A-Fib Patient Story #93
Prayer and CyroAblation: A-Fib Free! But Now Persistent PVCs
By AGL, December 2016
AGL first shared his story with A-Fib.com readers in August 2016 (My A-Fib Story: The Healing Power of Prayer, #88). Here, he shares the rest of the story…up-to-date and expanded.
In early 2011, I had my first heart episode. I sat down at my desk at work and my heart rate did not slow down. I was sitting there but my heart felt like I was jogging. I thought I’d sleep it off, so I went home and took a nap.
My First A-Fib Episode
It didn’t go away.
I eventually went to the ER where they said my heart rate was 235. They used adenosine which broke the episode, and my heart rate fell to 130s–140s.
They thought I had SVT [Supraventricular tachycardia] since my heart rate was so fast.
At this point they thought I had SVT [Supraventricular tachycardia], since my heart rate was so fast. If it was A-Fib ―it was difficult to determine due to the skewed heart rate graph. Since that was my first episode, I didn’t make any changes [to prevent future episodes]. I couldn’t be sure if it was simply a fluke or not.
Not a One-Time Fluke
But after a few more episodes within a year or two, I knew this wasn’t a one-time fluke.
I went to see a cardiologist who gave me three choices of proceeding: 1) do nothing 2) take medicine or 3) have an ablation. He didn’t recommend I go with an ablation due to risks involved.
I began taking 120mg of Cardizem, but that did not help―it simply slowed my heart rate and lowered by blood pressure. I was also taking 81mg of aspirin daily [for risk of stoke].
A-Fib Confounded by Sleep Disturbance
I wasn’t making progress in my A-Fib battle―and I was sleeping terribly. For three months I woke up every night at 2:30 a.m. Then, the rest of the night’s “sleep” was sketchy. (The sleep disturbance wasn’t caused by my A-Fib.)
After I came across an article online NSAIDs―The Unintended Consequences,
I told my cardiologist I was finished with taking Cardizem and asked how I could safely stop it.
Another decision is made, I told my cardiologist I was finished with taking Cardizem (120mg). I asked how I could safely stop it—did I need to wean off it or just stop cold turkey? He said, with a 120mg dose, cold turkey was fine. After I stopped taking the medicine, I was sleeping well.
A-Fib Episodes Every 4–6 Months
The A-Fib still hadn’t left. I had an episode every four to six months. My heart rate would go up to about 180 bpm and my heart felt like it was a fish trying to push through my chest.
I’d call 911 aach time and they’d come and either hook me up with Cardizem in my kitchen or in the ambulance to slow my heart rate. Then, while at the ER, my A-Fib would convert on its own.
The medicine they gave me never helped my heart rhythm―only heart rate. My heart rhythm would convert from A-Fib to sinus on its own.
My Pastors Pray for My Healing
As I shared before, being a Christian and believing what God says in the Bible about what He can do―I asked my pastors to anoint me with oil and pray over me for healing―as laid out in the book of James. They did that, and I did not have another A-Fib episode for 15 months.
I asked my pastors to anoint me with oil and pray over me for healing―as laid out in the book of James.
God touched me and stayed the A-Fib for that amount of time.
God’s Timing: Considers CryoAblation
After 15 months I had another A-Fib episode. This was around the beginning of 2013. At that point my cardiologist recommended I consider the CryoAblation.
Now that I look back on the timing of things, I think God chose to get me through the 15 months so more advancements could be made on the CryoAblation procedure for it to be safe for me to have it performed. He has His own reasons for sometimes miraculously and permanently healing some―and not permanently healing others.
I read about the CryoAblation procedure―mostly on StopA-Fib.org. The statistics proved good success rates and low risk―besides the obvious of it being invasive―and involving the heart.
Choosing an EP: High-Volume=Lower Complications
I had read that cardiologists/EPs who perform Cryoablations regularly [20 to 50 ablations/year] had increased safety statistically than compared to the ones who performed only a few. Well, it turned out my EP had performed 50 of them before mine. So, that made me feel a lot more comfortable! [See our article: Catheter Ablation: Complications Highest With Low-Volume Doctors]
So, in mid 2013 I had a CryoAblation for my A-Fib. And, I’m happy to say that the ablation was successful. I have not had an episode of A-Fib since!
I’m A-Fib Free! But Now Persistent PVCs
Life has been uneventful heart-wise until recently.
I have had persistent PVCs for a few months now. I basically have them 24/7…sometimes minutes apart sometimes seconds apart―but I don’t have any side effects except an occasional slight flush feeling in the face, but that’s it.
Testing for Magnesium Deficiency
After some research online, it seems like magnesium deficiency would be something to investigate first. But the common blood serum test [Red Blood Cell Count (RBC)] to determine magnesium levels is unreliable (your body works to keep your blood serum levels consistent or your heart would stop).
What you want tested is your intracellular level of magnesium―which the Exatest [Energy Dispersive X-Ray Analysis] measures. That test is performed by a lab in California named Intracellular Diagnostics. I had that test done, and my intracellular Mg level was 34 while the lowest number within “normal” is 32. [See: Serum vs Intracellular Magnesium Levels]
But, according to an article on livingwithatrialfibrillation.com, Travis’ doctor says that “normal” can be different per person. So, although I’m within the defined “normal” range…maybe my personal normal is 36 or 38 or something.
Electrolytes in Normal Range—But Not Magnesium
For what it’s worth, the majority of my other electrolytes within the test were spot on in the middle of the “normal” range―while Mg was not. So, I’m taking that as meaning I may be Mg deficient.
So, I have been taking Natural Rhythm’s Triple Calm Magnesium with three types of chelated magnesium. I’ve read it takes a while to raise your intracellular levels of Mg, so it will take time to see if this works or not.
Also, for what it’s worth―my PVCs seem to be affected by the vagus nerve. Sometimes sitting down seems to magnify the PVCs. They also seem more pronounced after heavier meals sometimes. This is an interesting 2011 article about the vagus nerve and PVCs.
Asks God for Guidance
I’ll continue to try what I can, and ask God for guidance all the while. After all, He made the heart! Too bad that in this fallen world it’s susceptible to malfunctioning at times―partly due to it simply being a fallen world and partly because we don’t follow His ways that are designed to keep us from disease.
I’ll hold onto His promise that says:
“And we know that all things work together for good to those who love God, to those who are called according to His purpose.” (Romans 8:28, NKJV)
Magnesium Deficiency: Congratulations to AGL for investigating his magnesium level and going beyond the common blood serum test to measure his intracellular level of magnesium.
If you have A-Fib, it’s safe to assume you are magnesium deficient. Most everyone is. Magnesium has been depleted from the soil by industrial scale farming. It’s hard to get enough magnesium from today’s food.
Consider taking magnesium supplements. It takes about 6 months of taking magnesium supplements to build up healthy Mg levels. For more about A-Fib and Magnesium Deficiency, see our articles:
• Cardiovascular Benefits of Magnesium: Insights for Atrial Fibrillation Patients
• Mineral Deficiencies/Magnesium
• Low Serum Magnesium Linked with Atrial Fibrillation
PVCs and PACs (Extra Beats): PVCs (Premature Ventricular Contractions) and PACs (Premature Atrial Contractions) are often considered benign. Everybody gets them occasionally, not just people with A-Fib. But A-Fibbers seem to have more problems with extra beats than healthy people. After a successful A-Fib ablation, patients seem to have more extra beats. But, unlike in AGL’s case, they usually diminish over time as the heart heals and gets used to beating properly.
But the sources of PACs/PVCs signals can also be mapped and ablated just like A-Fib sginals. Also, beta blockers and antiarrhythmic drugs may help diminish those extra beats.
Catheter Ablation can make you A-Fib free: The options AGL’s cardiologist gave him in 2011 really weren’t equal.
• “Doing nothing”. This was impractical for AGL considering how badly A-Fib affected him, how often he had to call the paramedics and go to the ER.
• “Take Medications.” AGL tried Cardizem (a Calcium Channel blocker rate control drug), but it didn’t work for him. He might have tried various antiarrhythmic drugs, but their record isn’t good.
• “Ablation, but not recommended.” Though there is risk with any procedure, even AGL’s cardiologist eventually recommended he get an ablation in 2013.
An ablation is a low risk procedure with a high rate of success. Currently it’s the only option that offers hope of fixing one’s A-Fib and becoming A-Fib free.
A-Fib begets A-Fib: Atrial Fibrillation is a progressive disease. The longer you have it, the greater the risk of your A-Fib episodes becoming more frequent and longer. Over time this can lead to fibrosis making the heart stiff, less flexible and weak, reduce pumping efficiency and lead to other heart problems.
Don’t let your doctor leave you in A-Fib. Educate yourself. And always aim for a Cure! To learn more, read my editorial, Leaving the Patient in A-Fib—No! No! No!
16. “I am 69 years old, in permanent A-Fib for 15 years, but non-symptomatic. My left atrium is over 55mm and several cardioversions have failed. My EP won’t even try a catheter ablation. I exercise regularly and have met some self-imposed extreme goals. What more can I do?
As you already know, being in permanent (long-standing persistent) Atrial Fibrillation can cause other long term problems like fibrosis, increased risks of heart failure and dementia. So you are wise to be concerned.
I’m not surprised your electrophysiologist (EP) is reluctant about a catheter ablation. Being asymptomatic with 15 years of long-standing persistent A-Fib and a Left Atrium diameter of 55mm, most EPs wouldn’t recommend or perform a catheter ablation on you.
Drug Therapy Option: Tikosyn
Have you tried the newer antiarrhythmic drug Tikosyn (generic name dofetilide)?
Tikosyn was designed for cases like yours. It’s a Class 1A drug that works by blocking the activity of certain electrical signals in the heart that can cause an irregular heartbeat.
The only inconvenience of Tikosyn drug therapy is you have to be in a hospital for 3 days for observation and to get the dosage right.
Benefits of Activity and Exercise on Your A-Fib
You are truly blessed to be so active and without noticeable symptoms in spite of being in A-Fib. While exercise will not reduce the size of your LA, your activity level may compensate for the lack of pumping of your left atrium. In fact, your ventricles may be acting kind of like a turkey baster sucking blood down from your non-functioning LA before pushing blood out to the rest of your body.
Catheter Ablation and Surgical Options
Catheter ablation: Studies of non-paroxysmal A-Fib have shown that a successful catheter ablation can significantly reduce atrial dilation and improve ejection fraction. But, with your A-Fib being persistent long-standing, this may not apply.
Surgery: A Cox Maze IV surgery may reduce the volume and size of your left atrium while hopefully making you A-Fib free, but surgeons may be reluctant to tackle your case since the success rate is under 80%. A Cox Radial Maze is open heart surgery which is very traumatic and risky. It may be hard to justify open heart surgery if you’re symptomaric.
1. If you haven’t tried it yet, ask your EP about taking the newer antiarrhythmic drug Tikosyn.
2. If you’ve tried Tikosyn and it doesn’t help you, I recommend you consult an EP who specializes in longstanding persistent A-Fib. See Steve’s Lists. You may need to travel, but it may be worth it to you for your peace of mind. Also, ask the EP if surgery may be a helpful option.
Making an Informed Choice
Armed with the above information you will be able to determine how you want to proceed. This is a decision only you can make.
With no A-Fib symptoms and a fulfilled life with plenty of body and soul enriching exercise, you may decide you are content with your present A-Fib status.
We’ve updated our article: Sleep Apnea: Home Testing with WatchPAT Device and the Philips Respironics.
There are several FDA-approved sleep study devices you can use in the comfort of your own bedroom to determine if you have sleep apnea. And it’s convenient (especially if being away from home overnight is problematic).
Everyone with A-Fib should be tested for sleep apnea. It’s now available at a fraction of the cost of an in-lab sleep study ($250-$300 vs. $1100-$2,000).
The Longer You Have A-Fib, the Greater the Risk
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 (Chronic) A-Fib. (However, some people never progress to more serious A-Fib stages.)
Fibrosis makes the heart stiff, less flexible and weak, reduces pumping efficiency and leads to other heart problems. The abnormal rhythm in your atria causes electrical changes and enlarges your atria (called remodeling) making it work harder and harder over time.
Don’t let your doctor leave you in A-Fib. Educate yourself. Any treatment plan for A-Fib must try to prevent or stop remodeling and fibrosis. And always aim for a Cure!
To learn more, read my editorial, Leaving the Patient in A-Fib—No! No! No!
Educate Yourself—and Always Aim for a Cure!
The author of Bad Pharma does an excellent job of shining a light on the truths that the drug industry wants to stay hidden.
Those truths include how they mislead doctors and the medical industry through sales techniques, and manipulate consumers into becoming life-long drug customers. (For doctors that industry influence begins in medical school and continues throughout their practice.)
We also learn truths about the internal workings of the medical academia, the U.S. FDA, and medical journals publishing.
The arguments in the book are supported by research and data made available to the reader. The author, Ben Goldacre, is a doctor and science journalist, and advocates for sticking to the scientific method, full disclosure and advocating for the interest of the patients. Here are a few highlights from Bad Pharma.
Manipulating Clinical Drug Trials
As consumers, how do we really know which drugs are best? The U.S. FDA protects us, right? Well sort of. Read how trials for drugs and their perceived usefulness can be manipulated, poor trials go unpublished or outright suppressed, and underperforming trials are stopped early or the trial period extended.
One way to manipulate clinical trials starts at the beginning―the design of the trial. Often, few comparison studies are done. Far more common are new drug studies going against placebo pills (that everyone knows don’t work). This helps inflate findings, makes new drugs look more effective than older drugs―because they were never compared against each other.
Bad Pharma & the Cost of Doing Business
Learn how pharmaceutical companies legitimately funnel $10 million to $20 million a year to major medical journals including the New England Journal of Medicine and the Journal of the American Medical Association. So, are we surprised then that studies funded by the pharmaceutical industry are much more likely to get published by these influential journals?
Direct to Consumer Drug Advertising
Did you know drug companies spend twice as much on marketing and advertising as on researching and developing new drugs? (I was shocked.)
Of special interest to me is the ‘Direct to Consumer’ drug advertising which has significantly increased drug sales in the U.S. ‘Direct to Consumer’ drug advertising is so misleading that it is banned in all countries except two: the U.S. and New Zealand. (No wonder that 70% of drug companies’ profit comes from the U.S.)
To be specific, I hate those misleading TV commercials that target A-Fib patients. What these ads for anticoagulants don’t tell you is:
• You are on their meds for life! (they want lifelong customers!)
• These meds do nothing to treat your A-Fib (only your risk of stroke)
• A-Fib can be cured (you don’t have to be on meds for the rest of your life)
These ads for anticoagulant medications imply if you just take their pill once day, you’ve taken care of your A-Fib. Wrong!
Well Written, Easy to Understand
Bad Pharma, is written in an easy-to-understand manner (you don’t need a medical or science degree). If you wish, you can skim through the book to get an overview, then stop and read a topic of interest. Or you can dig in for a full read, including the authors’s research and other references (documented in footnotes with citations.)
Check on Your Doctor
After reading how big Pharma may be influencing your doctor, you can now find out. In the U.S., with the passing of the Sunshine Act (part of the 2010 Patient Protection and Affordable Care Act), we can now research if a doctor has received pharma money to prescribe their products. Just go to the Open Payments or Dollars for Doctors website.
One of our tenets at A-Fib.com, is ‘Educate Yourself’! If you want to be a more savy consumer of health care services, I highly recommend Bad Pharma. I also recommend Ben Goldacre’s other book, Bad Science.
Bonus Idea: If you pair this book with “Know Your Chances: Understanding Health Statistics” by Steven Woloshin, you’ll have a complete course on how the drug industry skillfully markets their products.
It’s not a pill, nor a medication. Magnesium is the ‘magic’ pill that improves by 34% your chances of living a long, healthy life—a mineral naturally present in many foods. Magnesium is important for anyone with a high cardiovascular risk (including patients with Atrial Fibrillation).
Insights come from researchers in Spain who carefully monitored the diets of 7,216 men and women between the ages of 55-80 (an age range more likely to develop A-Fib). The people in the highest third of magnesium intake (442 mg/day) were 34% less likely to have died from any cause over a five-year period. And they had a 59% reduced risk of cardiovascular mortality, plus a 37% reduction in cancer mortality.
Why was the risk of cardiovascular disease (CVD) lowered by ingesting more magnesium? …Continue reading…
Obstructive Sleep Apnea (OSA) is so common that at least 43% of patients with Atrial Fibrillation also suffer with it. For that reason alone, you should be tested for sleep apnea.
Aside from causing or triggering A-Fib, untreated sleep apnea can cause many other serious health threats.
Got Sleep Apnea? Your Life-Threatening Risks
Researchers at the U. of Wisconsin examined 22-years of mortality data on the study’s participants and found the following:
The Wisconsin Sleep Cohort Study
Beginning in 1989, the U. of Wisconsin study used a random sample of 1,522 Wisconsin state employees. The participants underwent overnight sleep apnea studies and many other tests at four-year intervals. They were not selected because they had known sleep problems. (After the testing, researchers contacted participants with severe sleep apnea and explained the health risks.)
The study reveals the numerous life-altering and life-threatening health issues associated with sleep apnea.
Sleep Apnea: a condition in which one or more pauses in breathing occur while sleeping, pauses can last a few seconds to minutes and can occur 30 times or more an hour.
More EPs are Sending Patients for Sleep Studies
So many A-Fib patients also suffer from sleep apnea that many Electrophysiologists (EPs) routinely send their patients for a sleep apnea study. Some A-Fib centers have their own sleep study program. (The patient just walks down the hall to an A-Fib sleep study area.)
For some lucky patients, normal sinus rhythm (NSR) can be restored just by controlling their sleep apnea and getting a good night’s sleep.
Take Action: Sleep Apnea Can be Lethal
The Wisconsin Sleep Study findings demonstrate just how lethal sleep apnea can be. Sleep apnea isn’t a minor health problem, and it’s a condition you can do something about. (Just like A-Fib, you don’t have to just live with it).
If your significant other tells you that you pause breathing when you sleep or that you snore, do something about it! (Not everyone with sleep apnea snores, but snoring may indicate sleep apnea.)
Talk with your doctors about testing for sleep apnea. You may need an in-lab sleep study (or the newer option of a home sleep test).
Learn More About Sleep Studies
Read about in-lab and in-home sleep studies in our article, Sleep Apnea: Home Testing with WatchPAT Device and the Philips Respironics
On a Personal Note: My wife has sleep apnea (but not A-Fib). While sleeping, she would actually stop breathing for what seemed like a long time, then suddenly gasp for air. It was very scary! But now she uses a CPAP machine, sleeps soundly and wakes up rested.
Sleep apnea may run in families. Her brother has sleep apnea also.
Sleep Apnea is common amount Atrial Fibrillation
At least 43% of patients with Atrial Fibrillation suffer from Obstructive Sleep Apnea (OSA) as well.
Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
It is now established that there’s a correlation between Sleep Apnea and A-Fib.
You’re on a blood thinner for your increased stroke risk from A-Fib. But you hate it.
Is the monthly testing or diet restrictions a hassle? Is the increased risk of bleeding stressful? Have you developed side effects, i.e., gastrointestinal problems or poor kidney function? Maybe you just don’t want a lifetime on meds.
Or, perhaps you’re unable to take a blood thinner for other medical reasons. What do you do?
WATCHMAN™ Occlusion Device: The Alternative to Blood Thinners
There is an alternative to taking blood thinners―closing off your Left Atrial Appendage (LAA) with the Watchman™, an occlusion device. The LAA, a small sack located at the top of your left atrium, is where 90-95% of A-Fib strokes originate.
Inserting the Watchman is a very low risk procedure that takes as little as 20 minutes to install. Afterward, you usually don’t need to be on a blood thinner.
Review these articles to learn more about the Watchman:
Bonus: Video about the Watchman
Animation shows how the Watchman is inserted and positioned in the left atrial appendage (LAA) using a catheter; then how heart tissue grows over the Watchman, closing off the opening of the LAA trapping any blood clots. (1:04)
Updated November, 10, 2016
If you take several supplements (like I do), you may wonder:
“Should I take them at the same time each day? Or should I spread doses throughout the day? Should I take with meals? Or on an empty stomach?”
The best answer may depend on whether you are taking medication, on the specific supplement and/or on your personal life style.
Start with the ‘Suggested Use’
Read the supplement label. Some are fairly specific, i.e., “with or without food”, or “with food” or “on an empty stomach”; or specific time (morning or bedtime) or in divided dosages. Make notes for each supplement. Download and use this FREE form to help you keep track of everything.
Do you Have Other Medical Conditions?
If you have diabetes, hypertension or heart disease, first talk to your doctor or pharmacist. Combining supplements with prescription medications, can produce unexpected or life-threatening results.
They may offer advice specific to the combinations of your meds and supplements.
Do Some Reading, Take Some Notes
The best time to take a specific vitamin or supplement may depend on the specific supplement. Do some reading on each at the library or at a reputable website or two. Make notes of the information you find. A few examples:
• Taking a single dose multi-vitamin? It’s best to take it in the morning when nutrients are depleted and with or near breakfast so it’s broken down, then digested with the food.
• Vitamin D is best absorbed after your biggest meal, usually dinner, averaging 56 percent greater boost than those who take it without food.
• Calcium supplement, don’t take along with a multivitamin containing iron. The calcium may interfere with the iron’s absorption.
• Magnesium may be best taken in the evening, since Magnesium may support sound sleep.
Healthy Directions, Dr. David Williams
On the website Healthy Directions, Dr. David Williams offers advice about the best times to take vitamins. He lists specific vitamins and supplements and organized them into three groups, those that should be taken before meals, with meals, or in-between meals. See his article for specifics, The Best Times to Take Your Vitamins.
[Healthy Directions offers advanced nutritional supplements and guidance from highly respected integrative and alternative health doctors including Julian Whitaker, MD, Dr. David Williams, Dr. Stephen Sinatra, MD and others.]
My favorite independent research sites
For reliable, unbiased research and information on specific vitamins and supplements, we recommend these three sites (in order or preference). None of the three sell supplements (or anything else). They just offer information on vitamins, herbs, natural products and supplements.
1. Memorial Sloan Kettering Cancer Institute/Integrative Medicine: “About Herbs, Botanicals & Other Products”
2. Drugs.com: ‘MedFacts Natural Products Professional database’
3. The ‘Dietary Supplement Label Database’ at the U.S. National Institutes of Health.
Adjust for Your Life Style
You may need to adjust your supplement taking to accommodate work or school demands, family schedules, etc. For example, if you work the swing shift, your “morning” dose may need to be 1 pm, and your ‘evening’ doze may need to be at 2 am.
Or, if you often skip meals during your work day, taking equally divided doses may become erratic. So, it may be better taking your doses before you go to work.
Bottom Line: Try to be Consistent
For optimum benefit, it may take some effort to work up your supplement schedule. But you don’t have to obsess about it. Since these are ‘natural’ substances (vs. prescription drugs), you usually don’t have to be overly careful about when you take them. What’s important is do try to be consistent from day to day.
After you work out your schedule, consider using a vitamin/supplement organizer. Check out My Search for the Best 7-Day Medicine/Vitamin Organizer.
For more answers to your questions about mineral deficiencies, see our: FAQ Minerals & Supplements
For more on where to research specific vitamins and supplements see, FAQ Minerals Deficiencies: Reliable Research.
Our newest personal A-Fib story is told by a Canadian about his wife, Rani, who’s first symptom was feeling dizzy when checking in for a flight from Barbados. Over the next many months, she developed palpitations and A-Fib.
“Rani had fatigue and didn’t feel right. Before this, she was always healthy. She continued to exercise, as much as she could. But A-Fib really bothered her and made her feel both sick and anxious. Our whole family was worried about her.
Under the Canadian nationalized health care system, it took a lot of proactive action and aggressive approach to get proper help (which in the end wasn’t the proper treatment).
Almost every time we went to a doctor or a specialist, none of them had properly reviewed her file before they walked in to talk to her. It was pathetic. And we went to 4 cardiologists and 2 doctors.”
Frustrated for his wife, Moni turned to his friend, Google, and searched the web for information about Atrial Fibrillation. Read what Moni discovered and learn why they decided to cross the Canadian border to seek treatment in the U.S. …Continue reading…
A-Fib Patient Story #91
Urinary Tract Infection Leads to Persistent A-Fib Followed by Two Failed Cardioversions
by Joe Kempin, October 2016
I am 64 years old and live in Fairfax, VA. In January 2016, I was afflicted with a pronounced arrhythmia. I could feel it often. I had a stress test done and a sonogram of my heart. All were good, but they could see I was going in and out of A-Fib.
In early March, I got very sick with a urinary tract infection and a 104° temperature. I could not eat and was in constant A-Fib. After I got well with antibiotics, I stayed in A-Fib.
We tried Cardioversions twice. Each one took me out of A-Fib for 3 days, but then right back into it. I was on blood thinners (Eliquis) then.
Experience of a Lifetime: Ablation at Fairfax Hospital
On May 18 I had an ablation. Wheeling me into the operating room was an experience of a lifetime. This was a brand new hospital building at Fairfax Hospital. The operating room was right out of Star Trek. Huge! The operating table was skinny with 8 people standing around it as I climbed on. None of them were doctors.
I wasn’t nervous, but for some reason I was feeling VERY sick. I don’t know why. They all got very busy on me. There were 2 computer cubicles off to the side, stainless steel machines hanging from the ceiling, and a floating lap top. IT WAS AMAZING!
It all went well, out of A-Fib. My doctor was Dr. Haroon Rashid at Virginia Heart. He was very good.
Minor Bleeding Complication Post Ablation
During the ablation, they had inserted 2 catheters into veins in my left and right groins. But that night one hole started to bleed. That’s a big problem. They patched it up REAL QUICK. But I could not move for 8 hours total. <!–more.
There was no pain involved after the ablation. But my heart felt like it was bound up with rope, like it was a loose jellyfish before but now it felt tightened up with a rock sitting on the top of it, but not painful, just there. I was still able to go home the next morning.
Recovering Back Home
I had gone to the gym regularly, about 3 times a week for years. After a few weeks, I was able to try that again but really couldn’t do much and then was exhausted for the rest of the day. I was on Eliquis and Multaq. I got short of breath very quickly. This was true for 2½ months. I came off of Multaq, then felt somewhat better, and at 3 months came off Eliquis and felt much better.
I had A-Fib 2 weeks after the ablation for 2 days and then again after 6 weeks for a few hours. [This is common during the 3 month ‘blanking ‘period’.] I am at now 4 months post-ablation. I occasionally go into A-Fib for a few hours now, but feel good. Only taking aspirin now.
There is an App for your smartphone called Kardia by AliveCor that can tell you when you are in A-Fib. [See our review of the AliveCor Kardia by Travis Von Slooten]
Don’t worry about having an ablation. The operating room is an amazing experience, and there is no pain. The ablation procedure is very successful.
It won’t feel like you had a serious operation, but you did. It may take months to get back to feeling like yourself. You may feel a large loss of energy and need to sleep a lot. Plan on resting a good deal. 5 months since the ablation, I have only about half the energy I had last year at this time. Do the ablation right away.
Life and your abilities can change overnight. Get done what you want to do. Finish that bucket list.
Joe didn’t mess around. With persistent A-Fib he wanted results. When 2 cardioversions failed after a few days (most patients’ A-Fib returns in a week to a month), he didn’t waste time with six-months to a year of drug therapies. Just four months after his diagnosis, Joe opted for a catheter ablation. Good for you, Joe!
Is Joe’s ablation a success? Even though Joe still experiences occasional A-Fib episodes, he feels much better than when he was in Chronic A-Fib. His ablation was for him a success and greatly improved his quality of life.
Because of having been in persistent A-Fib and because he may have had paroxysmal (occasional) A-Fib for years, he was probably a more difficult case. If Joe wants to be completely A-Fib free, he may have to return for a second touch-up ablation which has a higher success rate. Rather than having to do a complete Pulmonary Vein Isolation procedure, the EP during a second ablation usually only has to isolate a few A-Fib producing spots or gaps to make Joe A-Fib free.
Why shortness of breath and loss of energy? It’s unusual to feel shortness of breath for as long as 2½ months after an ablation, as Joe did. It’s hard to speculate what may have caused that shortness of breath. Perhaps it was the medications. The bottom line is Joe feels OK now and is back exercising at the gym and living a normal life.
Most people after a successful ablation feel more energetic or at least as energetic than before they developed A-Fib, because their heart is pumping normally. We don’t know why Joe is experiencing a loss of energy. It may be because he still has occasional A-Fib episodes.
I am concerned about his low energy level. Joe should continue to discuss this with his doctor. Together they may find a solution to getting his pre-ablation energy back.
A-Fib Patient Story #90
Frustrated, Crosses Canadian Border for Ablation by Dr. Andrea Natale in Austin, TX
By Moni Minhas, Calgary, Alberta, Canada, October 2016
My wife, Rani Minhas, developed A-Fib in January 2015 when she was 61 years old. She felt dizzy when we were checking in for a flight from Barbados. She got better that day, and we took a later flight.
Over the next many months, she developed palpitations and A-Fib. We did not know it was A-Fib as we had never heard of the term.
“Get Used to It (A-Fib)…and It Will Get Worse.” NO! NO! NO!
Rani had fatigue and didn’t feel right. Before this, she was always healthy. She continued to exercise, as much as she could. But A-Fib really bothered her and made her feel both sick and anxious. Our whole family was worried about her.
Under the Canadian nationalized health care system, it took a lot of proactive action and aggressive approach to get proper help (which in the end wasn’t the proper treatment).
The first cardiologist suggested Rani start taking a blood thinner and dismissed A-Fib as something that “happens when you get old, get used to it; and it will get worse.”
He did not even prescribe beta blockers. Instead, he suggested a Blood Pressure medicine. Her BP that day was 165/90.
After waiting for weeks, we went to cardiologist #2. He prescribed beta blockers and recommended Rani take a higher dosage when she felt palpitations [known as pill-in-the-pocket drug therapy].
Frustrated! Searches Web and Finds the A-Fib Coach Steve Ryan
Frustrated, one day, I turned to my friend “Google” and found The A-Fib Coach. I contacted Steve Ryan and paid the small fee he charges [for one-to-one coaching]. Then I ordered the Beat Your A-Fib book he has written. I never read the book as it seemed scary to read (not the book but the symptoms and consequences of A-Fib!).
Steve was wonderful to talk to and told me about the Catheter Ablation procedure and gave me a lot of background on it and its benefits and risks, which were not many in my wife’s case.
Consultation with Dr. Thometz in Billings, Montana
I now went back to my friend “Google” and looked for an expert in Catheter Ablation close to our home in Calgary (Alberta Canada). Acrosss the U.S. border, I found someone in Billings, Montana. I made an appointment, and Rani and I drove 8 hours to Billings and stayed a night in the hotel.
The next morning, we spoke for 2 hours with Dr. Alan Thometz, the cardiac Electrophysiologist (EP) in Billings Clinic. He was very knowledgeable and helpful and answered every question we had. (We had a lot of help from Steve Ryan as to what questions to ask.)
We were comfortable with Dr. Thometz doing the procedure, but there was an 8 week wait. And Steve Ryan did not know him personally, which was not critical but was of some importance in deciding.
Let’s Find the Best EP in the USA
I asked Steve Ryan to suggest the best EP Cardiologist in the USA. He recommended Dr. Andrea Natale from Austin TX and Dr. Vivek Reddy in NY. We got an appointment with Dr. Natale quickly and in early June 2016 went for a catheter ablation procedure.
Ablation by Dr. Natale―No More Palpitations, No More A-Fib!
Dr. Natale did the procedure which took half a day. Rani stayed in the hospital overnight. Right after the procedure, we stayed in a hotel for another 10 days, even though it was not required. But I wanted Rani to be comfortable before coming home.
The procedure was great. No more A-Fib, no more palpitations. And no more beta blockers.
Recovery Period: 3 to 6 Months
We were told there is a 3 to 6 month recovery period [blanking period) for the heart to heal. Rani did have a few days of high BP and 1 day of low BP while her heart was healing. This is almost all gone, and she has 120 BP now on a regular basis which is perfect.
It has now been over 4 months, and Rani is now jogging and exercising every day. She does get some fatigue, but we feel pretty good that she will get over that by January 2017 based on trends. For now, she takes BP medicine and a blood thinner (Xarelto).
Gratitude to Steve Ryan
To say Steve Ryan was extremely helpful is an understatement. Without his guidance, we would not have known that Catheter Ablation is an option. Without him, we would not have found Dr. Natale. We haven’t met Steve Ryan in person, but the next time we’re in Los Angeles, we’ll take him out for dinner as a way of thanks.
Good health is the best gift we can have. If you have A-Fib (or any health issues), be aggressive and proactive in seeking treatment and advice.
Do not assume every healthcare professional is doing their job, including doctors and cardiologists. Use your own judgement and ask a lot of questions. Challenge the medical staff.
Be Proactive! Moni and Rani’s story is an excellent example of being proactive rather than passively living with A-Fib for the rest of her life.
I’m astounded that any doctor today would tell Rani and Moni to just live in A-Fib, “get used to…and it will get worse.”
Moni knew something was wrong with this doctor’s advice. He educated himself about A-Fib. He got second (and third) opinions. He didn’t let his beloved wife, Rani, suffer from A-Fib. He found the best doctor he could and got her treated and cured before her A-Fib could get worse. Her quick treatment may have made her A-Fib much easier to cure.
Long-Term Effects of Living in A-Fib: Aside from feeling miserable, having a reduced quality of life, and suffering emotional stress and anxiety, over time A-Fib can have devastating effects on your heart, brain and other organs.
Don’t Live in A-Fib! Follow Moni and Rani’s example! Don’t listen to doctors and others who may tell you that A-Fib can’t be cured, that the only thing possible is to improve A-Fib symptoms; or that catheter ablation is experimental and not proven; or that you have to take these A-Fib drugs for the rest of your life and you should just learn to live with A-Fib.
Instead, RUN, don’t walk to get a second opinion (and even a third)!
Compared to other heart ailments, A-Fib is relatively easy to fix. You owe it to yourself to get the facts, to look at all your treatment options, not just drugs.
You don’t have to live in A-Fib!
Any treatment plan for Atrial Fibrillation must address the increased risk of clots and stroke. By far the most commonly used medicine for stroke prevention is the anticoagulant warfarin (brand name Coumadin).
But warfarin is a tough drug to take long term with monthly blood tests and possible side effects. These are my top 5 articles to help you understand warfarin therapy, the associated risks and some of the alternatives.
Review these articles to learn more about Warfarin therapy:
Bonus: Video about Warfarin
Living with Warfarin: Patient Education
Excellent introduction to anticoagulant therapy with warfarin (Coumadin). Patients and medical professionals (clinical nurse, doctors, a pharmacist and clinical dietician) discuss the practical issues associated with taking warfarin. (16:22) Uploaded on Mar 7, 2011. Produced by Johns Hopkins Medicine.
An Alternative to Blood Thinners
Do you hate having to take Coumadin? Hate the monthly testing? Bothered by side effects? An alternative to taking blood thinners is closing off your Left Atrial Appendage (LAA) with the Watchman, an occlusion device. Learn more: The Watchman™ Device: The Alternative to Blood Thinners.
Don’t Expect Miracles from Current Medications
Antiarrhythmic drugs are only effective for about 40% of patients. Many patients can’t tolerate the bad side effects. When drugs do work, over time, the they become less effective or stop working. According to Drs. Savelieva and Camm:
“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.”
Drugs don’t cure A-Fib but merely keep it at bay.
Learn All Your Treatment Options
To start, educate yourself about Atrial Fibrillation and review all your treatment options on our page: Treatments for Atrial Fibrillation.
Next, move on to the guidelines we’ve posted: Which of the A-Fib Treatment Options is Best for Me? Then, discuss these treatment options with your doctor. This should be a ‘team effort’, a decision you and your doctor will make together.
Don’t just manage your A-Fib. Seek your Cure.
In September, I was the only patient invited to present at MAM 2016 in Zurich, Switzerland. After dinner the first night, I spoke to over 200+ surgeons and electrophysiologists (EPs).
I tried to describe for the doctors what it’s like to live in Atrial Fibrillation. Here is what I told them.
You Never Forget Your First A- Fib Attack
“As most A-Fib patients will testify, you never forget your first A- Fib attack.
Mine was 19 years ago, but I can remember it like it was yesterday. All of a sudden my heart started going crazy! It felt like my heart was trying to jump out of my chest or like there was a live fish flopping around in there. I can still feel the sheer terror, fear, confusion, anxiety and worry it created.
I remember thinking, “Am I going to die?” “Is this a heart attack?” It was one of the most terrifying experiences of my life.
Most symptomatic A-Fib patients have a similar story.
Psychological and Emotional Effects of A-Fib
A-Fib doesn’t just affect you physically, it affects you emotionally as well.A-Fib affects not just your heart—but also your head—and your quality of life.
It affects not just your heart—but also your head—and your quality of life.
By the way, I’ve never been to a medical conference where this aspect of A-Fib was studied. (Today is a first, I guess.)
I wish there were some way to give you a one-minute episode of A-Fib. It would change your perception of A-Fib forever. The psychological and emotional aspects of A-Fib can be as bad as or even worse than the physical.
Living in Fear (and Anger)—A-Fib Wrecked My Life
In my case, I lived in fear of the next A-Fib attack. I went through all the emotional gamut—anxiety, fear, worry, confusion, uncertainty, frustration, depression, and finally anger at my own heart.I went through all the emotional gamut—anxiety, fear, worry, confusion, uncertainty, frustration, depression, and finally anger at my own heart.
I’m a passionate runner. I used to run along Venice Beach. But my heart would go crazy and beat too fast. I’d have to stop and walk back to our apartment. Talk about frustration!
And A-Fib affected my work. I had a great job on the soap opera “Days Of Our Lives” as part of the technical crew. But I’d get dizzy and light headed and nearly lost my job. A-Fib wrecked my life!
Research—Then Going to Bordeaux for an Ablation
To make a long story short, I locked myself in a medical library and read everything I could find about Atrial Fibrillation. During this time, I tried every drug known to man including the dreaded amiodarone which made me cough up blood. Nothing worked.
I found that doctors in Bordeaux, France, had discovered how to make people A-Fib free.
One of the doctors who treated me with catheter ablation is here today, Dr. Dipen Shah. Thanks to him, Dr. Haissaguerre and Dr. Jais I’ve been A-Fib free for 18 years. I was their first US patient.
My Challenge to Doctors treating A-Fib Patients
Today I want to challenge you. Just ask yourself:
What are you doing to help your patients deal with the Fear and Anxiety of A-Fib?
What are you doing to help them cope with the Psychological and Emotional effects of A-Fib?
Helping Your Patients Deal With Stress and Anxiety
Knowledge is Power and Control! Learning about A-Fib relieves worry and anxiety. Two ways to help your patients:
1. Reference books and websites. Give your patients a short list of web sites and books which you have read and recommend. If you do this, think of how much better informed your patients will be! Knowledge is Power and Control! Learning about A-Fib relieves worry and anxiety.
Hint: For distribution, list your recommendations on the back of a business card. If it comes from you, your patients will devour them.
2. Counseling and medication. You should have a list you can give out of several psychiatrists who understand A-Fib and how it affects patients.
You’ll know who needs this kind of help. Men, especially, may not admit to themselves that they need help.
Thanks for Making Us A-Fib Free
Finally, I want to thank you on behalf of all the patients you’ve made A-Fib free. There are few medical procedures as transformative and life changing as going from A-Fib to Normal Sinus Rhythm.
There is simply no comparison between living in A-Fib and being A-Fib free! Normal Sinus Rhythm is wonderful!
There’s nothing like having a heart that beats normally again. No more tiredness, dizziness. being light headed. Your body feels alive. Your brain works. You can run and exercise again. [See the photo at right of me doing the high jump at age 75!]
Thank you for giving me my life back!”
After my talk I received enthusiastic complements and ‘fist bumps’.
I think I really made an impression. I don’t think anyone had ever talked to these doctors like that before.
My hope is that the effects of my talk will trickle down to helping others with Atrial Fibrillation.
If you find any errors on this page, email us. ♥ Last updated: Thursday, October 6, 2016
We can now say that CryoBalloon ablation is better than RF, at least according to a secondary analysis of a recent clinical study.
In the FIRE AND ICE clinical trial by Dr. Karl-Heinz Kuck and his colleagues, 762 patients with symptomatic paroxysmal A-Fib were randomized into two groups, either RF catheter ablation or CryoBalloon ablation.
Results: Many findings were comparable. Both groups had similar results in terms of primary efficacy and safety endpoints. Furthermore, both groups had improvement in quality of life over 30 months of follow-up.
Where Results Diverged: Re-Hospitalization and Recurrence
While many of the outcomes were similar between the two groups, there were some significant differences. The CryoBalloon group had lower rates of re-hospitalization (32% with CryoBalloon versus 41.5% with RF catheter ablation). In addition, the CryoBalloon patients had fewer:
• Cardiovascular re-hospitalizations (23.8% vs 35.9%)
• Repeat ablations (11.8% vs 17.6%)
• Direct current cardioversions (3.2% vs 6.4%)
According to lead researcher, Dr. Kuck:
“The secondary analysis (of the FIRE AND ICE study) favors CryoBalloon over (RF ablation), with important implications [for EPs] on daily clinical practice.”
Dr. Wilber Su of Banner-University Medical Center in Phoenix, who was not part of this FIRE AND ICE study, concluded:
“…for most operators, CryoBalloon may be a safer and more efficient approach… . In my practice, CryoBalloon has already become the preferred approach both from personal experience as well as patient demand.”
What Patients Need to Know
Which ablation procedure is better—RF or CryoBalloon? According to the FIRE AND ICE clinical trial, we can now say that CryoBalloon is better in terms of less re-hospitalizations, repeat ablations and recurrences within a 30 month period.
More important than the energy source used to perform the ablation, is the skill and experience of the operator (EP).
Don’t Avoid RF: In practical terms, the differences weren’t so great that you should avoid EPs who prefer to use RF.
Dr. Su points out that many electrophysiologists (EPs) may continue with RF ablation because being comfortable with their choice of technology is a critical factor.
Look for Skill and Experience: More important than the energy source used to perform the ablation, is the skill and experience of the operator (EP).
The Bottom Line: When researching an EP to do your ablation, look for the best, most experienced high volume operator you can find and afford, even if you have to travel.
Caveat About CryoBalloon Ablation
CryoBalloon ablation is much easier and faster to do than RF point-by-point ablation. Consequently, some operators are entering the field with little RF ablation experience on which to build or complement their Cryo skills.
Others are doing only “anatomical ablation”—only ablating the pulmonary vein openings and not looking for and ablating non-PV triggers. (Happily in many cases, this is often all that is needed, particularly in cases of recent onset or Paroxysmal A-Fib.)
For more critical information about choosing your EP for a Cryoballoon Ablation, read my posts: