Doctors & patients are saying about 'A-Fib.com'...


"A-Fib.com is a great web site for patients, that is unequaled by anything else out there."

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

"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."

Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
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


No Way Am I Having an Ablation! Seeks Alternative Treatments

Saul Lisauskas of Encinitas, CA, was 62 years old when he first detected something wrong with his heart. After his A-Fib was diagnosed, he started to note his episodes were associated with stress and getting angry, along with dehydration, too much caffeinated coffee and foods containing MSG.

Saul Lisauskas

He was disappointed by doctors who offered only drug therapy with no advice about nutrition and the benefts of an improved, healthy diet. He decided to educated himself on the topic: Saul wrote:

“I read a few books on the subject of food and the interaction with our body. The best book was The China Study. It will give you an education about food, its sources and dangers.”

Looking for Alternative Treatments: A Vegetarian Diet

While avoiding his A-Fib ‘triggers’, he decided to go vegetarian but eating fish (a pescetarian) to reduce exposures to foods laced with unhealthy chemicals. (As a bonus, he lost 20 pounds in 3 months.) He was feeling better, but his A-Fib was still active. In his A-Fib story, Saul shares:

“The cardiologist explained to me that the real solution lay in having an Ablation procedure. I was willing to do anything to avoid that surgery.
“I was willing to do anything to avoid that surgery [catheter ablation].”
But with time, my A-Fib episodes increased along with longer periods of activity and stronger symptoms.”
During my ordeal leading up to my Ablation procedure, I was taking various meds in order to control my A-Fib.
However, the meds would make me dizzy and slow down my heart rate to dangerous levels to the point that such levels in fact were counterproductive. My system would compensate by sudden increases of adrenaline and consequently place me in A-Fib mode.
Consequently, I had a pacemaker installed to prevent low levels of heart rate.”

After nearly 8 years since his A-Fib diagnosis, Saul writes about his decision to have a catheter ablation:

“I was getting tired of and frustrated with all these meds.
After too many episodes of A-Fib forcing me to go to the ER, I capitulated against the Ablation surgery and had it done.
Today I am feeling well and doing my daily activities. …I feel that I may be cured well enough not to have to have another ablation.”

― Saul Lisauskas, Encinitas, CA, A-Fib free with pacemaker and catheter ablation

Since his ablation, Saul writes that he remains cautious not to run the risk of stress, dehydration, too much caffeinated coffee or getting angry.

To read more about Saul’s story, see No Way Am I Having an Ablation! But Diet and Meds Disappoint—A-Fib Free After Ablation.

Lessons Learned

When asked if he had any ‘Lessons Learned’ to share, Saul offers these insights:

”Doctors do not have a solution for everybody with A-Fib…We need to carefully educate ourselves as we follow the doctor’s recommendations and observe how our body reacts. Do not follow blindly the doctor’s recommendations.”

Saul certainly did everything he could to avoid having an ablation—identifying what triggered his A-Fib, a vegan diet with fish and all kinds of meds.

Saul certainly did everything he could to avoid having an ablation.

His experience with meds was unfortunate. The meds Saul was taking slowed his heart rate to the point where his doctor had to insert a pacemaker to keep his heart rate normal. It’s crazy to think about it. If this happens to you, talk to your doctor about changing meds (or change doctors).

Unfortunately, once the heart starts to produce A-Fib signals, it’s hard to turn them off. Saul faced the decision that many people have to make. He bit the bullet and had a catheter ablation―with successful results. He’s now A-Fib free!

What’s the Best Treatment Options For You?

A-Fib is not a one-size-fits-all disease. Your Atrial Fibrillation is unique to you. Along with various treatments, you may need to address concurrent medical conditions (i.e, hypertension, diabetes, obesity, sleep apnea). Likewise, you may need to make lifestyle changes (e.g., diet, exercise, caffeine, alcohol, smoking).

In addition, your heart is a resilient muscle that tends to heal itself, so you may need a repeat procedure.

To learn about options for Atrial Fibrillation patients, see our pages under Treatments for A-Fib. Then go to: Decisions About Treatment Options. And remember…

Always Aim for a Cure!

Are Your Herbal Supplements Interacting With Your Medicines?

Many people take herbal or dietary supplements along with their prescription medicines. But medicines and supplements may interact in harmful ways!

Some supplements can decrease the effects of medicines, while others can increase the effects, as well as cause unwanted side effects.

The medicines affected have a ‘narrow therapeutic index’, which means that if the amount of the drug is even a little too low or too high, it can cause big problems.

Warfarin (Coumadin) is one such medicine. When taken with certain herbal supplements, such as Asian ginseng or St. John’s Wort (and possibly ginger), you may need to be closely monitored.

St. John’s wort, for example, interacts with many types of drugs. In most instances, it speeds up the processes that change the drug into inactive substances, leading to a decrease in drug levels in your body.

Other medicines with a narrow therapeutic index include digoxin (heart), theophylline (asthma), lithium (anti-depressant), acetaminophen (pain killer) and gentamicin (antibiotic).

The herb-drug interaction potential is high for St. John’s Wort, Asian ginseng, Echinacea, ginkgo (high dose) and goldenseal; But low for black cohosh, ginkgo (low dose), garlic and kava supplements.

Free download: Medication Inventory form at A-Fib.com

Medication Inventory form

Take an Inventory

If you take any of the described medicines and herbal supplements, use our free Medication Inventory form to make a list of everything you take.

List how often you take them, and the doses you take.

Then ask for a review by your doctor or pharmacist for any harmful interactions. You may find you want to modify your supplement regime.

Do Your Own Research

Learn more about herb-drug interaction potentials at:

Herb-Drug Interactions: What the Science Says. National Institutes of Health/National Center for Complementary and Integrative Health.
About Herbs, Botanicals & Other Products“ at the Memorial Sloan Kettering (MSK) website (one of our favorites).

Resources for this article
• 6 Tips: How Herbs Can Interact With Medicines. U.S. Department of Health & Human Services, National Institutes of Health, USA.gov. Last modified September 16, 2015. https://nccih.nih.gov/health/tips/herb-drug

• Davis SA, et al. Use of St. John’s Wort in potentially dangerous combinations. J Altern Complement Med. 2014 Jul;20(7):578-9. doi: 10.1089/acm.2013.0216. Epub 2014 Jun 23. PubMed PMID: 24956073.

• Chua YT, et al. Interaction between warfarin and Chinese herbal medicines. Singapore Medical Journal. 2015;56(1):11-18. doi:10.11622/smedj.2015004.

• Herb-Drug Interactions: What the Science Says. Clinical Guidelines, Scientific Literature, Info for Patients: Herb-Drug Interactions. National Institutes of Health/National Center for Complementary and Integrative Health. Last modified June 25, 2018. URL: https://nccih.nih.gov/health/providers/digest/herb-drug-science

• Jou J, Johnson PJ. Non-disclosure of complementary and alternative medicine (CAM) use to usual care providers: Findings from the 2012 National Health Interview Survey. JAMA Intern Med. 2016.Apr;176(4):545-6. doi: 10.1001/jamainternmed.2015.8593. PubMed PMID: 26999670.

Click image to go to her Personal A-Fib story.

Don’t be Fooled by the Numbers in Drug Ads: How You Get to the Absolute Truth

A while back we posted, Don’t be Fooled by Pay-to-Play Online Doctor Referral Sites, about how it’s common for doctors to pay io be listed in online doctor referral services. (Doctors can pay extra to be listed first in your database search results.)

How Some Drug Ads Mislead

This time we caution you about how some drug ads mislead you.

Here’s an example of an actual news report headline, “New Wonder Drug Reduces Heart Attack Risk by 50%.” Sounds like a great drug, doesn’t it?

Yet it sounds significantly less great when you realize we’re actually talking about a 2% risk dropping to a 1% risk. The risk halved, but in a far less impressive fashion.

A factual headline would be, “New Wonder Drug Reduces Heart Attacks from 2 per 100 to 1 per 100.” Doesn’t sound like such a great drug now, does it?

The online watchdog group HealthNewsReview.org reports, that’s why using “absolute numbers” versus percentages matter. “Absolute numbers” provide you with enough information to determine the true size of the benefit.

The Tale of a 50% Off Coupon

Professors Steve Woloshin and Lisa Schwartz of the Dartmouth Institute for Health Policy & Clinical Practice explain absolute numbers versus percentage (relative numbers) in a creative way.

“… [it’s] like having a 50% off coupon for a selected item at a department store. But you don’t know if the coupon applies to a diamond necklace or to a pack of chewing gum.
Only by knowing what the coupon’s true value is—the absolute data—does the 50% have any meaning.”

So, 50% off a diamond necklace might be a savings of $5,000. While 50% off a pack of gum might be 50 cents. Absolute numbers tell the whole story.

The Bottom Line: Be Skeptical, Ask Questions

As a healthcare consumer, it’s wise for you to be skeptical anytime you hear a benefit size expressed as a percentage, for example, a 50% improvement or 50% fewer side effects.

Read my book review

You should ask yourself 50% of how many? Of 10,000 patients? Or 10 patients? Which result is significant and which is just blowing smoke?

Numbers matter. That’s how you get to the absolute truth.

Additional Reading

See also How to See Through the Hype in Medical News, Ads, and Public Service Announcements, my review of the book “Know Your Chances―Understanding Health Statistics”.

The Math Behind a 50% Reduction

“New Wonder Drug Reduces Heart Attack Risk by Half.” How was this claim calculated?

The Raw Data: In the research study, the 5-year risk for heart attack for:

-a group of patients treated conventionally was 2 in 100 (2%) and
-a group of patients treated with the new drug was 1 in 100 (1%).

Absolute Difference: The absolute difference is derived by simply subtracting the two risks: 2% – 1% = 1%. Expressed as an absolute difference, the new drug reduces the 5-year risk for heart attack by 1 percentage point (or 1 in 100).

Relative Difference: The relative difference is the ratio of the two risks. Given the data above, the relative difference is: 1% ÷ 2% = 50%. Expressed as a relative difference, the new drug reduces the risk for heart attack by half, or 50%.

Absolute Numbers Versus Percentages:
How the numbers work (or mislead the reader)

Resource for this article
Tips for Understanding Studies: Absolute vs Relative-Risk. HealthNewsReview.org. Retrieved August 2, 2018.  URL: https://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/absolute-vs-relative-risk/

Learning About A-Fib: “A True Experience of Input, Input, Input!”

Advice from patients now free from the burden of A-Fib: Learn all you can about Atrial Fibrillation before making decisions.

Joan Schneider, Ann Arbor, MI, writes how she found online information and support:

Joan S.

“Upon questioning [my new EP]…I didn’t have a warm fuzzy feeling.
However, I found everything I needed to know (and even what I didn’t want to know) when I came across A-Fib.com, Stopafib.org, and the best support from the A-Fib support group.
It was a true experience of input, input, input!”

Charn Deol, Richmond, BC, Canada, now A-Fib Free after a 23-Year ordeal with Atrial Fibrillation writes:

Personal A-Fib story by Charn Deol, BC, Canada at A-Fib.com

Charn D.

“I am relying on his [EP’s] extensive knowledge to help me in a field where I am no expert. My gut said to ‘no longer trust’ this supposed best electrophysiologist at the hospital and search for an alternative path. 

From this experience I’ve learned to obtain as much knowledge as possible of your condition.”

Another A-Fib patient, Sheri Weber, from Boyce, VA, tells what led her to learn more about Atrial Fibrillation on her own:

Sheri W.

“While in the hospital, I questioned my cardio doctor about treatment options other than medication; He told me there were surgical procedures, but they had very low success rates (WRONG!).

Anger and determination led me to research my options [right then] on my laptop.”

Where to Start Learning About A-Fib

Here at A-Fib.com we offer you a plethera of experiences to learn about Atrial Fibrillation. Check out our “Where to Start” page to begin.

If you are newly diagnosed or new to our website, you can start with our Overview of Atrial Fibrillation. It introduces you to all the main topics of this website.

Then visit our Frequently Asked Questions (FAQs) section. We answer common patients’ questions. Also, visit our A-Fib Video Library with short clips at the Introductory Level. Along the way, refer to our Glossary of medical terms as needed.

Go to our “Where to Start” page.

Learn All You Can About A-Fib
Before Making Treatment Decisions.

How Can I Avoid Arterial Calcium Deposits When Taking Coumadin?

Holly Hannula wrote me about being on Coumadin (warfarin) for 12 years because she has a mechanical heart valve. She’s alarmed by a recent scan of her artery walls showing dangerously high calcium deposits, i.e., the amount of hardening of the arteries (atherosclerosis).

Holly’s doctors recommended an angiogram (X-ray) and stents to be put in wherever needed and done very soon. She felt that was too drastic, that her quality of life was good and she was active and social. She and her husband declined those procedures.

Her emailed continued:

“The doctors won’t or can’t change me to a different blood thinner. If I have to take Coumadin for the rest of my life, can I reduce the calcification with vitamin K2 (MK-7)?”

Holly’s coronary artery calcium score is 800 which is dangerously high.

A score between 100 and 399 is classified as increased calcification, and any score over 400 signifies extensive calcium deposits. If your score is over 1,000, you have a 20 percent chance of having a serious or fatal cardiac episode within one year of testing.  (See table below for all scores.)

A score over 1,000 equals a 20% chance of a serious or fatal cardiac event within one year.

No wonder Holly is worried!

What are Her Options?

Because she has a mechanical heart valve, Holly doesn’t have a lot of options. Treatment Guidelines by the American College of Cardiology/American Heart Association (ACC/AHA) only include warfarin (Vitamin K Antagonist) therapy and perhaps aspirin. None of the newer anticoagulants are included.

One might think that a newer anticoagulant like Eliquis would work as well as Coumadin if one has a mechanical valve. But right now, this isn’t a recommended treatment. (For example, the maker of Eliquis states that it isn’t for patients with artificial heart valves.)

My Best Effort for Holly: In my return email, I promised Holly that I would get in touch with Bristol-Myers Squibb, the maker of Eliquis, to see if it could possibly be used in her case.

Tragic Dangers of Warfarin Not Recognized

It’s tragic that Holly has such extensive calcium deposits due to having to take warfarin (Coumadin) which works by blocking Vitamin K.

Vitamin K is essential for heart and bone health. Without enough K-2, osteocalcin, a protein that binds calcium to bone, doesn’t function. Instead the calcium ends up clogging arteries. See Arterial Calcification From Warfarin: Vitamin K May Reverse it.

What’s equally tragic is how few doctors and their patients are aware of this side effect of taking warfarin (Coumadin).

Vitamin K2 Reverses Arterial Calcification!

But, as Holly has already researched and as I described in my article, Arterial Calcification From Warfarin, high doses of Vitamin K2 MK-7 reversed arterial calcification in recent preliminary studies. (MK-7 means the Vitamin K2 also has a Natto component. Natto[kinase] is a known natural blood thinner.)

But what K2 MK-7 dosage should Holly consider? We don’t have enough human research yet to give a definitive answer, but we do have some indications.

Animal research: In an animal study, rats were initially fed a six-week diet of warfarin to induce calcium buildup in blood vessels. Some rats were then fed high dose Vitamin K1 or K2 (MK-4) for six weeks. They not only had no further arterial calcium accumulation but, more importantly, had a 37% reduction of previously accumulated arterial calcification. After 12 weeks, there was an astounding 53% reduction.

Doses: Note the distinction between mg and mcg. 1 mg = 1000 mcg

Mega dose or RDA? In the above study of rats, the human equivalent of the vitamin K2 dose is in the range of  52,000 mcg (52 mg) to 97,000 mcg (97 mg) per day.

Admittedly, these are high doses compared to the standard daily recommend dosages (90 mcg [0.09 mg] for females and 120 mcg [0.12 mg] for males).

Already approved: In Japan, a 45,000 mcg (45 mg) daily dose of the MK-4 form of vitamin K2 is approved as a drug to treat osteoporosis.

Vitamin K and Dosages

Forms of Vitamin K: Consider a high quality MK-7 form of Vitamin K2. Plus, as they are inexpensive, include vitamin K1 and MK-4 to help inhibit and possibly reverse vascular calcification.

Remember to always take your Vitamin K supplement with fatty foods since it is fat-soluble and won’t be absorbed without it.

to avoid arterial calcification

Although the exact dosage of Vitamin K is yet to be determined, one of the world’s top Vitamin K researchers, Dr. Cees Vermeer recommends between 45 mcg and 185 mcg daily for normally healthy adults. LifeExtension magazine recommends 180 mcg.

To Reverse Arterial calcification

To reverse or reduce calcium plaque, you might consider the ultra high doses of 45-50 mg (45,000 mcg) daily, which is based on the research with rats. But only under your doctor’s supervision!

It’s most important that Holly should NOT make any changes to her treatment plan without consulting withher  doctor first.

No Overdosing on Vitamin K

You need not worry about overdosing on K2—people who have been given a thousand-fold increase over the recommended dose over the course of three years have shown no adverse reactions (i.e., no increased clotting tendencies).

Advice for Warfarin Users

If you are taking warfarin, your goal should be to maintain the highest healthy levels of Vitamin K to counteract the effects of warfarin on your arterial and bone health.

If you change from warfarin to a NOAC, your goal should be to restore your arterial and bone health from the effects of warfarin by maintaining the highest healthy levels of Vitamin K.

Additional reading about Vitamin K To learn more about the types of Vitamin K, see our article, Vitamin K―Protection Against Arterial Calcification & Cardiovascular Disease

On a personal note: I’ve had a CT scan which revealed calcium deposits in my heart’s arteries, especially in the “widow maker”, the Left Anterior Descending artery (LAD).
After writing this article, I’ve decided to take 45 mg (45,000 mcg) of Vitamin K2 daily.
Coronary Artery Calcium Score  Interpretation
 0 No identifiable plaque. Risk of coronary artery disease very low (<5%)
 1-10 Mild identifiable plaque. Risk of coronary artery disease low (<10%)
 11-100 Definite, at least mild atherosclerotic plaque. Mild or minimal coronary narrowings likely.
 101-400 Definite, at least moderate atherosclerotic plaque. Mild coronary artery disease highly likely. Significant narrowings possible
 > 400 Extensive atherosclerotic plaque. High likelihood of at least one significant coronary narrowing.

Back to Top

Resources for this article
• Goodman, Denonis. The New Nutrient Fix. Bottom Line/Health. July, 2015, p. 3.

• Faloon, William. Turning To Stone. Life Extension Magazine, July 2015, pp. 7-16. Last accessed Aug 10, 2015. URL: http://atlaschiropractichealthcenter.com/blog/wp-content/uploads/2015/06/Vitamin-K-LE1.pdf

• Tantisattamo E et al. Increased vascular calcification in patients receiving warfarin. Arterioscler Throm Ib Vasc Biol. 2015 Jan;35(1): 237-42. doi: 10.1161/ATVBAHA.114.304392

• Pilkey, RM, et al. Subclinical vitamin K deficiency in hemodialysis patients. Am J Kidney Dis. 2007 Mar;49(3):432-9. Last accessed Aug 10, 2015. URL: http://www.ncbi.nlm.nih.gov/pubmed/17336705

• Schurgers, LJ, et al. Regression of warfarin induced medial elastocalcinosis by high intake of vitamin K in rats. Blood. 2007 Apr 1;109(7):2823-31. Last accessed Aug 10, 2015. URL: http://www.bloodjournal.org/content/109/7/2823.full?sso-checked=true

• Westenfeld, R, et al. Effect of vitamin K2 supplementation on fictional vitamin K deficiency in hemodialysis patients: a randomized trial. Am J Kidney Dis. 2012 Feb;59(2):186-95. Last accessed Aug 10, 2015. URL: http://www.ajkd.org/article/S0272-6386(11)01570-8/abstract

• Geleijnse, JM et al. Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study. The Journal of Nutrition, November 1, 2004, Vol. 134, no. 11. 3100-3105. http://jn.nutrition.org/content/134/11/3100.full Last accessed 6/19/2015.

• Vitamin K: How much is too much? Alere/PTINR.com. April 1, 2013. Last accessed Aug. 10, 2015. URL: http://ptinr.com/warfarin-you/dietary-food-beverage/vitamin-k-how-much-too-much

• Mercola, J. 10 Important Facts About Vitamin K That You Need to Know. Mercola.com, March 24, 2004 Last accessed Aug 10, 2015. URL: http://articles.mercola.com/sites/articles/archive/2004/03/24/vitamin-k-part-two.aspx

• Mercola, J. New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation. Mercola.com. October 12, 2013. https://articles.mercola.com/sites/articles/archive/2013/10/12/vitamin-k2-benefits.aspx

Polypharmacy: A Cautionary Tale of Taking Too Many Prescription Drugs

Tracking prescription drug use from 1999 to 2012 through a large national survey, Harvard researchers reported that 39 percent of those over age 65 now use five or more medications— a 70 percent increase over the 12 years tracking period.

“Polypharmacy” is the term for prescribing patients five or more medications at the same time (even if all are given for legitimate reasons).

This often happens when a person has many chronic diseases, such as diabetes, high blood pressure and heart disease, each requiring long-term treatment with medications.

What’s the Problem?

First, drugs are chemicals that can interact with one another with the potential to cause all kinds of complications (versus if you take just one medication).

Polypharmacy contributes to higher rates of hospitalizations and death, and higher costs.

For example, an anti-inflammatory medication like Ibuprofen (Advil, Motrin, Midol, Nuprin), may increase blood pressure and worsen kidney function. Therefore they should not be used by persons with high blood pressure or kidney problems.

Next, as we age, the kidneys and liver become less efficient in passing medications out of the body. The lingering drugs can magnifying their effects as well as have side effects.

Polypharmacy contributes to higher rates of hospitalizations and death, and higher costs.

Should You Be Prescribed Fewer Drugs?

Some people outgrow their medication. They change their lifestyle (ex. diet, physical activity, and weight loss) and subsequently may no longer need medications for diabetes, cholesterol or high blood pressure.

But they keep taking them, because no one told them to stop.

To ‘deprescribe’ a drug is not as simple as saying “stop”. It’s a process requiring caution and skill by your doctor.

Simple errors can occur, too. Dr. Michael A. Steinman, a geriatrician at the University of California, San Francisco, recalled asking a patient to bring in every pill he took for a so-called ‘brown bag review’. He learned that the man had accumulated four or five bottles of the same drug without realizing it, and was ingesting several times the recommended dose.

De-Prescribing: A Brown Bag Review

Always keep an accurate and updated list of medications you are taking including over-the-counter drugs, herbal products, and supplements. Give your doctors each a copy. (See our free download form below.)

Periodically ask your physicians or pharmacist for your own ‘brown bag review’. Discuss whether to continue or change any of your regimens. Ask about:

▪ any medicines you no longer need?
▪ any medications you can do without?
▪ if a lower dose would work for any of your medicines?
▪ if any of your medications might interact with any another?
▪ any non-pharmacologic alternatives?

If your doctor agrees to ‘de-subscribe’ a medication, realize it isn’t as simple as saying “stop” taking it. It’s a process requiring caution and skill by your doctor. (Afterwards, remember to update your list of medications.)

“We spend an awful lot of money and effort trying to figure out when to start medications and shockingly little on when to stop.”

Dr. Caleb Alexander, Johns Hopkins Center for Drug Safety and Effectiveness

Free Download: Keep an Inventory List of Your Medications

As a service to atrial fibrillation patients, we offer Free Reports, Worksheets and Downloads of our own worksheets and articles and useful free services or downloads from others serving the atrial fibrillation community.

Inventory List of Your Medications: We want to help you keep your doctor and other healthcare providers up-to-date on all the medications you are taking by using this Medications List from Alere.

Download and use to help you keep track of everything (including over-the-counter drugs, vitamins, herbs and mineral supplements, too). Remember to save the PDF to your hard drive.

Because your medications will change over time, print several copies of the blank form so you will always have a clean copy ready to use. (Keep in your A-Fib file or binder.) Give a copy to each of your doctors or other medical healthcare providers.

Resources for this article
• Kantor ED, et al. Trends in Prescription Drug Use Among Adults in the United States From 1999-2012. JAMA. 2015;314(17):1818–1830. doi:10.1001/jama.2015.13766

• Onder G, Marengoni A. Polypharmacy. JAMA. 2017;318(17):1728. doi:10.1001/jama.2017.15764 JAMA. 2017; https://jamanetwork.com/journals/jama/fullarticle/2661582

• Span, P. The Dangers of ‘Polypharmacy,’ the Ever-Mounting Pile of Pills. New York Times, April 26, 2016. URL: https://www.nytimes.com/2016/04/26/health/the-dangers-of-polypharmacy-the-ever-mounting-pile-of-pills.html

• Mishori, R. Why doctors should be prescribing less drugs. The Independent. 30 January 2017. http://www.independent.co.uk/life-style/health-and-families/healthy-living/prescribing-drugs-is-good-so-is-deprescribing-a7552971.html

• Jou J, Johnson PJ. Non-disclosure of complementary and alternative medicine (CAM) use to usual care providers: Findings from the 2012 National Health Interview Survey. JAMA Intern Med. 2016.Apr;176(4):545-6. doi: 10.1001/jamainternmed.2015.8593. PubMed PMID: 26999670.

• Qato DM, et al. Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Intern Med. 2016 Apr;176(4):473-82. doi:10.1001/jamainternmed.2015.8581.

 

NEW VIDEO: What Should I Expect After my A-Fib Catheter Ablation Procedure?

What to expect post-ablation

We have posted a new video that features Cardiac Electrophysiologist Dr. Darryl Wells.

He talks about judging the success of your ablation, why it’s difficult to predict which patients will be completely cured after one ablation procedure and why some require two procedures.

He discusses safety of the procedure and the appropriate age range for patients to receive the ablation procedure. (3:17)

Published by Swedish Heart and Vascular Institute. Go to video->

Vitamin K―Protection Against Arterial Calcification & Cardiovascular Disease

Most people get just enough Vitamin K from their diets to maintain adequate blood clotting.

But NOT enough Vitamin K to offer protection against health problems including arterial calcification, cardiovascular disease, osteoporosis, various cancers and brain health problems, including dementia.

The name Vitamin K comes from the German word “Koagulationsvitamin” where its role in blood coagulation was first discovered.

Vitamin K is an essential vitamin. It is one of the four fat-soluble vitamins, along with vitamin A, vitamin D, and vitamin E. It’s found in leafy green vegetables, broccoli, and Brussels sprouts.

Vitamin K and Vitamin K supplements come in several forms and can be confusing. To increase your levels of Vitamin K, it’s important to understand the differences.

Vitamin K Can be Classified as Either K1 or K2

Vitamin K1: Found in green vegetables, K1 goes directly to your liver and helps you maintain a healthy blood clotting system; keeps your own blood vessels from calcifying, and helps your bones retain calcium.

Vitamin K2: Bacteria produce this type of Vitamin K; it goes straight to vessel walls, bones and tissues other than your liver. It is present in fermented foods, particularly cheese and the Japanese food natto (the richest source of K2).

Different Forms of Vitamin K2

Making matters even more complex, there are several different forms of Vitamin K2. MK-4 and MK-7 are the two most significant forms of K2 and act very differently in your body.

MK-4 is a synthetic product, very similar to Vitamin K1, and your body is capable of converting K1 into MK4. It has a very short biological half-life of about one hour, making it a poor candidate as a dietary supplement. It remains mostly in your liver where it is useful in synthesizing blood-clotting factors.

MK-7 is a newer agent with more practical applications because it stays in your body longer; its half-life is three days, meaning you have a much better chance of building up a consistent blood level, compared to MK-4 or K1. It slows down cardiovascular aging and osteoporosis, and prevents inflammation by inhibiting pro-inflammatory markers produced by white blood cells.

Food Sources of Vitamin K and MK-7

Photo by Like_The_Grand_Canyon on Flickr licensed CC-BY

MK-7 is extracted from the Japanese fermented soy product called ‘natto’. You get loads of MK-7 from natto. However, natto is generally not appealing to a Westerner’s palate (can’t tolerate its smell and slimy texture).

You can also find Vitamin K2, including MK-7, in other fermented foods including some fermented vegetables.

Certain types of fermented cheeses (Jarlsberg) are high in K2 but others are not. It really depends on the specific bacteria. You can’t assume that any fermented food will be high in K2.

Besides broccoli, Brussels sprouts and leafy green vegetables (kale, mustard greens, collard greens, raw Swiss chard, spinach), other foods high in Vitamin K include beef liver, pork chops and chicken, prunes and Kiwi fruit, soybean and canola oil.

Vitamin K Supplements

Choosing a K2 supplement: When supplementing your Vitamin K food sources, consider a high quality MK-7 form of vitamin K2. (Plus, as they are inexpensive, include Vitamin K1 and MK-4 to help inhibit and possibly reverse vascular calcification.)

Relentless Improvement

Dosage: Although the exact dosage of Vitamin K is yet to be determined, one of the world’s top Vitamin K researchers, Dr. Cees Vermeer recommends between 45 mcg and 185 mcg daily for normally healthy adults.

My choice: I’m taking Relentless Improvement Vitamin K2 MK4 Plus MK7; Read about it on Amazon.com. (Use our portal link to Amazon.com and support A-Fib.com)

(If you have a K2 supplement recommendation, email me.)

Remember!
Always take your Vitamin K supplement with food that contains fat
since it is fat-soluble and won’t be absorbed without it.

Read more about mineral deficiencies and Atrial Fibrillation, see FAQs: Mineral Deficiencies & Supplements for a Healthy Heart

This article is based on Dr. Mercola’s article, New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation.
Resources for this article
Mercola, J. New Study Shows Evidence That Vitamin K2 Positively Impacts Inflammation. Mercola.com. October 12, 2013. https://articles.mercola.com/sites/articles/archive/2013/10/12/vitamin-k2-benefits.aspx

Possible Sleep Apnea? Oximeter is DIY Way to Check your Blood’s Oxygen Level

As many as 43% of A-Fib patients also suffer with obstructive sleep apnea (OSA). An easy preliminary step towards finding out if you have a sleep disorder is with the use of an inexpensive oximeter. To check your blood’s oxygen level, just insert your finger.

Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor

Designed for pilots and sport enthusiasts who want to obtain their SpO2 (Blood Oxygen Saturation Levels) and PR (Pulse Rate) on the go. A-Fib patients can use one, too.

The pulse oximeter LED display faces you so it’s easy to read. (The Zacurate, Facelake and Santamedical are brands of Fingertip Pulse Oximeters. Reasonably priced, starting at $13 on Amazon.com. )

Taking a reading is easy. Just clip it on to your finger and turn it on at the press of a button. The large LED display makes viewing the results a snap.  (The one from Zacurate comes with 2 AAA batteries so that you can use it immediately.)

Your Blood’s Oxygen Level

A reading of 90% or lower means you should talk to your doctor, you may need a sleep study.

HINT for after you have taken your initial oxygen level: Take a BIG deep breath and HOLD it. You should see the reading increase as more oxygen enters your blood stream.

To learn more about sleep apnea and A-Fib, see Sleep Apnea: When Snoring Can Be Lethal and the Podcast: The Double Whammy? Sleep Apnea and Atrial Fibrillation.

A-Fib is Not a ‘One-Size-Fits-All’ Disease—May Involve Various Treatments

Over time, these patients chose more than one type of treatment to become free from the burden of Atrial Fibrillation.

kathy haxton - Personal A-Fib story

Kathy H.

Kathleen Haxton, Surprise, Arizona, describes her various treatments leading up to a successful Ablation:

“At first I was able to control the a-fibs by increasing my magnesium and potassium intake. (Low sodium V-8 juice was very helpful.) However, after a while that wasn’t quite good enough.
[Then] Sotalol worked pretty well, but I knew I had to do something. I did not want these a-fibs to control my life any longer.
Because in all the research I did, I knew I wanted to have a Cryo-Balloon Ablation.”

Jay Teresi, Atlanta, GA, describes his second ablation after being A-Fib free for three-years:

Jay T.

“[My EP] explained that my first procedure was a success. However, during the healing process a tiny spot did not scar and this allowed the A-Fib to trip again.
He ablated that portion and touched up all the other areas. I have now been free of A-Fib for over four years..”

Emmett F.

Harry Emmett Finch, Malibu, CA. With 40-years of A-Fib, Emmett’s treatment evolved beyond drug therapy: a PV catheter ablation, then AV Node ablation with Pacemaker and, most recently, installation of the Watchman device:

“There is more help available today than when I first developed my A-Fib [in 1972], and I’m sure more treatment options (like the Watchman device) will be available in the future.”

A-Fib is Not a One-Size-Fits-all Disease

Your Atrial Fibrillation is unique to you. Along with various treatments, you may need to address concurrent medical conditions (i.e, hypertension, diabetes, obesity, sleep apnea). Likewise, you may need to make lifestyle changes (e.g., diet, exercise, caffeine, alcohol, smoking).

Your heart is a resilient muscle that tends to heal itself. So, prepare yourself—over time you may need a repeat treatment or an additional procedure. Learn more at: Treatments for A-Fib

Need More Than One Treatment?
A Heart in Normal Sinus Rhythm is Worth it! 


‘From The Top 10 List of A-Fib Patients’ Best Advice’ , consensus of valuable advice from fellow Atrial Fibrillation patients; Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Go to Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

NEW VIDEO: The Hybrid Maze/Ablation for Persistent A-Fib

We’ve posted a new video about the Hybrid Maze/Ablation.

Video animation frame: Surgeon placing lesions on outside of heart at A-Fib.com

Animation frame: Surgeon placing lesions on outside of heart

For persistent or long-standing persistent atrial fibrillation, it combines the complementary efforts of both the cardiothoracic surgeon and the cardiac electrophysiologist.

The surgeon works on the outside the heart and the EP on the inside of the heart to eliminate the Atrial Fibrillation signals.

In this video, two cardiac EPs and a cardiothoracic surgeon describe the advantages, safety and effectiveness of the Hybrid approach and who is a good candidate. Includes animation and on-camera interviews.  Length 4:30.  Go to video->

PVCs Aren’t Always Benign, and He Didn’t Want to Live with Them

Do NOT listen when doctors say PVCs are harmless, writes John Thorton from Sioux Falls, SD. Besides A-Fib and A-Flutter, his PVCs were destroying his life and driving him crazy.

Premature Ventricular Contractions (PVCs) are premature beats that occur in the ventricles, i.e., the heart’s lower chambers. (Premature beats that occur in the atria, the heart’s upper chambers, are called premature atrial contractions, or PACs.) In his A-Fib story, John writes:

John & Marcia T.

“The local MDs (about a half dozen different ones), cardiologists, EPs, and other local specialists, all told me stuff like: “Everyone has PVCs” and “PVCs are benign,” and “It is just anxiety,” and “You just need to learn to live with it”.
Which was completely WRONG.
Being his Own Patient Advocate

In his A-Fib story, PVC-Free After Successful Ablation at Mayo Clinic, John advises: Be assertive, even aggressive.

“I had to set up my own appointment at Mayo Clinic to get evaluated there. It was a lot of work, by me alone, to get in to see the doctors at Mayo, but it was worth it.
I honestly believe that had I not gone to Mayo, I would have suffered some major heart event, or possibly death.”

PVCs Aren’t Always Benign

Especially for people with A-Fib, PVCs should be taken seriously. Often they precede or predict who will develop A-Fib. They can increase chances of a fatal heart attack or sudden death. The good news: sites in the heart that produce PVCs can be mapped and ablated just like A-Fib signals.

To learn more about PVCs, see my article: FAQs Coping with A-Fib: PVCs & PACs

Don’t be Afraid to Fire Your Doctor!

Kudos to John for being his own best patient advocate, for taking the bull by the horns and dealing with his PVCs. In spite of what he heard from everyone else, he persevered and went to probably the best center in the US for treating PVCs—the Mayo Clinic. Now John’s A-Fib free and only has occasional PVCs.

Like John, don’t be afraid to fire your doctor! To learn how to interview doctors, see our page: Finding the Right Doctor for You and Your A-Fib.

A-Fib Not only Affects You But Also Your Loved Ones

Diagnosed at age 54, Tony Hall was very physically active, primarily a runner. He was helped by the book, Beat Your A-Fib, and decided to enlist Steve Ryan as his A-Fib Coach. In his A-Fib story, Tony shares:

“On one of our conference calls with me and my wife, Steve asked, “So, Jill, how are you doing?”
That was a light bulb moment for me.
I consider myself to be a very supportive husband in many ways; but until Steve asked that question of Jill, it really did not occur to me how dealing with A-Fib affects the lives of those close to us.”

A-Fib not only impacts the patient’s health and quality of life but also the lives (and often livelihood) of their loved ones and co-workers.

“Top 10 Questions Families Ask about Atrial Fibrillation”

Download the Free report

A-Fib can be a life altering disease―yet people with A-Fib don’t look sick.

When a patient is diagnosed with Atrial Fibrillation, family members often struggle to understand what their loved one is going through.

Selected from our many Frequently Asked Questions (FAQs), these are the most asked questions (with our answers) from family members. Read more and download the 5-page PDF report, ‘Top 10 Questions Families Ask about Atrial Fibrillation’.

Free Reports, Worksheets and Downloads

As a service to Atrial Fibrillation patients, we offer FREE downloads of our own worksheets and reports. We have also collected useful FREE services or downloads from others serving the atrial fibrillation community.

Why not take a few minutes to browse our page with Free Reports, Worksheets and Downloads?

Patient Advice: The First Doctor You See isn’t Necessarily the Right One for You

Advice from Patients Now Free from the Burden of Atrial Fibrillation

Susan Klein, comes from a long line of people with cardiac rhythm disorders. She recalls finally being properly diagnosed:

Susan K.

“I began reading everything I could about the condition but mainly how to make it stop.

Along the way I can’t recall how many times I was told to take the medicine and stop looking for trouble. 

I’m so glad I didn’t listen to the naysayers, because today I’m A-Fib free and loving it.”

Warren Welsh, Melbourne, Australia, talks about the years he needlessly endured A-Fib, in part, based on one doctor’s advice:

Warren W.

“I would urge any A-Fib sufferers not to make the same mistakes I did by not researching their treatment options.

…I experienced several years of unnecessary suffering by accepting an opinion of one specialist who said I would have to live in A-Fib.

Sheri Weber, from Boyce, VA, shared this advice about finding the right doctor for your treatment goals:

Sheri Weber on A-fib.com

Sheri W.

“I wish I had realized that the first doctor you see is not necessarily the right one for you. I fooled around way too long, believing what my cardio doctor said. I should have been thinking outside the box. 

Run―don’t walk―to the best specialist you can find in your area.” 

How to Find the Best Doctor for You

To be cured of your A-Fib, you may need to ‘fire’ your current doctor.

Seek a heart rhythm specialist, a cardiac electrophysiologist (EP), who will partner with you to create a treatment plan—a path to finding your cure or best outcome.

To make this happen, see my page, Finding the Right Doctor for You and Your A-Fib.

The First Doctor You See is Not Necessarily the Right One for You.


From The Top 10 List of A-Fib Patients’ Best Advice’ , a consensus of valuable advice from fellow Atrial Fibrillation patients; Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Go to Top 10 List of A-Fib Patients’ Best Advice
Please, share the advice ♥ 

Read the July 2018 A-Fib Alerts! Subscribe & Get 50% Off My Book

From Chile and Egypt, to Australia, Canada and the Ireland, patients around the world are reading my July 2018 A-Fib Alerts newsletter. Read it here

Or sign-up to get my FREE monthly A-Fib Alerts sent directly to with:

News about A-Fib treatments and relevant research
 FREE downloads and special Videos
Links to new Personal A-Fib stories
Answers to Frequently Asked Questions (FAQ)

Sign Up Today - Round Blue buttion 200 pix at 300 resSpecial 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. Join Today!

Click to go to Terry’s story

The Impact of Race on Stroke Risk Among Atrial Fibrillation Patients

It’s well reported that African Americans have a lower risk of developing A-Fib as compared to Caucasians.

But it’s a different story regarding strokes. A new study has found that compared with whites, blacks are at increased risk of developing an ischemic stroke either before or after a diagnosis of atrial fibrillation (A-Fib).

A new University of Pennsylvania study found that such strokes may occur even before the patient is aware of having the heart-rhythm problem, and that this risk is higher for black patients. In many cases, the stroke was the red flag that led to the patient’s A-Fib diagnosis.

African Americans and Heart Disease

Heart disease tends to occur earlier in African American patients than in white counterparts.

The death rate from heart-related causes is higher, too, largely due to a higher rate of heart attacks, sudden cardiac arrest, heart failure, and stroke, according to the American Heart Association

The Penn Study: Looking Back and Monitoring Forward

Researchers used a centralized pool of patient data from across the University of Pennsylvania Health System, which was comprised of 56,835 patients without a history of atrial fibrillation or a remote history of stroke.

Of these patients, the authors identified 3,507 patients who developed A-Fib. Upon diagnosis, they checked each patient’s medical history for the prior six months to document any history of stroke.

Going forward, the authors monitored these A-Fib patients for strokes for a median of 3.6 years.

Unique Design: The study design was unique in that researchers had a time point that represented the initial diagnosis of atrial fibrillation.

This approach provided an opportunity to examine the risk of stroke during a six-month period prior to a formal, clinical diagnosis of atrial fibrillation. Until now, no prior study has examined stroke risk in this period prior to a diagnosis of atrial fibrillation.

Study Findings

Out of 538 strokes occurring in the study periods, nearly half, 254, occurred before diagnosis with atrial fibrillation.

The authors suspect that in many of those 254 cases, the patients already had A-Fib but were undiagnosed.

Blacks had an independently higher risk of stroke both before and after being diagnosed with A-Fib, as compared with whites.­

Prior Six Months Findings: For the strokes that occurred in the six months before A-Fib diagnosis, the rate in black patients was about one-third higher than the rate in white patients.

Findings after A-Fib Diagnosis: For the strokes that occurred in the years following an A-Fib diagnosis, the rate in black patients was two-thirds higher than in white patients — a 2.5 percent chance of stroke per year in black patients compared with a 1.5 percent chance for whites.

Blood-Thinning Medicines: The increased stroke risk for black patients (with A-Fib) was especially high among those who did not have prescriptions for blood-thinning medicines (i.e., warfarin or NOACs).

But even the black patients with prescriptions had a somewhat higher risk of stroke than their white counterparts. (Note: The study authors did not examine whether patients took the medicines, only if they had been given a prescription.)

Editor’s Comments

It’s well reported that African Americans have a lower risk of developing A-Fib as compared to Caucasians. But until now, there was little data on the additional risks that come with A-Fib for each race.

The new findings build on previous studies examining the impact of race on the risk of developing atrial fibrillation.

More Facts About Strokes in African Americans: On his website, Dr. Greg Hall, who specializes in urban health and the clinical care of African Americans shared these sobering facts about strokes in African Americans:

“Most strokes in African Americans occur due to high blood pressure, and a much higher number of African Americans have uncontrolled blood pressure.
quarter of all strokes occur in the presence of atrial fibrillation (a fib). And while representing 13 percent of the US population, African Americans experience almost twice that percentage of all strokes (26%).
Strokes are worse in Blacks. And when a stroke occurs, African Americans have them earlier in life and present with more severe and disabling conditions. “

To learn more, see Dr. Hall’s post: Atrial Fibrillation in African Americans

A-Fib Stroke Risk Greater for Blacks: This is obviously a very important study for black patients. If you’re African American, you have less chance of developing A-Fib. 

Blacks have almost twice the percentage of all strokes (26%) while making up only 13% of the U.S. population.

But if you do develop A-Fib, your stroke risk is much greater than for Caucasians. As Dr. Hall points out, African Americans experience almost twice the percentage of all strokes (26%) while making up only 13% of the U.S. population.

“Silent” A-Fib Stroke Risk Greater for Blacks: An even more disturbing fact is that in this study, half of the strokes occurred before an African American patient was diagnosed with A-Fib. Silent A-Fib is a danger for all A-Fib patients, but the stroke risk was nearly one-third higher in black patients.

Blacks Urgently Need Monitoring for Silent A-Fib: Most strokes in African Americans occur because of high blood pressure which is more prevalent in blacks. But from a public health aspect, it’s even more important to test black patients for silent A-Fib. Monitoring for silent A-Fib needs to become Standard Operating Procedure for blacks reaching middle age.

If you are African American, you should be monitored or get yourself a DIY A-Fib monitor to make sure you don’t have silent A-Fib.

(For recommended DIY heart monitors, see my article, Do-It-Yourself ECG: A Review of Consumer Handheld ECG Monitors.) 

Resources for this article
Patel PJ, et al. Race and stroke in an atrial fibrillation inception cohort: findings from the Penn Atrial Fibrillation Free study [published online February 19, 2018]. Heart Rhythm. doi:10.1016/j.hrthm.2017.11.025.

Avril, T. Black patients with a-fib at higher risk of stroke, Penn study finds, Health/The Inquirer, Daily News, Philly.com. Feb. 20, 2018. http://www.philly.com/philly/health/a-fib-stroke-penn-atrial-fibrillation-black-african-20180220.html

African Americans with Atrial Fibrillation at Significantly Higher Risk for Stroke Compared to Caucasians with the Disease.  Press Release. Newswise.com. Article ID: 689679, Released: 16-Feb-2018. https://www.newswise.com/articles/african-americans-with-atrial-fibrillation-at-significantly-higher-risk-for-stoke-compared-to-caucasians-with-the-disease

Ischemic Stroke Risk in Atrial Fibrillation Varies by Race. Cardiolog Advisor, February 28, 2018. https://www.thecardiologyadvisor.com/atrial-fibrillation/ischemic-stroke-risk-in-atrial-fibrillation-varies-by-race/article/745853/

Roger VL, Go AS, et al. Heart Disease and Stroke Statistics—2012 Update: A Report From the American Heart Association. Circulation. 2012;125(1):e2-e220. doi:10.1161/CIR.0b013e31823ac046. Strokes in African Americans.  October 22, 2017 by Dr Greg Hall. http://drgreghall.com/2017/10/22/strokes-african-americans/

 

Hiker Offers Insights About High Altitude and A-Fib

After reading our post, FAQ: How Does High Altitude Affect Atrial Fibrillation?, Michele Straube shared some insightful comments about high altitude and A-Fib. Michele Straube had A-Fib for 30 years until her successful ablation. She is an active hiker including walking the Alps.

“There is “high altitude” and then there is “really high altitude”. Plus, even at “high altitude”, it is possible that anyone who has ever had A-Fib may feel some adverse effects. I offer two stories:

Michele S.

1. I was “cured” of A-Fib in 2009. In December 2015, my family climbed Kilimanjaro taking a longer route up so we had time to acclimate. While the rest of the family summited, I stayed at base camp (15,580′) because my heart was no longer in NSR [normal sinus rhythm]. It returned to NSR as soon as we got down to 12,000′ elevation.
2. We do a lot of hiking in the mountains. Even though I’m not in A-Fib anymore, I feel the elevation (above 8,000′) more than most of my hiking companions. I don’t go into A-Fib (thank goodness), but my heart races and I often get dizzy. It takes me up to 5 days to acclimate, even at that not-so-high elevation.”

I admire Michele’s fearless attitude toward hiking and mountain climbing and her boldness in leading an A-Fib free life. Thanks, Michele, for sharing. To read Michele Straube’s story, go to ‘Cured after 30 years in A-Fib by Dr. Marrouche.

Which Comes First: Sleep Apnea or Atrial Fibrillation?

Obstructive Sleep Apnea (OSA) affects about 100 million people worldwide with 85% of cases going undiagnosed.

Of Atrial Fibrillation patients, about 43% additionally suffer with Obstructive Sleep Apnea.

Could undiagnosed sleep apnea be linked to development of Atrial Fibrillation?

OSA Link to A-Fib

OSA is characterized by repetitive episodes of shallow or paused breathing during sleep that lead to a drop in blood oxygen level and disrupted sleep.

85% of Sleep Apnea cases go undiagnosed.

New research has found that patients with Sleep Apnea may be at greater risk of developing Atrial Fibrillation. Abnormal oxygen saturation level during sleep may be responsible.

Patients with OSA are more likely to have high blood pressure, or hypertension, which is a major risk factor for heart disease and other cardiovascular conditions.

Risk of New Onset A-Fib: The Clinical Cohort Study

Lead author Dr. Tetyana Kendzerska, Ph.D., of the University of Ottawa in Canada, and colleagues reviewed the records of 8,256 adults (average age 47) with suspected OSA. Individuals with any diagnosis of arrhythmias were excluded. Participants were followed for an average of 10 years. During that time, 173 developed A-Fib resulting in hospitalization.

Study Results

The reviewers found that the amount of sleep time spent with lower than normal oxygen saturation (below 90 percent) was a significant predictor of developing Atrial Fibrillation.

By contrast, the number of breathing pauses during each hour of sleep did not appear to affect A-Fib risk.

Study participants who developed A-Fib during the follow-up period were more likely to be older, current or former smokers, and have a high level of comorbidities (i.e., high blood pressure, or hypertension).

“The association between oxygen desaturation and A-Fib remains significant, suggesting that OSA can directly cause A-Fib.”

What This Means to Patients

In light of this study, a diagnosis of Atrial Fibrillation raises the question, ”Could my A-Fib have been brought on by undiagnosed Sleep Apnea?”

Sandy from Boston

Sandy from Boston and her doctor say ‘yes”. Updating her personal A-Fib story, she wrote:

“After my [successful] CryoBalloon ablation at BWH in 2014, I underwent a sleep study that revealed during REM sleep I stopped breathing an average of 32 times every hour. My physician suspected that my traumatic brain injury in 1995 caused my undiagnosed sleep apnea, which in turn caused Paroxysmal A-Fib. I have been using a CPAP ever since.”

Take Action: Sleep Apnea Can be Lethal: If you have untreated Sleep Apnea, you are at greater risk of having a more severe form of A-Fib or of not benefiting from an A-Fib treatment.

So many A-Fib patients also suffer from sleep apnea that many Electrophysiologists (EPs) routinely send their patients for a sleep apnea study.

Sleep apnea isn’t a minor health problem, and it’s a condition you can do something about. To learn more, see Sleep Apnea: When Snoring Can Be Lethal.

Resources for this article
Atrial Fibrillation and Sleep Apnea. Heart Rhythm Society. http://resources.hrsonline.org/pdf/patient/HRS_AF_SleepApnea_R3.pdf

What You Need to Know: Sleep apnea may increase atrial fibrillation risk. Brighsurf.com, May 22, 2017. https://www.brightsurf.com/news/article/052217429745/sleep-apnea-may-increase-atrial-fibrillation-risk.html

Kendzerska, T, et al. Sleep Apnea Increases the Risk of New Onset Atrial Fibrillation: A Clinical Cohort Study. American Thoracic Society. Public Release: 22-May-2017. https://www.eurekalert.org/pub_releases/2017-05/ats-sam051517.php

Whiteman, H. Obstructive sleep apnea might lead to irregular heartbeat. Medical News Today. May 23, 2017. https://www.medicalnewstoday.com/articles/317577.php

Declare Your Independence! Seek a Life Free of A-Fib

By Steve S. Ryan, PhD.

I’ve been A-Fib free since 1998. You can be too! Read my story and other Personal A-Fib Stories of Hope and Courage including stories by these patients:

Larry Stichweh, Lacey, WA, now A-Fib free since a CryoBalloon ablation in 2016 at age 74, offers this advice:

“Success rate diminishes…As your A-Fib becomes more persistent, the lower your success rate of a permanent cure. Don’t delay too long.” 

Moni Minhas, Calgary, Alberta, Canada, writes about wife Rani’s A-Fib experience, and shares this insight:

“Good health is the best gift we can have. If you have A-Fib (or any health issues), be aggressive and proactive in seeking treatment and advice.”

P.S. This week in the U.S., we celebrate the founding of our country with the signing on July 4, 1776 of our Declaration of Independence. (BTW: Patti found this watermelon photo and writes: “Our family’s Fourth of July picnic celebrations always included a cold slice of watermelon for dessert.”)

Wondering if you Should Consider a Cox Maze or Mini-Maze for your A-Fib?

What are your options when drugs aren’t working or you can’t tolerate them? When your symptoms are impacting your quality of life? And you want to cure your A-Fib not just manage it? Treatment options to consider include Catheter Ablation or Maze or Mini-Maze surgeries.

We’ve published a new FAQ question and answer about the Maze or Mini-Maze surgeries:

Surgical Maze pattern of series of lesions

“When should A-Fib patients consider a full Cox Maze or a Mini-Maze surgery instead of a Catheter Ablation?”

In general, candidates for Maze or Mini-Maze surgeries are patients with significant, frequent A-Fib symptoms that do not respond to medication or catheter ablation. Patients who are unaware of their A-Fib symptoms are probably not candidates. However, each case is unique, so it’s best to discuss your options with your cardiologist.

There are several specific circumstances in which you might consider a Maze surgery…continue reading our answer…

Follow Us
facebook - A-Fib.comtwitter - A-Fib.comlinkedin  - A-Fib.compinterest  - A-Fib.comYouTube: A-Fib Can be Cured!  - A-Fib.com


A-Fib.com is a
501(c)(3) Nonprofit



Your support is needed. Every donation helps, even just $1.00.



A-Fib.com top rated by Healthline.com for fourth year 2014  2015  2016  2017

A-Fib.com Mission Statement
We Need You

Mug - Seek your cure - Beat Your A-Fib 200 pix wide at 300 resEncourage others
with A-Fib
click to order

Home | The A-Fib Coach | Help Support A-Fib.com | A-Fib News Archive | Tell Us What You think | Press Room | GuideStar Seal | HON certification | Disclosures | Terms of Use | Privacy Policy