A-Fib.com Mission Statement
Amazon review ad - Hope lies within these pages REVISED 225 pix wide by 96 res
 

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


This website is certified by Health On the Net Foundation. Click to verify.
This site complies with the HONcode standard for trustworthy health information: verify here.

Research and Innovations in the treatment of Atrial Fibrillation, A-FibAtrial Fibrillation Overview

This is an introduction to A-Fib concepts, terminology and facts about Atrial Fibrillation. We’ll address the following topics:

A-Fib—an Emerging Epidemic

Nearly five million people in the U.S. have A-Fib. 1 By the year 2050, the number will be 12-16 million. 2 , 3

A-Fib is the most common heart arrhythmia. In 2010 there were 1.2 million new cases of Atrial Fibrillation diagnosed in the US. It’s estimated that in 2030 this figure will double to 2.6 million cases. 4 A-Fib contributes to more than 80,000 deaths annually. 5 In the U.S. people over 40 have a one in four lifetime risk of developing A-Fib. 6 Worldwide the number of cases is estimated to be around 600 million. 7 Patients with A-Fib add $26 billion to our country’s healthcare costs in one year. 8 A-Fib has rightly been called an epidemic. 9

What is A-Fib?

In Atrial Fibrillation (A-Fib) the upper part of your heart beats (quivers) faster than the rest of your heart. If you could look inside your chest, the top part of your heart would be shaking like Jell-O or beating more rapidly than the lower section of your heart. You feel an uncomfortable flutter in your chest or like your heart is going to jump out of your ribs or that your heart is “flip-flopping around.”

Your pulse is irregular and/or more rapid than normal. Someone described their A-Fib as “…like a motor idling too fast in my chest.” Or “like I had a maniacal bass drummer hidden away in my chest.”

SYMPTOMS OF A-FIB

You may have one or more of the following symptoms: you may feel lightheaded (fainting), very tired, have shortness of breath, sweating and chest pain, swelling in your legs.…and you may be a bit frightened and anxious. Or perhaps you have few or no symptoms, and were surprised when the doctor said, “You have Atrial Fibrillation”.

How your Heart Works

Somewhere in your heart extra electrical signals are being generated which causes the top part of your heart (the atria) to contract and quiver rapidly and irregularly (fibrillate) like a bag of worms. The atria can contract as many as 300-600 times a minute.

Heart Illustration showing SA Node, AV Node, both Atria and Ventricles

(click on image to enlarge)

Your whole heart, however, does not beat 300-600 times per minute. Your heart is a muscular pump divided into four chambers―two atria located on the top and two ventricles on the bottom.

Normally, each heartbeat starts in the right atrium where a specialized group of cells called the Sinus Node generates an electrical signal that travels down a single electrical road called the AV Node (the natural pacemaker of the heart) that connects the atria to the ventricles below. This electrical signal causes the heart to beat.

First, the atria contract, pumping blood into the ventricles. Then, a fraction of a second later, the ventricles contract sending blood throughout the body. Normally the heart beats at 60-80 times per minute. When a doctor or nurse takes your pulse, he/she is counting contractions of your ventricles.

In A-Fib, electrical signals from other parts of the heart disrupt your heart’s normal rhythm and cause the atria to beat or quiver rapidly on their own, 300-600 beats per minute.

Video animations: normal beating heart and a heart in atrial fibrillation. Click on image to see animation of heart in A-Fib on the AHA website. (New browser window will open.) Once on the AHA site, use the ‘Select a condition’ at the bottom right of the page to change to the A-Fib animation.
Click to visit AHA Heart Animation website

Click to visit AHA Heart Animation website

Below is a graphic representation of your beating heart: on top is an ECG of a normal heart beat (normal sinus rhythm); notice the regular pattern. Below it is an ECG of a heart in Atrial Fibrillation. Notice the irregular and erratic pattern.

REV3 ECG - AFIB Heart Rhythm for A-Fib.com 500 pix by 96 resHowever, only a small number of these atrial beats make it through the AV Node which acts like a gate to the ventricles. This is fortunate, because you couldn’t live with a heartbeat that rapid. But some A-Fib beats do make it through the AV Node and make your whole heart beat irregularly and/or faster than normal.

Back To Top

TYPES OF A-FIB

There are three types of Atrial Fibrillation. In casual usage you may hear the three types of A Fib described as occasional, persistent, and permanent or chronic A Fib. Your doctor, however, may use one of the following medical terms:

    • Paroxysmal: (pronounced par-ok-SIZ-mal) describes episodes that stop on their own, and last anywhere from seconds or minutes, to hours or up to a week
    • Persistent: episodes which last more than a week; or episodes lasting less than a week but only stopped by cardioversion
    • Long-standing Persistent: a type of Persistent A Fib that lasts longer than one year; (formerly called Chronic or Permanent)

Note: the terms Paroxysmal and Persistent are not mutually exclusive. You may have several episodes of paroxysmal A Fib and occasional persistent A Fib, or the reverse. Your A Fib is called by whichever occurs most often.

Back To Top

How Serious An Illness is A-Fib?

Some A-Fib patients may develop an extremely rapid, irregular heart rate which can be life threatening. A very rapid, irregular heart rate can strain your heart, reduce your circulation to dangerous levels, and make you feel like you’re going to faint from lack of oxygen.

Increased Risk of Stroke

If you have A-Fib, just how sick are you? A-Fib may feel weird and can be very frightening, but an attack of A-Fib by itself usually isn’t life threatening. The biggest danger from A-Fib is stroke. Because your heart isn’t pumping out properly, blood can pool in your atria, particularly in the ‘Left Atrial Appendage’. Blood clots can form and travel to the brain causing stroke.

If you have A-Fib and aren’t being treated by a doctor, you are five-to-six times more likely to have a stroke than the general population. 10

Researchers estimate that 35% of patients with A-Fib will suffer a stroke 11 (unless treated). A-Fib is responsible for up to 25% of all strokes, or 140,000 strokes annually. 12 Each year, about 8% of people with untreated A-Fib have a stroke. 13

Graphic: A-Fib and Stroke
Illustration of A-Fib and Stroke

(There are two main types of stroke. An “ischemic” stroke is a clot in a narrow blood vessel and is the kind that often occurs in A-Fib. Almost 85% of strokes are ischemic. A “hemorrhagic” stroke occurs when a blood vessel leaks blood into the brain.) 14

An A-Fib stroke is worse than other causes of stroke. Half of all strokes associated with atrial fibrillation are major and disabling. 15 Of A-Fib stroke patients, 23% die and 44% suffer significant neurologic damage. This compares to only an 8% mortality rate from other causes of stroke. 16 , 17

Strokes in women are more disabling than in men. 18  There is also a danger of “silent” A-Fib strokes where stroke effects aren’t evident but may appear like attention deficit, forgetfulness, and senile dementia. 19 Silent A-Fib is common.

Up to 30%−50% of A-Fib patients are unaware they have A-Fib. 20 Of those who suffered an A-Fib stroke, 25% had no prior diagnosis of A-Fib. 21 , 22   

Talk To Your Doctor About Blood Thinners

If you have A-Fib, it’s most important to talk to your doctor about taking a blood thinner (an anticoagulant) like aspirin, warfarin (Coumadin), or the newer anticoagulants dabigatran (Pradaxa), rivaroxaban (Xarelto), or apixaban (Eliquis) to help prevent these clots from forming. (Aspirin is a less effective blood thinner than Coumadin or the newer anticoagulants.)

Warfarin, the most prescribed anticoagulant, reduces the risk of stroke by 60% to 70% in A-Fib patients 23 but is not an absolute guarantee one will never have an A-Fib stroke.

Risk of Bleeding From Blood Thinners

But be aware that the blood thinner warfarin has a 1.8% annual risk of life-threatening bleeding. 24 Warfarin may prevent an A-Fib (ischemic) stroke while somewhat increasing one’s chances of a bleeding (hemorrhagic) stroke, particularly among the elderly.

Warfarin and most other blood thinners are a trade-off for most patients. The danger of having an A-Fib stroke usually outweighs the risk of a bleeding (hemorrhagic) stroke due to taking blood thinners.

Some with A-Fib may not need a blood thinners at all. If you are young, active, and have an otherwise normal heart, you and your doctor may decide your A-Fib stroke risk is low, and you don’t need a blood thinner.

A-Fib Damages Your Heart, Brain and Other Organs

If you have A-Fib, the upper parts of your heart (the atria) aren’t pumping enough blood into the lower chambers of your heart (the ventricles). It’s estimated that this reduces the amount of blood flowing to the rest of your body by about 15%-30%. 25 26

You may not be getting enough blood to your brain and other organs which may cause weakness, fatigue, dizziness, fainting spells, swelling of the legs, and shortness of breath.

Recent studies indicate that A-Fib reduces mental abilities and may lead to dementia and to heart failure. 27

Patients with A-Fib are 44% more likely to develop dementia. 28 , 29 , 30 Of patients suffering from A-Fib, 20%–50% develop heart failure. 31

Over time a very fast heart rates can strain the heart and cause a heart attack. Inefficient atrial pumping puts an added burden on the ventricles. Prolonged A-Fib episodes may stretch and weaken the heart muscle. 32 A-Fib nearly doubles your chances of death.  33  The mortality rate from atrial fibrillation (as either the primary or an underlying cause of death) has been increasing for more than two decades. 34

[Editor’s comment: Please weigh the above statements carefully; the author is concerned that they may create unwarranted fear.]

PSYCHOLOGICAL AND EMOTIONAL EFFECTS

A-Fib can deeply affect your state of mind and emotional well-being. Research suggests that psychological distress is present in a substantial portion of A-Fib patients. 35

The shock of your first A-Fib attack, of something gone terribly wrong with your heart, the constant threat, fear and anxiety of an ever-possible A-Fib attack, the sense of sickness, the feelings of depression and impending doom, the sometimes lack of understanding from your family, friends, even from your doctor, the sense of helplessness and lack of control, the mood swings and the need to cry (sometimes worsened by the drugs one has to take)———these are all effects A-Fib can have both on your state of mind and on your social interactions. Your A-Fib can affect not only you but also your family, friends and colleagues (See Max Jusila’s story “A-Fib Was Devastating“). Anxiety is the most common effect of A-Fib. 36

This web site will give you an understanding of A-Fib and hopefully a sense of control. You will learn what A-Fib is and how to fix it. As terrible as A-Fib makes you feel, it’s a heart problem that’s relatively easily fixed (unlike most other heart problems). Did you recognize any of your symptoms in the above paragraph? Just acknowledging you have some or all of these symptoms is a step in the right direction.

But you may need more than this web site to deal with the psychological and emotional effects of A-Fib. Don’t be scared or ashamed to admit how A-Fib makes you feel (especially if you’re a guy). There’s nothing wrong with seeking counseling and medical help for how A-Fib affects your psyche. Your psyche is just as important as your physical heart.  (See Jay Teresi’s story “Anxiety the Greatest Challenge” and Kelly Teresi’s story “A Young Wife Copes with Husband’s A-Fib” in my book, Beat Your A-Fib, pages 101-105.)

And be aware that your heart doctor may not be of much help. They are often so focused on dealing with your physical symptoms and getting you cured that they often don’t recognize or acknowledge how A-Fib affects your psyche. And they aren’t trained or often have little effective experience in dealing with the psychological and emotional aspect of A-Fib. (I have yet to go to a conference on A-Fib where the emotional and psychological effects of A-Fib are even mentioned, let alone protocols discussed and developed to deal with them.) 37

And you need to recognize that A-Fib can have significant consequences on your social interactions, with your family, friends and colleagues. Sometimes family and friends, and even your doctor, may not understand what you are going through—that A-Fib has a psychological component in addition to the physical. A-Fib isn’t like having a broken leg. To your significant others, you may look normal. Sit down with your family, friends, especially with your work colleagues and explain to them what A-Fib does to you. But realize that many will never understand the suffering A-Fib causes. (I fantasize about being able to give people a 10 second shot of A-Fib so that they [especially doctors] could feel what A-Fib is like). (Also see our article: Seven Ways to Cope With Your A-Fib Fear and Anxiety)

Would you be helped by talking with or emailing people who have been through the A-Fib ordeal? A list of A-Fib Support Volunteers is available under Resources and Links. Having someone you can turn to for advice, emotional support, and a sense of hope that you can be cured, may bring you peace of mind. It helps to have someone who has “been there” and is there for you. These volunteers have gone through a lot to be cured of A-Fib, and have been helped along the way. They want to return the favor by offering you support and hope.

A-FIB REMODELS YOUR HEART AND IS A PROGRESSIVE DISEASE

It’s important to be treated as reasonably soon as possible.

In a process called “remodeling,” your heart actually changes if you have A-Fib long enough. The fast, abnormal rhythm in your atria causes electrical changes and enlarges your atria. Your heart develops fibrosis, the formation of fibrous tissue in the heart.

A-Fib begets A-Fib.

Your A-Fib episodes become more frequent and longer, often leading to continuous (Chronic) A-Fib. In a study of 5,000+ A-Fib patients, 54% of those on rate control meds went into permanent A-Fib in one year. 38

However, some people never progress to more serious A-Fib stages.

But even with Chronic A-Fib, people have been cured, and this remodeling of the heart partially or almost completely reversed.

But don’t delay! The longer you wait to be treated, the worse your A-Fib could get. (If you’ve had A-Fib for six weeks, your A-Fib probably hasn’t progressed very much. But if you’ve had A-Fib for six years, you should get treated as reasonably soon as possible.)

Back To Top

How Do You Get A-Fib? What causes, OR Triggers A-Fib?

For many A-Fib patients (around 50%), there is no discernible cause or trigger for their A-Fib. 39

For the others, the following may contribute to their Atrial Fibrillation:

If you’ve had other heart problems, this could lead to diseased heart tissue which generates the extra A-Fib pulse—possibly because they stretch and put pressure on the pulmonary veins where most A-Fib originates. Up to 40% of patients get A-Fib after open heart surgery. 40

Heavy drinking may trigger A-Fib. Extreme fatigue, emotional stress, severe infections, severe pain, traumatic injury, and illegal drug use can trigger A-Fib. Low or high blood and tissue concentrations of minerals (electrolytes) such as potassium, magnesium and calcium can trigger A-Fib. Thyroid problems (hyperthyroidism), lung disease, reactive hypoglycemia, viral infections, kidney disease, 41 diabetes, and smoking can trigger A-Fib. 42  

As we put on pounds, our risk of developing A-Fib increases. 43  A-Fib can run in families. 44

Some cases have been reported where antihistamines, 45 bronchial inhalants, local anesthetics, medications such as sumatriptan, a headache drug. 46  Tobacco use, MSG, cold beverages, coffee, chocolate, high altitude, GERD, sleep apnea and even sleeping on one’s left side or stomach are said to have triggered A-Fib.

A-Fib is associated with aging of the heart. As patients get older, the prevalence of A-Fib increases, roughly doubling with each decade. 47 This suggests that A-Fib may be related to degenerative, age-related changes in the heart.

For a more in-depth discussion of A-Fib causes and triggers, see Causes.

Back To Top

Review of Treatments

The key to stopping A-Fib is to eliminate the extra electrical pulses A-Fib generates.

Doctors usually start with medications (called drug therapy) to try and control the rhythm and rate of the heart. For most A-Fib patients drugs aren’t very effective (about 40-50% success rate) or have serious side effects. For a more in-depth discussion, see Treatment/Drug Therapies.

Sometimes an electrical shock called a cardioversion is used to return your heartbeat to normal. The benefit is usually temporary. For most A-Fib patients, their A-Fib returns in a week to a month (see Treatments/Cardioversion).

Drug therapy and cardioversion have their roles, but they ‘manage’ your A-Fib, neither treatment eliminates or ‘cures’ your A-Fib.

But know that Atrial Fibrillation is curable. 48

An effective treatment to eliminate these extra electrical pulses is Pulmonary Vein Ablation (PVA), a type of catheter ablation.

A soft, flexible tube (a catheter) with an electrode at the tip is inserted into a vein in your groin and moved to the inside your heart.

Catheter inserted into the heart and through septum wall into Left Atria
Catheter inserted into the heart and through septum wall into Left Atria

The catheter is directed to the precise locations in your heart that produce these extra signals. Using radiofrequency (RF) or other energy sources, these areas are burned off or “isolated”― disrupting the path of the irregular signals.

You are usually under general anesthesia during the PVA which means you don’t feel anything. If you are under “conscious sedation” and are awake during the procedure, you won’t feel the catheter being moved through your veins. There are usually no nerve endings in blood vessels. You also won’t feel a lot of the burns in your heart. There are motor nerve endings but usually no sensory nerve endings in the heart. But the procedure isn’t painless. Most patients can go home the next day. See Treatments/Catheter Ablation.

Surgery can also be an effective option to eliminate or isolate A-Fib pulses. The  open-heart version is the Cox Maze, but it’s usually only performed concurrently with other heart surgery, such as Mitral Valve replacement.

The more frequently performed surgery is the Mini-Maze which accesses the heart through several small incisions in the chest. The catheters and a tiny camera are inserted to locate, then burn or “isolate” the extra signals. All from outside of the heart. A stay in the hospital is necessary to recuperate. See Treatments/Cox Maze and Mini-Maze operations.

Maze incisions

For a more thorough discussion of the various treatments for A-Fib, see Treatments.

Back To Top

Order 'Beat Your A-Fib: The Essential Guide to Finding Your Cure' by Steve S. Ryan, PhD

Order TODAY ‘Beat Your A-Fib: The Essential Guide to Finding Your Cure’ by Steve S. Ryan, PhD

The Wrap-up

The bottom line is—how do you feel? If you don’t feel any symptoms and your doctor says your heart isn’t enlarging and/or developing poor ejection fraction, etc., then there’s no urgent need to rush out to get a Pulmonary Vein Ablation (or surgery).

Some people decide to simply live with A-Fib (usually while on A-Fib medications) rather than to undergo treatments to make them A-Fib free.

On the other hand, if you have bothersome A-Fib symptoms, if it’s impacting your quality of life, if you are miserable, then pursue treatment options that go beyond drug therapy, i.e., a Pulmonary Vein Ablation.

Your next step is to find the best doctor you can afford, who specializes in treating irregular heartbeats (i.e., an electrophysiologist, a type of Cardiologist). For advice in selecting the right doctor, see Finding The Right Doctor.

And lastly, remember: You don’t have to “just take your meds and get used to it.” (A quote from one patient’s doctor.)

Aim for a cure!

♦♦♦

Last updated: Friday, May 16, 2014

Back To Top

 

References    (↵ returns to text)
  1. Miyasaka, Yoko, et al. Secular Trends in Incidence of Atrial Fibrillation in Olmsted County, Minnesota, 1980 to 2000, and Implications on the Projections for Future Prevalence.  Circulation, 2006;114:119-125.PubMed PMID: 16818816. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/16818816?dopt=Abstract
  2. Go, Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention. JAMA, 2001:285:2370-2375. PubMed PMID:11343485. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/11343485.
  3. Go, A.S. et al. “Prevalence of diagnosed atrial fibrillation in adults. National implications for rhythm management and stroke prevention: the Anticoagulant and Risk Factors in Atrial Fibrillation (ATRIA) Study.” JAMA 2002;285:2370-2375; PubMed PMID: 11343485. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/11343485
  4. Colilla, S. et al. “Estimates of Current and Future Incidence and Prevalence of Atrial Fibrillation in the U.S. Adult Population.” The American Journal of Cardiology, July 8, 2013. doi: 10.1016/j.amjcard.2013.05.063. Epub 2013 Jul 4. PubMed PMID: 23831166. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/23831166
  5. Johnston, S.S. et al. “Treating atrial fibrillation patients costs U.S. $26 billion annually.” American Heart Association Rapid Access Journal Report. May 3, 2011AHA http://newsroom.heart.org/pr/aha/1329.aspx
  6. Lloyd-Jones,  D.M, Wang TJ, Leip E, et al. Lifetime risk for development of atrial fibrillation. Circulation. 2004;110:1042-1046. URL http://dx.doi.org/10.1161/01.CIR.0000140263.20897.42
  7. Camm, A. J., Kirchhof, P., & Lip, G. Y. H. (2010). Guidelines for the management of atrial fibrillation. European Heart Journal , 31 (19), 2369-2429. URL http://dx.doi.org/10.1093/eurheartj/ehq278
  8. Johnston, S.S. et al. “Treating atrial fibrillation patients costs U.S. $26 billion annually.” American Heart Association Rapid Access Journal Report. May 3, 2011AHA http://newsroom.heart.org/pr/aha/1329.aspx
  9. Gonzalez, A. (July 07, 2011). Atrial fibrillation is emerging as the new epidemic. Cardiac Rhythm News. Retrieved August 23, 2011, from http://www.cxvascular.com/crn-latest-news/cardiac-rhythm-news—latest-news/atrial-fibrillation-is-emerging-as-the-new-epidemic.
  10. Gillinov AM, Blackstone EH, et al. “Atrial Fibrillation: Current surgical options and their assessment.” Ann. Thorac. Surg. 2002; 74:2210-17. PubMed PMID: 12643434.Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/12643434
  11. Blackshear JL, Odell JA. “Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation.” Ann. Thorac. Surg. 1996;61:755-759. Last accessed April 3, 2014. URL: http://www.sciencedirect.com/science/article/pii/S0735109703009537
  12. Kiser, A C., et al. UNC Cardiac Surgery and Services Convergent Procedure: A Total Solution. Arrhythmia Center, Pinehurst, NC. Last accessed April 3, 2014. http://www.uncheartandvascular.org/index5289_3.html?d=7&p=106 
  13. Stark, Robert Puzzling Palpitations? Bottom Line Health, Volume 28, Number 6, June 2014.
  14. “Bottom Line Personal,” July 15, 2003, p. 10.
  15. Loftus, B. Atrial Fibrillation and Stroke. Bellaire Neurology Last accessed November 5, 2012 http://www.loftusmd.com/Articles/stroke/atrialfibrillation.html
  16. The Link Between Infections and Inflammation in Heart Disease. Life Extension Vitamins. Last accessed November 5, 2012 http://www.lifeextensionvitamins.com/cadico6otco.html
  17. ACC/AHA/ESC. 2006 “Guidelines for the Management of Patients with Atrial Fibrillation.” Circulation, 2006;114:700-752. Last accessed April 3, 2014. URL: http://circ.ahajournals.org/content/114/7/700.full.pdf
  18. Poli D,  et al “Gender differences in stroke risk of atrial fibrillation patients on oral anticoagulant treatment.” J. Thorac Cardiovasc Surg. 2010 Feb;139(2);326-32. PubMed PMID: 19404548. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/19404548
  19. Feinberg, “Epidemiological features of asymptomatic cerebral infarction in patients with nonvalvular atrial fibrillation.” Arch Intern Med 1990;150:2340-2344. PubMed PMID: 2241443. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/2241443.
  20. Furberg CD et al. “Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study).” Am J Cardiol. 1994; 74: 236-241.PubMed PMID: 8037127. Last accessed April 3, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/8037127
  21. Abdon NJ et al. “Is occult atrial disorder a frequent cause of non-hemorrhagic stroke? Long term ECG in 86 patients.” Stroke. 1982; 13: 832-837. PubMed PMID:7147300. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/7147300
  22.  Schuchert A et al. “Impact of long-term ECG recording on the detection of paroxysmal atrial fibrillation in patients after acute ischemic stro1e.” Pacing Clin Electrophyiol. 1999′ 22″ 1082-1084. Last accessed April 3, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/10456638
  23. Chatterjee, S. et al. “Left Atrial Appendage Occlusion: Lessons Learned From Surgical and Transcatheter Experiences.” Ann Thorac Surg 2011;92:2283-92. doi: 10.1016/j.athoracsur.2011.08.044
  24. Connolly, S.J. et al. “Dabigatran versus warfarin in patients with atrial fibrillation.” N Engl J Med 2009;361:1139-51. doi: 10.1056/NEJMoa0905561. Epub 2009 Aug 30. Last accessed April 3, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/19717844
  25.  Atrial Fibrillation. Cardiac Arrhythmia Institute/Sidney Peykar, MD. Last accessed Jan 5 2013. URL:http://caifl.com/arrhythmia-information/atrial-fibrillation/ 
  26.  Skillstat Heartscape/Chambers online educational program. Skillstat Learning, Inc. Last accessed November 5, 2012 http://www.skillstat.com/tools/heart-scape
  27. Elias, MF. et al. Atrial Fibrillation Is Associated With Lower Cognitive Performance in the Framingham Offspring Men. Journal of Stroke and Cerebrovascular Diseases, Vol. 15, No. 5 (September-October), 2006: pp. 214-222.  DOI:10.1016/j.jstrokecerebrovasdis.2006.05.009. Last accessed April 3, 2014 URL:http://www.strokejournal.org/article/S1052-3057(06)00075-9/abstract
  28. Bunch, J. J., Weiss, P. P., & Crandall, B. G. et al. Atrial fibrillation is independently associated with senile, vascular, and alzheimer’s dementia. Heart rhythm, 2010:7 (4), 433-437. URL http://dx.doi.org/10.1016/j.hrthm.2009.12.004
  29.  O’Riordan. M. Ablation of AF reduces risk of Alzheimer’s disease and dementia. May 17, 2010.  Heartwire/the Heart.org. Last accessed Jan 5, 2013 URL: http://www.theheart.org/article/1079365.do> 
  30. Camm, “Clinical Relevance of Silent Atrial Fibrillation: Prevalence, Prognosis, Quality of Life, and Management.” Journal of Interventional Cardiac Electrophysiology 4, 369-382, 2000, p. 376. Review. PubMed PMID: 10936003. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/10936003
  31. Lloyd-Jones, D M. Epidemiology and Treatment of Atrial Fibrillation: What Is AF? Medscape Education/Cardiology.2004;8(2) Last accessed Jan 5, 2013. URL: http://www.medscape.org/viewarticle/494006_2
  32. Atrial Fibrillation. Cardiac Arrhythmia Institute/Sidney Peykar, MD. Last accessed Jan 5 2013. URL:http://caifl.com/arrhythmia-information/atrial-fibrillation/
  33. What are the risks of Atrial Fibrillation? The London AF Centre. Last accessed November 6, 2012. URL: http://www.londonafcentre.co.uk/what_are_the_risks_of_af
  34. Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death File 1999-2004. CDC WONDER. Series 20 No. 2J, 2007. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Sep. 25, 2009.
  35. McCabe, P. J. (2010). Psychological distress in patients diagnosed with atrial fibrillation: the state of the science. The Journal of cardiovascular nursing, 25 (1), 40-51. URL http://dx.doi.org/10.1097/JCN.0b013e3181b7be36
  36. Lane, D. A., Langman, C. M., Lip, G. Y., & Nouwen, A. (2009). Illness perceptions, affective response, and health-related quality of life in patients with atrial fibrillation. Journal of psychosomatic research , 66 (3), 203-210. URL http://dx.doi.org/10.1016/j.jpsychores.2008.10.007
  37. Ladwig, K. Quality of life incorrectly assessed in over 50% of paroxysmal atrial fibrillation patients, Cardiac Rhythm News. October 2013, Issue 22; Last accessed April 3, 2014 URL: http://www.cxvascular.com/crn-newspapers-pdfs?DocumentScreen=detail&cl=474&ccs=665
  38. Atrial Fibrillation. Cardiac Arrhythmia Institute/Sidney Peykar, MD. Last accessed Jan 5 2013. URL:http://caifl.com/arrhythmia-information/atrial-fibrillation/
  39. Allessie M. “Pathophysiology and Prevention of Atrial Fibrillation,” Circulation. 2001;103(5):769. doi: 10.1161/​01.CIR.103.5.769 Last accessed April 3, 2014. http://circ.ahajournals.org/content/103/5/769.full
  40. Frost L., et al. “Atrial fibrillation and flutter after coronary artery bypass surgery: epidemiology, risk factors and preventive trials.” International Journal of Cardiology. 1992;36:253-262. Last accessed April 3, 2014 URL: http://www.sciencedirect.com/science/article/pii/016752739290293C
  41. Schmidt M, et al. Renal dysfunction and atrial fibrillation recurrence following cardioversion. J Cardiovasc Electrophysiol. 2011 Oct;22(10):1092-8. doi: 10.1111/j.1540-8167.2011.02069.x. Epub 2011 Apr 13. PubMed PMID: 21489032.
  42.  Heeringa J, et al. Cigarette smoking and risk of atrial fibrillation: the Rotterdam Study. Am Heart J. 2008 Dec;156(6):1163-9. doi: 10.1016/j.ahj.2008.08.003. Last accessed Jan 6, 2013 URL: http://www.ncbi.nlm.nih.gov/pubmed/19033014
  43. Gee, R. Atrial Fibrillation Caused or Worsened by Lasalocid Residue in Eggs 1998 – 2005, Updated 2006 and 2007. Last accessed April 3, 2014 URL: http://www.freewebs.com/lasalocid/lasalocid.pdf 
  44. Brugada R. “Identification of a genetic locus for familial atrial fibrillation,” New England Journal of Medicine 1997;336:p. 905-911. Last accessed: Apri 3, 2014. URL: http://www.nejm.org/doi/full/10.1056/NEJM199703273361302
  45. Collins, C. What Are the Symptoms of Atrial Fibrillation? Yahoo! Voices/Contributor Network. Mar 22, 2010. Last accessed Dec. 31, 2012. URL:http://voices.yahoo.com/what-symptoms-atrial-fibrillation-5682474.html
  46. The Link Between Infections and Inflammation in Heart Disease. Life Extension Vitamins. Last accessed November 5, 2012 ttp://www.lifeextensionvitamins.com/cadico6otco.html
  47. Calkins, H. and Berger, R. “Atrial Fibrillation The Latest Management Strategies.” The Johns Hopkins Medicine Library, p. 9.
  48. Jais, P. et. al “Ablation therapy for atrial fibrillation (AF) Past, present and future”  Cardiovascular Research 2002. Vol. 54, Issue 2, pp. 337-346. doi: 10.1016/S0008-6363(02)00263-8

Search our site

Support A-Fib.com

Use OUR link to shop

Amazon button with glow 100 pic 96 res

BOOKMARK THIS LINK!

Every purchase generates a small commission—at no extra cost to you.

Help keep A-Fib.com Ad-free!


 


 
A-Fib Alerts-BYA promo Red ALT Signup Button 200 pix wide by 96 res
View Steve S. Ryan, Ph.D.'s profile on LinkedIn  
 
website security

Home | Help Support A-Fib.com | Print Friendly | Tell Us What You think | Media Room | GuideStar Seal | HON certification | Disclosures | Terms of Use | Privacy Policy