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


Understanding A-Fib

Infographic: September is Atrial Fibrillation Awareness Month

This month we focus our efforts on reaching those who may have Atrial Fibrillation and don’t know it. We offer a new infographic to educate the public about this healthcare issue.

Share it! Pin it or Download (click on link to view full size, then ‘Save As’ )

Download (600 x 1875-pix): PNG format or JPEG format. Also available: Promo banner and promo poster.

A-Fib.com A-FibFacts.info

About Atrial Fibrillation: 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.

For more facts about Atrial Fibrillation, go to A-FibFacts.info or download the A-Fib Facts 5-page report.

Also available (click to enlarge, then Save As):

Promotional bannersept-is-a-fib-awareness-month-bannerPromotional poster:

sept-is-a-fib-month-orange-head-poster

 

 

 

InfoGFX: How Atrial Fibrillation Damages Your Heart, Brain and Other Organs

by Steve S. Ryan, PhD

It’s a bad idea to just live with your Atrial Fibrillation. A-Fib is a progressive disease. It reduces the amount of blood flowing to the rest of your body by about 15%–30% with damaging effects. At the same time, your heart is working progressively harder and harder.

A-Fib is progressive disease - Infographic Aug 2016

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

A-Fib is definitely curable. (I was cured of my A-Fib in 1998). If you have A-Fib, no matter how long you’ve had it, you should aim for a complete and permanent cure.

If your doctor is satisfied with just keeping your A-Fib “under control,” I recommend you get a second opinion.

Refer to our Finding the Right Doctor page and related readings. We step you through all you need to know to find the right doctor for you and your treatment goals.

#AtrialFibrillation #afib #Arrhythmia #AtrialTachycardia #Tachycardia

New FAQ Answered: Which Procedure Has the Best Success Rate?

We’ve answered a new FAQ under the category: Understanding Atrial Fibrillation. Thanks to Thomas Scheben for this question:

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. 

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

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.

How to achieve these high success rates? It’s crucial you choose the right electrophysiologist (EP)…Continue to read my full answer.

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

Inspiration: Choosing the Right Doctor: The Plumber vs The Electrician

When diagnosed with Atrial Fibrillation, you need to find the best heart rhythm specialist (electrophysiologist) you can afford.

From Michele Straub, now free of A-Fib after 30 years, comes this:

My advice to those with A-Fib:  Go to an electrophysiologist A-Fib expert right away, one with a high success rate at getting patients back into normal rhythm — you deserve nothing less.”

NOACs: Why Isn’t There a Way to Measure Their Effectiveness?

Warfarin has one, but the NOACs don’t. What am I talking about?

Warfarin (Coumadin) has a way to monitor and measure its effectiveness for a specific patient. But there’s no similar way to measure the effectiveness of the new Novel Anticoagulant drugs (NOACs).

Warfarin and Your INR

With warfarin, blood testing for your INR (International Normalized Ratio) will tell your doctor what dosage of warfarin is needed to maintain your ideal INR range between 2.0 and 3.0. (Below 2.0, there’s more of a risk of an ischemic [clotting] stroke; above 4.0, there’s more of a risk of a hemorrhagic [bleeding] stroke.)

An A-Fib-related stoke is an ischemic [clotting] stroke.

NOACs: No Blood Testing but at What Price?

From the clinical trials we know NOACs work as well as warfarin. In addition, the NOACs don’t require periodic blood testing. But the FDA, under pressure for new anticoagulants, approved the NOACs without there being any established or universally recognized method of determining their clot preventing effectiveness.

Without any method of determining their clot preventing effectiveness, how can you determine if your NOAC is working for you? … Continue reading this report…->

How to Avoid the Bleeding Risk of Anticoagulants

Taking almost any prescription medication has trade-offs.

In the case of anticoagulants, on the one hand you get protection from having an A-Fib stroke (which often leads to death or severe disability), but on the other hand you have an increased risk of bleeding. That’s how they work. Therefore blood thinners are inherently dangerous.

As an A-Fib patient, whether or not to be on anticoagulant or not, and which one, is one of the most difficult decisions you and your doctor must make.

Your Risk of Life-Long Anticoagulation Therapy

With the 2014 Guidelines for Management of Patients with Atrial Fibrillation, came significant changes to the rating scale doctors use to assess your risk of stroke. The guidelines call for many more people to be on a lifetime of anticoagulant therapy.

An anticoagulant should not be prescribed as a precaution, but only when a significant risk of stroke exists.

But taking an anticoagulant isn’t like taking a daily vitamin. An anticoagulant should not be prescribed as a precaution, but only when a significant risk of stroke exists.

Long term, we know the blood thinner warfarin (Coumadin) is associated with microbleeds, hemorrhagic stroke, and developing early dementia. What about the newer NOACs? There’s little long-term risk data, but we expect similar long-term risks.

Was 10 years of Anticoagulant Use the Cause of this Patient’s Dementia?

Dr. John Day, in an editorial in The Journal of Innovations in Cardiac Rhythm Management, described his patient, Bob, who had been on anticoagulation therapy for 10 years (even though he had had a successful catheter ablation and was A-Fib free).

“Could the drug therapy be the cause of this case of dementia? – Dr. John Day”

Bob was suffering from early dementia. A cranial MRI revealed … Continue reading this report…->

The Controversy Continues: Women, Anticoagulants, CHA2DS2-VASc and Risk of Bleeding

The controversy began with the publication of the 2014 Guidelines for Management of Patients with Atrial Fibrillation (A-Fib). The joint HRS/ACC/AHA committee report included significant changes to the rating scale used by doctors to assess an A-Fib patient’s risk of stroke (The rating scale now used is the CHA2DS2-VASc).

Magically, simply because of her gender, a woman is automatically given one point on the stroke risk scale no matter how healthy she is otherwise.

Yes, you read that correctly.

Just because of gender, ALL women automatically have one strike against them when assessing their risk of A-Fib-related stroke.

All it takes is one additional point, say for having hypertension, and the Guidelines call for life-long anticoagulant drug therapy. (It doesn’t seems to matter if your hypertension is under control with meds.) A score of 2 or higher (out of 10) = lifelong anticoagulation therapy!

Really? … Continue reading this report…->

Blizzard of 2016 Increases Risk of A-Fib Stroke

We’ve all heard of someone dropping dead from a heart attack while shoveling snow. But along with record snowfall and subfreezing temperatures comes a warning for those with Atrial Fibrillation. Winter increases stroke risk in people with A-Fib.

Winter and increased risk of stoke at A-Fib.com

Winter: increased stroke risk

Do You Live in a Cold Climate?

In a study from Taiwan, nearly 300,000 people with new-onset A-Fib were followed for eleven years. Almost 35,000 suffered an ischemic (A-Fib) stroke.

The risk for an ischemic stroke was nearly 20% higher in winter than in summer.

“When the average temperature was below 68⁰ F (20⁰C), the risk of ischemic stroke significantly increased compared to days with an average temperature of 86⁰F (30⁰C).”

Why More Ischemic Strokes During Winter?

Cold weather may make blood more prone to coagulate.

Cooler temperatures may produce greater plasm fibrinogen levels and factor VII clotting activity and may lead to “increased coagulability and plasma viscosity,” according to the author of this study, Dr. Tze-Fan Chao. 

Ischemic stroke was nearly 20% higher in winter than in summer.

What Patients Need To Know

The cold temperatures can put you more at risk for an A-Fib (Ischemic) stroke. So act accordingly. Bundle up during winter. Keep the thermostat set to keep you warm enough.
If you’re on a blood thinner, discuss this research with your doctor. You need to keep your anticoagulant levels up during winter.
References for this article

My 2015 Top Five List: Advancements in the Treatment of A-Fib

Looking back over 2015, I found five significant developments for those ‘living’ with A-Fib and those seeking their ‘cure’. My ‘Top Five List’ focuses on the Watchman device, a Pradaxa antidote and research findings about lifestyle choices, and reducing fibrosis.

1. FDA Approves the Watchman Device

The Watchman occlusion device

The Watchman is positioned via catheter

Anticoagulant Alternative: Because A-Fib patients are at high risk of stroke and clots, a blood thinner (anticoagulant) like warfarin is often prescribed. If you can’t or don’t want to be on blood thinners, you had few options.

That was until March 2015 when the US Food and Drug Administration (FDA) approved the Watchman device. There’s now an option to blood thinners! The Watchman device (Boston Scientific) is inserted to close off the Left Atrial Appendage (LAA), the origin of 90%-95% of A-Fib clots.

To read my complete Top Five List…go to My 2015 Top Five List: A Review of Advancements in the Treatment of A-Fib->.

Newly Diagnosed Patients: Answers to Frequently Asked Questions

Photo collage of patients who have shared their story on A-Fib.com

A few of the patients who have submitted questions to A-Fib.com.

For over a decade of publishing A-Fib.com, we have answered thousands of patient’s questions—many times the same questions. Perhaps the same questions you may have right now. In our section FAQ about Living with A-Fib, the first group of answers is For the Newly Diagnosed A-Fib Patient

Here we share answers to the most often asked questions by the new A-Fib patient and their family. Questions such as, “Did I cause my Atrial Fibrillation? Am I responsible for getting A-Fib?”, “Is Atrial Fibrillation a prelude to a heart attack?”, and “Can I die from my Atrial Fibrillation? Is it life threatening?”

We also answer questions about driving your car, your sex life, and dealing with the fear and anxiety.

We invite you to browse through the lists of questions. Then, just ‘click’ to read the answer. Go to -> Frequently Asked Questions by Newly Diagnosed Patients.

 

FREE Download: Keep an Inventory List of Your Medications

 Medication Inventory form complements of Alere at A-Fib.com

Medication Inventory form complements of Alere

It’s important to keep your doctor and other healthcare providers up-to-date on all the medications you are taking, the dosages, and for what purpose. And because over-the-counter drugs, vitamins and mineral supplements can interfere with your medications, you’ll want to include them, as well.

Download this FREE Medication List (PDF) and save to your hard drive.

Just type your information into the PDF document and print a copy for each of your doctors or other medical healthcare providers.

Because your medications will change over time, you may want to print a few blank worksheets. Use to collect changes for entering later into your PDF document. (Store the blanks with your A-Fib records binder or folder.)

 

Pinterest: Profiles of Over 40 Celebs with A-Fib

Ellen Degeners, TV host and comedian

Ellen Degeneres, TV host and comedian

Atrial Fibrillation doesn’t discriminate. Our Pinterest board has over 40 celebs who have dealt with A-Fib. You might be surprised to learn of the many celebrities with A-Fib. From the NBA, NFL, MLB, NHL to track & field athletes and Olympic champions. Political leaders and public servants to musicians, actors and performers.

For example, ELLEN DEGENERES, Talk show host, comedian, KEVIN NEALON, comedian-actor-writer and Saturday Night Live alumni and HERB ALBERT (and the Tijuana Brass), the king of easy listening in the 1960s; Co-founder of A&M Records.

Billie Jean King

Billie Jean King, Tennis legend

BILLIE JEAN KING, Tennis legend (Wimbledon champ 20 times) and advocate for gender equality, MARIO LEMIEUX, Canadian American NHL/AHL Hockey Hall of Fame and LARRY BIRD, NBA star and coach.

See many, many more Celebs with A-Fib on our Pinterest page: “Celebs With A-Fib“. #afib. Visit all our A-Fib-related Pinterest boards at https://www.pinterest.com/stevesryan/

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

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

FREE 12-page Report by Steve S. Ryan, PhD

In our free Special Report, How and Why to Read Your OR Report – Special Report by Steve S. Ryan PhD – A-Fib.com, we examine the actual O.R. report of the catheter ablation of Travis Van Slooten, publisher of Living With Atrial Fibrillation performed by Dr. Andrea Natale, Austin, TX.

What is an O.R. Report?

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

It’s a very technical document. Because of this, it’s usually given to a patient only when they ask for it. You need to call your doctor or his office to obtain it.

Why to Request and Read Your O.R. Report

The O.R. report is a historical record of how you became A-Fib free.
The O.R. report is a blow-by-blow account of your EP’s actions. It’s as close as you’ll get to understanding your own ablation without actually looking over the EP’s shoulder during the ablation. The O.R. report is a historical record of how you became A-Fib free. (File with your A-Fib medical records for future reference.)

If you’ve had an ablation that was less than successful, you want to know why! Your O.R. report would show what they found in your heart, what was done, and possibly why the ablation didn’t fulfill expectations.

Studying an O.R. report can be very revealing…you may decide to change EPs going forward!

Reading an O.R. report can be very revealing. Were there complications? Was your fibrosis more extensive than expected? Was there a problem with the EP’s ablation techniques? Or with the EP lab equipment? This information will help you and your healthcare team decide how next to proceed.

Also, depending on what you read in your O.R. report, you may decide to change EPs going forward!

O.R. Report with closeup

Close-up of O.R. Report with markups

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

In our FREE Special Report: How and Why to Read Your OR Report – Special Report by Steve S. Ryan PhD – A-Fib.com, I make it easy (well, let’s say ‘easier’) to learn how to read an O.R. report.

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

Get your PDF copy TODAY. Download How and Why to Read Your OR Report – Special Report by Steve S. Ryan PhD – A-Fib.com our FREE 12-page Special Report (Remember: Save to PDF  to your hard drive.)

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

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If you find any errors on this page, email us. Y Last updated: Monday, July 18, 2016

Intense Exercise: Lessons from Elite Athletes

Intense athletes have to face the fact that they’re more at risk of developing A-Fib and conditions like small heart injuries and fibrosis, and need to monitor their heart health more carefully.

That doesn’t mean you have to stop running or working out, but you have to be smart about it. Did you give yourself enough time to recover after the last race? What did the EP tell you about your overall heart health? Are you taking time to rest, sleep, and decrease other stressors in life?  Is your diet a healthy one, centered on whole foods?

‘Knowing your heart’ is the best tool in prevention. Understand your heart rate: your normal rate at rest, early in exercise, during peak exercise, and in recovery. For more, read my article, Intense Exercise and A-Fib: Lessons from Elite Athletes.

 

Understanding the Basics of an Ablation Procedure

In his 2015 AF Symposium presentation, Dr. Pierre Jais makes reference to the typical progression of a catheter ablation procedure. You may ask, what does he mean? What is the typical progression of an ablation?

Goals of Catheter Ablation for A-Fib

Just a reminder: the main goals of catheter ablation of A-Fib are to restore the heart to normal sinus rhythm and eliminate the symptoms of A-Fib. This also relieves the patient from the associated risks such as blood clot formation, stroke and increased risks of dementia and mortality.

The main goals of catheter ablation of A-Fib are to restore the heart to normal sinus rhythm and eliminate the symptoms of A-Fib.

Progression of a typical ablation for Persistent A-Fib:

• First, the sources of the rogue A-Fib electrical signals are mapped using a computerized system.

• The tip of the catheter is then maneuvered to the various sources of the A-Fib signals (usually starting with the openings to the pulmonary veins). Using RF energy (or Cryo) a tiny burn or lesion is made at each location to disrupt (or ablate) the electrical pathway.

• As the series of lesions progress, more and more of the A-Fib signals stop. OR, A-Fib signals may transition into Atrial Flutter which is a more stable and less erratic heart rhythm.

• At this point it is not uncommon for some A-Fib signals to continue. So, one or more rounds of mapping and ablation may be required to stop any remaining sources of arrhythmic signals.

 • Finally, the heart typically transitions to either a stable atrial tachycardia (a fast, but regular heartbeat) OR transitions into normal sinus rhythm (NSR).

After an ablation, some patients may be in atrial tachycardia but they are NOT in A-Fib. This is still a good… Click To Tweet

After the Ablation

While many patients will be in normal sinus rhythm (hurray!), some patients will be in stable atrial tachycardia (a fast and regular heartbeat)—but here’s the important part— they are NOT in A-Fib. This is still a good result!

Why? If you’re in stable atrial tachycardia, with rhythm or rate control medication your heart will typically heal itself over the following three months—called the ‘blanking period’ (or up to a year) and on its own return to normal sinus rhythm (NSR). (That’s why you shouldn’t rush to decide if your ablation is a success until several months post-ablation.)

For more about catheter ablation see, The Evolving Terminology of Catheter Ablation

See also, Dr. Pierre Jais’ 2015 AF Symposium presentation “The Spectrum of Atrial Tachycardias Following Ablation of Drivers in Persistent AF.”

 

FAQs Understanding A-Fib: Stiff Heart & Diastolic Dysfunction

 FAQs Understanding A-Fib: Stiff Heart

FAQs Understanding Your A-Fib A-Fib.com7. I’ve heard about ‘stiff heart’ or diastolic dysfunction. When you have A-Fib, do you automatically have diastolic heart failure? What exactly is diastolic dysfunction?

Someone with A-Fib can have much the same symptoms as someone with a ‘stiff heart’ or diastolic dysfunction. But A-Fib is an electrical problem that is often fixable, whereas diastolic dysfunction is a structural (or plumbing) problem usually not easily fixed.

Here are some statements from doctors I asked about this question:

• “Diastolic dysfunction (stiff heart) can lead to congestive heart failure. A-Fib is electrical. But some patients with A-Fib also have diastolic dysfunction.”

• “While many people with A-Fib do indeed have diastolic dysfunction (usually as a result of hypertension), this is not always the case.  On the other hand, there is no doubt that hypertension and the consequent effect on atrial stretch exacerbates the situation.  Perhaps the best way to think about it is that based on one’s genetic predisposition, one has a certain propensity to develop A-Fib. This can be modulated (i.e., exacerbated) by conditions that increase atrial pressure—such as hypertension, valve disease, heart failure, etc.”

Diastolic dysfunction refers to a decline in performance of one, or both ventricles. ‘Diastole’ refers to the time when the ventricles are relaxing and filling with incoming blood as compared to when the ventricles are propelling blood out to the rest of the body. Diastolic Dysfunction may refer to both the left atrium and left ventricle being stiff and not functioning properly. (Whereas in A-Fib the focus is on the left atrium.)

When someone in A-Fib is restored to normal sinus rhythm, usually both the left atrium and left ventricle begin to function normally again. But someone with long term A-Fib may also develop an anatomical or mechanical pumping problem—diastolic dysfunction (stiff heart), fibrosis, scarring, cardiomyopathy, etc. which are more permanent and harder to improve. (Another reason to treat your A-Fib as soon as possible.)

Last updated: Wednesday, August 26, 2015

Go back to FAQ Understanding A-Fib

Primary Care Doctor Ignorant of Electrophysiology?

I recently received an email from an A-Fib.com reader relaying a unexpected experience and asking my advice:

“When I was talking with my primary care doctor, he wasn’t sure what an ‘Electrophysiologist (EP)’ was or even if they were regular doctors. I had to explain how an Electrophysiologist (EP) is a cardiologist who specializes in heart rhythm problems, and is board certified in internal medicine, cardiology, and more importantly in Electrophysiology.

No wonder they didn’t refer me to an EP.

How widespread is this problem? How can we make the A-Fib community more aware of this?”

For decades, drug therapy was the traditional treatment for A-Fib. Today, it’s still common for a primary care doctor or general practitioner to treat A-Fib patients with rate and rhythm control medications rather than referring them to a heart rhythm specialist.

Treatment alternatives didn’t come until the pioneering research and procedures first developed by Dr. James L. Cox and Dr. Michel Haissaguerre (the Cox Maze surgeries in 1987 and pulmonary vein catheter ablation in 1996, respectively). Still, it has taken twenty years for Catheter Ablation procedures to be accepted as a first-line therapy for A-Fib patients (see the AHA/ACC/HRS. 2014 Guideline for the Management of Patients With Atrial Fibrillation).

On the A-Fib.com website, one of our core tenets is to encourage patients to seek the advice of one or more heart rhythm specialists (a cardiologist who specializes in heart rhythm problems is called an electrophysiologist or EP).

A-Fib is an Electrical Problem. While most people have heard of a cardiologist, they aren’t familiar with the term ‘electrophysiologist’ (EP) or what they do. They don’t know that cardiologists focus on the vascular function of the heart while electrophysiologists (EPs) specialize in the electrical function (think ‘plumber’ of the heart vs. ‘electrician’ of the heart).

Back in 2002 when we started the A-Fib.com website, our list of recommended electrophysiologists and medical centers offering catheter ablations to A-Fib patients had only seven facilities listed. Today, our Directory of Doctors and Facilities lists over 1,800 electrophysiologists and medical centers.

You can find an Electrophysiologist (EP) on your own; refer to our Finding the Right Doctor page and related readings; look for ‘board certified’ in ‘Clinical Cardiac Electrophysiology.

Speak out on A-Fib Forums: It is vital for A-Fib patients to seek out a heart rhythm specialist, i.e. an electrophysiologist (EP). (I often feel like John the Baptist in the desert trying to spread the word about EPs.) To help, you can post your comments and start a discussion on one or more of the online Atrial Fibrillation Support groups, groups such as Daily Strength Atrial Fibrillation Support Group and Facebook Group: Atrial Fibrillation Support Forum.

For a list of recommended groups see our page: A-Fib Online Discussion Groups and Message Boards.

References for this article

Questions & Answers (FAQ): Understanding Atrial Fibrillation

At A-Fib.com, we have answered thousands of patient questions—perhaps some of the same questions you may have right now. In our section FAQ about Living with A-Fib, we address the more physiological side of Understanding Atrial Fibrillation.

Here we share answers to questions asked by the more involved A-Fib patient who is researching atrial fibrillation to better understand their medical condition. Questions such as, “Is my Atrial Fibrillation genetic? Will my children get A-Fib too?“, “A-Fib and Flutter—I have both. Does one cause the other?” and “What’s the role of the Left Atrial Appendage?”

We also answer questions about stem cell research, the heart’s ejection fraction, fibrosis and many more.

We invite you to browse through the lists of questions. Then, just ‘click’ to read the answer. Go to -> Frequently Asked Questions: Understanding Atrial Fibrillation.

The largest Glossary of A-Fib related medical terms

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

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

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

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