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Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

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Jill and Steve Douglas, East Troy, WI 

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Baltimore, MD


Doctors & patients are saying about 'Beat Your A-Fib'...


"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

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

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

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

Dr. Wilber Su,
Cavanaugh Heart Center, 
Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA


Silent A-Fib: When to Call Your Doctor or Visit the Emergency Room

VIDEO: EKG display of heart in Atrial Fibrillation, A-Fib

EKG display of heart in A-Fib

With a ‘Silent’ A-Fib episode, when is it time to call your doctor or visit the emergency room? That’s the topic of this email we received from Ross Johnston. He wrote he was recently diagnosed with ‘Silent A-Fib’ (discovered during a routine ECG). He asked me:

“During a ‘silent’ episode with few symptoms, when is it time to visit the ER? When my heart rate hits 150, 175, or 200? Or when my A-Fib lasts more than 24 hours? Or 48 hours?”

Ross is very fortunate that his Silent A-Fib was discovered. About 30%–50% of people with Atrial Fibrillation are walking around not knowing they have it. All too often they have a stroke and only then find out they have Silent A-Fib (and the probable cause of their stroke). 

A-Fib is easily identified from an electrocardiogram (ECG or EKG), which should be part of your annual physical exam.

Silent A-Fib Is Seldom Totally Silent

Anyone with Silent A-Fib should learn to take their pulse and take it often. Besides the number of beats-per-minute, also note is it uneven? Too fast (or too slow)?

To learn how, see the Arrhythmia Alliance video: “Know Your Pulse wth Sir Roger Moore”. You can also use a device like a pulse oximeter (such as the Contec Pulse Oximeter for about $20 from Amazon.com or from your local drug store).

A Conservative Approach

Silent A-Fib is seldom totally silent. If you feel something is “off” or different about your body, check your pulse. Don’t hesitate about going to the emergency room.

A conservative, safe approach is to go to the ER if your heart rate is over 100 bpm and/or lasts for 24-48 hours.

My Best Advice: Create an ‘A-Fib Episode Action Plan’

Anyone with Silent A-Fib (or any type of A-Fib) should develop an action plan. During an A-Fib attack, an A-Fib Action Plan reassures you you’re taking the right actions and helps you stay calm.

To develop your A-Fib Action Plan, you need to team up with your doctor. Discuss the following items. When having an A-Fib episode, you should know:Keep Calm and Follow Your A-Ffib Action Plan poster at A-Fib.com

• When to contact your doctor’s office
• Your doctor’s cell number and email address for emergencies
• What symptoms or criteria should send you to the emergency room
• When at the ER, if you should call your doctor
• When at the ER, if your doctor will call and talk with the ER staff
• When you should “just ride out” the episode
• How to recognize the signs of stroke

Write up the answers and add other helpful information, i.e., your local emergency room, directions, phone numbers, etc. Post a copy in a prominent place and discuss your A-Fib Action Plan with your loved ones.

The Bottom Line

If you feel something is “off” or different about your body, check your pulse. Then refer to your A-Fib Episode Action Plan and check for your next actions. If not sure, don’t hesitate to go to the emergency room.

For more, see my article: Why & How to Create Your ‘A-Fib Episode Action Plan’.

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