ABOUT 'BEAT YOUR A-FIB'...


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

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

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

Dr. Wilber Su Cavanaugh Heart Center, Phoenix, AZ

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

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



ABOUT A-FIB.COM...


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

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

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

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

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

Terry Traver, former A-Fib patient

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

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


Treatments

Considering a Mini-Maze? Don’t Destroy the Ganglionic Plexus

Many surgeons performing Mini-Maze or other Maze operations for A-Fib routinely ablate/destroy the Ganglionic Plexus (GP) areas on the outside of the heart which contain clusters of nerve cells.

But recent studies show this strategy is not only ineffective but causes a lot of complications.

AFACT stands for Atrial Fibrillation and Autonomic modulation via Thoracoscopic surgery

The AFACT Trial: Mini-Maze Surgeries for Paroxysmal or Persistent A-Fib

The 2016 randomized clinical trial from Amsterdam in The Netherlands included 240 participants who underwent mini-maze surgeries: totally thoracoscopic pulmonary vein isolation for paroxysmal A-Fib or isolation plus Dallas lesion set for persistent A-Fib.

Approximately half also received ganglionic plexus ablation in which four major ganglionic plexus were ablated as well as the ligament of Marshall in the ganglionic plexus group. Patients were followed for one year.

Results: Ablating GPs—No Clinical Benefit, More Complications

ganglionic-plexus-areas-420-x-400-pix-at-96-res

Areas outside of the heart with clusters of nerve cells.

The researchers found no clinical benefits associated with ganglion plexus ablation added to a thoracoscopic ablation strategy, and significantly more complications.

There were significantly more recurrences in the ganglionated plexus group (78.1%) than in the control group (51.4%). And what is worse, more than double the number of major adverse events occurred in the ganglionic plexus group such as major bleeding and sinus node dysfunction which required pacemaker implantation.

Presenting at 2016 Heart Rhythm Society scientific session, researcher Dr. Joris R de Groot stated that “ganglionic plexus ablation is associated with significantly more periprocedural major bleeding, sinus node dysfunction and pacemaker outcome, but not with improved rhythm outcome.”

He concluded that routine ganglionated plexus ablation offers “no clinical benefit” in this patient category, and “should not be performed.”

The 2016 AFACT trial may finally have determined that ablating GPs doesn’t work.

What Patients Need to Know

Surgery Not Recommended as First Choice Treatment for A-Fib: Current guidelines do not recommend surgery as a first choice or option for A-Fib. Surgery is generally more invasive, traumatic and risky than a simple catheter ablation procedure.

Routine ganglionated plexus ablation offers “no clinical benefit” and causes major permanent complications.

Most current surgical strategies have built in limitations. For example, if you have A-Flutter coming from the right atrium, current surgical techniques don’t access the right atrium or some other non-PV trigger sites. See Cox-Maze, Mini-Maze and Hybrid Surgeries. In such cases, one often needs a catheter ablation after the surgery.

Make Sure Your Surgeon Doesn’t Ablate Ganglionic Plexus Areas: If you have to have surgery for A-Fib, make sure your surgeon does not ablate the ganglionic plexus areas as part of his A-Fib surgery. Ablating the ganglionic plexus areas doesn’t improve ablation results and causes more major permanent complications. As Dr. de Groot unequivocally states, ganglionic plexus ablation “should not be performed.”

The Bottom Line if Having Mini-Maze Surgery

If you have to have surgery for A-Fib (versus a catheter ablation by an EP), make sure you ask the surgeon if they ablate the ganglionic plexus areas as part of your A-Fib surgery. (Don’t expect a surgeon to volunteer this info. You have to ask!)

If they say yes, hand them a copy of this post. Then find another surgeon.

Resources for this article

Like Videos? Browse our A-Fib Library of Videos and Animations

We have loads of A-Fib-related videos in our Video Library. For the reader who learns visually through motion graphics, audio, and personal interviews, these short videos are organized loosely into three levels: introductory/basic, intermediate and in-depth/advanced. Click to browse our video library.

Video with Steve S. Ryan, PhD

Click image to go to video

Steve Ryan Videos: We’ve edited Steve’s most interesting radio and TV interviews to create several short (3-5 min.) videos. Check out Videos Featuring Steve S. Ryan, PhD, publisher of A-Fib.com.

A Popular Video: ‘Buyer Beware of Misleading or Inaccurate A-Fib Information’
Beware of misleading and incorrect A-Fib information published by reputable sources on the internet and in print media. Steve S. Ryan, PhD, gives three specific examples of why you need to be on the lookout for inaccurate statements about Atrial Fibrillation. 3:59 min. Click to Watch video.

Helping Doctors Understand A-Fib from the Patients’ Point-of-View

ssr-lake-zurich-400-x-300-pix-at-96-res

Steve Ryan in Zurich, Switzerland

Have you ever wished you could give your doctors an episode of Atrial Fibrillation, just so they would understand what you are going through? That’s what I did in Zurich last week (well, sort of).

I’m back from Zurich, Switzerland, where I was the only patient speaking at the 2-day 2016 Multidisciplinary Arrhythmia Meeting (MAM), a gathering of cardiologists and surgeons from leading institutions in Europe, the US and Asia who treat Atrial Fibrillation.

The Patient’s Point of View

After dinner on the first night, I spoke to a room of 200+ cardiac electrophysiologists (EPs) and surgeons. I was there to help them better understand A-Fib from the patient’s point of view. I focused on the psychological and emotional impact of A-Fib on patients―how the anxiety, fear and stress of the disease can be as bad (or worse) as the physical symptoms.

My Wish: Let Doctors Experience A-Fib for 60-Seconds

I shared my own journey with A-Fib and described my own stress, fear and frustration; then how I did extensive research and found my cure in Bordeaux by a catheter ablation (one of my Bordeaux doctors, Dr. Dipen Shah, was in the audience).

With Dr. Stefano Benussi, my host in Zurich

With Dr. Stefano Benussi, my host in Zurich

I next shared my wish that each of them could experience an episode of A-Fib for just 60-seconds―it would change their perspective of A-Fib forever. They wouldn’t soon forget the fear (am I going to die?) and anxiety (God, please stop this!).

My Challenge: Be a Resource for Your Patients

Then, I challenged them to go beyond the physical symptoms and help patients deal with their anxiety and fear. Knowledge is empowering so I recommended they personally check out and be ready to recommend at least two books and 2 websites about Atrial Fibrillation. In addition, I suggested they vet at least three psychiatrists who understand A-Fib and who could help patients in need of counseling and medication to address their anxiety.

Being Back in Normal Sinus Rhythm: Life Changing

And finally, I thanked them, on behalf of all the patients they have made A-Fib-free. There are few medical procedures as transformative and life changing as going from A-Fib to Normal Sinus Rhythm. For me, it was getting my life back.

I think I really made an impression. I don’t think anyone had ever talked to these doctors like that before. I hope my efforts will trickle down to helping others with A-Fib.

MAM 2016 300 x 100 pix at 96 resMultidisciplinary Arrhythmia Meeting 2016

The goal of MAM was to improve interaction between cardiac electrophysiologists (EPs) and surgeons who treat difficult A-Fib cases through a new Hybrid approach. Both a surgeon and an EP work together, one from inside the heart, the other from outside the heart. (Note: In the past, it’s been a rare occurrence for a surgeon to work with a cardiac electrophysiologist.) To learn more about the hybrid approach, see THE HYBRID SURGERY/ABLATION.

I want to thank my host, Dr. Stefano Benussi, University Hospital, Zurich, Switzerland, for his personal invitation to attend and speak at MAM 2016.

Look For My Reports

I’ll soon be writing reports on the key presentations. Just look for 2016 MAM.

New FAQ: Does Ablation Reduce Heart’s Pumping Volume?

Our new Frequently Asked Questions & Answers (FAQs) is about the heart’s blood pumping capacity after an ablation.

“I’m a life-long runner. I recently got intermittent A-Fib. Does ablation (whether RF or Cryo) affect the heart’s blood pumping output potential because of the destruction of cardiac tissue? And if so, how much? One doc said it does.”

As a fellow runner, I understand your concern on how an ablation might affect your ability to resume your athletic activities.

Lesions at PVs openings

Seek Your Cure: Keep in mind, with Atrial Fibrillation you lose 15% to 30% of your heart’s normal pumping volume along with lower oxygen levels. Your body and brain aren’t getting the blood and nourishment they need. An catheter ablation is an important way to improve or restore your heart’s pumping volume.

PVAI - Ccommon lesion set at A-Fib.com

More extensive lesions pattern

Ablate as Little Tissue as Possible: A common ablation technique for paroxysmal A-Fib (using RF or Cryo), ablates only around the opening of each Pulmonary Vein (PV) and isn’t likely to affect the heart’s output.

On the other hand, more extensive lesion patterns affecting more tissue may affect the heart’s output. For example, during a PV Wide Area Antrum Ablation, instead of just ablating around each of the PV openings, large, oval lesions are made in the left atrium encircling both the upper and lower vein openings.

My Best Advice to Runners with Atrial Fibrillation

For a runner, a more extensive ablation of the left atrium may affect heart output more than circular lesions of each vein opening. …Continue reading my answer…

September is A-Fib Awareness Month: Share our Infographic

Infographic - September is Atrial Fibrillation Month at A-Fib.com

Click image to see full Infographic.

This is the month we focus on reaching those who may have Atrial Fibrillation and don’t know it.

An estimated 30%−50% of those affected with Atrial Fibrillation are unaware they have it—often only learning about their A-Fib during a routine medical exam.

Of untreated patients, 35% will suffer a stroke. Half of all A-Fib-related strokes are major and disabling.

To spread the word about Atrial Fibrillation, A-Fib.com offers a new infographic to educate and inform the public about this healthcare issue.

See the full infographic here. (Then Share it, Pin it, Download it.)

In A-Fib for 15 Years, Eventually Unable to Work

Terry Traver' s story at A-Fib.com

Terry Traver’ s story

We’ve posted a new personal experience story. Terry Traver of Thousand Oaks, CA, shares his 15-year battle with A-Fib.

“For over 15 years I suffered with A-Fib. It was not so bad [at first]. I stopped using caffeine and chocolate and cut back on my [alcohol] drinking.

Every three months or so I would have an episode that would last about 15 hours and then I would be fine. Meds never really helped in my case.

A-Fib Progresses to Severe and Incapacitates

In 2011, my A-Fib became severe to the point where I was almost completely incapacitated [Persistent Atrial Fibrillation]. I was not even able to work. …Continue reading Terry’s story…

Top 10 List #1 Find the best EP your can afford - A-Fib.com

FAQs A-Fib Ablations: A Runner’s Heart After Ablation

 FAQs A-Fib Ablations: A Runner’s Heart 

Catheter ablation illustration at A-Fib.com

Catheter ablation

27. “I’m a life-long runner. I recently got intermittent A-Fib. Does ablation (whether RF or Cryo) affect the heart’s blood pumping output potential because of the destruction of cardiac tissue? And if so, how much? One doc said it does.”

As a fellow runner, I understand your concern on how an ablation might affect your ability to resume your athletic activities.

Seek Your Cure: Keep in mind, with Atrial Fibrillation you lose 15% to 30% of your heart’s normal pumping volume along with lower oxygen levels. Your body and brain aren’t getting the blood and nourishment they need. An catheter ablation is an important way to improve or restore your heart’s pumping volume.

Catheter Ablation Lesions around PV openings at A-Fib.com

Lesions around PV openings

Ablate as Little Tissue as Possible: A common ablation technique for paroxysmal A-Fib (using RF or Cryo), ablates only around the opening of each Pulmonary Vein (PV) and isn’t likely to affect the heart’s output.

On the other hand, more extensive lesion patterns affecting more tissue may affect the heart’s output. For example, during a PV Wide Area Antrum Ablation, instead of just ablating around each of the PV openings, large, oval lesions are made in the left atrium encircling both the upper and lower vein openings.

PVAI - Ccommon lesion set at A-Fib.com

More extensive lesion pattern

(This is intuitive on my part; we don’t have clinical studies confirming any effect or difference between the two approaches in terms of heart output and atrium function.)

For a runner, the more extensive ablation of the left atrium may affect heart output. Less active patients may not notice the difference, but a runner like you may.

My Best Advice to Runners with Atrial Fibrillation

Seek out the Best EPs: Select the most experienced Electrophysiologists (EPs) you can afford (and travel if you need to). Discuss catheter ablation and your concerns about decreased heart output after ablation. A good EP will make as few lesions during your ablation as possible.

Paroxysmal A-Fib Easiest to Ablate: At the moment you have “paroxysmal A-Fib of recent onset” and it’s usually the easiest to fix. It’s likely you will not need an extensive ablation. (Though one never knows till the actual ablation; Read what Travis Van Slooten wrote about how his “easy case” turned into a complex, extensive ablation.)

Ablate ASAP: Get your ablation as reasonably soon as possible, before your A-Fib has a chance to get worse and requires a more extensive ablation.

Keep your medical records in a binder or folder. at A-Fib.com

Keep A-Fib records in a binder or folder.

Monitor Progress of your A-Fib: A-Fib is a progressive disease. You should track if your heart’s measurements are getting better or worse, and by how much. Ask your doctor for the measurements of heart dimensions and its functions including the diameter and volume of the left atrium, your Ejection Fraction (EF) and any other test results.

Store all your test results and measurements in your A-Fib three-ring binder or file folder.

What Patients’ Need to Know: A progressively enlarging heart and a falling EF percentage (below 35%) means your A-Fib is worsening. To preserve your heart’s best functions, seek an ablation before your A-Fib worsens.

As a runner, even if your heart is somewhat enlarged and your EF has decreased, a successful catheter ablation may not only end your A-Fib and improve your Ejection Fraction but over time may even reduce your enlarged left atrium.

Thanks to Joe O’Flaherty for this question.

If you find any errors on this page, email us. Last updated: Friday, September 9, 2016

Return to FAQ Catheter Ablation and Maze Surgeries

In A-Fib for 15 Years, Eventually is Incapacitated, Unable to Work

Terry Traver' s story at A-Fib.com

Terry Traver’ s story

By Terry Traver, Thousand Oaks, CA, September 2016

I’m a sixty-five year-old male and live in southern California. I am writing this because, as great as Steve’s site [A-Fib.com] is, there aren’t many stories from the west coast.

For over 15 years I suffered with A-Fib. It was not so bad. I stopped using caffeine and chocolate and cut back on my [alcohol] drinking.

Every three months or so I would have an episode that would last about 15 hours and then I would be fine.

Meds never really helped in my case.

A-Fib Progresses to the Point Where I Can’t Work

In 2011, my A-Fib became severe to the point where I was almost completely incapacitated [Persistent Atrial Fibrillation]. I was not even able to work.

Luckily, through a friend I was put in touch with Dr. Anil K. Bhandari, a clinical Electrophysiologist (EP)] at Los Angeles Cardiology Associates in downtown Los Angeles.

Ablation and a Touch-up at Good Samaritan Hospital in Los Angeles

In March 2012, I went in to Good Samaritan Hospital for a catheter ablation (wonderful Hospital and staff). I knew I was a difficult case, so I was not surprised when I had to return in July 2012 for a second touch up ablation (I think Dr. Bhandari was more disappointed than I was).

I knew I was a difficult case, so I was not surprised when I had to return in July 2012 for a second touch up ablation.

Afterwards, no sign of A-Fib. I felt great! At my 30 day return visit and I was told to use up the remainder of my meds and then discontinue them.

A-Fib Free for Five Years

I’ve been A-Fib free for five years. I still doesn’t drink coffee but enjoy chocolate and an occasional cocktail without worry.

Dr. Bhandari and the ablation was the best thing I could have done. I would like to add that the procedure is very easy. I was home the next day. I had no pain and had a short recovery time.

I have nothing but great things to say about my experience with Dr. Bhandari, his staff and Good Sam. Hospital, I live 40 miles north of L.A. and the drive was worth it.

Lessons Learned

Lessons Learned graphic with hands 400 pix sq at 300 resWhat I wish I knew then or did differently:

• I would have had the ablation much sooner. No G.P. [family doctor] ever mentioned ablation as an option. I only heard about it from a friend!
• I had never heard of an electrophysiologist (EP), and wish I had seen one sooner.
• I would learn more about what my insurance covered and what expenses I could negotiate.

I also want to thank Steve Ryan for this wonderful web site. Good luck

P.S. For the guys: For bladder control during the catheter ablation, instead of a urinary catheter, Dr. Bhandari uses a condom. No insertion. Just sayin’.

Terry Traver
terrytraver@gmail.com

Editorial comments:
I’m still amazed when an A-Fib patient tells me his family doctor didn’t refer them to a cardiologist, and more importantly, to an Electrophysiologist.
Atrial Fibrillation is a problem with the electrical function of your heart. Most cardiologists deal with the pumping functions of the heart (think ‘plumber’). It’s important for A-Fib patients to see a cardiac Electrophysiologist (EP)—a cardiologist who specializes in the electrical activity of the heart (think electrician) and in the diagnosis and treatment of heart rhythm disorders.
Terry writes that his GP did not refer him to an EP. Thank goodness a friend stepped in to help him.
It’s so important for patients to educate themselves to receive the best treatment. To learn how to find the right doctor, go to our page: Finding the Right Doctor for You and Your Treatment Goals.
The longer you wait, the worse A-Fib tends to get. Look at Terry’s story. His disease progressed to Persistent Atrial Fibrillation and was incapacitating.

A-Fib is a Progressive Disease—Seek your Cure ASAP!

Note: Dr. Bhandari is still with Los Angeles Cardiology Associates (213-977-0419), also now works at Cedars Sinai in Los Angeles.

Top 10 List #1 Find the best EP your can afford - A-Fib.com

EPs Using Contact Force Sensing Catheters 

Steves Lists of Doctors by Specialty at A-Fib.comTo date I have been unsuccessful in finding or creating a list of Electrophysiologists (EP) usaing Contact Force Sensing Catheters. Two companies make the Contact Force sensing catheters currently on the market:

• Biosense Webster’s Thermocool Smart Touch irrigated tip ablation catheter with force sensing technology, 800-729-9010, 909-839-8500.
• St. Jude Medical’s TactiCath (Endosense) contact-force sensing ablation catheter, 800-328-9634, 651-756-2000

Neither company could provide me with a list of EPs or ablation centers using their contact force sensing catheters. One said that legally they couldn’t hand out such a list due to confidentiality agreements.

I will continue looking for this information and update this page when appropriate.

Reading Your A-Fib Alerts: August 2016 Issue Yet?

Beat Your A-Fib book link

Signup and save up to 50% on my book

Check your email boxes! Our A-Fib Alerts: August 2016 issue is out and being read around the world: from New Zealand to Chile and Canada, from the UK to Norway and Romania! Don’t miss the easy way to get your A-Fib news.

Not a subscriber yet? Special Bonus: Sign up for our A-Fib Alerts and get special discount codes to save up to 50% off my book, Beat Your A-Fib: The Essential Guide to Finding Your Cure, by Steve S. Ryan, PhD.  

Get the eBook for just $12 ($24.95 retail). Or get the softcover book for only $24 ($32.95 retail). Sign-up and you’ll get your special discount codes by return email. Sign-up TODAY!

My Top 7 Picks: Natural Supplements for a Healthy Heart

By Steve S. Ryan, PhD

While not considered “A-Fib specific” like your medications, these minerals and supplements may improve overall heart health and thereby help your Atrial Fibrillation.

Recommendations for Heart Health

For a detailed discussion of these minerals and supplements along with recommended dosages, see our article, ‘Natural’ Supplements for a Healthy Heart. Our seven recommendations are:

For a detailed discussion of these seven nutritional supplements, see our article ‘Natural’ Supplements for a Healthy Heart.

• Taurine
• Coenzyme Q10
• L-Carnitine
• Omega-3 Fish Oils
• Ribose (D-Ribose)
• Hawthorne Berry
• BCAA+G

Many Sources and My Amazon.com List

These minerals and supplements are available from many reputable retail and online sources. To make shopping easy for you, see my ‘Wish List’ on Amazon.com. (Note: Use any of these Amazon portal links, and your purchases help support A-Fib.com.)  

To get you started choosing brands, tablet size and forms of each supplement, we offer you 2 brands that meets our requirements.

1.  41A5986BbLL._SL500_SL135_Taurine, 1000 Mg

Taurine, along with Magnesium and Potassium, have been described as “the essential trio” for treating nutritional deficiencies relating to A-Fib. Taurine protects potassium levels inside the heart, regulates cellular calcium, and improves heart muscle contraction. Suggested products:

Now Foods Taurine 1000Mg, 100-Capsules; Source Naturals Taurine 1000mg, 240 Capsules

2. Ubiquinol CoQ10 (coenzyme) 100 Mg

Coenzyme’s ability to energize the heart is perhaps its chief attribute; improves heart functions and heart rhythm problems. Coenzyme is a naturally occurring enzyme and plays a key role in producing energy in the mitochondria. “Ubiquinol” is a more readily absorbed form.

Source Naturals Ubiquinol CoQ10 100mg, 90 Softgels; Jarrow Formulas Ubiquinol QH-Absorb, High Absorption/Enhanced Stability, 100 mg, 120 Softgels

3. GPL-Carnitine dosage: 500 -1000 Mg41pGdDbehjL._SL500_SL135_

L-Carnitine is a vitamin-like nutrient; a derivative of the amino acid lysine which helps to turn fat into energy. Considered by some to be the single most important nutrient in cardiac health. It reduces the incidence of cardiac arrhythmias and premature ventricular contractions (PVCs).

Swanson Glycine Propionyl-L-Carnitine Hcl Gplc 840 mg 60 CapsVitacost GPLC Glycine Propionyl L-Carnitine HCl-GlycoCarn 1000 mg PLC per serving – 60 Capsules

4. Omega 3 Fish Oil 1000 Mg 41XsPG8LBGL._SL500_SL135_

Essential fatty acids like EPA and DHA are considered by some to be natural defibrillators, lessening the incidence of cardiac arrhythmias and A-Fib. Krill Fish Oil 1000 Mg; Essential Fatty Acids (EPA and DHA) make blood platelets less sticky, less likely to form clots (cause of strokes). Some prefer Krill oil to fish oil as it’s exacted from organisms living in pristine deep-water seas.

Source Naturals Omega EPA Fish Oil, 1000mg, 100 SoftgelsMegaRed Extra Strength Omega 3 Krill Oil 500mg Supplement, 60 Count

5. Ribose/D-Ribose Powder 51d1BMLf-LL._SL500_SL135_41ZcLixRg3L._SL500_SL135_

Ribose increases tolerance to cardiac stress, lowers stress during exercise, and maintains healthy energy levels in heart and muscle. The heart’s ability to maintain energy is limited by one thing—-the availability of Ribose.

Now Foods D-Ribose Powder, 8-OunceDoctor’s Best Best D-Ribose Featuring Bioenergy Ribose, 250-Gram

6. Hawthorne Extract 41vl3oo6+7L._SL500_SL135_41VLGf88IyL._SL500_SL135_

Hawthorne Berry reduces tachycardias and palpitations and prevents premature ventricular contractions (PVCs). Hawthorne Berry can energize the heart without prompting arrhythmias. It has a normalizing effect upon the heartbeat. Dosage 300 to 510 Mg

Now Foods Hawthorn Extractract 300mg, Veg-capsules, 90-CountNature’s Way Hawthorn Berries , 510 mg., 180 Veg-capsules

7. 512+5YkmiCL._SL500_SL135_BCAA with L-Glutamine, 1000 Mg

‘Branched Chain Amino Acids’ (BCAA) are critical to the repair and maintenance of strong heart muscle and function. Be sure to get BCCA in combination with L-Glutamine (though challenging to find). We like the powder form. Suggested products:

MRM BCAA+G, Lemonade, 35.2-Ounce (1000g) Plastic JarBodyTech BCAA and Glutamine (13.8 Oz Powder)

Note: Mineral supplements may interfere or interact with your prescription medications, so always consult your doctor before adding any supplements to your treatment plan.

Many Physicians are Not Well Versed in Nutritional Support

Always discuss with your doctor before adding supplements - A-Fib.com

Always discuss with your doctor

Don’t expect a lot of support from your doctor. Unfortunately, a great number of doctors are not well versed in recommending or supervising nutritional support. Quite often, they may dismiss your inquiries about nutritional supplements. 

You may need to work with (or educate) your doctor to determine the benefit of supplements for your A-Fib health.

Learn about Mineral Deficiencies and Atrial Fibrillation

For an extensive discussion about mineral deficiencies, see our Treatments page: Minerals Deficiencies.

AliveCor Kardia May be Big Winner in Britain’s NHS Plan

AliveCor, maker of the Kardia ECG smartphone attachment to detect Atrial Fibrillation, may be a big winner in a plan by the British National Health Service (NHS).

AliveCor sensor with screen and smartphone 400 x 270 pix at 300 res

AliveCor Kardia attached to a smartphone

Dr. David Albert, AliveCor founder, said the British plan opens the door to the NHS buying AliveCor devices for all 2 million atrial fibrillation patients in England.

The NHS has announced plans to give millions of patients free health apps & connected health devices in a bid to promote self-management of chronic diseases.

The plan is expected to “save money and lives by preventing strokes.” About 20 percent of British A-Fib patients have strokes. The program will start in April 2017.

The AliveCor Kardia, cleared for use in the US by the FDA, attaches to Android and Apple Devices and by pressing the sensors with your fingers (or thumbs), capture single-lead, medical-grade EKGs in just 30-seconds. Instantly you know if your heart rhythm is normal or if atrial fibrillation (A-Fib) is detected in your EKG. Data can be captured and sent to your doctor. 

Request to Our Readers

Is anyone using the latest AliveCor® version, ‘Kardia™ Mobile’? (Model 1141, out since Feb. 2016) I want to update our Feb. 2015 review.

How do you typically use it? Are you satisfied with the performance? Do you transfer the data to your doctor?

Will you share your product experiences with me? Just shoot me an Email with your impressions.

Resource for this article

Don’t Take Any Medication Without Asking These 10 Questions

Before taking any prescription drug to treat your Atrial Fibrillation, you should educate yourself about the drug. We’ve prepared the top 10 questions you should ask your doctor. As a service to our readers, we offer the questions as a free PDF worksheet you can Download. It has convenient spaces to write down your doctor’s replies for later review.

Print as many as you need and take a copy to every doctor appointment (you never know when you’ll need one). Download our worksheet (and don’t forget to save to your hard drive).

Before Starting a Prescription Drug, Ask These Questions

Use our worksheet as a guide as you ask these questions of your doctor or healthcare professional, and note their responses:

Download our Free Worksheet

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

Keep your medical records in a binder or folder. at A-Fib.com

Keep your medical records in a binder or folder.

Your A-Fib Binder or Folder

When completed, file the worksheet in your A-Fib binder or file folder to use for future reference and follow-up.

Your A-Fib binder is where you should file and organize all your A-Fib-related treatment information: printouts of information from the internet and your local public library or medical center library, notes from phone calls with doctors’ offices, and answers to “interview” questions during doctor consultations.

Research Any Prescription Drug 

To determine if the prescription is the right one for you, do your research. An excellent prescription database is the U.S. National Library of Medicine Drug Information Portal. (For an example, see the page on Warfarin [Coumadin].)

Also see the free worksheet: Keep an Inventory List of Your Medications


Worksheet from Chapter 6 of Beat Your A-Fib: The Essential Guide to Finding Your Cure, by Steve S. Ryan, PhD

How A-Fib Damages Your Heart, Brain and Other Organs

A-Fib reduces the amount of blood flowing to the rest of your body by about 15%–30% and can have damaging effects.

That’s because the upper parts of your heart (the atria) aren’t pumping enough blood into the lower chambers of your heart (the ventricles). At the same time, your heart is working progressively harder and harder.

Here’s what can happen to your heart if you choose to just ‘live with Atrial Fibrillation”:

Don’t Just Live With Your A-Fib

Don’t listen to doctors who advise you to ‘live with A-Fib’ and who prescribe a lifetime on medication. Get a second opinion, or even a third! Educate yourself.

Seek your A-Fib cure!

Hybrid Surgery/Ablation Topic of the Multidisciplinary Arrhythmia Meeting (MAM)

Background: The Hybrid approach is an unusual team effort and is complementary in nature: the Surgeon works on the outside of the patient’s heart and the Electrophysiologist on the inside of the same patient’s heart.
Hybrid Surgery/Ablation is becoming an increasingly important and effective strategy for highly symptomatic patients with persistent atrial fibrillation or longstanding persistent atrial fibrillation who have failed one or two catheter ablations, and for the patient with a significantly enlarged left atrium. (Read more: Hybrid Surgery/Ablation.)

Multidisciplinary Arrhythmia Meeting (MAM)

Multidisciplinary Arrhythmia Meeting (MAM) GFXThe goal of MAM is to improve interaction between cardiologists and surgeons through multiple examples of cooperation in dealing with Atrial Fibrillation. [Note: In the past, it’s been a rare occurrence for a surgeon to work with a cardiac electrophysiologist.]

Zurich stamp GFX

Reporting for A-Fib.com

Cardiologists and surgeons from leading institutions in Europe, the US and Asia will discuss their experiences with hybrid simultaneous, hybrid stages, and multidisciplinary sequential approaches, and report their results.

Reporting from Zurich in September: I’ve been invited to attend this first Multidisciplinary Arrhythmia Meeting (MAM) by the organizers. I’ll be reporting on the key presentations and writing summary reports for our A-Fib.com readers.

FAQs Understanding A-Fib: Which Procedure Has the Best Cure Rates

 FAQs Understanding A-Fib: Best Cure Rate

FAQs Understanding Your A-Fib A-Fib.com15. “I have paroxysmal A-Fib and would like to know your opinion on which procedure has the best cure rate.”

The best cure rate isn’t the only criteria you should consider when seeking your Atrial Fibrillation cure.

Let me first review your top three procedure options: cardioversion, catheter ablation, and surgical Maze/Mini-Maze.

Electrocardioversion: When first diagnosed with Atrial Fibrillation, doctors often recommend an Electrocardioversion to get you back into normal sinus rhythm. But for most patients, their A-Fib returns within a week to a month. (However, you might be lucky like the A-Fib patient who wrote us that he was A-Fib free for 7 years after a successful cardioversion.)

Catheter Ablations: Radio-frequency and CryoBalloon catheter ablations have similar success rates 70%-85% for the first ablation, around 90% is you need a second ablation. Currently, CryoBalloon ablation has a slightly better cure rate with the least recurrence.

It’s crucial you choose the right electrophysiologist (EP), one with a high success rate and the best you can afford.

How to achieve these high success rates? It’s crucial you choose the right electrophysiologist (EP), one with a high success rate and the best you can afford (considering cost and any travel expense). What counts is the EP’s skill and experience.

You want an EP who not only ablates your pulmonary veins, but will also look for, map and ablate non-pulmonary vein (PV) triggers. That may require advanced techniques like withdrawing the CryoBalloon catheter and replacing it with an RF catheter to ablate the non-PV triggers. (See our Choosing the Right Doctor: 7 Questions You’ve Got to Ask [And What the Answers Mean].) 

Cox Maze and Mini-Maze surgeries: Success rates are similar to catheter ablation, 75%–90%. But surgery isn’t recommended as a first choice or option by current A-Fib treatment guidelines. Compared to catheter ablations, the maze surgeries are more invasive, traumatic, risky and with longer (in hospital) recovery times

When should you consider the Maze/Mini-Maze? The primary reasons to consider a Maze surgery is because you can’t have a catheter ablation (ex: can’t take blood thinners), you’ve had several failed ablations, or if you are morbidly obese.

Atrial Fibrillation is not a one-size fits all type of disease.

You should also consider that Mini-Maze surgeries have built in limitations. For example, unlike catheter ablations, mini-maze surgery can’t reach the right atrium, or other areas of the heart where A-Fib signals may originate (non-PV locations). The more extensive surgeries create a great deal of lesions burns on the heart which may impact heart function.

So How Do You Choose the Best Treatment For You?

Atrial Fibrillation is not a one-size fits all type of disease.

Your first step is to see a heart rhythm specialist, a cardiac electrophysiologist (EP), who specializes in the electrical function of the heart.

An EP will work with you to consider the best treatment options for you. If your best treatment option is surgical, your EP will refer you to a surgeon and continue to manage your care after your surgery.

To help you find the right EP for you, see Finding the Right Doctor for You and Your A-Fib.

Comment

If you find any errors on this page, email us. Last updated: Wednesday, August 24, 2016

Go back to FAQ Understanding A-Fib

New Story: Cardiologists Offer Little A-Fib Advice to Fellow Doctor

John Bennett, MD, practices emergency medicine in Miami, Florida. Dr. Bennett is known for his series of Google Hangouts live videos featuring experts in a variety of medical fields. To learn more, visit his website, Internetmedicine.com, “Where the Internet Meet Medicine.” His Atrial Fibrillation started at age 57.

John Bennett MD personal A-Fib story at A-Fib.com

John Bennett MD

“As a physician, I had the usual knowledge most physicians have about A Fib—which is not much. Especially the care of chronic Atrial Fibrillation. Like most people, I trusted my cardiologist to do the best thing for me.

First Cardiologist No Options But Drugs—I Hated Coumadin

My first cardiologist did the usual workup, and prescribed Coumadin. I hated that medicine. Made me feel tired, no energy, but I accepted it.

Finally, I got tired of being tired, so I started to do some online research.

I found out that you could elect to be cardioverted, which my first cardiologist did not even mention (since, of course, he would lose me as a patient, if I returned to normal sinus rhythm).

Electrocardioversion Works for 7 Years

I then went straight to an Electrophysiologist (EP), who converted me, and it lasted 7 years. Then last year…” Continue reading Dr. John Bennett’s story->

Stubborn A-Fib Returns Again and From Unusual Areas

We first posted Marilyn Shook’s personal A-Fib story, “Pill-In-the-Pocket” for Five Years, then Catheter Ablation for a Cure (#25) in 2008. She then sent us updates in 2014, 2015 and now her latest update after a third ablation in late April 2016. Marilyn’s A-Fib appears to find new and unusual places to originate from.

Marilyn Shook - A-Fib story at A-Fib.com

Marilyn S.

In her lasted installment, Marilyn writes:

“It’s been a few weeks since my third PVA [Pulmonary Vein Ablation] and I am doing  well.

Just to jolt your memory―I had my first PVA in 2007 and did well for 7 years. But my A-Fib returned in 2014 and was documented by a tiny Medtronic Reveal LINQ cardiac monitor implant. A second PVA followed in October of 2014.

I was A-Fib free until February 2016 when A-Fib/Flutter returned. I opted for my third PVA, which was performed in April 2016 by Dr. David Haines at Beaumont Hospital.

Marilyn Shook is also an A-Fib Support Volunteer who lives near Detroit, MI.

My Third Ablation and Post-Ablation Complication

Under general anesthesia, my PVA was extensive work but completed in about 4 hours. I was in sinus rhythm before and after the procedure. After my ablation, I was awake, alert and responsive and then suddenly became unresponsive, with thready pulse, blood pressure plummeted.

I was having a post PVA complication―a cardiac tamponade―an emergency situation!…”

Continue reading about Marilyn’s third ablation and her medical emergency->.

Cardiologists Offer Little A-Fib Advice, Even to a Fellow Doctor!

John Bennett MD personal A-Fib story at A-Fib.com

John Bennett MD

By John Bennett, MD, July 2016

John Bennett, MD, practices emergency medicine in Miami, Florida. Dr. Bennett is known for his series of Google Hangouts live videos featuring experts in a variety of medical fields. To learn more, visit his website, Internetmedicine.com, “Where the Internet Meet Medicine.”

I had the good fortune to run into Steve Ryan, find his website, and get his book. Ultimately I got fine care and returned to having a healthy heart. My story being at age 57 when I suddenly went into Atrial Fibrillation.

I Trusted My Cardiologist

As a physician, I had the usual knowledge most physicians have about A Fib—which is not much, especially the care of chronic Atrial Fibrillation. Like most people, I trusted my cardiologist to do the best thing for me.

My first cardiologist did not even mention cardioversion to get me back in sinus rhythm.

First Cardiologist No Options But Drugs—I Hated Coumadin

My first cardiologist did the usual workup, and prescribed Coumadin. I hated that medicine. Made me feel tired, no energy, but I accepted it.

Finally, I got tired of being tired, so I started to do some online research.

I found out that you could elect to be cardioverted, which my first cardiologist did not even mention (since, of course, he would lose me as a patient, if I returned to normal sinus rhythm).

Electrocardioversion Works for 7 Years

Well, he did. I then went straight to an Electrophysiologist (EP), who converted me, and it lasted 7 years. I was cardioverted again but this time it only lasted 5 months.

Still, no talk of catheter ablation. I had to chase my doctor down the hall to say, “What’s the plan?”

Research and reading  ‘Beat Your A-Fib’, I found I might be a candidate for catheter ablation.

Ablation and A-Fib Free—“Beat Your A-Fib” Book

Next, I went back to the internet where I ran across Steve’s book, ‘Beat Your A-Fib’ and found I might be a candidate for catheter ablation.

July 2015 I had an ablation by Dr. Todd Florin at Mount Sinai Medical Center in Miami Beach (highly recommended, good listener, super team) and returned to normal sinus rhythm.  It’s been one year and I am still in normal sinus rhythm. If you’ve had A-Fib, I don’t have to tell you the difference between A-Fib and sinus rhythm.

I am truly appreciative about Steve’s work [A-Fib.com] and his book. I feel like a real human being again, with normal energy levels.

Lessons Learned

Lessons Learned graphic at A-Fib.com

Take an active role in your care.

Like Steve says, catheter ablation may not be the answer for every patient with A Fib.

But you need to be aware of it! Read. Be aggressive with your cardiologist. Ask about catheter ablation [and other options]. Take an active role in the care of your pump!

Steve’s book, “Beat Your A-Fib,” motivated me to get active and investigate my treatment options.

Isn’t it sad that TWO of my Cardiologists did not care enough to even mention ablation to me? And I am a friggin’ doctor―and they treated me that way!

John Bennet, MD
Miami, Florida

Editor’s comments
Electrocardioversion best for recent-onset A-Fib: Dr. Bennett was very fortunate to have a cardioversion keep him in sinus rhythm for seven years.
Unfortunately for most patients, a cardioversion seldom lasts that long. It works best in cases of recent onset A-Fib. It’s a very safe procedure and is certainly worth a try, but cardioversion is seldom a permanent cure for A-Fib. Don’t be surprised if you’re back in A-Fib within a week to a month.

Amazing! Dr. Bennett’s fellow physicians didn’t tell him about options like electrocardioversion and catheter ablation.

You can’t always trust cardiologists (or the media): What’s most amazing about Dr. Bennett’s story is that his fellow physicians and colleagues (whom he trusted) didn’t tell him about options like Electrocardioversion and catheter ablation.
Today’s media and web sites talk about “Living with A-Fib”.  But living in A-Fib is detrimental to your long-term health.
In contrast, the message at A-Fib.com is: You don’t have to live in A-Fib. Seek your Cure.

Top 10 List #10 Be your own best patient advocate 600 x 530 pix at 300 res

 

2016 Cost of Ablation by Bordeaux Group (It’s Less Than You Might Think)

David Neth wrote us he’s feeling fine after his recent A-Fib catheter ablation for persistent A-Fib by the French Bordeaux Group [Drs. Michel Haïssaguerre, Pierre Jais and and Meleze Hocini at the Hôpital Cardiologique du Haut Lévêque-(CHU) de Bordeaux]. The Bordeaux Group has the most international experience in ablating persistent A-Fib and uses the ECGI/ECVUE mapping and ablation system. For example, they do 2 persistent A-Fib ablations per day.

David Neth Hopitaux de Bordeaux sign

David Neth at Hopitaux de Bordeaux

We had just updated our article on the Bordeaux Group, and I was curious how the cost compared to an ablation in the US. Here’s what David shared:

Total hospital payment for his 5-day stay was €16,598 (US exchange rate=$ 19,251)

Payment covered: the procedure, operating room charges, all medication and testing, doctors and hospital charges and a private room (including a second bed and 2 extra meals per day for spouse). There were no other charges.

Of course, David had to pay for personal transportation and local living costs.

Putting the Costs in Perspective

In recent years, David had two unsuccessful ablations for his Atrial Fibrillation at the University of Washington Hospital that each cost close to $75,000. His healthcare insurance negotiated the rate down to $48,000 (of which he had to pay $3,500 each time – his annual deductible).

Before booking his procedure in Bordeaux, his Medicare Advantage Supplemental insurance company incorrectly assured him his coverage included “out of country” medical treatment. Sadly, it turned out that this only applied for “emergency services” and their call center had misinformed him.

David shared his thoughts about his out-of-pocket costs:

“I don’t have a large savings and this [Bordeaux ablation] depleted much of it (since I also paid airfare and several nights hotel costs for 3 of us), but I’d have zero hesitancy to do it again if it were necessary. 

At $19,251 US, I feel that’s a small price to pay for cutting edge, successful service!”

David Neth being prepped with Cardio Insight vest with 252 leads; Inset: Front of Cardio vest

[Note: In contrast, my ablation in Bordeaux was covered by my health insurance the same as if the procedure had been in the US.]

To contact the Bordeaux Group, read my updated article on the Bordeaux Group.

The Bordeaux Group: Best in the World for A-Fib Patients!

Think of it—$20,000 for treatment by the best EPs in the world.

Dr. Michel Häissaguerre and his colleagues invented catheter ablation for A-Fib (Pulmonary Vein Isolation). Today their cutting edge research includes using CardioInsight’s noninvasive Electrocardiographic Imaging (ECGI) to map and ablate persistent A-Fib. (ECGI, available only in Europe at this time, will probably revolutionize how ablations are mapped and performed.) Currently at Bordeaux, ECGI is not used for cases of paroxysmal (occasional) A-Fib.

FYI: Drs. Michel Haïssaguerre and Pierre Jais cured my A-Fib in 1998. I was their first U.S. patient. Click to read my story.

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