"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"


"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

 FAQs A-Fib Ablations: Enlarged Heart 

Catheter Ablation

Catheter Ablation

9. “What is an enlarged heart? Does it cause A-Fib?. I was told I can’t have a Pulmonary Vein Ablation (Isolation) procedure because I have an enlarged heart. Why is that?”

A-Fib is a progressive disease that, among other bad effects, tends to enlarge and stretch your left atrium. Because your left atrium is fibrillating or quivering rather than beating properly, it isn’t filling and emptying properly. Your left atrium has to work harder than normal and tends to stretch and dilate over time.

(An enlarged heart may also proceed or cause A-Fib. High blood pressure or other heart problems may enlarge your heart and lead to or trigger A-Fib.)

A normal left atrium measures around 2.0-4.0 cm. Some centers won’t do a Pulmonary Vein Ablation (Isolation) procedure if the left atrium is over 5.5 cm. Because the left atrium heart walls have been stretched thin in an enlarged heart, it is easier to puncture them when doing a left atrium ablation. Surgeons also are reluctant to operate on someone with an enlarged heart. (Some people, like Lance Armstrong and other athletes, have a naturally larger heart due to their levels of physical activity. The above rules would not apply to them.)

However, some centers do perform PVA(I)s on patients with an enlarged heart. Newer ablation techniques are less likely to puncture heart walls. (The author does not currently have a list of centers doing ablations on patients with an enlarged heart. But if you email me, I will try to find someone near you.

If you have A-Fib, you should have your left atrium measured to see if it is being enlarged. One of the benefits of a successful PVA(I) (besides curing A-Fib) is that it often reduces an enlarged left atrium.

¤  Pappone, C. et al. “Atrial electroanatomical remodeling after circumferential radiofrequency pulmonary vein ablation. Efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation.” Circulation 2001;104:2539-2544.

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