, sleep apnea). Likewise, you may need to make lifestyle changes (e.g., diet, exercise, caffeine, alcohol, smoking).

In addition, your heart is a resilient muscle that tends to heal itself, so you may need a repeat procedure.

To learn about options for Atrial Fibrillation patients, see our pages under Treatments for A-Fib. Then go to: Decisions About Treatment Options. And remember…

Always Aim for a Cure!

How Can I Avoid Arterial Calcium Deposits When Taking Coumadin?

Holly Hannula wrote me about being on Coumadin (warfarin) for 12 years because she has a mechanical heart valve. She’s alarmed by a recent scan of her artery walls showing dangerously high calcium deposits, i.e., the amount of hardening of the arteries (atherosclerosis).

Holly’s doctors recommended an angiogram (X-ray) and stents to be put in wherever needed and done very soon. She felt that was too drastic, that her quality of life was good and she was active and social. She and her husband declined those procedures.

Her emailed continued:

“The doctors won’t or can’t change me to a different blood thinner. If I have to take Coumadin for the rest of my life, can I reduce the calcification with vitamin K2 (MK-7)?”

Holly’s coronary artery calcium score is 800 which is dangerously high.

A score between 100 and 399 is classified as increased calcification, and any score over 400 signifies extensive calcium deposits. If your score is over 1,000, you have a 20 percent chance of having a serious or fatal cardiac episode within one year of testing.  (See table below for all scores.)

A score over 1,000 equals a 20% chance of a serious or fatal cardiac event within one year.

No wonder Holly is worried!

What are Her Options?

Because she has a mechanical heart valve, Holly doesn’t have a lot of options. Treatment Guidelines by the American College of Cardiology/American Heart Association (ACC/AHA) only include warfarin (Vitamin K Antagonist) therapy and perhaps aspirin. None of the newer anticoagulants are included.

One might think that a newer anticoagulant like Eliquis would work as well as Coumadin if one has a mechanical valve. But right now, this isn’t a recommended treatment. (For example, the maker of Eliquis states that it isn’t for patients with artificial heart valves.)

My Best Effort for Holly: In my return email, I promised Holly that I would get in touch with Bristol-Myers Squibb, the maker of Eliquis, to see if it could possibly be used in her case.

Tragic Dangers of Warfarin Not Recognized

It’s tragic that Holly has such extensive calcium deposits due to having to take warfarin (Coumadin) which works by blocking Vitamin K.

Vitamin K is essential for heart and bone health. Without enough K-2, osteocalcin, a protein that binds calcium to bone, doesn’t function. Instead the calcium ends up clogging arteries. See Arterial Calcification From Warfarin: Vitamin K May Reverse it.

What’s equally tragic is how few doctors and their patients are aware of this side effect of taking warfarin (Coumadin).

Vitamin K2 Reverses Arterial Calcification!

But, as Holly has already researched and as I described in my article, Arterial Calcification From Warfarin, high doses of Vitamin K2 MK-7 reversed arterial calcification in recent preliminary studies. (MK-7 means the Vitamin K2 also has a Natto component. Natto[kinase] is a known natural blood thinner.)

But what K2 MK-7 dosage should Holly consider? We don’t have enough human research yet to give a definitive answer, but we do have some indications.

Animal research: In an animal study, rats were initially fed a six-week diet of warfarin to induce calcium buildup in blood vessels. Some rats were then fed high dose Vitamin K1 or K2 (MK-4) for six weeks. They not only had no further arterial calcium accumulation but, more importantly, had a 37% reduction of previously accumulated arterial calcification. After 12 weeks, there was an astounding 53% reduction.

Doses: Note the distinction between mg and mcg. 1 mg = 1000 mcg

Mega dose or RDA? In the above study of rats, the human equivalent of the vitamin K2 dose is in the range of  52,000 mcg (52 mg) to 97,000 mcg (97 mg) per day.

Admittedly, these are high doses compared to the standard daily recommend dosages (90 mcg [0.09 mg] for females and 120 mcg [0.12 mg] for males).

Already approved: In Japan, a 45,000 mcg (45 mg) daily dose of the MK-4 form of vitamin K2 is approved as a drug to treat osteoporosis.

Vitamin K and Dosages

Forms of Vitamin K: Consider a high quality MK-7 form of Vitamin K2. Plus, as they are inexpensive, include vitamin K1 and MK-4 to help inhibit and possibly reverse vascular calcification.

Remember to always take your Vitamin K supplement with fatty foods since it is fat-soluble and won’t be absorbed without it.

to avoid arterial calcification

Although the exact dosage of Vitamin K is yet to be determined, one of the world’s top Vitamin K researchers, Dr. Cees Vermeer recommends between 45 mcg and 185 mcg daily for normally healthy adults. LifeExtension magazine recommends 180 mcg.

To Reverse Arterial calcification

To reverse or reduce calcium plaque, you might consider the ultra high doses of 45-50 mg (45,000 mcg) daily, which is based on the research with rats. But only under your doctor’s supervision!

It’s most important that Holly should NOT make any changes to her treatment plan without consulting withher  doctor first.

No Overdosing on Vitamin K

You need not worry about overdosing on K2—people who have been given a thousand-fold increase over the recommended dose over the course of three years have shown no adverse reactions (i.e., no increased clotting tendencies).

Advice for Warfarin Users

If you are taking warfarin, your goal should be to maintain the highest healthy levels of Vitamin K to counteract the effects of warfarin on your arterial and bone health.

If you change from warfarin to a NOAC, your goal should be to restore your arterial and bone health from the effects of warfarin by maintaining the highest healthy levels of Vitamin K.

Additional reading about Vitamin K To learn more about the types of Vitamin K, see our article, Vitamin K―Protection Against Arterial Calcification & Cardiovascular Disease

On a personal note: I’ve had a CT scan which revealed calcium deposits in my heart’s arteries, especially in the “widow maker”, the Left Anterior Descending artery (LAD).
After writing this article, I’ve decided to take 45 mg (45,000 mcg) of Vitamin K2 daily.
Coronary Artery Calcium Score  Interpretation
 0 No identifiable plaque. Risk of coronary artery disease very low (<5%)
 1-10 Mild identifiable plaque. Risk of coronary artery disease low (<10%)
 11-100 Definite, at least mild atherosclerotic plaque. Mild or minimal coronary narrowings likely.
 101-400 Definite, at least moderate atherosclerotic plaque. Mild coronary artery disease highly likely. Significant narrowings possible
 > 400 Extensive atherosclerotic plaque. High likelihood of at least one significant coronary narrowing.

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Resources for this article
• Goodman, Denonis. The New Nutrient Fix. Bottom Line/Health. July, 2015, p. 3.

• Faloon, William. Turning To Stone. Life Extension Magazine, July 2015, pp. 7-16. Last accessed Aug 10, 2015. URL: http://atlaschiropractichealthcenter.com/blog/wp-content/uploads/2015/06/Vitamin-K-LE1.pdf

• Tantisattamo E et al. Increased vascular calcification in patients receiving warfarin. Arterioscler Throm Ib Vasc Biol. 2015 Jan;35(1): 237-42. doi: 10.1161/ATVBAHA.114.304392

• Pilkey, RM, et al. Subclinical vitamin K deficiency in hemodialysis patients. Am J Kidney Dis. 2007 Mar;49(3):432-9. Last accessed Aug 10, 2015. URL: http://www.ncbi.nlm.nih.gov/pubmed/17336705

• Schurgers, LJ, et al. Regression of warfarin induced medial elastocalcinosis by high intake of vitamin K in rats. Blood. 2007 Apr 1;109(7):2823-31. Last accessed Aug 10, 2015. URL: http://www.bloodjournal.org/content/109/7/2823.full?sso-checked=true

• Westenfeld, R, et al. Effect of vitamin K2 supplementation on fictional vitamin K deficiency in hemodialysis patients: a randomized trial. Am J Kidney Dis. 2012 Feb;59(2):186-95. Last accessed Aug 10, 2015. URL: http://www.ajkd.org/article/S0272-6386(11)01570-8/abstract

• Geleijnse, JM et al. Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study. The Journal of Nutrition, November 1, 2004, Vol. 134, no. 11. 3100-3105. http://jn.nutrition.org/content/134/11/3100.full Last accessed 6/19/2015.

• Vitamin K: How much is too much? Alere/PTINR.com. April 1, 2013. Last accessed Aug. 10, 2015. URL: http://ptinr.com/warfarin-you/dietary-food-beverage/vitamin-k-how-much-too-much

• Mercola, J. 10 Important Facts About Vitamin K That You Need to Know. Mercola.com, March 24, 2004 Last accessed Aug 10, 2015. URL: http://articles.mercola.com/sites/articles/archive/2004/03/24/vitamin-k-part-two.aspx

• Mercola, J. New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation. Mercola.com. October 12, 2013. https://articles.mercola.com/sites/articles/archive/2013/10/12/vitamin-k2-benefits.aspx

NEW VIDEO: What Should I Expect After my A-Fib Catheter Ablation Procedure?

What to expect post-ablation

We have posted a new video that features Cardiac Electrophysiologist Dr. Darryl Wells.

He talks about judging the success of your ablation, why it’s difficult to predict which patients will be completely cured after one ablation procedure and why some require two procedures.

He discusses safety of the procedure and the appropriate age range for patients to receive the ablation procedure. (3:17)

Published by Swedish Heart and Vascular Institute. Go to video->

Vitamin K―Protection Against Arterial Calcification & Cardiovascular Disease

Most people get just enough Vitamin K from their diets to maintain adequate blood clotting.

But NOT enough Vitamin K to offer protection against health problems including arterial calcification, cardiovascular disease, osteoporosis, various cancers and brain health problems, including dementia.

The name Vitamin K comes from the German word “Koagulationsvitamin” where its role in blood coagulation was first discovered.

Vitamin K is an essential vitamin. It is one of the four fat-soluble vitamins, along with vitamin A, vitamin D, and vitamin E. It’s found in leafy green vegetables, broccoli, and Brussels sprouts.

Vitamin K and Vitamin K supplements come in several forms and can be confusing. To increase your levels of Vitamin K, it’s important to understand the differences.

Vitamin K Can be Classified as Either K1 or K2

Vitamin K1: Found in green vegetables, K1 goes directly to your liver and helps you maintain a healthy blood clotting system; keeps your own blood vessels from calcifying, and helps your bones retain calcium.

Vitamin K2: Bacteria produce this type of Vitamin K; it goes straight to vessel walls, bones and tissues other than your liver. It is present in fermented foods, particularly cheese and the Japanese food natto (the richest source of K2).

Different Forms of Vitamin K2

Making matters even more complex, there are several different forms of Vitamin K2. MK-4 and MK-7 are the two most significant forms of K2 and act very differently in your body.

MK-4 is a synthetic product, very similar to Vitamin K1, and your body is capable of converting K1 into MK4. It has a very short biological half-life of about one hour, making it a poor candidate as a dietary supplement. It remains mostly in your liver where it is useful in synthesizing blood-clotting factors.

MK-7 is a newer agent with more practical applications because it stays in your body longer; its half-life is three days, meaning you have a much better chance of building up a consistent blood level, compared to MK-4 or K1. It slows down cardiovascular aging and osteoporosis, and prevents inflammation by inhibiting pro-inflammatory markers produced by white blood cells.

Food Sources of Vitamin K and MK-7

Photo by Like_The_Grand_Canyon on Flickr licensed CC-BY

MK-7 is extracted from the Japanese fermented soy product called ‘natto’. You get loads of MK-7 from natto. However, natto is generally not appealing to a Westerner’s palate (can’t tolerate its smell and slimy texture).

You can also find Vitamin K2, including MK-7, in other fermented foods including some fermented vegetables.

Certain types of fermented cheeses (Jarlsberg) are high in K2 but others are not. It really depends on the specific bacteria. You can’t assume that any fermented food will be high in K2.

Besides broccoli, Brussels sprouts and leafy green vegetables (kale, mustard greens, collard greens, raw Swiss chard, spinach), other foods high in Vitamin K include beef liver, pork chops and chicken, prunes and Kiwi fruit, soybean and canola oil.

Vitamin K Supplements

Choosing a K2 supplement: When supplementing your Vitamin K food sources, consider a high quality MK-7 form of vitamin K2. (Plus, as they are inexpensive, include Vitamin K1 and MK-4 to help inhibit and possibly reverse vascular calcification.)

Relentless Improvement

Dosage: Although the exact dosage of Vitamin K is yet to be determined, one of the world’s top Vitamin K researchers, Dr. Cees Vermeer recommends between 45 mcg and 185 mcg daily for normally healthy adults.

My choice: I’m taking Relentless Improvement Vitamin K2 MK4 Plus MK7; Read about it on Amazon.com. David Holzman writes that he uses Whole Foods Vitamin K2 which is less expensive. (Use our portal link to Amazon.com and support A-Fib.com)

(If you have a K2 supplement recommendation, email me.)

Remember!
Always take your Vitamin K supplement with food that contains fat
since it is fat-soluble and won’t be absorbed without it.

Read more about mineral deficiencies and Atrial Fibrillation, see FAQs: Mineral Deficiencies & Supplements for a Healthy Heart

This article is based on Dr. Mercola’s article, New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation.
Resources for this article
Mercola, J. New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation. Mercola.com. October 12, 2013. https://articles.mercola.com/sites/articles/archive/2013/10/12/vitamin-k2-benefits.aspx

Possible Sleep Apnea? Oximeter is DIY Way to Check your Blood’s Oxygen Level

As many as 43% of A-Fib patients also suffer with obstructive sleep apnea (OSA). An easy preliminary step towards finding out if you have a sleep disorder is with the use of an inexpensive oximeter. To check your blood’s oxygen level, just insert your finger.

Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor

Designed for pilots and sport enthusiasts who want to obtain their SpO2 (Blood Oxygen Saturation Levels) and PR (Pulse Rate) on the go. A-Fib patients can use one, too.

The pulse oximeter LED display faces you so it’s easy to read. (The Zacurate, Facelake and Santamedical are brands of Fingertip Pulse Oximeters. Reasonably priced, starting at $13 on Amazon.com. )

Taking a reading is easy. Just clip it on to your finger and turn it on at the press of a button. The large LED display makes viewing the results a snap.  (The one from Zacurate comes with 2 AAA batteries so that you can use it immediately.)

Your Blood’s Oxygen Level

A reading of 90% or lower means you should talk to your doctor, you may need a sleep study.

HINT for after you have taken your initial oxygen level: Take a BIG deep breath and HOLD it. You should see the reading increase as more oxygen enters your blood stream.

To learn more about sleep apnea and A-Fib, see Sleep Apnea: When Snoring Can Be Lethal and the Podcast: The Double Whammy? Sleep Apnea and Atrial Fibrillation.

A-Fib is Not a ‘One-Size-Fits-All’ Disease—May Involve Various Treatments

Over time, these patients chose more than one type of treatment to become free from the burden of Atrial Fibrillation.

kathy haxton - Personal A-Fib story

Kathy H.

Kathleen Haxton, Surprise, Arizona, describes her various treatments leading up to a successful Ablation:

“At first I was able to control the a-fibs by increasing my magnesium and potassium intake. (Low sodium V-8 juice was very helpful.) However, after a while that wasn’t quite good enough.
[Then] Sotalol worked pretty well, but I knew I had to do something. I did not want these a-fibs to control my life any longer.
Because in all the research I did, I knew I wanted to have a Cryo-Balloon Ablation.”

Jay Teresi, Atlanta, GA, describes his second ablation after being A-Fib free for three-years:

Jay T.

“[My EP] explained that my first procedure was a success. However, during the healing process a tiny spot did not scar and this allowed the A-Fib to trip again.
He ablated that portion and touched up all the other areas. I have now been free of A-Fib for over four years..”

Emmett F.

Harry Emmett Finch, Malibu, CA. With 40-years of A-Fib, Emmett’s treatment evolved beyond drug therapy: a PV catheter ablation, then AV Node ablation with Pacemaker and, most recently, installation of the Watchman device:

“There is more help available today than when I first developed my A-Fib [in 1972], and I’m sure more treatment options (like the Watchman device) will be available in the future.”

A-Fib is Not a One-Size-Fits-all Disease

Your Atrial Fibrillation is unique to you. Along with various treatments, you may need to address concurrent medical conditions (i.e, hypertension, diabetes, obesity, sleep apnea). Likewise, you may need to make lifestyle changes (e.g., diet, exercise, caffeine, alcohol, smoking).

Your heart is a resilient muscle that tends to heal itself. So, prepare yourself—over time you may need a repeat treatment or an additional procedure. Learn more at: Treatments for A-Fib

Need More Than One Treatment?
A Heart in Normal Sinus Rhythm is Worth it! 


‘From The Top 10 List of A-Fib Patients’ Best Advice’ , consensus of valuable advice from fellow Atrial Fibrillation patients; Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Go to Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

NEW VIDEO: The Hybrid Maze/Ablation for Persistent A-Fib

We’ve posted a new video about the Hybrid Maze/Ablation.

Video animation frame: Surgeon placing lesions on outside of heart at A-Fib.com

Animation frame: Surgeon placing lesions on outside of heart

For persistent or long-standing persistent atrial fibrillation, it combines the complementary efforts of both the cardiothoracic surgeon and the cardiac electrophysiologist.

The surgeon works on the outside the heart and the EP on the inside of the heart to eliminate the Atrial Fibrillation signals.

In this video, two cardiac EPs and a cardiothoracic surgeon describe the advantages, safety and effectiveness of the Hybrid approach and who is a good candidate. Includes animation and on-camera interviews.  Length 4:30.  Go to video->

PVCs Aren’t Always Benign, and He Didn’t Want to Live with Them

Do NOT listen when doctors say PVCs are harmless, writes John Thorton from Sioux Falls, SD. Besides A-Fib and A-Flutter, his PVCs were destroying his life and driving him crazy.

Premature Ventricular Contractions (PVCs) are premature beats that occur in the ventricles, i.e., the heart’s lower chambers. (Premature beats that occur in the atria, the heart’s upper chambers, are called premature atrial contractions, or PACs.) In his A-Fib story, John writes:

John & Marcia T.

“The local MDs (about a half dozen different ones), cardiologists, EPs, and other local specialists, all told me stuff like: “Everyone has PVCs” and “PVCs are benign,” and “It is just anxiety,” and “You just need to learn to live with it”.
Which was completely WRONG.
Being his Own Patient Advocate

In his A-Fib story, PVC-Free After Successful Ablation at Mayo Clinic, John advises: Be assertive, even aggressive.

“I had to set up my own appointment at Mayo Clinic to get evaluated there. It was a lot of work, by me alone, to get in to see the doctors at Mayo, but it was worth it.
I honestly believe that had I not gone to Mayo, I would have suffered some major heart event, or possibly death.”

PVCs Aren’t Always Benign

Especially for people with A-Fib, PVCs should be taken seriously. Often they precede or predict who will develop A-Fib. They can increase chances of a fatal heart attack or sudden death. The good news: sites in the heart that produce PVCs can be mapped and ablated just like A-Fib signals.

To learn more about PVCs, see my article: FAQs Coping with A-Fib: PVCs & PACs

Don’t be Afraid to Fire Your Doctor!

Kudos to John for being his own best patient advocate, for taking the bull by the horns and dealing with his PVCs. In spite of what he heard from everyone else, he persevered and went to probably the best center in the US for treating PVCs—the Mayo Clinic. Now John’s A-Fib free and only has occasional PVCs.

Like John, don’t be afraid to fire your doctor! To learn how to interview doctors, see our page: Finding the Right Doctor for You and Your A-Fib.

VIDEO: What Should I Expect After the Atrial Fibrillation Ablation Procedure?

Atrial Fibrillation videos at A-Fib.comCardiac electrophysiologist Dr. Darryl Wells talks about judging success of your ablation, why it’s difficult to predict which patients will be completely cured after one ablation procedure and why some require two procedures, safety and the appropriate age range for patients to receive the ablation procedure. (3:17)

Published by Swedish Heart and Vascular Institute.

YouTube video playback controls: When watching this video, you have several playback options. The following controls are located in the lower right portion of the frame: Turn on closed captions, Settings (speed/quality), Watch on YouTube website, and Enlarge video to full frame. Click an icon to select.

If you find any errors on this page, email us. Y Last updated: Wednesday, July 18, 2018
Return to Instructional A-Fib Videos and Animations

VIDEO: The Hybrid Maze/Ablation for Atrial Fibrillation for Persistent A-Fib

For persistent or long-standing persistent atrial fibrillation, the Hybrid Maze/Ablation (also called the Hybrid Convergent Procedure) combines the complementary efforts of both the cardiothoracic surgeon and the cardiac electrophysiologist. The surgeon works on the outside the heart and the EP on the inside of the heart to eliminate the Atrial Fibrillation signals.

In this video, two cardiac EPs and a cardiothoracic surgeon describe the advantages, safety and effectiveness of the Hybrid approach and who is a good candidate. Includes animation and on-camera interviews.

Published by Tenet Heart & Vascular Network. Length 4:30. 

YouTube video playback controls: When watching this video, you have several playback options. The following controls are located in the lower right portion of the frame: Turn on closed captions, Settings (speed/quality), Watch on YouTube website, and Enlarge video to full frame. Click an icon to select.

If you find any errors on this page, email us. Y Last updated: Tuesday, July 17, 2018

Return to Instructional A-Fib Videos and Animations

Which Comes First: Sleep Apnea or Atrial Fibrillation?

Obstructive Sleep Apnea (OSA) affects about 100 million people worldwide with 85% of cases going undiagnosed.

Of Atrial Fibrillation patients, about 43% additionally suffer with Obstructive Sleep Apnea.

Could undiagnosed sleep apnea be linked to development of Atrial Fibrillation?

OSA Link to A-Fib

OSA is characterized by repetitive episodes of shallow or paused breathing during sleep that lead to a drop in blood oxygen level and disrupted sleep.

85% of Sleep Apnea cases go undiagnosed.

New research has found that patients with Sleep Apnea may be at greater risk of developing Atrial Fibrillation. Abnormal oxygen saturation level during sleep may be responsible.

Patients with OSA are more likely to have high blood pressure, or hypertension, which is a major risk factor for heart disease and other cardiovascular conditions.

Risk of New Onset A-Fib: The Clinical Cohort Study

Lead author Dr. Tetyana Kendzerska, Ph.D., of the University of Ottawa in Canada, and colleagues reviewed the records of 8,256 adults (average age 47) with suspected OSA. Individuals with any diagnosis of arrhythmias were excluded. Participants were followed for an average of 10 years. During that time, 173 developed A-Fib resulting in hospitalization.

Study Results

The reviewers found that the amount of sleep time spent with lower than normal oxygen saturation (below 90 percent) was a significant predictor of developing Atrial Fibrillation.

By contrast, the number of breathing pauses during each hour of sleep did not appear to affect A-Fib risk.

Study participants who developed A-Fib during the follow-up period were more likely to be older, current or former smokers, and have a high level of comorbidities (i.e., high blood pressure, or hypertension).

“The association between oxygen desaturation and A-Fib remains significant, suggesting that OSA can directly cause A-Fib.”

What This Means to Patients

In light of this study, a diagnosis of Atrial Fibrillation raises the question, ”Could my A-Fib have been brought on by undiagnosed Sleep Apnea?”

Sandy from Boston

Sandy from Boston and her doctor say ‘yes”. Updating her personal A-Fib story, she wrote:

“After my [successful] CryoBalloon ablation at BWH in 2014, I underwent a sleep study that revealed during REM sleep I stopped breathing an average of 32 times every hour. My physician suspected that my traumatic brain injury in 1995 caused my undiagnosed sleep apnea, which in turn caused Paroxysmal A-Fib. I have been using a CPAP ever since.”

Take Action: Sleep Apnea Can be Lethal: If you have untreated Sleep Apnea, you are at greater risk of having a more severe form of A-Fib or of not benefiting from an A-Fib treatment.

So many A-Fib patients also suffer from sleep apnea that many Electrophysiologists (EPs) routinely send their patients for a sleep apnea study.

Sleep apnea isn’t a minor health problem, and it’s a condition you can do something about. To learn more, see Sleep Apnea: When Snoring Can Be Lethal.

Resources for this article
Atrial Fibrillation and Sleep Apnea. Heart Rhythm Society. http://resources.hrsonline.org/pdf/patient/HRS_AF_SleepApnea_R3.pdf

What You Need to Know: Sleep apnea may increase atrial fibrillation risk. Brighsurf.com, May 22, 2017. https://www.brightsurf.com/news/article/052217429745/sleep-apnea-may-increase-atrial-fibrillation-risk.html

Kendzerska, T, et al. Sleep Apnea Increases the Risk of New Onset Atrial Fibrillation: A Clinical Cohort Study. American Thoracic Society. Public Release: 22-May-2017. https://www.eurekalert.org/pub_releases/2017-05/ats-sam051517.php

Whiteman, H. Obstructive sleep apnea might lead to irregular heartbeat. Medical News Today. May 23, 2017. https://www.medicalnewstoday.com/articles/317577.php

Wondering if you Should Consider a Cox Maze or Mini-Maze for your A-Fib?

What are your options when drugs aren’t working or you can’t tolerate them? When your symptoms are impacting your quality of life? And you want to cure your A-Fib not just manage it? Treatment options to consider include Catheter Ablation or Maze or Mini-Maze surgeries.

We’ve published a new FAQ question and answer about the Maze or Mini-Maze surgeries:

Surgical Maze pattern of series of lesions

“When should A-Fib patients consider a full Cox Maze or a Mini-Maze surgery instead of a Catheter Ablation?”

In general, candidates for Maze or Mini-Maze surgeries are patients with significant, frequent A-Fib symptoms that do not respond to medication or catheter ablation. Patients who are unaware of their A-Fib symptoms are probably not candidates. However, each case is unique, so it’s best to discuss your options with your cardiologist.

There are several specific circumstances in which you might consider a Maze surgery…continue reading our answer…

Daniel Shares About A-Fib: “I Have Gotten a Lot of Bad Advice From Various GPs”

Advice from a patient now free from the burden of Atrial Fibrillation: Educate yourself on all treatment options before making decisions.

Daniel Doane, Sonora, California, talks about all the false info he got from doctors.

“Don’t believe your GP. I have gotten a lot of bad advice from various GPs.

Daniel D.

• ‘Just take a little digoxin and you will be fine.’
• ‘You are probably missing some micro-nutrient. If you buy this product I sell, it may well provide that and stop your A-Fib.’
• ‘I think that all of these tests your EP is requesting are just a waste of money.’
• (From a cardiologist) ‘Don’t worry about a little A-Fib. It won’t kill you.’ “

“If you have Atrial Fibrillation, see an electrophysiologist. If you aren’t comfortable with what they are saying, see another one.” 

Daniel did his research and is now A-Fib-free after a Totally Thoracoscopic (TT) Mini-Maze operation.

If you want to read more of Daniel Doane’s story, you’ll find it on pp. 152-162 in Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD. Learn more about my book.

Don’t Believe Everything You’re Told About A-Fib

In Daniel’s story you read how important it was for him to educate himself. You, too, can learn about all your treatment options. Check our Treatments section covering diagnostic tests, common mineral deficiencies, drug therapies, cardioversion, catheter ablations, surgery and more.

Next, read answers at FAQ: About A-Fib Treatments Options including natural therapies and holistic treatments.

In addition, you may want to browse our A-Fib Video Library and check our list of Online Discussion Groups.

Finally, ask yourself, ‘What are my treatment goals?”, then read our Q&A section: Decision About Treatment Options.

Remember: Always Aim for a Cure.

A Tale of Two Ablations and Why All EPs Are Not Equal

I just received an email and O.R. (Operating Room) reports from Louis who in 2014 had a successful catheter ablation by Dr. David Wilber at Loyola in Chicago. Dr. Wilber is nationally known for both his ablation skills and experience, as well as for his research.

First Ablation with Dr. David Wilber

Dr. Wilbur’s ablation of Louis was textbook. Louis’ A-Fib terminated during his ablation procedure, which is considered the ideal outcome.

But Dr. Wilber didn’t stop there.

Dr. Wilber didn’t stop there; he found A-Fib signals coming from the Superior Vena Cava (SVC).

He used isoproterenol (IV medication) to try to induce non-PV triggers and found A-Fib signals coming from the Superior Vena Cava (SVC). He isolated the SVC and could no longer induce any arrhythmias in Louis. (Some EPs would not work that hard, and would have trouble finding and ablating non-PV triggers.)

Relocation, Then Second Ablation―Failure!

But later Louis did develop A-Fib/Flutter again. He had relocated to a distant state so he selected a second EP and had a second ablation there. This ablation was a failure.

After touching up the right pulmonary veins (PVs), the second EP used adenosine and pacing to try to induce arrhythmia signals. He induced Flutter and isolated the right atrium by making a cavo-tricuspid isthmus line. He documented bidirectional block in the right atrium, but Louis still had Flutter.

The second EP didn’t map and track down the flutter.

Rather than map and track down the source of the Flutter, the EP simply Electrocardioverted Louis and stopped the ablation at that point. Then he put Louis on the dreaded antiarrhythmic drug amiodarone.

Still in Flutter―Amiodarone Side Effects

But after the second ablation, Louis still had A-Fib/Flutter.

On amiodarone, Louis developed the symptoms of loss of weight, thinning hair, extreme dry mouth, increased hand tremors, etc. Louis was taken off of amiodarone and is doing better. But he is still bothered by Flutter. See Amiodarone Effective but Toxic.

I’m working with Louis to get him to a “master” EP, a highly skilled EP with a high success rate with difficult A-Fib cases.

What Went Wrong with Louis’ Second Ablation?

From what can be deduced from Louis’ O.R. (Operating Room) report, there seems to be no mention of checking for entrance and exit block after ablating Louis’ pulmonary veins.

As a “crutch”, he put Louis on amiodarone, the most effective but also the most toxic of the antiarrhythmic drugs.

The second EP did use adenosine and pacing and induced a Flutter circuit. He ablated the right atrium and made a cavo-tricuspid isthmus line to make sure no Flutter came from the right atrium. But Louis still had Flutter.

Instead of using any of today’s advanced mapping and isolation strategies, Louis’ EP simply Electrocardioverted him to restore him to sinus. Then he stopped the ablation.

As a “crutch”, he put Louis on amiodarone, the most effective but also the most toxic of the antiarrhythmic drugs.

All EPs are Not Equal―It May Take Work to Find the Right EP

I’m sorry to say, the second EP Louis went to is indeed listed in our directory of EPs. He has all the proper credentials and is a member of the Heart Rhythm Society. But all EPs are obviously not equal. (See my editorial, Huge Growth in Number of EPs Doing Catheter Ablations, But All EPs Are Not Equal.)

Don’t just go to the EP whose office is near you. Go to the best, most experienced EP you can reasonably find. I know it’s a lot of effort. But you have to work at finding the right EP for you.

Do your due diligence. Seek recommendations from your General Practitioner (GP) and from other A-Fib patients (see our Resources/Bulletin Boards for a list of online discussion groups).

If you know nurses or support staff who work in the cardiology field or in Electrophysiology (EP) labs, they can be great resources.

Don’t rely on a single online source when researching and selecting doctors. Be cautious of all doctor informational listings you find on web sites (yes, including this one).

Be prepared to travel if that’s what it takes.

Learn How to Select Your EP

On our page Finding the Right Doctor for You and your A-Fib, we take you step-by-step to finding the right EP for you and your treatment goals.

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