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

After 18 years in A-Fib, Triathlete Mike Jones Asked, “Could I Be so Fortunate?”

In his A-Fib story, Mike Jones writes that he’d been a very physically active middle age man who competed in running, triathlons and handball. It was difficult for him to accept that “something was wrong”.

In fact, he had paroxysmal A-Fib episodes for at least three years before his official diagnosis. Over the many years, he had been on various drug therapies, but nonetheless, his A-Fib episodes become very debilitating. He shares:

Mike Jones

“For many years, surgical intervention was out of reach, and financially out of the question for me. And, in those days, there was only the “Maze”. Along the way, I read a little bit about the Mini Maze, which did not inspire me much either.
It wasn’t until I found “A-Fib Resources for Patients” [A-Fib.com] that I began to take a real interest in researching PVI/PVA [Pulmonary Vein Isolation/Ablation] .”

Mike recalls the day after his life-changing catheter ablation:

“On the drive home the following afternoon, I thought about all those years that I had spent….with all of the drugs, and all of the depressing hours, with all of the sacrifices, and all of the fear…nearly 15 years of it.
Then, my long-awaited PVI procedure. In a 2 day period of time, with little discomfort (and within my budget!) all of that might now be behind me.
Could I be so fortunate?
I feel a little foolish now, a little sheepish, that I had made such a big thing out of getting this procedure done.”

Life After His Ablation

In the ten months following his ablation, Mike writes that he only had two episodes early on and that he continues to take soaks in Epson salts once a week to keep his magnesium levels up.

He writes about his life now that it is free of A-Fib:

 “I do not take any blood thinners, and no heart medication whatsoever. In my 70’s now, I won’t be running any endurance races, and my conditioning level is too low for any serious handball (yet).
But my energy level is high enough that I live a very normal life. I am a hobby woodworker, and I typically spend anywhere from 4 to 6 hours a day in my shop. I walk, swim, cut wood, and, when nobody is looking…I dance.
“I walk, swim, cut wood, and, when nobody is looking…I dance.”
I understand that the A-Fibs might one day return, but I would have no hesitation in returning for a tune up if, or when, that day should ever arrive.”

―Mike Jones, Redding, CA, Now A-Fib free after an ablation using both CryoBalloon and RF methods 

A-Fib is a Progressive Disease

It’s really remarkable that Mike could live in paroxysmal A-Fib for 18 years and not progress to Persistent or Longstanding Persistent A-Fib. In one study over half the people who developed paroxysmal A-Fib turned Persistent after only one year. Perhaps Mike’s athleticism and fitness kept his A-Fib from getting worse.

In most people, A-Fib is a progressive disease that remodels the heart and gets worse over time. To avoid this happening to you, aim to be A-Fib free as soon as you can.

For more about Mike, read his A-Fib story, Triathlete 18 years in A-Fib, on Amiodarone for eight years―then A-Fib free after ablation by Dr. Padraig O’Neill.

For more A-Fib stories to encourage and inspire you, go to Personal A-Fib Stories of Hope.

How One Reader Detects if He’s in (Silent) A-Fib

Some people have A-Fib with no obvious symptoms. This can be dangerous, lead to a stroke and, over time, to a deteriorating heart. Many of these patients do a self-check during the day to monitor for an irregular pulse. Here’s another idea from a fellow A-Fib patient.

Taking Your Pulse

After reading our article, A-Fib Self-Care Skills: How to Check Your Heartbeat and Heart Rate, our reader, Frank, wrote us about how he goes beyond just a self-check to determine if he’s in A-Fib.

“I read your self-care skills articles and wanted to comment.
I check for when I’m in A-Fib very easily. I purchased a pulse oximeter. And whenever my reading is significantly above my normal resting pulse, then I know I’m in A-Fib. I don’t believe there’s any other reason for my resting heart rate to be elevated unless I’m in atrial fib.
A good oximeter is not very expensive at all, and it may be a very useful tool for others.”

Our thanks to Frank for sharing his advice.

How Pulse Oximeters Measure Pulse Rate

Masimo‘s MightySat fingertip pulse oximeter

Pulse oximeters are easily recognized by their associated clip-type probe which is typically applied to a patient’s finger. They are lightweight and intuitive to use.

When your heart beats, it pumps blood through your body. During each heartbeat, the blood gets squeezed into capillaries, whose volume increases very slightly. Between heartbeats, the volume decreases. This change in volume affects the amount of light (such as the amount of red or infrared light) that will transmit through your finger.

Though this fluctuation is very small, it can be measured by a pulse oximeter.

Not Just for Pulse Rates but Blood Oxygen Levels, Too

Measuring your blood oxygen saturation level (SpO2) is also important for A-Fib patients because a very low blood oxygen level puts a strain on your heart (and your brain).

Blood oxygen saturation

Using the same type of setup to measure pulse rate, an oximeter indirectly measures the amount of oxygen that is carried by your blood. By measuring the light that passes through the blood in your finger, your blood oxygen saturation level (SpO2) is calculated and expressed as a percentage.

Accuracy: The American Thoracic Society reports that the oxygen level from a pulse oximeter is reasonably accurate. The best reading is achieved when your hand is warm, relaxed, and held below the level of your heart. Most oximeters give a reading 2% over or 2% under what your saturation would be if obtained by an arterial blood gas test. (For example, if your oxygen saturation reads 92% on the pulse oximeter, it may be actually anywhere from 90 to 94%.)

Pulse Oximeters and Sleep Apnea 

Another application for a pulse oximeter. We’ve written about using a fingertip oximeter as an inexpensive way to check if you might have sleep apnea. A blood oxygen saturation level of 90% or lower means you should talk to your doctor, you may need a sleep study. For more, see Possible Sleep Apnea? Oximeter is DIY Way to Check your Blood’s Oxygen Level

Know Your Pulse Rate and Blood Oxygen Level

Starting at about $25, an assortment of pulse oximeters are available at Amazon.com and other retailers. One CE and FDA approved unit is the Pulse Oximeter Portable Digital Oxygen Sensor with SPO2 Alarm ($23).

On a personal note: As many of our readers know, I’ve been A-Fib free for 20 years. But nonetheless I often will check my pulse using an oximeter at night before going to sleep. Just as Frank describes, it’s very easy to do.

Amazon button with glowUse our A-Fib.com Amazon portal link and help support this website at no extra cost to you. Every purchase generates a small commission which we apply to the publishing costs of A-Fib.com. 

Bookmark and use every time you shop at Amazon.com.

Update: PVCs/PACs and My Medtronic Reveal LINQ Insertable Monitor

I’ve had my Medtronic Reveal LINQ insertable monitor since the middle of September. (See Has my A-Fib Returned?)  It has produced a lot of false positives. The other day, I visited my EP’s office and reviewed my LINQ data results with the nurse/Reveal LINQ specialist.

Steve Ryan: My Medtronic Reveal LINQ is inserted just under my skin near my heart: at A-Fib.com

My Medtronic Reveal LINQ is inserted just under my skin near my heart:

The LINQ data showed I had Premature Ventricular Contractions (PVCs) and Premature Atrial Contractions (PACs) which made my heart beat irregular but were not A-Fib.

No A-Fib for me: My data showed I always had the P wave component in my EKG signal—which is lost when one has Atrial Fibrillation.

Most PVCs/PACs benign: Most A-Fib doctors aren’t overly concerned about extra beats Premature Ventricular Contractions (PVCs) or Premature Atrial Contractions (PACs), because they are considered benign.

I’m not worried. Everybody gets PVCs and PACs, not just people with A-Fib.

Take a Look at My Premature Atrial Contractions (PACs)

When you look at my LINQ ECG signal (see excerpt below), notice how the PAC comes before one would expect a normal beat. The irregularities above the R wave indicate the signal is coming from atria above the ventricles and is a PAC.

PAC beats comes before one would expect a normal beat

…and a Look at My Premature Ventricle Contractions (PVCs)

When you look at another section of my ECG signal (see excerpt below), the R wave spikes are thicker and wider than the normal R waves indicating they are coming from the ventricles and are Premature Ventricle Contractions (PVCs).

PVCs: R wave spikes are thicker and wider than the normal

Detection Settings for A-Fib Only

To avoid false positives such as PACs and PVCs, the nurse adjusted the settings and sensitivity of the Reveal LINQ monitor to detect A-Fib only. (For Medtronic settings, see below.)

I will return to Dr. Doshi’s office in a month to see if these new setting are working properly. Look for my next update on data from my Medtronic Reveal LINQ insertable monitor.

ECG waveform diagram

ECG waveform diagram

Learn to Read Your ECG/EKG

An electrocardiogram, ECG (EKG), is used to measure the rate and regularity of heartbeats, as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart.

The ECG signal strip is a graphic tracing of the electrical activity of your heart.

To learn to read your own ECG/EKG signal, see Understanding the EKG Signal.

My Medtronic Reveal LINQ is inserted just under my skin near my heart: For you tech types, here are the new settings:

AT/AF Detection—On
Type—AF only
AF Detection—Balanced Sensitivity
Ectopy Rejection—Aggressive (this is probably the most important change in the settings)
AT/AF Recording Threshold—Episodes >= 60 min

A-Fib Self-Care Skills: How to Check Your Heartbeat and Heart Rate

Some Atrial Fibrillation patients know immediately when their heart is in A-Fib. They experience one or more symptoms including shortness of breath, palpitations, heart flutters, etc. Other A-Fib patients may have subtle symptoms (or silent A-Fib) and can’t be sure.

The following self-care skills will reassure you any time you suspect you’re in A-Fib—how to check for irregular heartbeat and how to tell if your heart rate is too fast or too slow.

Self-Check if Your Heartbeat is Regular or Irregular

I found an informative post with these self-care skill steps on the Scope Blog by Stanford University School of Medicine. To check whether your heartbeat is regular or irregular:

♥ Begin by placing your right hand on the left side of your chest while seated and leaning forward.
♥ Position your hand so that you feel your heartbeat most strongly with your fingertips.
♥ A normal heart rhythm should feel like a regular drum beat cadence; you can usually anticipate when each beat will come after the last beat.
♥ Because heart rate and the strength of the heartbeat can vary with breathing, sometimes holding your breath for a few seconds is helpful. With an irregular rhythm, it will be hard to predict when the next beat will come.
♥ In addition, some irregular beats will be softer (less strong) than other beats, so the strength as well as the timing may not be consistent.

Self-Check If Your Heart Rate is Too Fast or Too Slow

The Stanford blog continues with a second set of self-care skill steps—how to measure if your heart rate is too fast or too slow so you know when to seek medical care. (An optimal heart rate is 50–100 bpm when you are at rest.) To check your heart rate:

♥ Place your right hand over your heart so that you feel your heart beating under your fingertips.
♥ Use a watch or timer and count the number of beats for 15 seconds.
♥ Be sure to count all heartbeats; including beats that are not as strong or that come quickly following one another.
♥ Take the number of beats you’ve counted and multiply it by four. For example, if you count 30 beats in 15 seconds, then you would calculate 4 x 30 = 120 beats per minute.
♥ Repeat this process three times right away, writing down each heart rate to later share with your doctor.
Stethoscope and EKG tracing at A-Fib.com

While an Electrocardiograph (ECG or EKG) or Holter monitor are the only sure ways to document you are in A-Fib, you can use the above self-care skills to recognize A-Fib symptoms of an irregular heart beat or if beating too fast or too slow.

These skills with help you remain calm and confident when you suspect you may be in A-Fib.

Resource for this article
Stafford, R. Understanding AFib: How to measure your own heart rate and rhythm. Scope/Stanford Medicine, October 25, 2018. URL: https://scopeblog.stanford.edu/2018/10/25/understanding-afib-how-to-measure-your-own-heart-rate-and-rhythm/

“Normal” Has a New Meaning for Jim After His Ablation

Before you developed Atrial Fibrillation, did you lead an active lifestyle? Has A-Fib robbed you of your energy and replaced it with fatigue? That’s what happened to Jim. After years of drug therapy that didn’t work, read how Jim recovered his active lifestyle post-ablation.

Three years after his ablation, Jim McGauley of Macclenny, FL, shared his personal A-Fib story with our A-Fib.com readers. His atrial fibrillation had been detected several years earlier but was not controlled effectively with drug therapy.

Jim underwent a catheter ablation in the summer of 2009. His procedure was performed without complications by Dr. Saumil Oza and his team at St. Vincent’s Medical Center, Bridgeport, CT.

He writes that, after a brief period of recuperation, he resumed normal activity.  In his story, After Years in A-Fib, New Energy and Improved Life, Jim shares: 

“Within a matter of days [of my ablation], I realized that “normal” had a new meaning.
I had lived with the atrial fibrillation for years, and it took the ablation and resulting corrected heart rhythm to bring about a marked surge in my energy level with less fatigue and an overall sense of “fitness”.
I have always maintained an active lifestyle, but post-ablation I was able to increase significantly my exercise regimen. I now run 2-3 miles three times a week and include modest weight training to keep my upper body toned.”
Jim McGauley, Publisher, The Baker County Press, Macclenny, FL. After failed drug therapy, now A-Fib free via catheter ablation.

Catheter Ablation Can Have Life-Altering Effects

Atrial Fibrillation patients seeking a cure and relief from their symptoms often have many questions about catheter ablation procedures. To learn more, see:

• VIDEO: When Drug Therapy Fails: Why Patients Consider Catheter Ablation (3:00 min., includes transcript)
• Treatments/Catheter Ablation
• Frequently Asked Questions: Catheter Ablation, Pulmonary Vein Isolation, CyroBalloon Ablation

About the ablation experience itself, Jim went on to share:

“The ablation itself is minimally invasive considering that it is correcting an abnormality inside the heart itself, and the recovery period was brief and generally comfortable.

I would readily recommend it… to anyone qualifying as a candidate to correct atrial fibrillation.”

―Jim McGauley, now A-Fib free after catheter ablation 

‘A Patient Cured is a Customer Lost’ & Other Facts About Big Pharma

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.)

Misleading Drug Ads

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 that if you just take their pill once a day, you’ve taken care of your A-Fib. Wrong! Don’t fall for the hype.

Bad Pharma—How Drug Companies Mislead Doctors & Harm Patients

The author of Bad Pharma does an excellent job of shining a light on the truths that the drug industry wants to stay hidden.

Bad Pharma by Ben GoldacreThose 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. Read a critical review of Bad Pharma in the British Journal of Clinical Pharmacology.

My Best Advice: ‘Educate Yourself’

One of our tenets at A-Fib.com, is ‘Educate Yourself’! if you want to be a more savvy 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 withKnow Your Chances: Understanding Health Statistics by Steven Woloshin, you’ll have a complete course on how the drug industry skillfully markets their products. Read my review.

Read the book for FREE: The ebook version is online at U.S. National Library of Medicine PubMedHealth, and you can download the .PDF version (remember to save to your hard drive).

See my post: How Big Pharma Issues Misleading News and Why it Matters.

Features the report by the online watchdog group HealthNewsReview.org.

 

Don’t Settle for a Lifetime on Medications—

Seek your A-Fib Cure

Part 2: Has My A-Fib Returned? 21 Day Results from My Medtronic Reveal LINQ loop recorder

In Part 1, Steve describes how during a recent medical exam, one of his doctors (not a cardiologist) detected an irregular heart beat. Steve didn’t feel any symptoms but went to see his EP who checked him over and found no A-Fib. 

But, just to be sure, his EP implanted a tiny wireless heart monitor so he can review Steve’s heart activity over time. Go here to read our first post.

21 Days of Data with my Medtronic Reveal LINQ ICM

Section of Steve’s ECG

After having worn the Medtronic Reveal LINQ loop recorder for 3 weeks, I went in to check my results with my EP, Dr. Shephal Doshi, at Pacific Heart in Santa Monica, CA. (Reports are sent wirelessly each night by the bedside transmitter.)

The monitor report was saying I was having multiple A-Fib attacks, though I didn’t feel anything. When Dr. Doshi did an EKG of me, I was in perfect sinus. He suspected the monitor or I might be producing false positives.

Steve & his CAM

I Get a 7-Day Carnation Ambulatory Monitor, Too

To check the accuracy of the LINQ monitor, he gave me a Carnation Ambulatory Monitor (CAM) to wear for a week. It’s similar to a Zio Patch, but is stuck vertically along my sternum.

For the next 7 days I should avoid immersing the device in water. I was told I could take a shower, but I am being cautious and just taking sponge baths.

I’m supposed to keep a log of when I eat meals, exercise, drink any alcohol, and include any A-Fib symptoms. If I do feel symptoms, I’m to press the button on the monitor. So far, I haven’t had any occasion to press the button. I’ll return the monitor to Dr. Doshi’s office in a week.

Monitoring the Monitor

Carnation Ambulatory Monitor

Reveal LINQ loop recorder

Since the LINQ monitor is still actively collecting data, my EP can compare the LINQ results with the results collected by the Carnation Ambulatory Monitor. Hopefully, Dr. Doshi will find no occurrences of A-Fib (just false positives).

I’ll write more when I have something to report.

Have you worn a Carnation Ambulatory Monitor? Email with your experience.

 

The Watchman Occlusion Device and Risk of Device-Related Blood Clot

The Watchman is an occlusion device that closes off the Left Atrial Appendage (LAA) to prevent clots from getting into the heart. For those with A-Fib, 90%–95% of clots and strokes come from the LAA.

The Watchman device is considered an alternative or an improvement to a lifetime of taking anticoagulants including warfarin and the NOACs. See Watchman Alternative to Coumadin and Watchman Better Than Warfarin.

2018 HRS Report: Clots Can Form on the Watchman

A new meta-analysis of clinical trials and registries of the Watchman device is believed to be the largest to date of Device-Related Thrombi (blood clot) following left atrial appendage closure.

Size comparison of the Watchman occlusion device

The study shows that in about 3.7 percent of patients a blood clot forms on a metal screw on the face of the device. The clot can form many months, even a year after installation.

“While not frequent, when present, thrombus on the face of an LAA occluder is associated with a high rate of ischemic stroke,” said study presenter Vivek Y. Reddy of Mount Sinai Hospital in New York City. (Dr. Reddy was one of the original investigators of the Watchman clinical trials.) These findings were presented at the 2018 Heart Rhythm Society meeting.

Device-related thrombi (DRTs) are troublesome because they increase the risk of ischemic stroke by over 3 fold. However, no significant association with mortality emerged.

This risk, Dr. Reddy said, calls for aggressive management of patients at risk for device-related blood clots.

The Study: Finds Device-Related Thrombi (DRTs)

To better understand the mechanism of stroke after LAA closure, Dr. Vivek Reddy and his colleagues, looked at the incidence, predictors and clinical outcomes of device-related thrombus (DRT).

Watchman device: inserted (L) and progression of proper tissue growth (R)

The meta-analysis study looked at data on 1,739 patients who were successfully implanted with the Watchman device as part of four prior clinical studies. Patient follow-ups included a transesophageal echocardiography (TEE).

Findings: Among those patients receiving a Watchman, the investigators found 65 patients (3.74%) had DRT. Most were detected after anticoagulation had been discontinued at 45 days post-insertion. Some DRTs first showed up at the 1-year TEE.

“A majority of Watchman patients with an identified DRT (74% of the 65 patients) did not have a stroke.” Dr. Vivek Reddy

Dr. Reddy reported that despite these findings, a majority of Watchman patients with an identified DRT (74% of the 65 patients) did not have a stroke. And in Watchman patients who did have stroke, 87% occurred in the absence of a DRT.

Implications: There is a strong case for rethinking the timing of planned follow-up TEE examinations of Watchman patients. The standard protocol is a TEE at 45 days after placement, when routine anticoagulation usually stops, and then a second TEE 12 months after placement.

Dr. Reddy suggests a better schedule might be to perform the first TEE at 3-4 months after placement when oral anticoagulant therapy stops. This gives time for a potential DRT to form.

What this Means For Those Patients With a Watchman

“Prevention and management of DRT may require that each [Watchman] patient receive a tailored regimen of anticoagulation and surveillance,” said B. De Lurgio, MD, a cardiac electrophysiologist at Emory Healthcare commenting on Reddy’s report.

If you have a Watchman device, you and your EP should discuss “aggressive surveillance” to find any clots on the face of your Watchman. Usually these can be resolved by taking a course of anticoagulants.

If Closing the LAA: An Alternative Occlusion Device

Lariat placement: lasso around opening to LAA

With no metal involved, another occlusion device is the Lariat II noose-like device which is slipped around the LAA. This ‘lasso’ is then tightened, and eventually the tissue dies and shrivels up (like a grape into a raisin).

But there has been a reported problem with the Lariat, too. For more on the Lariat see my article: Alert: Patients with Lariat Device for Left Atrial Appendage Closure.

A Challenge to Install: Compared to the Watchman, the Lariat is more challenging to install and is currently used less often than the Watchman. Not all EPs install and have experience with the Lariat II. You may need to do research to find an EP experienced and good at installing the Lariat. For more about the Lariat, see Lariat II Suture to Close the Left Atrial Appendage.

Watchman Still As Effective As Warfarin

Regarding this DRT data, Dr. Reddy said he didn’t think this data takes away from the argument that the Watchman is a reasonable strategy. “It doesn’t add or detract from the previous data.”

Clots can form on any foreign body as well as inside the heart.

Comparing stroke risks: In cases where no treatment was applied (neither anticoagulants nor the Watchman), the overall ischemic stroke rate is 6.0% per year.

Contrast that 6% rate to the stroke rates of 1.77% per year in people with the Watchman device and 1.71% per year for those on oral anticoagulation.

The Watchman is still a viable option against stroke risk.

Resource for this article
Dukkipati, SR et al. Device-related thrombus after left atrial appendage closure: incidence, predictors, and outcomes. Circulation. 2018; May 11: (Epub ahead of print) https://www.acc.org/latest-in-cardiology/journal-scans/2018/05/21/12/30/device-related-thrombus-after-left-atrial-appendage

Perriello, B. HRS 2018 Roundup: Device-related blood clots with Boston Scientific’s Watchman implant. MassDevice.com. May 11, 2018.  https://www.massdevice.com/hrs-2018-device-related-blood-clots-with-boston-scientifics-watchman-implant/

Andrew D. Bowser. Device-related thrombus associated with ischemic events. Cardiology News. May 14, 2018. https://www.mdedge.com/ecardiologynews/article/165539/interventional-cardiology-surgery/device-related-thrombus-associated

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 ♥ 

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