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


More Bad News for Warfarin: Older A-Fib Patients Risk Severe Brain Bleeds

Researchers looked at 31,951 veterans with A-Fib. All were over age 75 and newly taking warfarin. The study found that one in 50 of these veterans developed severe bleeding inside the skull.  The rate of traumatic intracranial bleeding in this group was higher than previously reported in clinical trials, researchers noted.

Dementia in particular doubled the risk of intracranial bleeding.

Comorbidities may be a factor: These patients often had other illnesses (comorbidities) such as hypertension 82.5%, coronary artery disease 42.6%, diabetes 33.8% and chronic obstructive pulmonary disease 25.5%. Many of these patients also had dementia and depression.

Dementia, in particular, doubled the risk of intracranial bleeding (possibly because cerebral amyloid angiopathy increases bleeding risk).

Rates of Ischemic Stroke vs. Brain Bleeds

There’s one bit of good news. While the rates of ischemic stroke and intracranial bleeding in this study were similar, not all intracranial bleeds were traumatic.

But there’s no good news if you have a low CHAD2DS2-VASc score (low score = low risk of stroke). Intracranial bleeding remained relatively constant over the range of CHAD2DS2-VASc scores. (For more, see The CHADS2 & CHA2DS-VASc Stroke-Risk Grading Systems.)

What Patients Need To Know: Possible Options

War farin (brand name Coumadin) at A-Fib.com

Warfarin (brand name Coumadin)

Older patients with A-Fib are between a rock and a hard place. On one hand, if you take warfarin, you reduce your risk of an ischemic stroke. But on the other hand, if taking warfarin, you may get brain bleeds which can kill you or cause dementia.

While we don’t have a guaranteed method of preventing A-Fib-related strokes, here are two options to avoid a lifetime of taking warfarin (or another anticoagulant).

• Close off your Left Atrial Appendage (LAA). This is the origin of 90%-95% of ischemic clots. LAA closure is a recognized alternative to having to take anticoagulants. Some say it’s an improvement rather than an alternative to anticoagulants.

• Have a catheter ablation to stop your A-Fib. If you no longer have A-Fib, you can no longer have an A-Fib-related stroke. Your stroke risk drops down to that of someone without A-Fib. (But, of course, people without A-Fib also have strokes.)

Warning: Anticoagulation is No Guarantee Against Stroke

Warning - cautionBe advised that warfarin greatly reduces but doesn’t totally eliminate stroke risk in A-Fib.

On a personal note, a close friend of ours with A-Fib was in the correct range of her INR testing (2.5) when she had a massive ischemic stroke that paralyzed her left side.

It breaks our hearts when we visit and have dinner with her to see food dripping from the left side of her mouth. But happily, her thinking and communication skills are still good.

For additional readings, see Watchman Better Than Warfarin and Anticoagulants Increase Hemorrhagic Stroke Risk.

Resource for this article
Dodson, JA et al. Incidence and Determinants of Traumatic Intracranial Bleeding Among Older Veterans Receiving Warfarin for Atrial Fibrillation. JAMA Cardiol. 2016 Apr 1; 1(1): 65-72. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600874/ doi: 10.1001/jamacardio.2015.0345.

Did You Get Yours? Steve’s A-Fib Alerts for September 2018

The A-Fib Alerts September 2018 issue is out and being read from the U.S. to the UK and Australia to France. Read it online today.

My A-Fib Alerts is presented in a condensed, easy-to-scan format. It’s convenient! Get all your A-Fib news in one compact, easy-to-scan newsletter! …Or make it more convenient to read and have our A-Fib Alerts newsletter sent directly to you via email. 

Amazon.com review of Beat Your A-Fib book at A-Fib.comSubscribe NOW. It’s Risk Free! You can unsubscribe at any time! Join TODAY!

Special Signup Bonus: Subscribe and receive discounts codes to SAVE up to 50% off my book, Beat Your A-Fib: The Essential Guide to finding Your Cure by Steve S. Ryan, PhD.

The Watchman Occlusion Device and Risk of Device-Related Blood Clot

The Watchman is an occlusion device that closes off the Left Atrial Appendage (LAA) to prevent clots from getting into the heart. For those with A-Fib, 90%–95% of clots and strokes come from the LAA.

The Watchman device is considered an alternative or an improvement to a lifetime of taking anticoagulants including warfarin and the NOACs. See Watchman Alternative to Coumadin and Watchman Better Than Warfarin.

2018 HRS Report: Clots Can Form on the Watchman

A new meta-analysis of clinical trials and registries of the Watchman device is believed to be the largest to date of Device-Related Thrombi (blood clot) following left atrial appendage closure.

Size comparison of the Watchman occlusion device

The study shows that in about 3.7 percent of patients a blood clot forms on a metal screw on the face of the device. The clot can form many months, even a year after installation.

“While not frequent, when present, thrombus on the face of an LAA occluder is associated with a high rate of ischemic stroke,” said study presenter Vivek Y. Reddy of Mount Sinai Hospital in New York City. (Dr. Reddy was one of the original investigators of the Watchman clinical trials.) These findings were presented at the 2018 Heart Rhythm Society meeting.

Device-related thrombi (DRTs) are troublesome because they increase the risk of ischemic stroke by over 3 fold. However, no significant association with mortality emerged.

This risk, Dr. Reddy said, calls for aggressive management of patients at risk for device-related blood clots.

The Study: Finds Device-Related Thrombi (DRTs)

To better understand the mechanism of stroke after LAA closure, Dr. Vivek Reddy and his colleagues, looked at the incidence, predictors and clinical outcomes of device-related thrombus (DRT).

Watchman device: inserted (L) and progression of proper tissue growth (R)

The meta-analysis study looked at data on 1,739 patients who were successfully implanted with the Watchman device as part of four prior clinical studies. Patient follow-ups included a transesophageal echocardiography (TEE).

Findings: Among those patients receiving a Watchman, the investigators found 65 patients (3.74%) had DRT. Most were detected after anticoagulation had been discontinued at 45 days post-insertion. Some DRTs first showed up at the 1-year TEE.

“A majority of Watchman patients with an identified DRT (74% of the 65 patients) did not have a stroke.” Dr. Vivek Reddy

Dr. Reddy reported that despite these findings, a majority of Watchman patients with an identified DRT (74% of the 65 patients) did not have a stroke. And in Watchman patients who did have stroke, 87% occurred in the absence of a DRT.

Implications: There is a strong case for rethinking the timing of planned follow-up TEE examinations of Watchman patients. The standard protocol is a TEE at 45 days after placement, when routine anticoagulation usually stops, and then a second TEE 12 months after placement.

Dr. Reddy suggests a better schedule might be to perform the first TEE at 3-4 months after placement when oral anticoagulant therapy stops. This gives time for a potential DRT to form.

What this Means For Those Patients With a Watchman

“Prevention and management of DRT may require that each [Watchman] patient receive a tailored regimen of anticoagulation and surveillance,” said B. De Lurgio, MD, a cardiac electrophysiologist at Emory Healthcare commenting on Reddy’s report.

If you have a Watchman device, you and your EP should discuss “aggressive surveillance” to find any clots on the face of your Watchman. Usually these can be resolved by taking a course of anticoagulants.

If Closing the LAA: An Alternative Occlusion Device

Lariat placement: lasso around opening to LAA

With no metal involved, another occlusion device is the Lariat II noose-like device which is slipped around the LAA. This ‘lasso’ is then tightened, and eventually the tissue dies and shrivels up (like a grape into a raisin).

But there has been a reported problem with the Lariat, too. For more on the Lariat see my article: Alert: Patients with Lariat Device for Left Atrial Appendage Closure.

A Challenge to Install: Compared to the Watchman, the Lariat is more challenging to install and is currently used less often than the Watchman. Not all EPs install and have experience with the Lariat II. You may need to do research to find an EP experienced and good at installing the Lariat. For more about the Lariat, see Lariat II Suture to Close the Left Atrial Appendage.

Watchman Still As Effective As Warfarin

Regarding this DRT data, Dr. Reddy said he didn’t think this data takes away from the argument that the Watchman is a reasonable strategy. “It doesn’t add or detract from the previous data.”

Clots can form on any foreign body as well as inside the heart.

Comparing stroke risks: In cases where no treatment was applied (neither anticoagulants nor the Watchman), the overall ischemic stroke rate is 6.0% per year.

Contrast that 6% rate to the stroke rates of 1.77% per year in people with the Watchman device and 1.71% per year for those on oral anticoagulation.

The Watchman is still a viable option against stroke risk.

Resource for this article
Dukkipati, SR et al. Device-related thrombus after left atrial appendage closure: incidence, predictors, and outcomes. Circulation. 2018; May 11: (Epub ahead of print) https://www.acc.org/latest-in-cardiology/journal-scans/2018/05/21/12/30/device-related-thrombus-after-left-atrial-appendage

Perriello, B. HRS 2018 Roundup: Device-related blood clots with Boston Scientific’s Watchman implant. MassDevice.com. May 11, 2018.  https://www.massdevice.com/hrs-2018-device-related-blood-clots-with-boston-scientifics-watchman-implant/

Andrew D. Bowser. Device-related thrombus associated with ischemic events. Cardiology News. May 14, 2018. https://www.mdedge.com/ecardiologynews/article/165539/interventional-cardiology-surgery/device-related-thrombus-associated

Get Support: A-Fib Wreaks Havoc with Your Head as Well as Your Heart

Anxiety, fear, worry, confusion, frustration and depression, and at times, anger. Most A-Fib patients deal with one or more of these feelings. Beware: research indicates that “psychological distress” worsens the severity of A-Fib symptoms.

Advice About Stress from Patients (and a Spouse) Now Free from the Burden of A-Fib

Jay Teresi, Atlanta, GA, USA. cured after having A-Fib for over ten years:

Jay T.

“Of the entire experience, anxiety has been the greatest challenge. Don’t beat yourself up if you deal with this. 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, about coping with her husband’s A-Fib:

Kelley T.

“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. Jay’s A-Fib and the associated anxiety has left its imprint on our lives.”

Max Jussila, Shanghai, China, about the emotional impact of his A-Fib:

Max J.

“I have never been mentally so incapable…even the simplest work-related problems seemed impossible for me to handle, let alone solve.
I was only 52 years old…but mentally I was reduced to a six–year-old child with constant tantrums.”

Joe Mirretti, Gurnee, IL, a 62-Year old cyclist, about the personal A-Fib stories on A-Fib.com:

Joe M.

“Like everyone has said in their A-Fib stories, A-Fib does such a job on your head. Every time you feel something, it scares you like you’re going back into A-Fib. That’s been a mental battle.
That’s why reading those patient stories [on A-Fib.com] help.”

A-Fib Doesn’t Have to be in Your Head as Well

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 or all of these symptoms is a step in the right direction.

PODCAST: 15 Ways to Manage the Fear & Anxiety of Atrial FibrillationTune in to learn ways to cope. Listen as Steve Ryan and Travis Van Slooten, publisher of LivingWithAtrialFibrillation.com discuss ways to help you with the emotional component of A-Fib. (See show notes for the list of 15 tips.)

Acknowledge the Stress and Anxiety.
Seek Emotional Support. 


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

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

Apple Watch 4: Do ECG Readings Give A-Fib Patients a False Sense of Security?

We received a couple of emails about the new Apple Watch 4. As many A-Fib patients may be aware, recently Apple unveiled the next generation of Apple Watch which includes a second generation optical heart sensor.

Among several interesting features, it can generate an ECG tracing similar to that of a single-lead electrocardiograph.

In her Sept. 14, 2018 editorial on Medscape.com, ECG Readings From the Apple Watch? This Doctor Is Leery, Dr. Hansa Bhargava gives her perspective of this feature for those diagnosed with atrial fibrillation. She writes that she finds the Apple Watch’s ability to do a one-lead ECG interesting but has some reservations.

“…Here’s what I worry about: the false sense of security that a person could have.

Apple Watch 4 screens

Being able to do a one-lead ECG is definitely interesting, but does it always help? Here’s a scenario. A 40-year-old runner starts feeling dizzy, lightheaded, and has chest pain. He worries but remembers that there is an ECG function on his watch. He proceeds to do the ECG which then reads “normal.” Because of this he decides to continue to run.
What he doesn’t know is that this is only a one-lead ECG, and even though it seems normal, it is an isolated data point; more information is needed to diagnose what is going on. What if he is having angina? In fact, 30% of cardiovascular events happen to people under the age of 65. One lead on an ECG could certainly miss this; in fact, even a 12-lead ECG, if the only isolated data point, could miss this.

Dr. Andrew Moore, an emergency department physician at the Oregon Health and Science University is also skeptical of the Apple Watch 4 ECG feature:

“The ECG thing is a little bit overhyped in terms of what it will really provide. …The tech that Apple is working with is very rudimentary compared to what we’d do for someone in a hospital or health care setting.” 

While the watch can detect changes in the patterns of a person’s heart rate such as too fast, too slow, or beating irregularly—signifying A-Fib, the watch doesn’t diagnose a medical issue.

Apple Watch and Other DIY Heart Rate Monitors

Guide to HRMs and Handheld ECG monitors

Keep in mind these doctors’ concerns apply to all consumer heart rate monitors (HRM), those with optical heart sensors and those with electrode-containing monitors.

Wrist vs. Chest Bands: Wrist-band optical heart-rate monitors (like Apple Watch 4) may be more convenient or comfortable and have advanced over the years. But researchers found that electrode-containing chest-strap monitors were always more accurate than their wrist counterparts and more reliable and consistent. To learn about this research, read When Tracking Your Heart: Is a Wrist-Worn Heart Rate Monitor Just as Good as a Chest Strap Monitor?

Blue-tooth chest-band with smartphone app

As an A-Fib patient, when monitoring your heart beat rate is important to you (while exercising or doing heavy work), you’ll want to stick with an electrode-containing monitor (chest band-style, shirts or sports bras with built-in electrode pads, etc.).

For help selecting a HRM, see our article: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I). Also take a look at Steve’s list on Amazon.com: Top Picks: DIY Heart Rate Monitors for A-Fib Patients.

Keep in mind: None of these DIY heart rate monitors are diagnostic tools. But they can be helpful once you know you have A-Fib, A-Flutter or suffer from PVCs, PACs, etc. Just don’t make medical decisions based on their readings. See your doctor if you have any concerns or symptoms.

Remember: None of these DIY heart rate monitors are diagnostic tools

Resource for this article
Hansa Bhargava, MD. ECG Readings From the Apple Watch? This Doctor Is Leery: The Apple Watch Gets ‘Medical’. Medscape/NEWS & PERSPECTIVE.  September 14, 2018. https://www.medscape.com/viewarticle/902001?src=wnl_edit_tpal&uac=159481AX&impID=1739393&faf=1

Hauk, C. Data Collected by Apple Heart Study Used to Obtain Apple Watch Series 4 ECG Clearance from FDA. Mac trast.com. Sep 14, 2018.
https://www.mactrast.com/2018/09/data-collected-by-apple-heart-study-used-to-obtain-apple-watch-series-4-ecg-clearance-from-fda/

Has My A-Fib Returned? I Get an Insertable Wireless Monitor to Find Out

Update 5 pm (see below): During a recent medical exam, one of my doctors (not a cardiologist) detected an irregular heart beat. I didn’t feel any symptoms before, during or after the appointment, so I wasn’t alarmed. But I did make an appointment with my EP.

Medtronic Reveal LINQ ICM

When I met with my EP, he took an ECG but didn’t find A-Fib (thank goodness). But, just to be sure, he recommended implanting a tiny wireless heart monitor so he can review my heart activity over time.

I Get a Reveal LINQ Insertable Cardiac Monitor

So yesterday, as an outpatient, I had a tiny cardiac monitor implanted just under the skin near my heart. The minimally invasive procedure took the doctor about 2 minutes to do. (Most of my time at the hospital was spent doing paperwork).

My doctor used the Medtronic Reveal LINQ Insertable Cardiac Monitor (ICM)—one of the world’s smallest cardiac monitors—the device is approximately one-third the size of a AAA battery.

MyCareLink transmitter

The Reveal LINQ System includes a bedside unit that collects heart rhythm data from the ICM and wirelessly sends it to my doctor every evening.

The device allows my cardiologist to continuously monitor my heart for up to 3 years.

Setup to transmit: I got it all set up and it’s working. But I don’t expect to get any feedback from my EP any time soon. I’ll publish an update when I have something to report.

My incision for the ICM

Update 5 pm: I forgot to mention that I had no pain with this procedure. They used some numbing agent on the incision area, but I’ve had no pain afterwards (it’s now about 36 hours since the insertion). No sutures. They applied a clear bandage that holds the tissue together while healing.

There’s no visible sign of the device. If I press the area I can barely feel the outline of the ICM. It’s possible this will diminish with time as the surrounding tissue encases it.

I’ll write more:  I’ll talk with my EP in a couple of weeks when he has reviewed some of the data received via the MyCareLink wireless transmitter. (I assume he has some data processing feature that will alert him before that if the readings are outside normal specs.)

VIDEO: The Insertion Procedure

An animated video (music, no narration) by Medtronic, shows how the Reveal LINQ ICM monitor is inserted through a tiny incision just under the skin near the heart. Special tools are used to make a small incision and another to hold the ICM and “plunge” it under the skin. About 2:45 min.

To enlarge video: click and start the video. At the lower right, click on the frame icon. To exit, click again.

Build Your ‘Dream Team’ to Seek Your A-Fib Cure (or Best Outcome for You)

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!

Your ‘Dream Team’ will be unique to you, based on your age, symptoms, and other medical conditions.

The Core Members of your ‘Dream Team’ 

♥ 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 device), a pacemaker, or perhaps an AV Node Ablation with Pacemaker procedure.

▪ Cardiac surgeon: if you need a Maze 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 symptom relief with acupuncture. Research indicates that acupuncture may have an anti-arrhythmic effect in patients with atrial fibrillation. Read about acupuncture research.

▪ Yoga: The practice of yoga has benefits, many A-Fib patients report. 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 their symptoms were relieved with chiropractic treatments. In fact, a few clinical studies have focused on arrhythmia and ‘manipulation’ techniques. Read more.

Where to Start: Ask for Referrals

To form your ‘Dream Team’ of health and wellness experts, ask for referrals from other A-Fib patients and from your family and friends.

If you know nurses or support staff who work in the cardiology field or in Electrophysiology (EP) labs, they can be great resources. Also, seek advice from the nurses, nurse practitioners and physician assistants at your doctors’ offices.

To find the right doctor, start with our page, How to Find the Right Doctor for You

Don’t depend on websites of patient’ ratings of doctors or with patient surveys. They lend themselves to manipulation. Ratings often reflect how well-liked a doctor is, not competency. Consult several sites. Read my article, Don’t be Fooled by Pay-to-Play Online Doctor Referral Sites.

Why You Need an A-Fib Notebook and 3-Ring Binder

As an A-Fib patient, you want to create a ‘treatment plan’—an organized path to finding your A-Fib cure or best outcome. Forming your ‘Dream Team’ is an important step toward this goal.

As you form your team, you will want to organize the information you are collecting. Start with a notebook and a three-ring binder or a file folder.

Your A-Fib binder is where you should file and organize all your A-Fib-related treatment information. Learn What to Include in Your A-Fib Binder

Remember, above all,
Aim for Your A-Fib Cure!

Reference for this Article
Iliades, C. Team approach: Your Atrial Fibrillation Management Team. Everydayhealth.com. 5/30/2013 http://www.everydayhealth.com/hs/atrial-fibrillation-and-stroke/your-afib-management-team/

Diet and Nutrition: ‘The China Study’ and Other Diet Plans With Dr. Joseph Mercola

After Saul Lisauskas of Encinitas, CA was diagnosed with Atrial Fibrillation, he was disappointed by doctors who offered only drug therapy with no advice about improving his symptoms through diet and nutrition. He decided to educated himself on the topic: In his A-Fib story Saul wrote:

Saul Lisauskas

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

The China Study Book and its Critics

The China Study by T. Colin Campbell & Thomas M. Campbell II was first published in 2004. The book’s title comes from the China-Cornell-Oxford Project, a 20-year study that began in 1983 and was conducted jointly by the Chinese Academy of Preventive Medicine, Cornell University, and the University of Oxford.

By Campbell & Campbell II

Conflicting opinions: There has been criticism of some of the conclusions drawn in The China Study (mostly focused on data collection, collection bias and data analysis).

Publisher of Cholesterol-and-Health.com Christopher Masterjohn, PhD has written: “Only 39 of 350 pages are actually devoted to the China study…[The China Study] would be more aptly titled, A Comprehensive Case for the Vegan Diet, and the reader should be cautioned that the evidence is selected, presented, and interpreted with the goal of making that case in mind.”

The Cornell-Oxford-China Study: A Critique (Jesse and Julie Racsh Foundation) states: “After performing regression analyses, the data does not justify the indictment of all animal foods as risk factors for chronic degenerative disease.” Read the report online or download the PDF.

A Critical Look at ‘The China Study’ and Other Diet Plans: Dr. Mercola Interviews Denise Minger

Dr J. Mercola

A jam-packed, up-to-date article for those interested in improving current health problems and long-term health through diet and nutrition.

Denise Minger

Published in July 2018, natural health expert and Mercola.com founder Dr. Joseph Mercola interviewed Denise Minger, most noted for her comprehensive rebuttal of “The China Study” (The China Study: Fact or Fallacy?) some eight years ago. She’s heavily vested in the vegan versus omnivore battle, having cycled through vegetarianism and raw veganism, finally coming full circle to being an omnivore.

Topics covered in a Critical Look at ‘The China Study’ and Other Diet Plans:

• Raw Veganism Took a Toll on Health
• Debunking ‘The China Study’
• The Case for Lowering Protein Intake
• Protein Cycling
• Macronutrient Cycling — An Overlooked Component of Optimal Health
• Cyclical Ketogenic Diet Is Ideally Combined With Cyclical Fasting
• Focus on Nutrient Density
• How Minger’s Diet Has Changed Over the Years
• Critiquing the Blood Type Diet
• Awesome Omnivore
• Plant-Based Paleo
• Lifelong Learning Is Key to Staying Ahead

Go to A Critical Look at ‘The China Study’ and Other Diet Plans.

VIDEO: Highlights from Dr. Joseph Mercola’s interview with Denise Minger (2:28)


YouTube video playback controls are located in the lower right portion of the frame: closed captions,
speed/quality, watch on YouTube website and enlarge video to full frame.

Additional Resources About Diet and Nutrition

Download the full transcript of Dr. Mercola’s interview with Denise Minger. Read Debra Minger’s The China Study: Fact or Fallacy?.

Read The China Study for Free: The 2006 edition is available to read online or download.

The 2017 edition of The China Study is available at Amazon.com and other bookstores.

See my article: The Effect of Diet & Nutrition on Your A-Fib: My Top 5 Articles.

Resources for this article

• The China Project: Studying the Link Between Diet and Disease. Study room provides a general overview and introduction to the Cornell-China-Oxford project. Accessed August 7, 2018 URL: http://www.cornell.edu/video/playlist/the-china-project-studying-the-link-between-diet-and-disease

• Cornell-Oxford-China Study: A Critique. Jesse and Julie Racsh Foundation. Accessed August 7, 2018 URL: http://www.raschfoundation.org/wp-content/uploads/Cornell_Oxford_China-Study-Critique.pdf

• Masterjohn, C. The Truth About the China Study. Cholesterol and Health.com Accessed August 7, 2018 URL: http://www.cholesterol-and-health.com/China-Study.html

• Mercola, J. A Critical Look at ‘The China Study’ and Other Diet Plans. Mercola.com, July 08, 2018. URL: https://articles.mercola.com/sites/articles/archive/2018/07/08/the-china-study-and-other-nutrition-plans.aspx

• Minger, D. The China Study: Fact or Fallacy? July 7, 2010. DeniseMinger.com. https://deniseminger.com/2010/07/07/the-china-study-fact-or-fallac/

September is A-Fib Awareness Month: The Threat of ‘Silent A-Fib’

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

‘That Demon A-FIB ZEBUB’

During September each year, we focus our efforts on reaching those who may have Atrial Fibrillation and don’t know it. ‘Silent A-Fib’ is a serious public health problem. In his personal A-Fib story, Kevin Sullivan, age 46, wrote about his diagnosis of Silent A-Fib.

“I was healthy, played basketball three times per week, and lifted weights. I started to notice on some days playing basketball, I was having some strange sensations in my chest. And sometimes, difficultly catching my breath. But the next day I would feel fine. I assumed this was just what it felt like to get old.”

At the time, he happened to see a cardiologist about medication for high cholesterol:

“I went to see a cardiologist. They looked at my heart with ultrasound and asked if I could feel “that.” I asked them what they were talking about, and they told me that I was having atrial fibrillation. That was the first time I had ever heard of the phrase.”

Like Kevin Sullivan, about 30%–50% of people with Atrial Fibrillation are walking around not knowing they have 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

A-Fib.com offers an infographic to educate and inform the public about this healthcare issue. See the full infographic here. (See the posters too).

To help spread awareness:

Share it, Pin it, Download it. 

Resources for Writers and Journalists

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.

Drugs Don’t Cure Atrial Fibrillation But Merely Keep it at Bay

Advice from Patients Now Free from the Burden of Atrial Fibrillation

Daniel Doane, Sonora, California, USA, shares his mistake:

Daniel D.

“Don’t think that the medication is a long term solution. Don’t put up with nasty side effects.
That was the mistake I made. I thought I could tough out the medication as long as I stayed out of A-Fib.
Terry Dewitt at A-Fib.com

Terry D.

Terry DeWitt, Massachusetts, USA, advises act sooner than later:

“I knew I could continue on medication for several years, but I was concerned about the remodeling of my heart. …I would need an ablation…and sooner seemed better when my heart was still strong.”  

 

Max Jussila, Shanghai, China, says meds are for the short term:

Max J.

“Do not listen to your doctors if they suggests medication as a long-term solution!
The doctors who see medication as a solution commit serious negligence and are ignorant of the terrible nature and consequences of Atrial Fibrillation.”

Don’t Just Manage Your A-Fib with Meds. Seek your Cure.

According to Drs. Irina Savelieva and John Camm of St. George’s University of London, London, UK:

“The plethora of antiarrhythmic drugs currently available for the treatment of A-Fib is a reflection that none is wholly satisfactory, each having limited efficacy combined with poor safety and tolerability.”

In general, don’t expect miracles from current medications. Antiarrhythmic drugs are only effective for about 40% of patients; many can’t tolerate the bad side effects. When they do work, the drugs become less effective or stop working over time.

In his, personal A-Fib story, Dr. Sam T. MD, from Tennessee, USA, shares:

“At this time when all medicines and cardiac procedures have their risks and limitations, finding a way to get to NSR [Normal Sinus Rhythm] and staying in NSR is most important.”

The goal should be to end your A-Fib episodes not manage them. Learn more at: Drug Therapies. Always Aim for a Cure!

Drugs Have a Role, but Other Treatment Options Target a Cure.

Resources for this article
CAMM, J, MD. Medical Management of Atrial Fibrillation: State of the Art First published: 03 August 2006 https://doi.org/10.1111/j.1540-8167.2006.00581.x

Savelieva I, Camm J. Update on atrial fibrillation: part II. Clin Cardiol. 2008 Mar;31(3):102-8. doi: 10.1002/clc.20136. PubMed PMID: 18383050. URL: http://www.ncbi.nlm.nih.gov/pubmed?term=PMID%3A%2018383050


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

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

Updated Article: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors

We’ve updated our Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I) with new models of chest bands/wristwatches sets, Bluetooth versions and wearable technologies.

A consumer heart rate monitor (HRM) is useful when Atrial Fibrillation patients want to monitor their heart rate and pulse when exercising or when performing physically demanding activities.

To our section on handheld real-time ECG monitors, we added the Contec PM-10. Our recent review read in part:

Illustration: Three ways to hold the Contec PM-10 when taking an ECG scan at A-Fib.com

Three ways to hold the Contec PM-10 when taking an ECG scan

“The Contec PM10 (about $79 on Amazon.com) is a very easy-to-use small 4 oz. unit that can track a single channel ECG waveform. You can observe the scan live, then download the recordings (up to 30) to your computer or smartphone for review and print to share with your doctor.” Read the full review.

Also updated: WEARABLE TECHNOLOGY WITH WIRELESS SENSORS

From Sensoria Fitness

“Wearable technology” offers a new option for those who find a chest strap uncomfortable or chafing. Instead of the chestband, these workout clothes have sensors built-in. Just snap on your heart rate sensor from your chestband. Starting at $75.

♥  Sensoria Fitness Men’s T-Shirt with standard sensor snaps (no heart rate sensor)
♥  Sensoria Fitness Sports Bra with standard sensor snaps (no heart rate sensor)

To read the updated article, go to: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I)

Not to be Confused with Optical Fitness Wristbands

Optical LEDs on inside of fitness wristband

The HRM sensors/monitors in our guide work by being in contact with the skin. Don’t confuse DIY/consumer heart rate monitors with fitness bands like Fitbit or running/sport watches.

This group of fitness wristbands use an optical sensor to shine a light on your skin illuminating your capillaries to measure your pulse. Optical sensor wristbands are not accurate enough for A-Fib patients.

For more, see my article: When Tracking Your Heart: Is a Wrist-Worn Heart Rate Monitor Just as Good as a Chest Strap Monitor?

Calling All A-Fib Patients: Participate in On-Line Research Survey on Anxiety and A-Fib

Many of us know how debilitating the emotional component of A-Fib can be and the impact on our quality of life. We often say that Atrial Fibrillation wreaks havoc with our heads as well as with our hearts.

This is what doctoral student Sevinc E. Uzumcu is investigating—the anxiety and depression often associated with Atrial Fibrillation. She has asked all our A-Fib.com readers to help with her research.

This survey is part of her doctoral applied research project at A.T. Still University’s Arizona School of Health Sciences. She is seeking all A-Fib patients to answer her online questionnaire whether or not suffering with anxiety or depression.

This aspect of Atrial Fibrillation is seldom investigated.

Give Just 7 Minutes for A-Fib Research

We strongly encourage all A-Fib patients to take this online survey. I answered the questions, and it only takes about 7 minutes. Your responses are anonymous.

To participate, go to the survey “Invitation”.

Submissions will be accepted through September 30, 2018. As part of her doctoral studies, she hopes to publish the results of her research.

A-Fib Doctors Need to Treat the Emotional Effects

The A-Fib patient community really needs this research study and needs to share the findings with doctors treating A-Fib patients. Raising doctors’ awareness of the psychological aspects may encourage them to develop treatment protocols.

Kudos to doctoral student Sevinc E. Uzumcu for undertaking this research.

(In all my years of attending A-Fib conferences, I’ve never seen doctors discuss this topic. But I did! As a patient advocate, I talked on this topic to 200 cardiologists in Zurich, Switzerland at MAM 2016.)

For dealing with the anxiety associated with A-Fib, see my article: Coping With A-Fib Anxiety and the PODCAST: 15 Ways to Manage the Fear & Anxiety of Atrial Fibrillation.

The Survey Title:The Association Between Atrial Fibrillation and Anxiety

Click here to go the survey Invitation (link is at the bottom of the page).

How Big Pharma Issues Misleading News and Why it Matters

Part of our Don’t Be Fooled series: TV commercials, print ads and news releases by pharmaceutical companies often include misleading statements. As healthcare consumers we all need to use a critical eye (and ear) when considering any health benefit claim.

A Prime Example: A Xarelto News Release

Recently Janssen Pharmaceutical issued news about their anticoagulant Xarelto. The news release was targeted at journalists, hoping they would write and publish articles about Janssen’s news report. (Read the full Jun 14, 2018 news release here.) 

Click image for News Release

It’s a prime example of misleading journalists into passing on inaccurate information to the public. The headline reads:

XARELTO® (rivaroxaban) Associated with Significantly Reduced Time in Hospital and Decreased Costs Compared to Standard of Care in New Study of Patients with Low-Risk Pulmonary Embolism (PE)

A Health News Review Evaluation

HealthNewsReview.org is an online watchdog group that reviews health news stories and news releases that include a claim about medical treatments, tests, products or procedures.

Learn about their 10-point grading scale at the end of this post.

They use a 10-point grading scale to assess whether a story gives information about its sources and their competing interests, quantifies the benefits of a treatment, and appraises the evidence supporting the story’s claims. (To learn about their 10-point grading scale, see the end of this post.)

As an example of a flawed news release, let’s look at the Jun 14, 2018 Janssen/ XARELTO® release. I’ll quote from the summary report by HealthNewsReview.org.

HealthNewsReview.org began their summary by describing the study design:

“The news release is about a study that explores if patients with pulmonary embolism, a blood clot in the lungs, who are at low risk for complications can be sent home from the emergency department early rather than be admitted to hospital.
The patients were divided into two groups: One group of patients were sent home early while taking rivaroxaban (Xarelto), a type of blood thinner,
…whereas the “usual care” group could get any blood thinner of their physician’s choosing, including rivaroxaban, and hospitalization.”

Next they discussed the study findings as reported in the news release:

“The study findings suggest that early discharge of low-risk patients was safe and feasible and also resulted in cost savings because of less time spent in hospital.
Unfortunately, the news release seemed to suggest that it was the use of rivaroxaban (Xarelto) that resulted in cost savings–rather than the strategy of sending low risk patients home early.
The news release failed to state that over half the patients in the comparison group who got usual care also received rivaroxaban.
In other words, the news release implies that rivaroxaban (Xarelto) was being compared to other anti-coagulants when what was actually being compared was an early vs. late discharge strategy.”

Total Score: After completing the 10-point criteria, HealthNewsReview.org gave the Janssen Pharmaceutical press release a score of 6 of 10. (Read the full evaluation on the HealthNewsReview.org website.)

Why This Matters

Not so good a score, 6 out of 10. While the news release writers did many things right, overall the release had a “spin” that misrepresented crucial facts.

First, the headline of this release crosses the line into unjustified language. It credits rivaroxaban with reducing the time patients spent in the hospital, when the early discharge strategy was actually the main difference between the groups—not the use of rivaroxaban (Xarelto).

Next, the writers implied their product (Xarelto) was responsible for cost-savings, when it was not. They implied their product (Xarelto) was compared to other anti-coagulants, when it was not. They neglected to mention that most of the usual care group also got rivaroxaban.

And finally, the news release obscured the actual purpose of the study—to compare the safety of an early discharge strategy compared to keeping patients in the hospital.

To quote from the HealthNewsReview review again:

“Janssen’s misleading news release could result in news stories trumpeting rivaroxaban (Xarelto) as a superior blood thinner, when that is not what this study looked at.”
“In addition, the principal investigator quoted in the news release has financial ties to the company, which should have been disclosed.”

What This Means to Patients

Journalists can fall for misleading information as well as consumers (but not the good ones). They can write articles and pass on misleading data and results.

Some news sources are no better. Many news sites on the web and small newspapers often reprint a news release word for word, and present it as a “news” story.

As a healthcare consumer: You should question the benefit claims in ads. For any health-related news story, look for the source(s). Are they legitimate and from a credible, independent source?

If it’s about a new treatment, ask yourself is this news story balanced? Are alternatives presented (such as lifestyle changes, another drug, surgery, or no treatment)? If you’re only hearing about the potential benefits, ask what the harms are, and how often do they occur?

Don’t be fooled by health-related ads and news stories that ‘spin’ a company’s product or treatment with misleading statments.

Additional Reading

Read my review

For more on this topic, check How to See Through the Hype in Medical News, Ads, and Public Service Announcements. It’s my review of the book “Know Your Chances―Understanding Health Statistics” by Steven Woloshin, Lisa M. Schwartz, and H. Gilbert Welch.

BTW: you can read the book online for free at PubMed Health, part of the U.S. National Library of Medicine.

Resources for this article
• Here’s a prime example of how Big Pharma issues misleading news releases to journalists. healthnewsreview.org June 18, 2018. URL:  https://www.healthnewsreview.org/news-release-review/heres-a-prime-example-of-how-big-pharma-issues-misleading-news-releases-to-journalists/

• Our Review Criteria. HealthNewsReview.org. Last accessed August 3, 2018. URL: https://www.healthnewsreview.org/about-us/review-criteria/

News Story Review Criteria

The HealthNewsReview.org criteria consist of 10 different elements that they think should be included in all health care news stories and all health care news (press) releases:

1.Does the news release adequately discuss the costs of the intervention?

2.Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

3.Does the news release adequately explain/quantify the harms of the intervention?

4.Does the news release seem to grasp the quality of the evidence?

5.Does the news release commit disease-mongering?

6.Does the news release identify funding sources & disclose conflicts of interest?

7.Does the news release compare the new approach with existing alternatives?

8.Does the news release establish the availability of the treatment/test/product/procedure?

9.Does the news release establish the true novelty of the approach?

10.Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Learn more about the News Story Review Criteria on the HealthNewsReview.org website.

Ready for You: Steve’s A-Fib Alerts for August 2018

From Chile and Brazil to the UK and Australia, world-wide subscribers are reading Steve’s A-Fib Alerts August 2018. It’s condensed and easy-to-scan. Read it online NOW.

…Or Subscribe NOW and have our A-Fib Alerts newsletter sent directly to your email inbox. It’s Risk Free! You can unsubscribe at any time! LEARN MORE.

Signup Bonus: Want to SAVE up to 50% off my book, Beat Your A-Fib: The Essential Guide to finding Your Cure? Get the eBook for $12 ($24.95 retail) or the softcover book for $24 ($32.95 retail). LEARN MORE.

Only another a-Fib patient can appreciate how wonderful it is to have your heart once again beat in 'normal sinus rhythm' at A-Fib.com

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Just shop online at Amazon.com using the A-Fib.com Amazon portal link (this link automatically credits us, you don’t have to do anything else).

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Your Support is Needed and Appreciated

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Bookmark this Link—Use it every time!Amazon.com portal llink from A-Fib.com

Don’t Delay. Get Your A-Fib Taken Care of. It Won’t Go Away.

Advice from Patients Now Free from the Burden of Atrial Fibrillation

Daniel D.

Daniel Doane, Sonora, California, USA, A-Fib free after Totally Thoracoscopic (TT) Mini-Maze surgery:

“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. 

Roger M.

Roger Meyer, Columbus, Ohio, from three generations of A-Fib, had the Cox-Maze surgery:

“I can now say, first hand, that there ARE bad effects from A-Fib and especially from A-Fib that is not treated early. I now wish I had had some of the today’s more aggressive A-Fib treatment options which weren’t available to me in my younger years.
My best advice: Don’t let A-Fib wreak its havoc untreated!” 

Joan S.

Joan Schneider, Ann Arbor, MI, from Pill-in-the-Pocket therapy to A-Fib free after catheter ablation:

“My advice to other AF patients: Know that paroxysmal AF becomes chronic. Drugs only work for so long. Heart modification will occur, and options will become few. Get with a great EP  and/or AF clinic and find your cure.” 

Don’t Delay—A-Fib Begets A-Fib. 

Do not remain in A-Fib indefinitely if possible. Your A-Fib episodes may become more frequent and longer, often leading to continuous (Chronic) A-Fib. (However, some people never progress to more serious A-Fib stages.)

Controlling symptoms with drugs, but leaving patients in A-Fib, overworks the heart, leads to fibrosis and increases the risk of stroke.

Drug therapies are never curative. Don’t just manage your A-Fib with medication. See Editorial: Leaving the Patient in A-Fib—No! No! No!

Don’t delay—Seek your Cure.


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

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

Review: CONTEC Handheld Portable ECG Heart Rate Monitor (PM10)

Tim Zhang from Contec Medical Systems CO., LTD, offered us a Contec Handheld Portable ECG Heart Rate Monitor, PM10, to try for ourselves hoping we would add it to our reviews of other similar units.

Contec PM10/EMAY Ltd EMG-10

The Contec PM10, an FDA Certified device, is also sold as the EMAY Ltd EMG-10. Both handheld portable ECG heart rate monitors are about $79 on Amazon.com. The PM10 is a small 4 oz. unit that can track a single channel ECG waveform. You can observe the scan live, then download the recordings (up to 30) to your computer or smartphone for review and print to share with your doctor. It claims to detect up to 12 cardiac conditions. I don’t have A-Fib anymore (thank goodness), so I wasn’t able to test while in A-Fib.

The user guide’s small size, tiny printing and wording leaves a lot to be desired. (Note: You can find the guide on the internet and download in a normal full-size page layout.)

Easy to Record an ECG, But Requires Software to Review

To charge the PM10 battery: Use the provided micro USB cable to connect the unit to a USB port on your computer. While charging, you’ll see a faint blinking blue light beneath the white plastic at right top front of the curved end.

Taking a scan (no cable or smartphone needed): To turn on, press the blue button (the only button on the unit) and hold down for 3-4 seconds and you’ll hear a beep (it turns off automatically). You’ll notice the metal contacts are sizeable on this relatively small device.

Measurement positions of Contec PM10 at A-Fib.com

Measurement positions of Contec PM10

Hold the unit as shown in the drawings (between both hands, or hold with one hand and the unit on your chest.) You can watch the unit capture your heart beats. It takes a few seconds for the waveform to stabilize, then start recording for a 10 sec measurement. (There’s a 10 sec countdown on the screen). It displays your heart rate as well.

Summary screen: When completed, the ECG scan is replaced with a summary screen with its best guess about the recording. Examples: No abnormal, Bradycardia, Missed beat. You can’t review the recording on the unit. You must download to software on your computer or smartphone.

Contec PHMS App or Software

The PM10 connects by Bluetooth or USB cable to a smartphone phone or computer. You’ll want to install the app or software so you can download your scans for review or printing. The PHMS app can be found on iTunes and Google Play.

Download screen opens first

For a computer, you can download the PHMS software from the Contecmed.com download page or the EMAY Ltd download page (I found EMAY easier and faster).

Reviewing your recordings: On my laptop I connected to the PM10 just like when I charged the battery. (The first time you might want to open the software, then connect the cable and the PM10.)

Manage tab with downloaded scans

The ‘Download’ tab opens first. Press the ‘Start new search’ and the software displays a list of scans from your PM10. Press the button ‘Download all’. Then switch to the ‘Manage’ tab. From here you can select a scan from the list and press ‘Review’ to see the ECG. A Diagnosis column is on the right.

Review screen with ECG and data

From here you can print the scan. (To close, double-click on the ECG to return to the downloaded list).

Helpful tip: When you ‘print’ you can also select ‘Adobe PDF’ as your printer and save to your hard drive, but I had poor image results. An alternative is to take a screenshot or use the Windows snipping tool. Save the image, then print. Either way, you can attach it to an email and send to your doctor.

Amazon.com Contec Reviews from Customers with A-Fib

A curious point about the Amazon.com reviews: The Contec PM-10 has a customer review rating of 3.1 out of 5 stars, whereas the EMAY EMG-10 has a customer rating of 4.5 out of 5 stars. From scanning the reviews, EMAY purchasers are happier with their contacts with EMAY customer service. (I’ll let you draw your own conclusions.)

Amazon.com link

Use the A-Fib.com portal link to Amazon.com

I’ve included comments from three reviewers (who mention having A-Fib) on the Contec PM10 product page:

• A Contec review on Amazon.com by Ron Crist noted there’s no hidden fees like other popular devices (i.e., monthly fee for Kardia Heart Monitor by AliveCor). He went on to write: “I have persistent AFib and have had 2 crippling strokes. No more cardioversions (electric shocks) for me. I hope. I Strongly recommend it.”

• A doctor with A-Fib, PD, wrote on Amazon.com: This is a very good machine but ekg has some static. I am a doc with atrial fib and this helps in terms of heart rate and ekg…took some experimenting [to set up] but the results are gratifying…Once set up I give it 5 stars.”

• An Amazon reviewer with paroxysmal atrial fibrillation writes: “This monitor allows me to see just when my condition occurs and gives my cardiologist a better picture of my condition. Although not a perfect answer it does enhance the overall picture.”

You can read the Amazon.com reader reviews for yourself at the Contec PM10 and the EMAY EMG-10 product description pages.

Lightweight, Easy to Use, But Not a “Diagnostic” Device

Contec PM10 box & contents

The Contec PM10 is easy to use and carry in a pocket or handbag for scans on the go. Or leave with your laptop for periodic checks. While you can observe the ECG scan live on the screen, there’s no review screen. You must download the scan to review it or print it.

Unlike the AliveCor Kardia, no smartphone or tablet is needed to take scans. Observing the live ECG tracing may be enough for most A-Fib patients who just want a quick check of their heart beat and heart rate. I think you get a lot for the $79 price.

But remember this is not a diagnostic device. It doesn’t replace an ECG by your doctor or use of a mobile type of heart rhythm monitor to capture the electrical activity of your heart (e.g., a Holter monitor or event monitor).

I welcome your comments if you have used this unit or others in our reviews, Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I) and Do-It-Yourself ECG: A Review of Consumer Handheld ECG Monitors. Just send me an email.

No Way Am I Having an Ablation! Seeks Alternative Treatments

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

Saul Lisauskas

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

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

Looking for Alternative Treatments: A Vegetarian Diet

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

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

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

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

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

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

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

Lessons Learned

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

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

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

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

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

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

What’s the Best Treatment Options For You?

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

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

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

Always Aim for a Cure!

Are Your Herbal Supplements Interacting With Your Medicines?

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

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

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

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

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

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

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

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

Medication Inventory form

Take an Inventory

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

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

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

Do Your Own Research

Learn more about herb-drug interaction potentials at:

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

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

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

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

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

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

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

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

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

How Some Drug Ads Mislead

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

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

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

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

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

The Tale of a 50% Off Coupon

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

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

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

The Bottom Line: Be Skeptical, Ask Questions

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

Read my book review

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

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

Additional Reading

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

The Math Behind a 50% Reduction

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

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

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

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

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

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

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

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