There’s a growing body of evidence linking atrial fibrillation with early onset of dementia, one of the most feared diseases. (New cases of dementia are diagnosed every four seconds.)
When 65+ year olds were asked what disease or condition they were most afraid of getting, 56 percent cited the memory-robbing dementia.
While both Atrial fibrillation and dementia have been linked to aging, neither is a normal part of growing older.
A-Fib Patients: Reducing Your Risk of Developing Dementia
You CAN impact developing or avoiding dementia. Review these articles to learn more about the link between Atrial Fibrillation and dementia:
1. 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?”
2. Leaving Patients in A-Fib Doubles Risk of Dementia—The Case for Catheter Ablation
4. FAQ: I’m concerned because Vitamin D deficiency has been tied to both A-Fib and Dementia. What is a normal level of Vitamin D?
5. Risks of Life-Long Anticoagulation Therapy: Patient on Anticoagulation Therapy for 10 years Develops Cerebral Microbleeds and Associated Early Dementia
Strategies for Preventing Dementia
What doesn’t work: current drugs, even statins, don’t work or have mixed results in preventing dementia.
What does work: Catheter ablation to eliminate your Atrial Fibrillation. Patients who get a catheter ablation have long-term rates of dementia similar to people without A-Fib. (This result holds regardless of their initial CHADS2 score.)
Don’t Settle. Seek your A-Fib cure: To decrease your increased risk of dementia, your goal should be to get your A-Fib fixed and get your heart beating normally again. We can’t say it enough:
Do not settle for a lifetime on meds. Seek your A-Fib cure.
We are proud to announce, for the fourth year, Atrial Fibrillation: Resources for Patients (A-Fib.com) has been named to Healthline.com’s short list of 2017 Best A-Fib Blogs. (We proudly display our 2017 Best Blogs badge in our website’s right column.)
From the Healthline.com article: “We’ve carefully selected these blogs because they are actively working to educate, inspire, and empower their readers with frequent updates and high-quality information.”
We also extend our congratulates to our friends who also made the list: Travis Van Slooten (Living with Atrial Fibrillation) Dr. John Mandrola (Dr. John M) and Mellanie True Hills (StopAFib.org).
About Healthline: Over 40 million people turn to Healthline every month. From their website: “Healthline’s mission is to be your most trusted ally in your pursuit of health and well-being.”
Visit the Healthline The 2017 Best A-Fib Blogs to review all the winners.
OUR MISSION: A-Fib.com offers hope and guidance to empower patients to find their A-Fib cure or best outcome. We are your unbiased source of well-researched information on current and emerging Atrial Fibrillation treatments.
Treating Atrial Fibrillation doesn’t sound like a team sport. But you don’t beat your A-Fib on your own. It takes a team of healthcare professionals and wellness experts to help you seek your A-Fib cure!
While your ‘Dream Team’ will be unique to you, based on your age, symptoms, and other medical conditions, the core members of your Dream Team’ will include:
♥ Your primary care physician: often diagnoses your atrial fibrillation; may prescribe and manage your initial medications (especially for risk of stroke); usually refers you to a cardiologist (hopefully a heart rhythm specialist).
♥ Cardiac Electrophysiologist (EP): a cardiologist who specializes in the electrical functions of your heart; often the leader of your Dream Team! (Read: How to Find the Right Doctor for You.) In addition to your EP, other cardiac professionals may be added to your team including:
▪Cardiac procedure specialist: if you need a catheter ablation, a left atrial appendage occlusion device, i.e. Watchman, AV Node/Pacemaker procedure, pacemaker, etc.
▪Cardiac surgeon: if you need a Maze surgery or Mini-maze surgery
Recruit Beyond Your Team Starters
Don’t stop with just recruiting your star performers. Many of our readers at A-Fib.com have drafted other healthcare practitioners and wellness experts to join their Dream Team. You may benefit from one or more of the following:
♥ Sleep specialist: More than 40% of A-Fib patients also suffer from sleep apnea. Everyone with A-Fib should be tested (Sleep Lab or home study). In fact, your EP may require testing before agreeing to perform a catheter ablation. Learn more about sleep apnea.
♥ Nutritional counselor/Naturopathic physician: Many A-Fib patients have found relief of symptoms through herbal and mineral supplementation (starting with magnesium and potassium). Learn more about a more integrated or natural method of healthcare.
♥ Diet & Exercise specialist: Losing weight through diet and exercise has benefited many A-Fib patients. Some report their A-Fib symptoms have diminished or stopped completely through changes in lifestyle. Read more about a heart-healthy eating plan.
♥ Complementary treatment practitioners:
▪Acupuncture: Many A-Fib patients have reported relief with acupuncture. Research indicates that acupuncture may have an anti-arrhythmic effect in patients with atrial fibrillation. Read about acupuncture research.
▪Yoga: Many A-Fib patients practice yoga and report benefits, specifically, the number of symptomatic A-Fib events were down, heart beat and blood pressure dropped, depression eased and anxiety decreased. Read about A-Fib and yoga.
▪Chiropractor: Several A-Fib.com patients have reported relief with chiropractic treatments. In addition, a few clinical studies have focused on arrhythmia and ‘manipulation’ techniques. Read more.
How to Build Your ‘Dream Team’
Forming your ‘Dream Team’ is an important step toward seeking your A-Fib cure. To build your team, we advise you to use all the resources available to you. Ask for referrals from other A-Fib patients, family and friends, and from your doctors’ nurses, nurse practitioners and physician assistants.
For inspiration, learn how others have dealt with their atrial fibrillation. Just browse our list of over 90 A-Fib Stories of Hope and Encouragement. Read a few stories with similar symptoms to your own, age group, etc.
Also, consider corresponding with one of our A-Fib Support Volunteers. They’ve all been where you are now. They have been helped along the way, and want to help other A-Fib patients.
Remember, above all,
Aim for Your A-Fib Cure!
Ian’s a 49-year-old male and has had paroxysmal A-Fib for 6 years. He wrote me about how he uses intense exercise to get out of an Atrial Fibrillation attack. But, he adds, this strategy may be too demanding for some people.
“I can bring myself back to a normal sinus rhythm by going for a run up a steep hill near my home. It’s not necessarily a pleasant experience, but has been successful 100% of the time.
Once I’m back into rhythm, I can either continue on a run or head back home to get on with the day. The only issue is when going for a run is inconvenient—on several occasions I’ve had to run at 2 or 3 am.”
Could This Work for You? If you are in otherwise good health and exercise regularly, you might give it a try. Just be cautious. (If you’re in A-Fib, I recommend you don’t run alone. Take a buddy with you.)
We appreciate Ian taking the time to write and share what’s working for him in managing his A-Fib symptoms. If you would like to correspond with Ian, you can email him at: firstname.lastname@example.org.
Do You Have Advice to Share? Something that helps you cope with your Atrial Fibrillation symptoms? Email me with your story.
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A-Fib, Inc. Earns GuideStar Platinum Seal for Transparency and Accountability in the Non-Profit World
A-Fib Inc. has earned GuideStar’s highest rating, the GuideStar Exchange Platinum Seal, a leading symbol of transparency and accountability in the non-profit world.
In order for A-Fib, Inc. to earn the GuideStar Exchange Platinum Seal, we filled in all required and optional sections of the report pages for Bronze, Silver and Gold levels and uploaded requested and additional documents to our profile on www.guidestar.org, including our annual financial report, 990 IRS filings, corporate officers, incorporation documents, etc.
A-Fib.com was first rated by GuideStar in 2014.
Our GuideStar seal is displayed at the bottom of every A-Fib.com page. To learn more about us, visit our A-Fib, Inc.’s GuideStar Profile.
About GuideStar USA, Inc.: GuideStar is the world’s largest source of information on nonprofit organizations and allows nonprofits to supplement the public information that is available from the IRS.
I have written about how aspirin is no longer recommended as first-line therapy to prevent A-Fib stroke. (See my Update: Aspirin No Longer Recommended as First-Line Therapy for Stroke Prevention.).
But it’s not just A-Fib patients who shouldn’t be on aspirin therapy for stroke prevention.
Data indicates more than 1 in 10 adults take aspirin when they shouldn’t.
Warn your family and friends who are taking daily aspirin: Maybe they shouldn’t be.
50 Million in the US Take Aspirin for Prevention of Cardiovascular Disease
The problem with routinely taking aspirin, acetylsalicylic acid (ASA), is an increased risk of bleeding complications. More than one-third of all adults in the U.S. are now taking aspirin for primary and secondary prevention of cardiovascular disease (CVD).
“Primary” means preventing a first event like a heart attack. “Secondary” means preventing a reoccurrence of an event, like a second stroke.
When Aspirin Therapy Is Appropriate
As a “primary” prevention, only patients with a moderate to high 10-year risk of cardiovascular disease and stroke should be on aspirin therapy (estimated using the ACC/AHA risk-prediction calculator or similar calculator).
Aspirin is recommended for “secondary” prevention.
If you’ve had a stroke, aspirin IS appropriate as a means of preventing a re-occurrence or ‘secondary’ event.
When Aspirin Therapy Is Not Appropriate
Aspirin is not appropriate for adults who are at low risk of cardiovascular disease—defined by their 10-year stroke risk score. For these adults, the risks of gastrointestinal bleeding and hemorrhagic strokes outweigh any potential benefit.
“Among the more than 16,000 deaths each year linked to bleeding… about one-third of these deaths occur in those who take low-dose (81-mg) aspirin.” The 2014 an FDA statement warned against widespread use of aspirin in adults of average risk.
Aspirin is a Drug, Just Like Other Blood Thinners
It’s all too easy to take an aspirin―we don’t need a prescription to get it. But taking an aspirin isn’t like taking a vitamin. Aspirin, acetylsalicylic acid (ASA), is a pharmaceutical drug.
Warn Loved Ones Taking Daily Aspirin
Maybe they shouldn’t be! Instead of routinely taking aspirin, adults should discuss aspirin therapy with their doctor just as they’d do for any ‘by prescription’ blood thinner. (Hint: Take along a copy of this post.)
Caution: Suddenly stopping daily aspirin therapy could have a rebound effect that may trigger a blood clot. It’s important to talk to your doctor before making any changes.
Searching for electrophysiologists who treat A-Fib patients? Or looking to change doctors? We make it easier for you with our A-Fib.com Directory of Doctors and Medical Centers. (See the left menu for the Directory link)
Don’t be Fooled by Pay-to-Play Online Doctor Referral Sites
Paying to be listed in a doctor referral service is common among online directories. In addition, doctors can pay extra to be listed first in your database search results.
Don’t fall prey to hype, advertising, or third parties that have something to gain by recommending a particular healthcare provider. See my article: Don’t be Fooled by Pay-to-Play Online Doctor Referral Sites
What Makes our Directory Unique?
We list only those cardiologists, electrophysiologists (EPs) and surgeons who treat Atrial Fibrillation patients. It’s in two parts: U.S. and international. Organized by city/state or country/region, you’ll find doctor’s names and contact information. (This evolving list is offered as a free service and convenience to A-Fib patients.)
Tip: Refer to our page, Finding the Right Doctor for You and Your A-Fib. It covers what you need to know to research and select the best doctor for you and your treatment goals. (Also, look at our article: Physician Credentials: Acronyms and What They Mean for Atrial Fibrillation Patients.
Listed in Castle Connolly ‘Top Doctors’
Update March 24: The Cleveland Clinic has given us permission to host this graphic of the Heart’s Electrical System on A-Fib.com for the viewing and printing by our readers.
Print and keep this illustration handy for the next time you talk with your doctor about the workings of your heart. Draw and make notes directly on the picture. Add comments in the text box we added at the bottom.
Download the illlustration.
Also see our Free Offers and Downloads page.
There is a tendency for ablated heart tissue to heal itself, regrow the ablated tissue, reconnect, and start producing A-Fib signals again. But if this happens, it usually occurs within the first three to six months of the initial PVA(I).
An A-Fib.com reader sent me this question about recurrence of his A-Fib after a successful ablation:
Regrowth/Reconnection of Ablated Heart Tissue
I think your chances of staying A-Fib free are pretty good.
If your Pulmonary Veins (PV) are well isolated and stay that way, you can’t get A-Fib there again. When the PVs are isolated and disconnected and haven’t reconnected, it seems to be permanent. But it’s too early in the history of PVA(I)s to say this definitively. …read the rest of my answer.
Note: This research study is important if you have Persistent A-Fib or your Paroxysmal A-Fib has progressed to Persistent A-Fib.
The Cost of Waiting to Ablate
In patients with persistent atrial fibrillation undergoing ablation, the time interval between the first diagnosis of persistent A-Fib and the catheter ablation procedure had a strong association with the ablation outcomes.
Cleveland Clinic researchers found that shorter diagnosis-to-ablation time spans were associated with better outcomes. Longer diagnosis-to-ablation times was associated with a greater degree of atrial remodeling.
According to electrophysiologist Dr. Oussama Wazni, “once the diagnosis of atrial fibrillation is made, it’s important not to spend too much time trying to keep a patient in normal rhythm with medical [drug] therapy” before referring for radio-frequency ablation.” Dr. Wazni is Co-Director of the Center for Atrial Fibrillation at the Cleveland Clinic.
His comments are based on the published analysis of two-year outcomes among 1,241 consecutive patients undergoing first-time ablation of persistent atrial fibrillation over an eight-year period at Cleveland Clinic. All patients had successful isolation of all 4 PVs (pulmonary veins), and the superior vena cava was isolated in 69.6%. In addition, Left Atrium ablations (including complex fractionated electrograms) were performed in 65.6% of patients.
First Diagnosis-to-Ablation Time Span: The Shorter the Better
Importantly, the first diagnosis-to-ablation time interval (of persistent A-Fib) had a stronger impact on outcomes than the time spent with a paroxysmal A-Fib diagnosis or the duration of continuous A-Fib before the ablation procedure.
Recent additions to our A-Fib.com Glossary of Medical Terms and Phrases:
A “failed” heart is NOT one that has suddenly stopped. Instead, it occurs when the heart is unable to pump enough blood to the other organs to satisfy their need for oxygen and nutrients. It usually manifests as tiredness and weakness, breathlessness and swelling of the legs and abdomen.
The force or strength of the atrial contraction (which forces blood into the ventricles).
Fiber-like characteristics that develop in place of the normal smooth walls of the heart making you more vulnerable to A‑Fib…Over time it makes the heart stiff, less flexible and weak, overworks the heart, reduces pumping efficiency and leads to other heart problems…read the entire definition…
Check it out. Bookmark it! Refer to it often!
The A-Fib.com Glossary of Medical Terms and Phrases is the most complete online glossary devoted exclusively to Atrial Fibrillation. Each definition is written in everyday language—a great resource for patients and their families.
In a live case from the 2017 AF Symposium, Dr. David Wilber from Loyola University Medical Center showed how he uses the Topera FIRM rotor mapping system to identify rotors in conjunction with a PVI. (‘FIRM’ stands for Focal Impulse and Rotor Modulation.)
Dr. Wilber described how he first does voltage mapping while the patient is in normal sinus rhythm. He started in the right atrium, then moved to the left; he used the FIRM system to map where rotors were coming from. (In patients with persistent A-Fib, he typically finds as many as 4-8 rotors.) He mapped and ablated until there were no more rotors.
Only after using the FIRM system did he do a Pulmonary Vein ablation…Continue reading my report.
Patients with ‘Valvular Atrial Fibrillation’ are often restricted from most A-Fib clinical studies and research. In particular, for NOAC trials, people with Valvular A-Fib have generally been excluded because they may have a higher rate of forming clots (e.g.: left atrial clots).
“Valvular Atrial Fibrillation” refers to those A-Fib patients with artificial heart valves or mitral stenosis.
Like most A-Fib patients, Valvular A-Fib patients with bioprosthetic or mechanical valves have to be on an anticoagulant which up to now was restricted to warfarin. So, are the new NOACs an option?
Bioprosthetic valves are non-synthetic (usually porcine) devices used to replace a defective heart valve. Compared to mechanical valves, bioprosthetic valves are less likely to cause clots, but are more prone to structural degeneration (35% fail within 15 years).
Warfarin vs Edoxaban (NOAC)
A 2017 study showed that the Novel Oral Anticoagulant (NOAC) edoxaban (brand name: Savaysa) was safer than warfarin in preventing an A-Fib stroke in people with bioprosthetic heart valves.
Edoxaban works by inhibiting factor Xa in the coagulation process. The lower dose (30 mg) was associated with a reduced rate of major bleeding, but not the higher dose (60 mg).
Compared to warfarin, edoxaban was associated with lower annual stroke rates, systemic embolic events, major bleeds, and deaths annually.
“Our analysis suggests that edoxaban appears to be a reasonable alternative to warfarin in patients with Afib and remote bioprosthetic valve implantation,” according to Dr. Robert P. Giugliano of Brigham and Women’s Hospital in Boston, MA.
Edoxaban Works With Bioprosthetic Valves But Not Mechanical Ones
For the first time, research indicates that a NOAC (edoxaban) can be used for Valvular A-Fib to prevent an A-Fib stroke―but only in the case of bioprosthetic (porcine) valves.
The NOAC, Edoxaban (Savaysa), was safer than warfarin for A-Fib patients with bioprosthetic valves.
With regards to mechanical valves, the authors cited a study in which dabigatran (Pradaxa) fared poorly in mechanical valves.
What About Other Factor Xa NOACs?
What about the other ‘factor Xa inhibitors’ such as Xarelto and Eliquis? Can they be used like edoxaban? Currently there is little clinical data on this subject. But since all three are factor Xa inhibitors, most likely they will be proven to be effective in A-Fib patients with bioprosthetic valves.
What Patients Need to Know
Do you have Valvular A-Fib and a bioprosthetic valve? Are you on warfarin? If being on warfarin is difficult for you, you now have a choice of anticoagulant. Ask your doctor about switching to the NOAC, edoxaban.
The Problem: During an ablation, doctors take great precautions to not heat or injure the esophagus which lies behind the posterior wall of the left atrium. Injuring the esophagus can, in very rare cases, cause an atrial esophageal fistula which can be fatal.
Fear of causing esophageal injury can cause the EP to modify the ablation lesion set delivery, thereby reducing ablation success.
New Solution: an Esophagus displacement tool.
The EsoSure Esophageal Retractor allows doctors to re-position a section of the esophagus away from the nearby heart tissue and avoid the heat generated during ablation.
Live streaming ablation: In this re-do ablation, entrainment (pacing) mapping was used to identify non-PV triggers.
Since they had to ablate in the posterior of the left atrium next to the esophagus, they simply moved the EsoSure Retractor up and down to displace the esophagus. The EPs remarked they could now ablate at a higher wattage without fear of harming the esophagus. …continuing reading my report…
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