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


A Primer: What is the Typical Progression of an Ablation for A-Fib?

In his AF Symposium presentation, Dr. Pierre Jais, of the French Bordeaux group made a reference to the ‘typical progression of a catheter ablation procedure.‘ Readers may ask, what does he mean? What is the typical progression of an ablation procedure?

The Goals of Catheter Ablation for A-Fib: Let’s start by looking at the two main goals of a catheter ablation for A-Fib:

Restore the heart to normal sinus rhythm
Eliminate the symptoms of A-Fib

Additional benefits: Achieving these goals also relieves the patient from the associated risks such as blood clot formation, stroke and increased risks of dementia and mortality.

The EP Lab: Typical Ablation for Persistent A-Fib

We know that Atrial Fibrillation is not a ‘one-size fits all’ type of disease. Every operating electrophysiologist (EP) caters each catheter ablation to the specific patient’s needs. In this simplified example we are looking at the progression of a typical ablation for Persistent A-Fib:

Dr Ali Sovari in EP lab, Oxnard, CA at A-Fib.com

Dr Ali Sovari in EP lab, Oxnard, CA

1. Mapping: First, the sources of the rogue A-Fib electrical signals are mapped using a computerized system.

2. Ablation/Isolation: The tip of the catheter is then maneuvered to the various sources of the A-Fib signals (usually starting with the openings to the pulmonary veins). Using RF energy (or Cryo) a tiny burn or lesion is made at each location to disrupt (or ablate) the electrical pathway.

3. Rogue signals terminate or transition: As the series of lesions progress, more and more of the A-Fib signals stop. Or, A-Fib signals may transition into Atrial Flutter which is a more stable and less erratic heart rhythm.

4. Re-Mapping/ablation: At this point it is not uncommon for some A-Fib signals to continue. So, one or more rounds of mapping and ablation may be required to stop any remaining sources of arrhythmic signals.

 5. NSR or Tachycardia: Finally, the heart typically transitions to either normal sinus rhythm (NSR) or a stable atrial tachycardia (a regular but fast heartbeat).

Outcomes After the Ablation

NSR: After their ablation, many patients will be in normal sinus rhythm (NSR). Hurray! Obviously, this is the best outcome.

Stable Atrial Tachycardia: A second good outcome is being in stable atrial tachycardia, i.e., a regular but fast heartbeat. It’s not NSR, but being in atrial tachycardia instead means the patient is NO LONGER in A-Fib.

Graphic: Cryoablation heat withdrawl at A-Fib.com

Graphic: Cryoablation heat withdrawl

Why is stable atrial tachycardia still a good outcome? Typically, your heart will heal itself over the following months—called the ‘blanking period’ and, on its own, return to normal sinus rhythm (NSR). (That’s why you should wait for the 3+ months blanking period before you decide if your ablation is a success.)

Benefits from Failed Ablation? When the patient doesn’t return to NSR (or tachycardia), researchers who studied the follow-up data, found a few ‘side’ benefits to a ‘failed’ ablation. Some patients found their A-Fib symptoms were less intense or shorter in duration. Some patients found they could take certain medications that prior to their ablation had been ineffective.

Conclusion: So, either way, a catheter ablation offers benefits. You may still reap some substantial benefits from the previous “failed” ablation even if you need a second (or third) ablation.

Atrial Fibrillation PVI: Can the Need for Multiple Ablations be Forecasted?

Could the necessity for multiple ablation procedures be predicted? According to a research study, the answer is YES!

In a study of patients who had catheter ablation of the Pulmonary Veins (PVs) for paroxysmal (occasional) A-Fib, 8% had to have more than two ablations to be A-Fib free.

The only independent predictor of the need for multiple procedures was the presence of non-PV triggers. According to this research, electrophysiologists (EPs) should check for non-PV triggers such as at the ligament of Marshall.

Illustration of RF ablation at A-Fib.com

Illustration of RF ablation

The lesson to be learned from this study: When having an ablation, make sure your Electrophysiologist (EP) is experienced at tracking down (mapping) and ablating (isolating) non-PV triggers.

For example, I reviewed the an O.R. (Operating Room) report of a patient who, after isolating the PVs, was still in A-Fib. Instead of looking for non-PV triggers, the EP just electrocardioverted the patient back into sinus rhythm. This does sometimes work. But not in this case. The ablation failed.

This is particularly important for EPs doing CryoBalloon ablations.

Graphic: Cryoablation heat withdrawl at A-Fib.com

Illustration: Cryoablation heat withdrawl

Find EPs Experienced at Ablating Non-PV Triggers

When getting a CryoBalloon ablation, you need to find an EP who is willing to do more than just isolate your PVs—someone who will put out the extra effort to find and ablate non-PV triggers such as at the ligament of Marshall.

To do this, your EP may have to replace the CryoBalloon catheter with an RF catheter to ablate these non-PV triggers. This may require mapping and ablation skills not all EPs have.

What to Ask Prospective EPs

To find the right EP for your CryoBalloon ablation ask:

What do you do if I’m still in A-Fib after you do the CryoBalloon ablation?

(You want to hear they’ll search for and ablate non-PV triggers.)

For more about Ablating Non-PV Triggers, see my article: CryoBalloon Ablation Study: 30% of Patients Required RF to Achieve Isolation

Note: This research study was conducted before the widespread use of Contact Force sensing catheters, whose use is another contributor to the reduction of recurrence and need for multiple ablation procedures.

References for this article

A-Fib Patients’ Best Advice #9: Learn All Your Options Before Making Treatments Choices


‘Educate Yourself on All Treatment Options Before Making Decisions.’


Sheri Weber, Boyce, Virginia: “I questioned my cardio doctor about treatment options other than medication; He told me surgical procedures had very low success rates (WRONG!). Anger and determination led me to research my options .”

Daniel Doane, Sonora, California: “I have gotten a lot of bad advice from various GPs: ‘I think that all of these tests your EP is requesting are just a waste of money.’ and ‘Don’t worry about a little A-Fib. It won’t kill you.’ ”

Joan Schneider, Ann Arbor, MI: “I found everything I needed 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!”

A-Fib.com, your unbiased source on treatments for Atrial Fibrillation: Check our Treatments section covering diagnostic tests, common mineral deficiencies, drug therapies, cardioversion, catheter ablations and surgery and more.

Don’t Believe Everything You’re Told About A-Fib.


‘The Top 10 List of A-Fib Patients’ Best Advice” is a consensus of valuable advice from fellow patients who are now free from the burden of Atrial Fibrillation. From Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Available Now: A-Fib Alerts for September 2017

Join other readers from around the world reading Steve Ryan’s A-Fib Alerts September 2017 issue.

Subscribe to our A-Fib Alerts monthly emails.

From Chile to Turkey, from the U.K. and Ireland to Australia, and the U.S. and Canada to the France, A-Fib patients are getting their news in one compact, easy-to-scan newsletter! Read the September 2017 jam-packed issue here.

Subscribe NOW to get your issues sent directly to your desktop via email. I’ll send you:

♥ advancements in A-Fib treatments, relevant research findings and evolving technologies
♥ A-Fib stories of hope and encouragement by patients seeking their cure (or best outcome)
♥ free downloads, online resources and special offers
♥ Frequently asked & answered questions from patients and their families 

Amazon.com review of Beat Your A-Fib book at A-Fib.comSign-up Bonus

SAVE up to 50% off my book, Beat Your A-Fib: The Essential Guide to Finding Your Cure, by Steve S. Ryan, PhD. Sign-up and receive your discount codes by email. (There’s no risk! Unsubscribe at any time.) Subscribe NOW.

FAQ: Updated Answer About A-Fib and Marijuana Use

During the past few years compelling evidence has developed that marijuana has significant effects on the cardiovascular system. Recently, we’ve updated our answer to this question regarding marijuana use by A-Fib patients:

Q: “Is smoking medically prescribed marijuana or using Marinol (prescription form) going to trigger or cause A-Fib? Will it help my A-Fib“?

There isn’t much clinical research on this subject. But due to the increased use of medical marijuana in California and other states, we should soon be getting more data on marijuana’s effects on A-Fib.

Feedback from A-Fib Patients About Marijuana

Recreational Marjuana and A-Fib at A-Fib.com

A-Fib and marijuana

THC and CBD: From speaking to actual marijuana users, the THC component, such as is found in the marijuana plant Stavia, is what makes you feel “high.”

The CBD component, such as is found in the marijuana plant Endica, works better to reduce pain and anxiety and induce sleep.

Best Marijuana Product for A-Fib Patients? Probably the edible forms of marijuana using primarily the CBD component seem to be something that A-Fib patients might want to investigate. Read my full answer->

Personal Experiences: You may want to read the personal experiences of A-Fib patients Jim, John, William, Jonathan and Scott who share how marijuana use has improved or provoked their A-Fib episodes. Read more->

Don’t let anyone tell you that A-Fib isn’t that serious


“Don’t let anyone—especially your doctor—tell you that A-Fib isn’t that serious…or you should just learn to live with it…or to  just take your meds.”

From Beat Your A-Fib: The Essential Guide to Finding Your Cure


The longer you have Atrial Fibrillation, the harder it can be to cure it. A-Fib patient Daniel Doane, Sonora, CA, shares:

“I didn’t realize how continued A-Fib so drastically remodels your heart. ‘A-FIB BEGETS A-FIB’ was the phrase that brought it home to me. Every instance of A-Fib changed my heart, remodeled the substrate, and made it more likely to happen again. Get your A-Fib taken care of. It won’t go away. It may seem to get better, but it will return.”

To be cured of your A-Fib, you may need to ‘fire’ your current doctor, see Finding the Right Doctor for You and Your A-Fib.

New Video: EKG of Actual Heart in Atrial Fibrillation

We’ve added a new video to our Library of Videos & Animations. A graphic display of actual heart in Atrial Fibrillation. How it could look to your doctor on an EKG/ECG monitor; (Your EKG may look different, but will be fast and erratic). Includes display of the changing heartbeat rate in the lower left.

For comparison, we’ve included a graphic comparing the tracing of a heart in normal sinus rhythm vs. a heart in A-Fib.

Share with you family and friends when you talk about your A-Fib. (:59 sec)  Go to video->

EKG tracing

How to Interpret an ECG Signal

A-Fib is fairly easy to diagnose using EKG. The ECG signal strip is a graphic tracing of the electrical activity of the heart.

An electrocardiogram, ECG (EKG), is a test used to measure the rate and regularity of heartbeats. To learn more, see our article, Understanding the EKG Signal.

Newest Member of Our A-Fib Support Volunteers Was Diagnosed at Age 18

I’m pleased to welcome Warren Darakanada from Los Angeles, CA to our group of A-Fib Support Volunteers. At age 23, he’s one of our youngest volunteers. He hopes to be a resource for those patients closer to his age.

His cardiac health story started about 10 years ago. At age 13, a severe acne breakout landed him in the doctor’s office. While checking his vitals, a problem was found with his blood pressure (and an elevated cholesterol level). Warren shares:

Warren D.

“While the diastolic pressure was normal, the systolic was above 140 mmHg. Without a doubt, I needed to see a cardiologist. I went through a series of tests to rule out causes of secondary hypertension. Luckily or unluckily, nothing was found.
Over the next years, I had several EKGs, but it was not until a routine cardiologist visit when I was 18 that I was diagnosed with atrial fibrillation. I think I had A-Fib for some time prior to my diagnosis, but had no idea my heart beat was irregular. I was in shock! I didn’t know what to think or feel.
I was put on a beta-blocker and warfarin. Given my young age and the perpetual nature of atrial fibrillation, I knew I was headed toward a cardiac ablation.
Suffers Most from Mental and Psychological Effects: While I had few A-Fib symptoms, what I found hard to endure and most debilitating was the mental and psychological effects. I would ask myself:
‘Why is this happening to me and not anybody else?
Why can’t I go back to college and enjoy my freshman year with my friends?
Given all these circumstances, is my life worth living?’
These questions may sound stupid to a mature person in good mental condition. But that wasn’t me. Remember, I was only 18 years old and just starting college… Continue reading Warren’s story…
One-to-One, our A-Fib Support Volunteers are just an email away at A-Fib.com

Our A-Fib Support Volunteers Offer One-to-One Support

When you need someone who will listen and who understands A-Fib, our A-Fib Support Volunteers are just an email away. These volunteers have gone through a lot while seeking their A-Fib cure. They have been helped along the way and want to return the favor. Learn more.

A-Fib Patients’ Best Advice #8: Acknowledge the Stress and Anxiety—Seek Emotional Support


Get emotional support for the stress and anxiety, and to keep up your spirits.’


Jay Teresi, Atlanta, GA: “Of the entire experience, anxiety has been the greatest challenge. Be honest with the doctors about it and get help. And help your family to understand as they are your greatest support system.” 

Kelly Teresi, wife of Jay Teresi: “This disease is so far beyond what a non-A-Fib person can comprehend—many times I found myself frustrated, not understanding what was going on with Jay’s thoughts and heart.

Max Jussila, Shanghai, China: “I have never been mentally so incapable. I had become totally obnoxious towards my wife and colleagues. I was only 52 years old…but mentally I was reduced to a six–year-old child with constant tantrums.”

A-Fib Wreaks Havoc with Your Head as Well as Your Heart: Your psyche is just as important as your physical heart. For a step-by-step guide, see our article: Seven Ways to Cope with Your A-Fib Fear and Anxiety.

Recognize the Stress and Anxiety. Seek Emotional Support.


‘The Top 10 List of A-Fib Patients’ Best Advice” is a consensus of valuable advice from fellow patients who are now free from the burden of Atrial Fibrillation. From Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

September A-Fib Awareness Month: Silent A-Fib is a Public Health Issue

GIF: 'That Demon A-FIB ZEBUB' at A-Fib.com

‘That Demon A-FIB ZEBUB’

‘Silent A-Fib’ is a serious public health problem; 30%-50% of those with ‘silent’ Atrial Fibrillation don’t know it.

They may get used to their symptoms or they write off the tiredness, dizziness or mental slowness to growing older, but their heart health may be deteriorating; Untreated, about 35% will suffer a stroke (half of all A-Fib-related strokes are major and disabling).

How You Can Help

To inform the public about this healthcare issue, A-Fib.com offers an educational infographic and awareness posters. See the full infographic.Infographic - September is Atrial Fibrillation Month at A-Fib.com

To help spread awareness, Share it, Pin it, Download it. See the posters here.

Atrial Fibrillation Resources for Writers and Jounalists

For more about Silent A-Fib, go to The Threat to Patients with “Silent A-Fib” How to Reach Them

Visit the A-Fib.com Press Room to learn more about Atrial Fibrillation, videos, get free graphics and other resources.

New Video Posted: Dr. Bruce Janiak’s Cardioversion from Atrial Fibrillation

Dr. Bruce Janiak

Dr. Bruce Janiak, a 74 year old full-time emergency medicine physician, videotaped his cardioversion from atrial fibrillation in order to demonstrate both the ease and safety of this procedure.

In a very low-key, conversational manner, Dr. Janiak and the hospital staff conduct his cardioversion. Dr Janiak discusses his previous experiences with chemical conversions. He shares before and at the conclusion of the procedure. 15:08 min. Published by Augusta University, Medical College of Georgia.  Go to video->

Caution: Some A-Fib-Related Resources are Biased


“Caution: Some A-Fib-related resources may be biased toward a particular treatment techniques, pharmaceutical, or medical device (often for financial gain).

A-Fib Websites: When searching sites on the web, always ask yourself: “Who is paying for this website” And what is their agenda?”.

From Beat Your A-Fib: The Essential Guide to Finding Your Cure.


Our Recommended Resources and Links: We evaluated hundreds of online sites to narrow down our choices for these lists.

We value the information these sites offer or share and they may be useful as you continue your education and expand your knowledge of Atrial Fibrillation. Go to our A-Fib.com Resources and Links.

 

Top My 5 Articles: Atrial Fibrillation and Women’s Health

There are important gender differences in the electrical activity of the heart, e.g., women have higher resting heart rates compared to men. Women with atrial fibrillation are at a higher risk of stroke, and they are less likely to receive anti-coagulation and ablation procedures compared to men in the U.S.

Learn more about the health concerns for women with Atrial Fibrillation:

  1. Women with A-Fib: Mother Nature and Gender Bias
  2. Under-Diagnosed & Under-Treated Women & A-Fib
  3. Women, Anticoagulants, CHA2DS2-VASc and Risk of Bleeding
  4. Doubles Chance of A-Fib: Obesity in Young Women
  5. Hormone Replacement Therapy (HRT): Will it Help or Hinder my Atrial Fibrillation

Good News: EPs Less Likely to Have Gender Bias

Research indicates female gender bias tends to disappear when a woman sees an cardiac electrophysiologist (EP), particularly concerning catheter ablation. This suggests that treatment bias may be more at the primary care level, i.e., your GP or general cardiologist.

Click to order at Spreadshirt.com

Click to order

Reference for this Article

New A-Fib Story: Small Intestine Bleeding Linked to Coumadin; After 8 Years, CryoBalloon Ablation at Age 76

Larry Stichweh from Lacey, WA, begins his A-Fib story at age 66 in 2008 with a 20 year history of high blood pressure.

“To investigate its possible causes, my doctor sent me to a urologist to look for a kidney stenosis problem. The ultrasound proved negative, but the urologist listened to my heart and noted an irregular beat. He ordered an ECG and after one look at it, he took me to his office, and said he was admitting me to the hospital right then and there. He said I had no “P” wave and was in A-FIB. Thus, began my A-FIB history.

I spent 6 days in the hospital while I was introduced to the arrhythmic drug, Sotalol. After I left the hospital, I had to report to a “Coumadin lab” every few days while they struggled to adjusted the Coumadin dosage to the target INR level.

High Blood Pressure and Intestinal Bleeding

A month later, I was back in the hospital when my blood pressure increased rapidly from my normal systolic of about 130mm to 200mm. Intestinal bleeding was found too, and eventually linked with the Coumadin. When it was discontinued, the intestinal bleeding stopped. Three units of blood brought my hemoglobin up to 11.5. I was put on aspirin instead (it was 2008, before the new NOACs).   

Next 8 Years: Paroxysmal A-Fib Gets Worse

My A-FIB was clearly paroxysmal with episodes lasting between 1 and 2 days with 8 episodes over the next 8 years. When the last A-FIB attack lasted three weeks, it was time to consider an ablation. I was 74. 

By 2016, cryogenic balloon ablations had become readily available in major medical centers in the US”…continue reading Larry’s A-Fib story.

HAVE A STORY TO SHARE?

How about you!? Do you have a personal A-Fib experience to share with other patients? It can be your own story or perhaps the story of your spouse, parent or sibling. Just tell the story from your point-of-view. If you are interesting in offering your insights and ‘lessons learned’, read how to write and submit your A-Fib story!

A-Fib Patients’ Best Advice #7: Persevere—Multiple Treatments May be Needed


Persevere-Try More Than One Treatment if Necessary’


Joan Schneider, Ann Arbor, MI, USA, tells about starting with drug therapy: “The Pill-in-the-Pocket (PIP) [drug therapy] served me well prior to my [catheter ablation] procedure.”

Jay Teresi, Atlanta, GA, describes his second ablation after being A-Fib free for three-years: “[My EP] explained that my first procedure was a success. However, during the healing process a tiny spot did not scar [completely] 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 [since 2007].”

A-Fib is Not a One-size-fits-all Disease: 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).

Be tenacious: Your heart is a resilient muscle that tends to heal itself. You may need multiple treatments (drugs, cardioversion, etc.) and repeated procedures (cardioversion, ablation).

Try More Than One Treatment if Necessary.


‘The Top 10 List of A-Fib Patients’ Best Advice” is a consensus of valuable advice from fellow patients who are now free from the burden of Atrial Fibrillation. From Chapter 12, Beat Your A-Fib: The Essential Guide to Finding Your Cure by Steve S. Ryan, PhD.

Eleven Things I Know About A-Fib Drug Therapy: Seldom a Lasting Cure

Anti-arrhythmic drugs are certainly better than living a life in A-Fib. They are useful for many patients. But Dr. Peter Kowey, Lankenau Heart Institute, describes them as a stopgap, i.e., they don’t deal with the underlying cause, and are seldom a lasting cure for A-Fib.

Eleven Things I Know About A-Fib Drug Therapy

Peter R. Kowey MD

P. Kowey MD

About Dr. Peter Kowey: An internationally respected expert in heart rhythm disorders, his research has led to the development of dozens of new drugs and devices for treating a wide range of cardiac diseases. (Summary of his 2014 American Heart Association (AHA) Scientific Session presentation.)

Fact #1 “An anti-arrhythmic drug is a poison administered in a therapeutic concentration.” Like most meds, anti-arrhythmic drugs, (AADs), are a trade-off between the unnatural and possible toxicity with the power to alleviate our A-Fib symptoms.

Fact #2 “Amiodarone is by far the most effective of the antiarrhythmics but is also the most toxic.” Amiodarone has never been reviewed or approved by the FDA for the treatment of A-Fib (this is called “off label” use).

Fact #3 “Doctors choose anti-arrhythmic drugs based on their relative chances of harm, not comparative efficacy.” That is. the least dangerous anti-arrhythmic first, rather than the drug most likely to suppress A-Fib.

Fact #4 “Anti-arrhythmic drug therapy is highly empiric (based on observable evidence), and exposure-related.” In practice, doctors don’t monitor how much of a drug is actually in a patient’s blood, but instead use a patient’s response to adjust dosage.

Fact #5 “Antiarrhythmics drugs require surveillance of varying intensity.” An example is Amiodarone requires intense surveillance—lungs, thyroid, eyes, liver, skin and heart.

Fact #6 “Anti-arrhythmic drugs with multi-channel effects may be more effective than those that target single channels or receptors.” For instance, in one study, ‘Pill-In-The-Pocket’ didn’t reduce A-Fib symptoms but did significantly reduce emergency room visits and hospitalizations.

Fact #7 “Anti-arrhythmic drug therapy of A-Fib is imperfect.” It’s treatment without dealing with the underlying cause and not total eradication of symptoms.

Fact #8 “Anti-arrhythmic drug therapy can be creative.” Such as, a strategy like Pill-In-The-Pocket.

Fact #9 “Anti-arrhythmic drugs may supplement the effectiveness of other interventions like catheter ablation.” For instance, used during the 3 month blanking period following a catheter ablation.

Fact #10 “Taking anti-arrhythmic drugs does not preclude the need for stroke prevention.” For example, withdrawal of anti-coagulation therapy after a successful ablation.

Fact #11 “The holy grail is prevention.” But there is no proof that any treatment is conclusively effective.

Dr. Kowey’s Conclusions

• If doctors made better and more intelligent use of anti-arrhythmic drugs, patients would fare better and there’d be fewer ablations.

• Intelligent use requires an in-depth knowledge of pharmacology and familiarity with all aspects of clinical use, especially dosing.

• Anti-arrhythmic therapy is not perfect, but it can improve quality of life and functionality for a significant percentage of A-Fib patients.

Editors Comments:
Dr. Kowey’s statement that “an anti-arrhythmic drug is a poison administered in a therapeutic concentration” should set off alarm bells for patients. In the US, we’ve been conditioned to think “ if we’re sick, just take a pill”.
But today’s anti-arrhythmic drugs have poor success rates (often under 50%), often have unacceptable side effects, and when they do work they tend to lose their effectiveness over time.
In general, anti-arrhythmic drugs are toxic substances which aren’t meant to be in our bodies―so our bodies tend to reject them.
References for this Article

Personal Story: Urology Test Led to A-Fib Diagnosed at Age 66

Larry Stichweh tells us about his 8 year journey with Atrial Fibrillaiton. It all started with his high blood pressure.

“It was taking an increasing level of meds to keep my blood pressure in check. At a routine office visit, I suggested to my doctor that we should look at possible causes of my high blood pressure.

My doctor agreed, and as a starting point, sent me to an urologist to look for a kidney stenosis problem. The ultrasound proved negative, but the urologist listened to my heart and noted an irregular beat. I had no known prior history of heart problems.

The urologist sent me down the hall for an ECG with instructions to have the technician give the chart to me to take back to him. He took one look at it, took me to his office, and said he was admitting me to the hospital right then and there. He put me in a wheel chair (even though I felt no symptoms) and off I went.

He said I had no “P” wave and was in A-FIB. Thus, began my A-FIB history.” Continue reading Larry’s story.

It Takes a Team: Build a Support System

Realize there are others who have been through A-Fib. Find them, use them as part of your A-Fib support system. at A-Fib.com


“Realize that there are others who have been through A-Fib. Find them. Use them as part of your A-Fib support system.”

Joy Gray, Manchester, NH, USA from Beat Your A-Fib: The Essential Guide to Finding Your Cure


You are not alone. Many, many others are dealing with Atrial Fibrillation.

A-Fib Online Discussion Groups: One-to-one support and online support groups can be very helpful to patients and others interested in Atrial Fibrillation.

Reading the discussion can offer information, recommendations and perhaps a new perspective. But don’t stay on the sideline, participate! Join in. You’ll feel better.

To learn more, go to our list of Online Discussion Groups.

 

In your 80s? Are You Doomed to a Life in A-Fib or Can You Still Have a Catheter Ablation?

If you’re in your 80s, you’re not automatically doomed to a life in A-Fib and on A-Fib drugs. You most likely can still have a catheter ablation. The research by Dr. Pasquale Santangeli is very hopeful and encouraging.

Study of Octogenarians Who Had a Catheter Ablation (PVI)

Dr. Pasquale Santangeli and his colleagues at the Texas Cardiac Arrhythmia Institute in Austin, TX examined data from 103 octogenarians who had an RF catheter ablation between 2008 and 2011. They compared this older group to younger patients who underwent the same procedure.

 If you’re in your 80s, you’re not automatically doomed to a life in A-Fib and on A-Fib drugs.

• There was no difference in the rate of success between the octogenarians and the younger group (69% vs. 71%).

• The rate of procedure-related complications was also not significantly different between the two groups, even when looking at different types of A-Fib such as paroxysmal and non-paroxysmal A-Fib.

• Octogenarians with paroxysmal A-Fib had more non-pulmonary vein trigger sites, and consequently required longer procedural time to effectively isolate such non-pulmonary vein areas. (Dr. Santangeli suggested a hypothesis that the underlying pathology of A-Fib in older patients might be different from younger patients.)

In practice, octogenarians have been largely excluded from clinical trials of catheter ablation. Current guidelines are also very conservative, because there has been a lack of adequate clinical studies in this area. Dr. Santangeli’s report is a step in the right direction.

When Old Isn’t Necessarily Old

In the real world old isn’t necessarily old. People in their 80s may indeed have ‘excellent functional and health status” which would make them good candidates for a catheter ablation. Most healthy 80-year-olds aren’t so frail that they can’t have a catheter ablation.

You can still have a catheter ablation but you need to find an EP Experienced in Non-PV Triggers.

After all, a catheter ablation is a non-invasive procedure. It isn’t like open heart surgery which is incredibly taxing and physically demanding. You don’t have to be a ‘Johnny Atlas’ muscleman to have a catheter ablation. Most healthy 80-year-olds aren’t so frail that they can’t have a catheter ablation.

In your 80s? Find an EP Experienced in Non-PV Triggers

If you’re in your 80s, you most likely can still have a catheter ablation. But, you need to find the right electrophysiologist (EP).

Make sure you select an EP with a proven track record of finding and isolating non-PV triggers. (Dr. Santangeli’s research found that octogenarians have more non-pulmonary vein trigger sites.) Some EPs can’t or won’t make the extra effort to map and ablate non-PV triggers.

(I’ve read O.R. reports where the patient was still in A-Fib after the EP had ablated their PVs. Instead of trying to map and ablate non-PV triggers, the EP simply electrocardioverted [shocked] the patient back into sinus rhythm. After a short time, the patient went back into A-Fib.)

Questions to Ask a Prospective EP

When interviewing a prospective EP, ask:

 “What do you do if I’m still in A-Fib after you’ve ablated my pulmonary veins?” (You want a reply such as “I use mapping to search for non-PV triggers in other areas of the heart”.)

We are indebted to Dr. Santangeli and his colleagues for showing that octogenarians can have a successful, safe ablation, and shouldn’t be excluded from a catheter ablation simply on the basis of their age.

To learn more: read my related article: FAQs A-Fib Ablations: Is 82 Too Old for a PVA?  

References for this article

My 7 Ways of Coping With the Psychological Distress of Atrial Fibrillation

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

(Don’t expect much help from your cardio doctors. When it comes to the psychological and emotional aspects of A-Fib, most doctors aren’t trained or often have little effective experience in dealing with it.)

A-Fib stress attack

Coping with 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. Just acknowledging you have some of these symptoms is a step in the right direction.

Read my article Coping With the Fear and Anxiety of Atrial Fibrillation for seven ways to fight your fears and ambush your anxiety!

Atrial Fibrillation may be in your heart— 
But it doesn’t have to be in your head.

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