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


Personal Update: Surviving the Woolsey/Malibu Fire

For our earlier posts and fire photos, see On a Personal Note: Malibu Fires and Mandatory Evacuation and Personal Update on the Malibu Fires.

Wow! The last 30 days have been an experience I hope you never have to live through.

The left sign post was burned, but not the right.

We evacuated our Malibu, CA, home on November 9th due to the Woolsey brush fire that was burning its way toward us and the Pacific Ocean. We were in a motel for 5 days. Then we got word our home was okay. When road blocks were lifted we returned home but without electricity, no heat, spoiled food in the frig/freezers, no phone landline and no internet access (FIOS). But we had water and our cell phones worked.

Fire damage: The fire did come down the land on either side of our home, singed the trunks of our palm trees near the street, but only burned a few isolated spots (see our Island sign). Our structures were spared but the soot and ash was throughout the house, even the closets (despite closed windows).

Making do without and filing claims: First came treks to the library to charge our devices and get on the internet. Cold drinks were out of styrofoam cooler, hot food from a drive-thru. We burned a lot of candles at night. Next, came insurance, FEMA, SBA disaster claims paperwork. After about two weeks without power we bought a gas powered generator. Over several days (and lots of industrial extension cords) I got power for our devices, hot water heater (and satellite TV) then furnace and laundry. But it required daily trips for gasoline (Patti could now use her CPAP at night).

The green brush and tree mark our property line; The rains caused the hill side erosion next to us.

Then the mud slides. Then came the dreaded rains. We had been advised where to place the free sand bags from the fire station to protect our property and propane tank. We had little mud but you can see the erosion next door were the fire burned the brush that had been securing the soil.

Thank God for Friday: This weekend was a big one for us. Friday, after 28 days with no power, the electric company discovered and replaced a fried transformer next door and restored our electricity!

About 12 cleaners desended on our home and started three days of cleaning. Our insurance paid for us to move out while Service Master cleaned our entire house (inside and out), frig and freezers, closets, rugs, etc. to get rid of the soot and odors (and will pay to wash or dry clean the clothes in our closets). On Saturday, surprise! our phone service and internet access were restored.

Home sweet home after 30 days: When you read this we will be back in our freshly cleaned home. We still have a bunch of work to do, but we now have everything we need in one place.

Thoughts and prayers: We thank God our home was spared and the disaster center services and our insurance claim agent were there to help. Blessed be all the firefighters, first responders, evacuation center volunteers and all the utility company workers.

Please keep all those who lost their homes in your thoughts and prayers. No matter your income level or the size of your home, the loss is still devastating.

Blood Thinner Myths Debunked by Healthcare Monitor Guide to AFIB

Every Atrial Fibrillation patient has to deal with the increased risk of clots and stroke and that often includes taking a blood thinner or anticoagulant.

At my doctor’s office I came across one of those “free take home copy” publications about Atrial Fibrillation. Healthcare Monitor Guide to Living with AFib 2018 had an interesting sidebar with a few myths and truths about blood thinners. I’d like to share a few misconceptions they list:

Guide to Living with AFib 2018

• “I’m afraid of shaving because I heart it’ll take forever to stop bleeding.”
• “Blood thinners will make me feel tired.”
• “It seems I bruise much more easily now-and that can’t be good.”

Do any of these ring a bell with you? Are you concerned with the same issues? Healthcare Monitor debunks these as myths and explains way.

Blood Thinner Myths Debunked

“I’m afraid of shaving because I heart it’ll take forever to stop bleeding…If bleeding while shaving is a problem, consider using an electric shaver. And remember: Even if you seem to bleed more easily now, suffering a stroke could cost you your life.

Blood thinners will make me feel tired. There’s no evidence that blood thinners cause or worsen fatigue. In fact, fatigue has not been identified as a problem in numerous studies done in thousands of patients. Of course, several things can effect your energy levels, including other medications you’re taking and lack of sleep. If you’re feeling more exhausted than usual, bring it up with your doctor.

It seems I bruise much more easily now-and that can’t be good. It’s true that bruising may be somewhat increased while you’re on a blood thinner. Although this can be a nuisance, it is important to remember that you are taking this medication to lower the risk of stroke. So the trade-off—accepting a slight increase in bruising—is worth the protection from dangerous clots.”

An Alternative to Blood Thinners

Catheter positioning the Watchman occlusion device at the mouth of the Left Atrial Appendage

Catheter placing Watchman in LAA

But blood thinners are not like taking vitamins. They have their own set of risks and side effects. However, preventing a stroke is for most people a welcome trade-off for any bad effects of anticoagulants.

If you can’t or don’t want to take blood thinners, an option is to have a device installed to close off the Left Atrial Appendage. The LAA is a small pocket of heart tissue located above the left atrium where 90-95% of A-fib strokes originate.

To learn more see my articles: Watchman: the Alternative to Blood Thinners or LAA Occlusion for A-Fib Patients: The Lariat II Versus the Watchman Device.

Or watch the 3:28 min. video: The Watchman Device: Closure of the Left Atrial Appendage.

Resource for this article
Blood thinner myths debunked. Healthcare Monitor Guide to Living with AFib. 2018. print publication, p 21. healthmonitor.com.

How Wide-Spread is Silent Brain Damage in A-Fib Patients?

A-Fib patients are at increased risk for cognitive problems and dementia, even in the absence of stroke. But why?

Swiss researchers devised a study to determine what causes A-Fib patients to experience more cognitive dysfunction.

Mechanisms of A-Fib Cognitive Decline

The Swiss-AF research is an observational study designed to identify the mechanisms of cognitive decline in A-Fib patients. The study enrolled A-Fib patients between 2014 and 2017 from 14 centers in Switzerland.

Analyzed were 1,389 A-Fib patients with no history of stroke or transient ischemic attack (TIA)

All patients had standardized brain magnetic resonance imaging (MRI). Analyzed were 1,389 A-Fib patients with no history of stroke or transient ischemic attack (TIA). The average age of the A-Fib patients was 72 years. Most (89%) were being treated with oral anticoagulants.

Study Findings: Types of Silent Brain Damage

The MRI scans showed that 569 (41%) had at least one type of previously unknown (silent) brain damage.

 15% (207) had a cerebral infarct (dead tissue resulting from a failure of blood supply)
 19% (269) had small bleeds in the brain (microbleeds)
 16% (222) had small brain lesions

41% had at least one type of previously unknown (silent) brain damage

Oral Anticoagulants and Silent Brain Damage: In this study the researchers couldn’t determine if the cerebral infarcts and other brain lesions occurred before or after patients started taking oral anticoagulants.  But the researchers did state:

“The findings nevertheless raise the issue that oral anticoagulation might not prevent all brain damage in patients with atrial fibrillation.”

Additional analysis incomplete: The patients in this study underwent extensive cognitive testing to determine if patients with silent brain damage also have impaired cognitive function. But this analysis hasn’t been completed.

What A-Fib Patients Need to Know

The Swiss-AF research was a small study in one country over four years with 1,389 A-Fib patients. The risk of silent brain damage was found in 4 of 10 A-Fib patients. But the findings are alarming and worth continued research.

For A-Fib patients these findings can be frightening―especially for older patients. On top of that, it’s likely further analysis will show ‘cognitive decline’ as well in patients with these types of brain damage.

So, what can you do?

• Aim to get cured of A-Fib as soon as practical, such as by a catheter ablation. (Don’t let anyone tell you that you’re too old to have an ablation. People in their 90s have successful ablations.)

• Seek ways to avoid taking oral anticoagulants, if possible. Intuitively one suspects that anything that causes or increases bleeding in the brain like anticoagulants can be risky and dangerous for older patients. Consider installing a device to close off the Left Atrial Appendage (LAA) where 90%-95% of A-Fib clots originate.

Learn More About Risks for Cognitive Problems and Dementia

To learn more about how A-Fib patients are at increased risk for cognitive problems and dementia, see my articles: Anticoagulants, Dementia and Atrial Fibrillation and Increased Dementia Risk Caused by A-Fib: 20 Year Study Findings.

Also see my answer to this FAQ: “I’m scared of getting dementia. Can the right minerals help? I’ve read about the link with A-Fib. What does research reveal about this risk?”

Resources for this article
Conen, David. The Swiss Atrial Fibrillation Cohort (Swiss-AF). A presentation at the European Society of Cardiology Congress 2018, Munich, Germany. August 2018. As reported in the Cardiac Rhythm News, October 18, 2018, Issue 42, p. 14.

Conen, David. Hidden AFib Risk. Bottom Line Health. Volume 32, Number 12, December 2018, p.1.

 

A-Fib Patients: 2018-2019 Top Rated Hospitals for Cardiology & Heart Surgery

Out of nearly 5,000 hospitals evaluated, U.S. News has published their 2018-2019 Best Hospitals rankings and ratings which also includes rankings for 16 specialties. The top 16 Best Hospitals national specialty rankings are updated annually.

U.S. News estimates that nearly 2 million hospital inpatients a year face the prospect of surgery or special care that poses either unusual technical challenges or significantly heightened risk of death or harm. The rankings can help patients find sources of especially skilled inpatient care.

Top Cardiology & Heart Surgery Hospitals for 2018-2019

Atrial Fibrillation patients may be most interested in the Top Hospitals for Cardiology & Heart Surgery. A partial list of the top rated hospitals follows (click a score card for the hospital’s full review):

Cardiology & Heart Surgery

#1 Cleveland Clinic (Cleveland, OH); score card 100/100
#2 Mayo Clinic (Rochester, MN); score card 99.6/100
#3 Smidt Heart Institute at Cedars-Sinai (Los Angeles, CA); score card 84.3/100
#4 New York-Presbyterian Hospital-Columbia and Cornell (New York, NY); score card 83.3/100
#5 Massachusetts General Hospital (Boston, MA); score card 79.8/100
#6 Hospitals of the University of Pennsylvania-Penn Presbyterian (Philadelphia, PA); score card 78.0/100
#7 Northwestern Memorial Hospital (Chicago area); score card 76.9/100

On their website, U.S. News provides information about 613 hospitals in Cardiology & Heart Surgery that see many challenging patients, including those needing heart transplants, those with cardiovascular disease and other complex heart conditions.The 50 top-scoring hospitals are ranked. The rankings should just be a starting point when choosing a hospital.

How Are the Top Hospitals Chosen? A complete description of the data analysis, the 2018-19 Best Hospitals Methodology Report, is available as a viewable and downloadable PDF.

Look up Your Local Hospital

Is your local hospital one of the over 600 listed? Go to the Best Hospitals for Cardiology & Heart Surgery page to search for any hospital treating heart patients to read their rating information. The 50 top-scoring hospitals are ranked, followed by high performing hospitals.

Search for any hospital and any expertise: On the same page, you can also reset the parameters and search by specialty or procedure and by location or zip code.

Choosing the Right Doctor for You and Your A-Fib

To learn how to find the right doctor and medical center for you and your treatment goals, go to our page, Finding the Right Doctor for You where we take you step by step through it all.

Steve’s Directory of Doctors and Medical Centers is unlike other directories—we accept no fee to be included.

Also see Steve’s Directory of Doctors & Medical Centers. Our list is unique because we list only those cardiologists, electrophysiologists (EPs) and surgeons who treat Atrial Fibrillation patients. The directory is divided into three categories: U.S., international and Steve’s Lists: Doctors by Specialties. (Unlike other directories, we accept no fee to be included.)

Organized by U. S. city/state, country/region or specialty, you’ll find doctor’s names and contact information. (This evolving list is offered as a free service and convenience to A-Fib patients.)

A-Fib Patients (and Others): Should You Be Prescribed Fewer Drugs?

Did you know you can outgrow your medication? Perhaps your lifestyle has changed with more physical activity, better nutrition or weight loss and subsequently you may no longer need medications for diabetes, cholesterol or high blood pressure.

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

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.

“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

De-Prescribing: A Brown Bag Review

Always keep an accurate and updated list of medications you are taking. (See our free download form below.)

Periodically ask your physicians or pharmacist for a ‘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 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.)

Free Download: Keep an Inventory List of Your Medications

Medications List from Alere at A-Fib.comKeep 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 remember to save the PDF to your hard drive).

Besides prescriptions, the form has sections to list over-the-counter drugs, vitamins, herbs and mineral supplements, too (as they can interact).

Print several copies of the blank form and keep handy in your A-Fib file or binder. When completed, give a copy of your inventory to each of your healthcare providers.

Also see my article: Are Your Herbal Supplements Interacting With Your Medicines?

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

• 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

• 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.

 

Personal Update on the Malibu Fires

An update to our earlier post about evacuating our home because of the Malibu brush fires. Rest assured we are okay. Got back into our home this past Tuesday. Still no power, but water (and toilet) is working. Local hotel hosted all evacuees for Thanksgiving dinner. God bless all our fires fighters, first responders and volunteers.

Our home is okay, just a few singed palm trees and spots of burnt brush. Thanks to God.

A few photos for you. Continue to pray and send us your positive thoughts. Will write more soon.

The Mental Games that A-Fib Plays―Anthony Offers Ways to Cope

For a substantial portion of A-Fib patients, the impact on ‘quality of life’ extends beyond our beating heart. Atrial Fibrillation wreaks havoc with your head as well.

In his A-Fib story, Anthony Bladon wrote:

“The mental games that A-Fib play are insidious. The constant lurking fear that A-Fib may spontaneously return. I absolutely needed to develop coping mechanisms. I firmly encourage you to do the same!”

Recent research indicates that “psychological distress” worsens the severity of A-Fib symptoms.

How Anthony Learned to Cope

Now A-Fib free, Anthony recommends several coping techniques: frequent short rests, staying hydrated and practicing relaxation exercises to help you remain unstressed.

He advises you to confront your A-Fib fears directly. Don’t let your fears mill around in your subconscious. Another suggestion is to:

“…set aside a 20 minute worrying time during the day and refuse to think about troubling fears at any other time.”

In addition, he developed what he calls an ‘anxiety thoughts log’ for writing down word-for-word what the anxious thought was, when, and what was the trigger. He explained how it helped him:

“By confronting my most extreme fears very explicitly (‘Is this a TIA or A-Fib?’ or ‘I’m afraid of a stroke, I might die or be disabled’, or ‘I can’t contemplate a third ablation!’), it became easier to re-state and contextualize them in a more reasonable frame of mind, thereby reducing my anxiety.”

Anthony is pleased with the eventual outcome of his two CryoAblations. After being A-Fib free for two years he wrote, “I feel like a new man!” To read more, see Anthony’s A-Fib story.

Fight your Fears! Ambush your Anxiety!

The emotional effects of Atrial Fibrillation can be debilitating. Recent research indicates that “psychological distress” worsens the severity of A-Fib symptoms.

A-Fib wreaks havoc with your head as well as your heart. Anxiety, fear, worry, confusion, frustration and depression. And at times, anger.

But, don’t expect much help from your heart doctors. They aren’t trained or often have little effective experience in dealing with the psychological and emotional aspects of A-Fib.

Don’t be ashamed to admit how A-Fib makes you feel (especially if you’re a guy). Your psyche is just as important as your physical heart. Anthony shared about seeking professional advice:

“If fears of A-Fib prey on your mind, I encourage you to seek out the help of a professional psychologist, as I did. After a few sessions of consultation, and with the continued use of tools like these, I was fully able to cope.”

Tell yourself: It’s okay to seek professional help to deal with the emotions that often accompany A-Fib. (Just acknowledging you have some or all of these symptoms is a step in the right direction.)

For more ideas, see our article: Seven Ways to Cope With Your A-Fib Fear and Anxiety

Have you tried any of Anthony’s coping techniques? Or do you have other ideas? If you have suggestions or programs that helped reduce your A-Fib-related anxiety, please email me and let me know.

Where it All Began: Steve Ryan’s A-Fib Story (A-Fib.com’s 1st Personal Experience)

Steve Ryan had his first A‑Fib attack in early 1997 at age 56 when in apparent good health. He ran 400 meter dashes and 5K’s, lived in Los Angeles, CA and worked on the camera crew of the NBC-TV soap opera “Days of Our Lives”. He had to take disability leave when episodes of erratic heart beats lead to dizzy spells making it unsafe for him to work around heavy equipment.

Steve shares that since finding his Atrial Fibrillation cure in April 1998, his mission has been to spare others the frustration, depression, and debilitating quality of life that Atrial Fibrillation caused him.

Steve Ryan, Bordeaux France before his 1998 ablation - A-Fib.com

Steve with 10-lead portable monitor before PVI, Bordeaux hospital, April 1998

“…before I decided to go to CHU Hopitaux de Bordeaux in France, I was on and off many, many different medications over the course of 15 months or so. None of them seemed to do much good. Then I had two catheter ablations of the right atrium, and one aborted attempt of the left atrium. All to no effect.
During my ten-day stay in the Bordeaux hospital, I had a successful “Focal Point Catheter Ablation” (now called Pulmonary Vein Ablation/Isolation) in the left atrium. Due to recurrence, I had a second ablation a week after the first. (So does that add up to two failed right atrium ablations and two left-atrium ablations?)
Looking back to 1997, I see that the two right atrium ablations were probably a waste of effort as we now know that A-Fib usually originates in the left atrium (and A-Flutter from the right atrium). For that reason, most of today’s EPs will ablate the left atrium for A-Fib, but as a precaution, will also ablate the right atrium against any rogue A-Fib signals and to address diagnosed (or undiagnosed) A-Flutter.”

Learn How Steve Found his A-Fib Cure

Steve Ryan, Bordeaux France before his 1998 ablation - A-Fib.com

Steve with monitor

Continue reading to learn how Steve educated himself about his Atrial Fibrillation and sent his records to the best EPs in the U.S. for advice.

And how he decided to travel to France to see Dr. Michel Haissaguerre, the world-reknown researcher and cardiac electrophysiologist who discovered the link between A-Fib and the Pulmonary Veins and who invented the PVI procedure.

Go to the first A-Fib.com personal experience story: Steve S. Ryan: Finding My A‑Fib Cure by Early Focal Catheter Ablation Procedure in 1998.

Rainbow over Steve’s hospital room after his second PVI; We took it as a blessing for his cure!

Heart-Filled Thanks to our A-Fib.com Advisory Board of Electrophysiologists and Surgeons

To publish A-Fib.com I seek advise and opinions from many expert cardiac electrophysiologists and surgeons many of whom are members of our A-Fib.com Advisory BoardWe invite readers to browse the names of members and their affiliations.

Since the start of A-Fib.com in 2002, many cardiac electrophysiologists (EP) and surgeons have given me invaluable advice and support. They have helped make our website the ‘go-to’ destination for over 350,000 visitors a year. (In fact, we’ve been recognized by Healthline.com as a top A-Fib blog since 2014).

It’s a great blessing to be able to tap into the knowledge and experience of these talented professionals when writing on a difficult A-Fib subject or to get help for an A-Fib.com reader with a difficult case.

From all regions of the U.S., and from France, The Netherlands, Switzerland, Italy and Australia, these doctors may not always agree with all my positions, but they try to point me in the right direction.

Sharing the names and affiliations of The A-Fib.com Advisory Board with you is one way to publicly thank the board members and acknowledge their continued support.

I encourage you to go to The A-Fib.com Advisory Board page and review the list of members. (You can also find the link at “About Us“.) 

Holiday Season Warning: How Drinking Too Little Can Trigger Your A-Fib!

With the holiday season approaching, we want to remind Atrial Fibrillation patients that cold weather, dry air and drinking too little water can lead to dehydration which can trigger an Atrial Fibrillation episode.

Many people don’t realize how quickly and deeply dehydration can set in, especially since the early warning signs are subtle.

The Good News, The Bad News

The good news is that usually dehydration on its own won’t cause an Atrial Fibrillation episode. The bad news, when combined with other well-known triggers, it will.

For example: You risk dehydration when traveling by air (low humidity) during the hectic holidays (tired and stressed), drinking too much coffee (diuretic effect), and vacationing in the desert (dry climate).

Hydration Affects the Rhythm of Your Heart

Your body contains significant amounts of water. A change in fluid levels in your body can affect a number of bodily functions, including heart function. When you have atrial fibrillation, drinking enough water is important.

When you’re dehydrated, your body’s electrolytes (electrolytes in general, and sodium and potassium in particular) are crucial for heart health. Electrolyte levels plummet when you’re dehydrated. This can lead to abnormal heart rhythm.

Dehydration Risk Factors Beyond Sweating and Heat

Your risk of dehydration isn’t just from sweating during exercise or from the extreme heat of summer. Other risks include high altitudes, the arid desert, exhaustion and increased stress, missing meals or a change in eating patterns, and vomiting or diarrhea.

Do you travel by plane often? Flying dehydrates you because the humidity level on a plane is usually less than 10%. How about your choice of beverages? Alcohol and caffeinated drinks also dry you out.

Cold weather can also dehydrate you. When it’s cold, the body works to maintain its core temperature, and works less to keep ideal fluid balance. And since you don’t feel thirsty when it’s cold, you often don’t think about drinking extra water.

A-Fib Patients: Preventing Dehydration

Under normal conditions, 64 to 80 ounces of water per day is considered enough. On a plane, a good rule of thumb is 6 to 12 ounces of water (or club soda) for every hour in the air.

Drink at least 64-80 oz of water a day or more when…

Be aware of the not-so-obvious signs of dehydration: dry mouth, constipation, feeling tired and sleepy, low urine output, dry skin and dizziness or lightheadedness. Furthermore, your body may misinterpret the need for water as the need for food making you feel hungry, when what you really need is more water.

Drink more water when…the weather is too hot or too cold, when traveling by plane, when you’ve skipped meals, when exhausted or you’re sick. For each coffee or alcohol beverage, have a glass or two of water.

Check your hydration level. Each body has individual needs for water intake. If you’re drinking enough, look at the color of your urine when you go to the washroom. If your urine is clear or light yellow, you are well hydrated. If it’s darker, you need to drink more water.

Stay Aware—Stay HydratedThe A-Fib and Dehydration link at A-Fib.com

Dehydration is never a healthy state, but the mineral imbalance that results can be especially troublesome for A-Fib patients. Sometimes it’s the lack of a dietary staple that causes the heart to misfire, and in many cases, that substance is water.

Many Thanks to Our Patrons and A-Fib Readers

We wish to thank all those A-Fib.com readers who support our mission and this website financially.

As you might know, since its founding in 2002, A-Fib.com has been funded personally by Patti and Steve Ryan who research and write its content. (See About Us to learn more.)

Donate with PayPal: All donations made by using our orange PayPal “Donate” button (see right column) and through our Facebook page are applied toward the out-of-pocket costs to publish A-Fib.com and keep it on the web (without relying on third-party ad revenues).

Amazon portal link: We also receive a small commission on sales by readers who use our portal link to shop at Amazon.com.

These revenue sources help us continue our ongoing A-Fib.com Mission to empower A-Fib patients as their unbiased source of well-researched information and advice on current and emerging A-Fib treatments.

One-Time Donation or Make it a Monthly or Annual Affair

Any donation to A-Fib.com is appreciated and needed. Even a $1 donation helps. Just click our orange PayPal button. (You can also send us a personal check.)

We’re especially grateful for recurring donations. We have received annual donations, and for several months now a generous patron donates to A-Fib.com every month. It’s easy to set up.

This is the screen you get when you click on our PayPal DONATE button.

When you click on our orange “Donate” button you’ll go to the PayPal page “Donate to A-Fib, Inc”.

Instead of a one-time donation, if you click the small box, you can authorize a reoccurring monthly donation which is automatic. (You can change or cancel a recurring donation anytime in your PayPal account settings.)

Financial Transparency: You can review our financials and other A-Fib, Inc. records by going to the A-Fib, Inc profile on GuideStar. (GuideStar is the world’s largest source of information on nonprofit organizations; It encourages nonprofit transparency and allows nonprofits to supplement the public information that is available from the IRS.)

A-Fib.com supporters

Many Ways to Contribute to A-Fib.com

There are many ways you can contribute to A-Fib.com. You can join our support volunteers who offer others hope and encouragement. You can share your A-Fib story to inspire others.

Or, write an article about a topic you’re passionate about. (We welcome other ideas too.)  Learn more at Participate at A-Fib.com.

On a Personal Note: Malibu Fires and Mandatory Evacuation

Malibu flames; photo: AFP/Getty Images

Due to the spreading brush fires heading toward the Pacific shoreline, Patti and I evacuated our home Friday noon under mandatory order for all in the City of Malibu, CA.

Fanned by the roaring “Santa Ana winds”, we had been smelling the fires since early morning when we got an automated call to prepare to evacuate. We lost power mid-morning. The air was filled with soot and ashes and covered our patio and steps. We wore filter masks.

Time to Go: Billowing grey clouds rolled out over the ocean. Fires lit up the crests of the hills off Pacific Coast Hwy (CA#1). What sounded like rain drops on the car roof were actually airborne ash bits.

Malibu smoke clouds; photo David-McNew-Getty-Images

We were heading south to the evacuation center at the Pacific Palisades high school. We didn’t make it.

About 2 miles from our home (before we got to Zuma Beach and the Pt. Dune area) we encountered smoke across the road and with flames on both sides. So we turned around and headed north instead. Since Friday noon, we’ve been tucked away safely at a motel in Oxnard about 30 miles north/west of Malibu.

Surfing for News: Every few hours we check TV news coverage, online video footage, official city/county emergency websites and social media posts for any news about the area around our home. As best we can tell, the fires reported at Pt. Dune and Trancas Canyon are the closest at about 4 miles south/east.

Based on TV news aerial footage from Sunday morning, we are optimistic the fires have not reached our home and it will still be there when we are allowed back in.

Blessings upon our firefighters

Our Thanks to First Responders: Blessings to the firefighters and police all working to protect our homes, as well as those staffing the evacuation centers ranging from Thousand Oaks to Santa Monica. (Including special centers sheltering animals including horses, llamas, dogs, etc.).

Please pray (and send out positive thoughts) for those who have lost everything. No matter your income level, it’s still devastating.

We’re still writing and posting to A-Fib.com from our motel room. We’ll update when we have news about returning to our home, God willing.

After 18 years in A-Fib, Triathlete Mike Jones Asked, “Could I Be so Fortunate?”

In his A-Fib story, Mike Jones writes that he’d been a very physically active middle age man who competed in running, triathlons and handball. It was difficult for him to accept that “something was wrong”.

In fact, he had paroxysmal A-Fib episodes for at least three years before his official diagnosis. Over the many years, he had been on various drug therapies, but nonetheless, his A-Fib episodes become very debilitating. He shares:

Mike Jones

“For many years, surgical intervention was out of reach, and financially out of the question for me. And, in those days, there was only the “Maze”. Along the way, I read a little bit about the Mini Maze, which did not inspire me much either.
It wasn’t until I found “A-Fib Resources for Patients” [A-Fib.com] that I began to take a real interest in researching PVI/PVA [Pulmonary Vein Isolation/Ablation] .”

Mike recalls the day after his life-changing catheter ablation:

“On the drive home the following afternoon, I thought about all those years that I had spent….with all of the drugs, and all of the depressing hours, with all of the sacrifices, and all of the fear…nearly 15 years of it.
Then, my long-awaited PVI procedure. In a 2 day period of time, with little discomfort (and within my budget!) all of that might now be behind me.
Could I be so fortunate?
I feel a little foolish now, a little sheepish, that I had made such a big thing out of getting this procedure done.”

Life After His Ablation

In the ten months following his ablation, Mike writes that he only had two episodes early on and that he continues to take soaks in Epson salts once a week to keep his magnesium levels up.

He writes about his life now that it is free of A-Fib:

 “I do not take any blood thinners, and no heart medication whatsoever. In my 70’s now, I won’t be running any endurance races, and my conditioning level is too low for any serious handball (yet).
But my energy level is high enough that I live a very normal life. I am a hobby woodworker, and I typically spend anywhere from 4 to 6 hours a day in my shop. I walk, swim, cut wood, and, when nobody is looking…I dance.
“I walk, swim, cut wood, and, when nobody is looking…I dance.”
I understand that the A-Fibs might one day return, but I would have no hesitation in returning for a tune up if, or when, that day should ever arrive.”

―Mike Jones, Redding, CA, Now A-Fib free after an ablation using both CryoBalloon and RF methods 

A-Fib is a Progressive Disease

It’s really remarkable that Mike could live in paroxysmal A-Fib for 18 years and not progress to Persistent or Longstanding Persistent A-Fib. In one study over half the people who developed paroxysmal A-Fib turned Persistent after only one year. Perhaps Mike’s athleticism and fitness kept his A-Fib from getting worse.

In most people, A-Fib is a progressive disease that remodels the heart and gets worse over time. To avoid this happening to you, aim to be A-Fib free as soon as you can.

For more about Mike, read his A-Fib story, Triathlete 18 years in A-Fib, on Amiodarone for eight years―then A-Fib free after ablation by Dr. Padraig O’Neill.

For more A-Fib stories to encourage and inspire you, go to Personal A-Fib Stories of Hope.

How One Reader Detects if He’s in (Silent) A-Fib

Some people have A-Fib with no obvious symptoms. This can be dangerous, lead to a stroke and, over time, to a deteriorating heart. Many of these patients do a self-check during the day to monitor for an irregular pulse. Here’s another idea from a fellow A-Fib patient.

Taking Your Pulse

After reading our article, A-Fib Self-Care Skills: How to Check Your Heartbeat and Heart Rate, our reader, Frank, wrote us about how he goes beyond just a self-check to determine if he’s in A-Fib.

“I read your self-care skills articles and wanted to comment.
I check for when I’m in A-Fib very easily. I purchased a pulse oximeter. And whenever my reading is significantly above my normal resting pulse, then I know I’m in A-Fib. I don’t believe there’s any other reason for my resting heart rate to be elevated unless I’m in atrial fib.
A good oximeter is not very expensive at all, and it may be a very useful tool for others.”

Our thanks to Frank for sharing his advice.

How Pulse Oximeters Measure Pulse Rate

Masimo‘s MightySat fingertip pulse oximeter

Pulse oximeters are easily recognized by their associated clip-type probe which is typically applied to a patient’s finger. They are lightweight and intuitive to use.

When your heart beats, it pumps blood through your body. During each heartbeat, the blood gets squeezed into capillaries, whose volume increases very slightly. Between heartbeats, the volume decreases. This change in volume affects the amount of light (such as the amount of red or infrared light) that will transmit through your finger.

Though this fluctuation is very small, it can be measured by a pulse oximeter.

Not Just for Pulse Rates but Blood Oxygen Levels, Too

Measuring your blood oxygen saturation level (SpO2) is also important for A-Fib patients because a very low blood oxygen level puts a strain on your heart (and your brain).

Blood oxygen saturation

Using the same type of setup to measure pulse rate, an oximeter indirectly measures the amount of oxygen that is carried by your blood. By measuring the light that passes through the blood in your finger, your blood oxygen saturation level (SpO2) is calculated and expressed as a percentage.

Accuracy: The American Thoracic Society reports that the oxygen level from a pulse oximeter is reasonably accurate. The best reading is achieved when your hand is warm, relaxed, and held below the level of your heart. Most oximeters give a reading 2% over or 2% under what your saturation would be if obtained by an arterial blood gas test. (For example, if your oxygen saturation reads 92% on the pulse oximeter, it may be actually anywhere from 90 to 94%.)

Pulse Oximeters and Sleep Apnea 

Another application for a pulse oximeter. We’ve written about using a fingertip oximeter as an inexpensive way to check if you might have sleep apnea. A blood oxygen saturation level of 90% or lower means you should talk to your doctor, you may need a sleep study. For more, see Possible Sleep Apnea? Oximeter is DIY Way to Check your Blood’s Oxygen Level

Know Your Pulse Rate and Blood Oxygen Level

Starting at about $25, an assortment of pulse oximeters are available at Amazon.com and other retailers. One CE and FDA approved unit is the Pulse Oximeter Portable Digital Oxygen Sensor with SPO2 Alarm ($23).

On a personal note: As many of our readers know, I’ve been A-Fib free for 20 years. But nonetheless I often will check my pulse using an oximeter at night before going to sleep. Just as Frank describes, it’s very easy to do.

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Update: PVCs/PACs and My Medtronic Reveal LINQ Insertable Monitor

I’ve had my Medtronic Reveal LINQ insertable monitor since the middle of September. (See Has my A-Fib Returned?)  It has produced a lot of false positives. The other day, I visited my EP’s office and reviewed my LINQ data results with the nurse/Reveal LINQ specialist.

Steve Ryan: My Medtronic Reveal LINQ is inserted just under my skin near my heart: at A-Fib.com

My Medtronic Reveal LINQ is inserted just under my skin near my heart:

The LINQ data showed I had Premature Ventricular Contractions (PVCs) and Premature Atrial Contractions (PACs) which made my heart beat irregular but were not A-Fib.

No A-Fib for me: My data showed I always had the P wave component in my EKG signal—which is lost when one has Atrial Fibrillation.

Most PVCs/PACs benign: Most A-Fib doctors aren’t overly concerned about extra beats Premature Ventricular Contractions (PVCs) or Premature Atrial Contractions (PACs), because they are considered benign.

I’m not worried. Everybody gets PVCs and PACs, not just people with A-Fib.

Take a Look at My Premature Atrial Contractions (PACs)

When you look at my LINQ ECG signal (see excerpt below), notice how the PAC comes before one would expect a normal beat. The irregularities above the R wave indicate the signal is coming from atria above the ventricles and is a PAC.

PAC beats comes before one would expect a normal beat

…and a Look at My Premature Ventricle Contractions (PVCs)

When you look at another section of my ECG signal (see excerpt below), the R wave spikes are thicker and wider than the normal R waves indicating they are coming from the ventricles and are Premature Ventricle Contractions (PVCs).

PVCs: R wave spikes are thicker and wider than the normal

Detection Settings for A-Fib Only

To avoid false positives such as PACs and PVCs, the nurse adjusted the settings and sensitivity of the Reveal LINQ monitor to detect A-Fib only. (For Medtronic settings, see below.)

I will return to Dr. Doshi’s office in a month to see if these new setting are working properly. Look for my next update on data from my Medtronic Reveal LINQ insertable monitor.

ECG waveform diagram

ECG waveform diagram

Learn to Read Your ECG/EKG

An electrocardiogram, ECG (EKG), is used to measure the rate and regularity of heartbeats, as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart.

The ECG signal strip is a graphic tracing of the electrical activity of your heart.

To learn to read your own ECG/EKG signal, see Understanding the EKG Signal.

My Medtronic Reveal LINQ is inserted just under my skin near my heart: For you tech types, here are the new settings:

AT/AF Detection—On
Type—AF only
AF Detection—Balanced Sensitivity
Ectopy Rejection—Aggressive (this is probably the most important change in the settings)
AT/AF Recording Threshold—Episodes >= 60 min

A-Fib Self-Care Skills: How to Check Your Heartbeat and Heart Rate

Some Atrial Fibrillation patients know immediately when their heart is in A-Fib. They experience one or more symptoms including shortness of breath, palpitations, heart flutters, etc. Other A-Fib patients may have subtle symptoms (or silent A-Fib) and can’t be sure.

The following self-care skills will reassure you any time you suspect you’re in A-Fib—how to check for irregular heartbeat and how to tell if your heart rate is too fast or too slow.

Self-Check if Your Heartbeat is Regular or Irregular

I found an informative post with these self-care skill steps on the Scope Blog by Stanford University School of Medicine. To check whether your heartbeat is regular or irregular:

♥ Begin by placing your right hand on the left side of your chest while seated and leaning forward.
♥ Position your hand so that you feel your heartbeat most strongly with your fingertips.
♥ A normal heart rhythm should feel like a regular drum beat cadence; you can usually anticipate when each beat will come after the last beat.
♥ Because heart rate and the strength of the heartbeat can vary with breathing, sometimes holding your breath for a few seconds is helpful. With an irregular rhythm, it will be hard to predict when the next beat will come.
♥ In addition, some irregular beats will be softer (less strong) than other beats, so the strength as well as the timing may not be consistent.

Self-Check If Your Heart Rate is Too Fast or Too Slow

The Stanford blog continues with a second set of self-care skill steps—how to measure if your heart rate is too fast or too slow so you know when to seek medical care. (An optimal heart rate is 50–100 bpm when you are at rest.) To check your heart rate:

♥ Place your right hand over your heart so that you feel your heart beating under your fingertips.
♥ Use a watch or timer and count the number of beats for 15 seconds.
♥ Be sure to count all heartbeats; including beats that are not as strong or that come quickly following one another.
♥ Take the number of beats you’ve counted and multiply it by four. For example, if you count 30 beats in 15 seconds, then you would calculate 4 x 30 = 120 beats per minute.
♥ Repeat this process three times right away, writing down each heart rate to later share with your doctor.
Stethoscope and EKG tracing at A-Fib.com

While an Electrocardiograph (ECG or EKG) or Holter monitor are the only sure ways to document you are in A-Fib, you can use the above self-care skills to recognize A-Fib symptoms of an irregular heart beat or if beating too fast or too slow.

These skills with help you remain calm and confident when you suspect you may be in A-Fib.

Resource for this article
Stafford, R. Understanding AFib: How to measure your own heart rate and rhythm. Scope/Stanford Medicine, October 25, 2018. URL: https://scopeblog.stanford.edu/2018/10/25/understanding-afib-how-to-measure-your-own-heart-rate-and-rhythm/

“Normal” Has a New Meaning for Jim After His Ablation

Before you developed Atrial Fibrillation, did you lead an active lifestyle? Has A-Fib robbed you of your energy and replaced it with fatigue? That’s what happened to Jim. After years of drug therapy that didn’t work, read how Jim recovered his active lifestyle post-ablation.

Three years after his ablation, Jim McGauley of Macclenny, FL, shared his personal A-Fib story with our A-Fib.com readers. His atrial fibrillation had been detected several years earlier but was not controlled effectively with drug therapy.

Jim underwent a catheter ablation in the summer of 2009. His procedure was performed without complications by Dr. Saumil Oza and his team at St. Vincent’s Medical Center, Bridgeport, CT.

He writes that, after a brief period of recuperation, he resumed normal activity.  In his story, After Years in A-Fib, New Energy and Improved Life, Jim shares: 

“Within a matter of days [of my ablation], I realized that “normal” had a new meaning.
I had lived with the atrial fibrillation for years, and it took the ablation and resulting corrected heart rhythm to bring about a marked surge in my energy level with less fatigue and an overall sense of “fitness”.
I have always maintained an active lifestyle, but post-ablation I was able to increase significantly my exercise regimen. I now run 2-3 miles three times a week and include modest weight training to keep my upper body toned.”
Jim McGauley, Publisher, The Baker County Press, Macclenny, FL. After failed drug therapy, now A-Fib free via catheter ablation.

Catheter Ablation Can Have Life-Altering Effects

Atrial Fibrillation patients seeking a cure and relief from their symptoms often have many questions about catheter ablation procedures. To learn more, see:

• VIDEO: When Drug Therapy Fails: Why Patients Consider Catheter Ablation (3:00 min., includes transcript)
• Treatments/Catheter Ablation
• Frequently Asked Questions: Catheter Ablation, Pulmonary Vein Isolation, CyroBalloon Ablation

About the ablation experience itself, Jim went on to share:

“The ablation itself is minimally invasive considering that it is correcting an abnormality inside the heart itself, and the recovery period was brief and generally comfortable.

I would readily recommend it… to anyone qualifying as a candidate to correct atrial fibrillation.”

―Jim McGauley, now A-Fib free after catheter ablation 

A-Fib Patients Ask: Which Brands of Vitamins and Minerals Can I Trust?

Supplements, minerals and vitamins are of interest to many A-Fib patients and are often discussed on this website. So, I wasn’t surprised when I received an email from Seila J. with this excellent question about purchasing supplements.

 “I don’t know what brand of vitamins and minerals to take. Is there a type of organization that inspects them and puts it on the label?”

In general, don’t look for much help from the U. S. Food and Drug Administration (FDA). In the U.S. the FDA does not regulate natural products or supplements but does require that supplements be produced in a quality manner and ensure that they do not contain contaminants or impurities and are accurately labeled. Supplements are not allowed to be marketed for the purpose of treating, diagnosing, preventing, or curing diseases.

In the European Union, food supplements are regulated as foods. Learn more at the European Food Safety Authority (EFSA). In Canada, see the Natural Health Product Regulation. In Australia, see the Therapeutic Goods Regulations 1990.

Independent Organizations Test and Certify Supplement Brands

In the U.S., there are several independent organizations that test branded supplements. Supplement manufacturers pay, on a voluntary basis, to get their supplements tested and certified (many supplement brands don’t participate so don’t carry any of these test lab seals).

The purpose of testing is to verify that the product contains the amount of the ingredient(s) advertised on the label and that it isn’t contaminated with dangerous substances, such as arsenic, bacteria, or lead.

ConsumerLab.com

ConsumerLab.com (CL) is a leading provider of independent test results and information to help identify the best quality health and nutrition products. CL has tested more than 5,600 products, representing over 850 different brands and nearly every type of popular supplement. Look for specific CL Seals to identify products that have met ConsumerLab.com standards.

CL tests products purchased from retail stores (not products supplied by the manufacturer/distributor). For the full list, see Brands Reviewed and Tested at ConsumerLabs.com.

ConsumerLab.com is probably the most useful site for the average consumer.

ConsumerLab.com is probably the most useful site for the average consumer. Though not every product produced by a specific brand has been tested and approved, the following brands are judged reliable and good choices when selecting a supplement. This is a partial list of the brands ConsumerLab has tested and rated:

Doctor’s Best, Dr. Sears, Dr. Whitaker, Garden of Life, iHerb, Integrative Therapeutics, Jarrow Formulas, Julian Whitaker, Life Extension, Metagenics, Natrol, Natural Factors, Nature Made, Now Foods, NutriCology, Nutritional Science, One-A-Day, Optimum Nutrition, Ortho Molecular Products, Perque, Physiologics, Pure Encapsulations, Puritan’s Pride, ReMag, Solaray, Source Naturals, Swanson, Thorne Research, TwinLab, VitaCost, Vitamin Shoppe.

Private brands: ConsumerLab also lists retails companies which sell supplements under their house or private brand including:

Albertsons, Costco, CVS, GNC, Herbalife, Kirkland, Kroger, Rexall, Target, Trader Joe’s, Walgreens, WalMart.

The Value of ConsumerLab.com Membership: There is much free information on the ConsumerLab.com website. But to access the comprehensive testing reports, ConsumerLab offers membership that gives you instant access to comprehensive, unbiased testing reports including quality ratings and CL’s Top Picks. (Testing reports contain information you can’t find anywhere else). Cost: $42/year or $69/2 years. Go to membership page.

Other Testing Organizations

US Pharmacopeia (USP) tests and certifies products provided by the manufacturer. They currently have certified only over 100 products which can be found on the USP website. Most products are from NatureMade and Kirkland Signature.

NSF International is an independent, accredited organization that tests and certifies products and writes standards for the food, water and consumer goods industries. Products that earn NSF certification will display “NSF certified” or “NSF listed”.

NSF Certification helps confirm that what’s on the label is in the product and that the product contains no unsafe levels of contaminants such as heavy metals, pesticides and herbicides. Certified For Sports products have also been tested for banned substances, which is particularly important for college and professional athletes.

The NSF search engine can be checked to see if a particular product is NSF certified. (I wasn’t able to find many products with NSF certification.)

Bottom Line About Brands

To select a brand of reliable supplement with the ingredient(s) and amounts as advertised on the label and not contaminated with dangerous substances, your best resource may be the Brands Reviewed and Tested at ConsumerLabs.com. (Read more at ConsumerLab Brands.)

Bonus: Recommended Sources for Reliable Info on Vitamins and Supplements

The three directories we recommend don’t sell supplements (or anything else). They just offer information on vitamins, herbs, natural products and supplements.

In our review of each database, we’ve included a screen shot and a link to our test search. To read our recommendations, go to: Our Top 3 Sources for Reliable, Unbiased Info on Vitamins and Supplements References

Resource for this article
Worth, Katie. Five Questions to Ask When Considering Health Supplements. Frontline, January 19, 2016. https://www.pbs.org/wgbh/frontline/article/five-questions-to-ask-when-considering-health-supplements/

Stop Panic Attacks, Use the THOUGHTARREST Technique by Janco Vorster

Janco Vorster is a blogger who shares his heart arrhythmia journey at My Afib Heart. Diagnosed at age 24, he had his first anxiety attack a couple years later. Fear was his closest companion for a while. He writes, “Then as if sent from above I went to see a psychiatrist. He helped me to understand that I cannot be in control all the time.”

In his post, When Panic And Anxiety Wants to Take Over Your World, Janco describes his method for dealing with the anxiety that often accompanies Atrial Fibrillation. He writes that his THOUGHTARREST technique has not only helped him with his panic attacks, but its use and understanding has had a big impact in his life.

THOUGHTARREST

Stop Panic! Arrest Your Thoughts

1. DO NOT DENY OR SUPPRESS IT
Look deep into what you are really fearing in the thought or symptoms you are experiencing. Dismantle the thought.

2. WRITE IT DOWN, OR TALK ABOUT IT.
When you write down your thought you “capture” it. Write down how bad it is or was. Don’t sugarcoat it!

3. WRITE DOWN A “BETTER” STATEMENT.
If you get thoughts of “I cannot breathe” rather write down “I feel as if I cannot breathe but I am.”

4. UNMASK AND EXPOSE THE FALSE THOUGHT.
Now that you have your panic attack or anxiety thought pinned down on paper you can expose it as false, and relax.

WWW.MYAFIBHEART.COM

About Janco Vorster: He was born with Tetralogy of Fallot (TOF), a birth defect that affects normal blood flow through the heart. After surgery as a child, his TOF (and an enlarged right atria), made him susceptible to heart arrhythmia. His A-Fib was diagnosed at age 24. After numerous cardioversions over several years, he had an ablation (followed by some intermittent episodes afterwards). He lives in South Africa and has been A-Fib free for several years. His blog is My Afib Heart.

Read the Janco Vorster post, “4 Steps Before You Do a THOUGHTARREST” at My Afib Heart. It’s based on a mixture of CPT (Cognitive Processing Therapy), CBT (Cognitive Behavioral Therapy) and his own experience with panic attacks.

Part II Framingham Study: Research Milestones in Heart Disease and Atrial Fibrillation

Now celebrating its 70th year, the Framingham Heart Study (FHS) is a long-term, ongoing cardiovascular study of residents of the city of Framingham, MA, a small, middle-class community 23 miles west of Boston.

Starting in 1948, the objective of the Framingham Heart Study was to identify the common factors that contribute to cardiovascular disease by following its development over a long period of time. Participants would have no overt symptoms of heart disease and not suffered a heart attack or stroke. Today 15,447 people of varying ages, backgrounds and heritage are enrolled including second and third generations.

Findings Integral to Scientific Understanding A-Fib

The Framingham study has contributed greatly to our understanding of Atrial Fibrillation and to the risk of stroke, heart attack and heart failure. A few important milestones about A-Fib include:

1957    High blood pressure and high cholesterol levels increase likelihood of heart disease

1960    Cigarette smoking found to increase the risk of heart disease

1970    Atrial fibrillation increases stroke risk 5-fold

1982    Chronic atrial fibrillation associated with a doubling of overall mortality and of mortality from cardiovascular disease

1991    Atrial fibrillation as an independent risk factor for stroke

1994    Diabetes and hypertension risk factors for atrial fibrillation

2002    Obesity is a risk factor for heart failure

2009    New genetic variant associated with increased risk for atrial fibrillation

2010    Sleep apnea tied to increased risk of stroke

2010    Having first-degree relative with atrial fibrillation associated with increased risk

Framingham Research: Expect More Findings About Atrial Fibrillation

Framingham scientists circa 1948

Framingham data resources are available for researchers to use, and those data continue to spur new scientific discoveries. The study data has spawned over 3,600 published studies in medical, peer-reviewed journals.

As A-Fib patients, we owe a huge debt to the Framingham participants, doctors, scientists and researchers. With continuation of the Framingham Heart Study, we can expect more research findings about Atrial Fibrillation for years to come.

Resources for this article

• The Framingham Heart Study. Research Milestones. Accessed Oct. 22, 2018. https://www.framinghamheartstudy.org/fhs-about/research-milestones/

• Kannel, WB, et al. Epidemiologic Features of Chronic Atrial Fibrillation — The Framingham Study; N Engl J Med 1982; 306:1018-1022. DOI: 10.1056/NEJM198204293061703

• Wolf PA, et al. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.  Stroke.1991;22:983-988.

• Benjamin, EJ, et al. Independent Risk Factors for Atrial Fibrillation in a Population-Based Cohort; The Framingham Heart Study. JAMA. 1994;271(11):840-844. doi:10.1001/jama.1994.03510350050036

• Stewart, S. et al. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. The American Journal of Medicine, Volume 113, Issue 5, 1 October 2002, Pages 359-364. https://doi.org/10.1016/S0002-9343(02)01236-6

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