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-Fib stroke

FAQs A-Fib Treatments: Medicines and Drug Therapies

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

Drug Therapies for Atrial Fibrillation

Atrial Fibrillation patients often search for unbiased information and guidance about medicines and drug therapy treatments. These are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer.)

1. “ I have a heart condition. Which medications are best to control my Atrial Fibrillation?” What medications work best for me?“

2. HRT: “Do you have information about Hormone Replacement Therapy (HRT) and if it might help or hinder my atrial fibrillation?”

3. Rate Control Drug: “I take atenolol, a beta-blocker. Will it stop my A-Fib.”

Antiarrhythmic Drugs

1. “Is the “Pill-In-The-Pocket” treatment a cure for A-Fib? When should it be used?” (“Pill-In-The-Pocket” makes use of an antiarrhythmic drug such as flecainide)

2. I’ve been on amiodarone for over a year. It works for me and keeps me out of A-Fib. But I’m worried about the toxic side effects. What should I do?”

3. “Is the antiarrhythmic drug Multaq [dronedarone] safer than taking amiodarone? How does it compare to other antiarrhythmic drugs?”

4. “My doctor told me about the Tikosyn drug option that I want to consider in getting rid of my 5-month-old persistent A-Fib. That seems like something that should be discussed on your web site.”

Blood Thinners/Anticoagulants

Note: August 2015 Update: Aspirin is no longer recommended as first-line therapy to prevent A-Fib stroke.

1. “Are anticoagulants and blood thinners the same thing? How do they thin the blood?

2. Should everyone who has A-Fib be on a blood thinner like warfarin (brand name: Coumadin)?”

3. Which is the better to prevent stroke—warfarin (Coumadin), an NOAC or aspirin?

4. “I am on Coumadin (warfarin). Do I now need to avoid foods with Vitamin K which would interfere with its blood thinning effects?”

5. Are natural blood thinners for blood clot treatment as good as prescription blood thinners like warfarin?”

6. “I’m worried about having to take the blood thinner warfarin. If I cut myself, do I risk bleeding to death?

Related question: My new cardiologist wants me to switch from Pradaxa to Eliquis. if bleeding occurs, is Eliquis easier to deal with?

Related question: My heart doctor wants me to take Xarelto. I am concerned about the side effects which can involve death. What else can I do?”

7. “I”ve read about a new anticoagulant, edoxaban (brand names: Lixiana, Savaysa) as an alternative to warfarin (Coumadin). For A-Fib patients, how does it compare to warfarin? Should I consider edoxaban instead of the other NOACs?”

Post-Procedure

1. I’ve had a successful catheter ablation and am no longer in A-Fib. But my doctor says I need to be on a blood thinner. I’ve been told that, even after a successful catheter ablation, I could still have “silent” A-Fib—A-Fib episodes that I’m not aware of. Is there anything I can do to get off of blood thinners?“

2. “I just had an Electrical Cardioversion. My doctor wants me to stay on Coumadin for at least one month. Why is that required? They mentioned something about a “stunned atrium.” What is that?“

A-Fib Stroke Risk

1. “What are my chances of getting an A-Fib stroke?

2. “The A-Fib.com web site claims that an A-Fib stroke is often worse than other causes of stroke. Why is that? If a clot causes a stroke, what difference does it make if it comes from A-Fib or other causes? Isn’t the damage the same?“

3. “How long do I have to be in A-Fib before I develop a clot and have a stroke?

4. “Is there a way to get off blood thinners all together? I hate taking Coumadin. I know I’m at risk of an A-Fib stroke.”

If you find any errors on this page, email us. Y Last updated: Tuesday, February 14, 2017
Return to Frequently Asked Questions

With A-Fib, Stroke is Not Your Only Risk

Xarelto advertisement

We hear it every day on TV, ads about ‘living with Atrial Fibrillation’. In today’s media, the message is about how to ‘manage’ your A-Fib. You’re advised to ‘just take our anticoagulant’ and you’ll live happily ever after.

But recent research (and common sense) indicates otherwise.

Mega Research Analysis of Your Additional Risks

Researchers at Oxford University, Oxford, UK and Massachusetts Institute of Technology (MIT), Cambridge, MA, USA, conducted a systematic review and analysis of 104 different studies involving nearly 10 million people, of which, over a half-million had A-Fib.

They found that Atrial Fibrillation is associated with not just stroke, but also with:

• Heart Disease
• Heart Failure
• Kidney Disease
• Sudden Death
• Death from All Causes

The term “associated with” is as strong as academic researchers can state their findings as other factors may be at play.

Heart failure: The strongest association was with heart failure, which was five times more likely in people with A-Fib. Because your heart isn’t pumping properly, it’s not surprising that A-Fib leads to heart disease, heart failure and sudden death.

Kidney disease: A surprising association is that A-Fib is tied to kidney disease and peripheral arterial disease, probably because of poor circulation due to A-Fib.

Death from all Causes: This isn’t such a surprising finding as A-Fib affects the whole body. A-Fib damages your heart, brain and other organs. It reduces the heart’s pumping capacity by about 15%-30% which may cause weakness, fatigue, dizziness, fainting spells, swelling of the legs, and shortness of breath.

Patients with A-Fib, even if they don’t have a stroke or heart failure, are more likely to die from other causes compared with people in normal sinus rhythm (NSR).

Note: this study didn’t examine the known link between dementia and A-Fib. See Leaving Patients in A-Fib Doubles Risk of Dementia—The Case for Catheter Ablation

Don’t be Misled by Pharmaceutical Ads

Xarelto drug ad at A-Fib.com

Xarelto drug ad with Brian Vickers, Arnold Palmer & Kevin Nealon

For patients with A-Fib, it isn’t enough to simply take an anticoagulant!

We need to worry not just about stroke, but also about the risks and potential damage of A-Fib to our overall health.

Contrary to today’s media, your goal shouldn’t be to just ‘manage your A-Fib’. It’s a Pollyanna fantasy to just ‘Take a pill (anticoagulant) and live happily ever after’.

That misconceoption is propagated by drug manufacturers who want you to stay an A-Fib patient and thus a customer for life.

Don’t Just Live with A-Fib

Don’t Settle. Seek your A-Fib cure. Your goal should be to get your heart beating once again in normal sinus rhythm (NSR). We can’t say it enough…

Do not settle for a lifetime on meds. Seek your A-Fib cure.

Resources for this article

New Report: Is Your Stroke A-Fib-Related or Something Else?

Third in my series from the Ninth Annual Western Atrial Fibrillation Symposium held February 26-27, 2016 in Park City, UT. Read my other reports here.

If you have A-Fib, it’s important to realize that not all strokes are ‘A-Fib related’. You may be perfectly anticoagulated or have a Watchman Device installed and still experience a stroke.

Realize: an A-Fib patient can have a stroke that isn’t caused by A-Fib.

Dr. Jennifer Majersik of the Stroke Center of the Un. of Utah described the case of a man with A-Fib who had an ischemic stroke even though his INR on warfarin was in the correct range.

An A-Fib patient can have a stroke that isn’t caused by A-Fib. There are multiple mechanisms which can cause a stroke. Of the 690,000 strokes in the US/year nearly 1/3 are cryptogenic (of unknown cause) and of those 30% is caused by asymptomatic or Silent A-Fib.

Read my full report in which Dr. Majersik described five subtypes of artery occlusion strokes (as opposed to hemorrhagic [bleeding or vessel rupture] strokes.) <…continue reading…>

 

New FAQ: In Case of Stroke, How Your Family Should Plan Now!

A new FAQ answers what your family should plan NOW, and what do in case you have an A-Fib-related stroke.

“In case I have a A-Fib stroke, what does my family need to know to help me? (I’m already on a blood thinner.)  What can I do to improve my odds of surviving it?”

Stroke is the most dreaded effect of having A-Fib. And an A-Fib-related stroke is usually worse because the clots tends to be larger. They often result in death or permanent disability.

CT brain with Ischemic stroke at A-Fib.com

Brain CT showing ischemic (clotting) stroke

Prepare Your Plan: The 4 Steps

For your own and your family’s peace of mind, you need to create a ‘Stroke Action Plan’.

Step 1: Learn the Signs of a Stroke

Make it a family affair. Discuss the most common signs of stroke: sudden weakness of the face, arm or leg, most often on one side of the body.  Stroke may be associated with a headache, or may be completely painless.

Step 2―Ask Your Doctor

Discuss with your doctor what actions to take in case of stroke. For example, some doctors recommend aspirin to help avoid a second ischemic stroke (A-Fib). If so, ask what dosage.

Step 3―Locate Your Nearest ‘Certified Stroke Center’

Why a Certified Stroke Center? If a stroke victim gets to a Certified Stroke Center within four hours... Continue reading the answer—>..

FAQs Coping with A-Fib Stroke: What Your Family Should Learn Now

 FAQs Coping with A-Fib: Stroke Action Plan

FAQs A-Fib afib“In case I have an A-Fib-related stroke, what does my family need to know to help me? (I’m already on a blood thinner.)  What can I do to improve my odds of surviving it?

Stroke is the most dreaded effect of having A-Fib. And an A-Fib-related stroke is usually worse because the clots tends to be larger. They often result in death or permanent disability.

Here are some basic facts and steps you and your family can take to prepare for and what to do if stroke strikes any member of your family.

Prepare Your Plan: The 4 Steps

For your own and your family’s peace of mind, you need to create a ‘Stroke Action Plan’.

Step 1: Learn the Signs of a Stroke

Make it a family affair. Discuss the most common signs of stroke: sudden weakness of the face, arm or leg, most often on one side of the body.  Stroke may be associated with a headache, or may be completely painless. Each person may have different stroke warning signs.

Step 2―Ask Your Doctor

Discuss with your doctor what actions to take in case of stroke. For example, some doctors recommend aspirin to help avoid a second ischemic stroke (A-Fib). If so, ask what dosage.

Step 3―Locate Your Nearest ‘Certified Stroke Center’

Why a Certified Stroke Center? If a stroke victim gets to a Certified Stroke Center within four hours, there is a good chance specialists can dissolve the clot without any lasting damage.

Only a fraction of the 5,800 acute-care hospitals in the U.S are certified as providing state-of-the-art stroke care.

A certified or ‘Advanced Comprehensive Stroke Center’ is typically the largest and best-equipped hospital in a given geographical area that can treat any kind of stroke or stroke complication.

A Certified Stroke Center will have drugs such as Tissue Plasminogen Activator (tPA) to dissolve the clot. Can use Clopidogrel or acetylsalicylic acid (ASA) to stop platelets from clumping together to form clots. Or use anticoagulants to keep existing blood clots from getting larger.

So do your homework. To find the nearest certified or ‘Advanced Comprehensive Stroke Center’ check these listings:

Find A Certified U.S. Stroke Center Near You/NPR News
Find a Certified Comprehensive Stroke Center

Step 4―Post Your ‘Stroke Action Plan’

Write up the three components of your plan (i.e., the signs of stroke, aspirin dosage and location of the nearest Certified Stroke Center).

What about your workplace? Locate the nearest Certified Stroke Center to your job, too, and post a copy.

Also, print handouts with the name and address of the nearest Certified Stroke Center (Advanced Comprehensive Stroke Center) for EMS responders. Keep a bottle of aspirin nearby.

Store your ‘Stroke Action Plan’ in a special binder or post so that family can easily find the information.

If a Stroke Strikes: Work the Plan

1. Immediately call your emergency medical services (EMS)―even if the person having the stroke doesn’t want you to. (e.g., 911 in US and Canada, 0000 in Australia, 999 in the UK.)

Note: DO NOT try to diagnose the problem by yourself, and DO NOT wait to see if the symptoms go away on their own.

2. While waiting for EMS, administer aspirin in the proper dosage (if advised by your doctor beforehand) to help avoid a second stroke.

Note: The emergency operator might connect you to a hospital that gives you instructions based on symptoms.

3. When EMS arrives, tell them to take the patient to your nearest Certified Stroke Center (give them a handout with the name and address).

Note: If necessary, be firm, insist they go to your choice of Certified Stroke Center. (Realize that some paramedics and ambulance services have side deals with hospitals to take patients to their hospitals, even if it’s not the right hospital for stroke victims.)

The Wrap Up

A ‘Stroke Action Plan’ with specific steps is reassuring during a medical emergency and helps everyone stay calm. Your family will be confident they’re supporting you in taking the right action at the right time.

The only guarantee of not having an A-Fib stroke is to no longer have A-Fib.

Know that quickly going to a certified or ‘Advanced Comprehensive Stroke Center’ may save you from the debilitating effects of an A-Fib stroke, or even death.

For additional reading, see Ablation Reduces Stroke Risk to that of a Normal Person.

References for this article

If you find any errors on this page, email us. Y Last updated: Monday, February 13, 2017
Back to FAQs: Coping with Your A-Fib

Archive: FAQs A-Fib Treatments: Medicines and Drug Therapies

FAQs A-Fib Treatments: Medicines and Drug Therapies

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

Drug Therapies for Atrial Fibrillation

Atrial Fibrillation patients often search for unbiased information and guidance about medicines and drug therapy treatments. These are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer.)

1. Which medications are best to control my Atrial Fibrillation?” “I have a heart condition. What medications work best for me?

2. “Is the “Pill-In-The-Pocket” treatment a cure for A-Fib? When should it be used?”

3. “I take atenolol, a beta-blocker. Will it stop my A-Fib.”

4. I’ve been on amiodarone for over a year. It works for me and keeps me out of A-Fib. But I’m worried about the toxic side effects. What should I do?”

5. Should everyone who has A-Fib be on a blood thinner like warfarin (Coumadin)?”

6. Which is the better anticoagulant to prevent stroke—warfarin (Coumadin) or aspirin?

7. What’s the difference between warfarin and Coumadin?

8. I’m on warfarin. Can I also take aspirin, since it works differently than warfarin? Wouldn’t that give me more protection from an A-Fib (ischemic) stroke?

9. “What are my chances of getting an A-Fib stroke?

10. “I’m worried about having to take the blood thinner warfarin (brand name Coumadin). If I cut myself, do I risk bleeding to death?

11. “I am on Coumadin (warfarin) to thin my blood and prevent A-Fib blood clots. Do I now need to avoid foods with Vitamin K which would interfere with the blood thinning effects of Coumadin?” UPDATED

12. “The A-Fib.com web site claims that an A-Fib stroke is often worse than other causes of stroke. Why is that? If a clot causes a stroke, what difference does it make if it comes from A-Fib or other causes? Isn’t the damage the same?

13. “I just had an Electrical Cardioversion. My doctor wants me to stay on Coumadin for at least one month. Why is that required? They mentioned something about a “stunned atrium.” What is that?

14. Are natural blood thinners for blood clot treatment as good as prescription blood thinners like warfarin?”

15. “How long do I have to be in A-Fib before I develop a clot and have a stroke?

16. I have to be on aspirin for stroke prevention. Which is better—the low-dose baby aspirin (81 mg) or a high dose (325 mg)? Should I take the immediate-release (uncoated) or the enteric-coated aspirin?

17. I don’t want to be on blood thinners for the rest of my life. I’ve had a successful catheter ablation and am no longer in A-Fib. But my doctor says I need to be on a blood thinner. I’ve been told that, even after a successful catheter ablation, I could still have “silent” A-Fib—A-Fib episodes that I’m not aware of.  Is there anything I can do to get off of blood thinners?

18. “My last cardiologist had me on Pradaxa. My new cardiologist wants me to switch to Eliquis. Is Eliquis easier to deal with if bleeding occurs?

19. “My doctor told me about the Tikosyn drug option that I want to consider in getting rid of my 5-month-old persistent A-Fib. That seems like something that should be discussed on your web site.

20. “I hate taking Coumadin. Is there a way to get off blood thinners all together? I know I’m at risk of an A-Fib stroke.”

21. “I”ve read about a new anticoagulant, edoxaban, as an alternative to warfarin (Coumadin) for reducing risk of stroke. For A-Fib patients, how does it compare to warfarin? Should I consider edoxaban instead of the other NOACs?

22. “Do you have information about Hormone Replacement Therapy (HRT) and if it might help or hinder my atrial fibrillation?

23. Are Anticoagulants and blood thinners the same thing? How do they thin the blood?

24. I have A-Fib, and my heart doctor wants me to take Xarelto 15 mg. I am concerned about the side effects which can involve death. What else can I do?

25. “Is the antiarrhythmic drug Multaq [dronedarone] safer than taking amiodarone? How does it compare to other antiarrhythmic drugs?”

Last updated: Saturday, February 11, 2017

Back to FAQs by Patients with Atrial Fibrillation

FAQs A-Fib Drug Therapy: Why is an A-Fib Stroke Worse

 FAQs A-Fib Drug Therapy: A-Fib Stroke 

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

12. “Why is an A-Fib stroke often worse than other causes of stroke. If a clot causes a stroke, what difference does it make if it comes from A-Fib or other causes? Isn’t the damage the same?”

When we refer to an A-Fib stroke, we are talking about an ischemic stroke. An ischemic stroke is caused by a clot which obstructs blood flow to the brain (versus a hemorrhagic stroke when a weakened blood vessel ruptures).

Several research studies have compared ischemic stroke patients with A-Fib against those without A-Fib. A-Fib stroke patients were associated with more widespread deprivation of blood supply to the brain, more extensive growth of dead tissue areas (from failure of blood supply), more rapid and severe deterioration, and higher mortality rate. In addition, outcomes were worse for patients with a longer duration of Atrial Fibrillation.

A-Fib strokes may be worse because of the larger size of the clots. Most (95%) of A-Fib strokes originate with clots from the Left Atrial Appendage (LAA). Clots that form in the LAA can be quite large and completely block blood vessels in the brain often resulting in death or severe neurologic damage.

References for this article
.

Return to FAQ Drug Therapies

Last updated: Monday, September 28, 2015

FAQs A-Fib Drug Therapy: “Chances of A-Fib stroke?”

 FAQs A-Fib Drug Therapy: Chance of Stroke

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

9. “What are my chances of getting an A-Fib stroke?”

The incidence of stroke in patients with atrial fibrillation is 2-17 times greater than in the general population, dependent on the cause of AF and is also dependent on age, with older patients being at higher risk.1

The Center for Shared Decision Making/Dartmouth-Hitchcock gives somewhat controversial odds of getting an A-Fib stroke depending on one’s overall heart health.

Under age 65 with no history of hypertension, stroke, arterial embolism, left ventricular dysfunction, or TIA:

•  Chance of stroke in two years 2 out of 100
•  Taking daily coated aspirin 1.5 out of 100
•  Taking daily warfarin 1 out of 100

Age 65-75 with no history of hypertension, stroke, arterial embolism, left ventricular dysfunction, or TIA:

•  Chance of stroke in two years 4 out of 100
•  Taking daily coated aspirin 3 out of 100
•  Taking daily warfarin 2 out of 100

Over age 75, or under age 75 with history of hypertension or left ventricular dysfunction:

•  Chance of stroke in two years 12 out of 100
•  Taking daily coated aspirin 9 out of 100
•  Taking daily warfarin 4 out of 100

Any age with a history of TIA, stroke or arterial embolism, or over age 75 with a history of hypertension or left ventricular dysfunction:

•  Chance of stroke 20 out of 100

CHADS2 Risk Assessment Tool

One simple, well-validated, points-based risk assessment tool is known by the acronym ‘CHADS2’. It’s widely used to assess individual patient risk for stroke. To read more see our article, The CHADS2 Stroke-Risk Grading System.

Return to FAQ Drug Therapies

References    (↵ returns to text)

  1. Atrial Fibrillation is a Major Risk Factor for Stroke. Thrombosis Adviser website.

    http://www.thrombosisadviser.com/en/atrial-fibrillation/af-is-a-major-stroke-risk-factor/

    Last accessed November 15, 2014.

Cardioversion to Restore Normal Sinus Rhythm

VIDEO: EKG display of heart in Atrial Fibrillation, A-Fib

EKG display of heart in A-Fib

Cardioversion for Atrial Fibrillation

Your doctor may recommend a cardioversion to restore your heart to normal sinus rhythm (NSR). There are two types of cardioversion: chemical and electrical. Cardioversion through the use of drugs is called chemical cardioversion. Electrical cardioversion uses a low-voltage, timed electrical shock to restore normal rhythm.

Most cardioversions are planned and scheduled several weeks in advance.

On the other hand, if your A-Fib is so irregular and rapid that it is life threatening, you may be sent to the emergency room, given the intravenous anticoagulant Heparin, and an electrical cardioversion performed.

CHEMICAL CARDIOVERSION

The goal of chemical cardioversion is to make your heart beat regularly (in normal sinus rhythm). It is usually done in a hospital. Some combination of medications (see Treatment/Drug Therapies) is administered intravenously, such as Cardizem, verapamil, ibutilide, or adenosine (a class V antiarrhythmic agent). Doctors monitor you closely for adverse side effects.

Chemical cardioversion is often done in combination with Electrical Cardioversion described below.

Electrical Cardioversion

Electrical Cardioversion is a medical term for giving your heart a low-voltage electrical shock to synchronize it, that is, to make it beat regularly (in normal sinus rhythm). It is often used in combination with Chemical Cardioversion.

Note: Electrical cardioversion is not the same as Defibrillation. In defibrillation, doctors use high-voltage shocks to treat life-threatening arrhythmias or a heart that has stopped.

During Electrical Cardioversion you are anesthetized and are unconscious when you receive the shock. The shock causes the signal producing areas of your heart to discharge all at once. This stops all electrical activity in your heart momentarily, hopefully allowing your normal heart rhythm to take over. Usually only one shock is required to restore NSR.

VIDEO 1: Patient video, short animation (:60) explaining the steps in performing an electrical cardioversion for patients in Atrial Fibrillation; By eMedTV 1

Low Risk Treatment But High Risk of Clots Forming

Electrical Cardioversion is considered a low risk procedure. But it is a ‘shock’ to the body and requires general anesthesia. (It’s like a mini electrocution. The metal paddles or patches, for example, can potentially leave burn marks on the chest.)

Cardioversion does carry a high risk of forming clots and causing stroke.2

Why? An Electrical cardioversion “stuns” your heart along with your Left Arial Appendage (LAA). Clots may form in the LAA while your heart is stunned and not beating. The clot can break away and enter the blood stream with the potential of causing a stroke. (The LAA is where most A-Fib clots originate.)

To dissolve potential clots, your doctor will have you take an anticoagulant like warfarin (Coumadin) before the treatment and in the three to four weeks following treatment.

While on warfarin (Coumadin), your blood will be tested for how long it takes to clot (a prothrombin time test, PT). The goal is to keep your INR (International Normalized Ratio) score between 2.0 and 3.0. Your dosage will be adjusted if necessary. You may have to have your blood tested weekly until your doctor determines you are in the proper INR range.

Success Rate of Cardioversion

Electrical Cardioversion (often combined with Chemical Cardioversion) is considered a standard, routine, low risk treatment option, particularly for recent onset A-Fib patients. If your A-Fib has just started, it may be a momentary aberration; and an Electrical Cardioversion may correct it.

Cardioversion has a very high initial success rate, returning up to 95% of A-Fib patients to NSR.

While the conversion rate is high, recurrence of A-Fib is high too. As few as 23% of patients remain in normal sinus rhythm for more than one year post-procedure. For most, their A-Fib returns within the first five days.4

Are Repeated Electrical Conversions Dangerous?

People with A-Fib often ask, “How often can I be Electrical Cardioverted? Does it ever become counterproductive or dangerous?” Right now we just don’t know the answer to this question.

Former Senator and NBA basketball player Bill Bradley had three successful Electrical Cardioversions from 1996-1998 without any apparent ill effects.5 I’ve heard of an A-Fib patient who received an Electrical Cardioversion once a month for a year without any apparent problems.

VIDEO 2: Watch an actual Electrical Cardioversion recorded at the patient’s request: “Me Being Cardioverted” posted by reddy321.6But be advised: the patient in this video is partially awake (this is not the norm). This video is a bit unsettling to watch (but not dangerous or painful for the patient).

Don’t Be Frightened

Don’t let this type of video frighten you. It may look and sound traumatic, but Electrical Cardioversion is in fact non-invasive and is one of the easiest and safest short term treatments available for A-Fib.

And don’t let TV shows with emergency room scenes frighten you either. In fact, those scenes are usually depicting defibrillation, not cardioversion (defibrillators use high-voltage shocks to treat a heart that has stopped beating).

In her Personal Experiences story, Kris tells of accidentally being awake during an electrical cardioversion (see Personal Experiences story #37). According to Kris, the shock is relatively mild compared to what you often see portrayed in medical dramas on TV.

Last updated: Wednesday, April 6, 2016

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Return to Treatments for Atrial Fibrillation

 

 

References    (↵ returns to text)

  1. VIDEO 1: Short animation explaining electrical cardioversion when in Atrial Fibrillation. YouTube video posted by eMedTV; Last accessed Oct 12, 2014; URL: http://www.youtube.com/watch?v=-jkhQ5Tl2fs
  2. Haines, D. “Atrial Fibrillation: New Approaches in Management.” Un. of Virginia multi-media presentation, 1999, p.2. http://www.a-fib.com/HainesUnOfVirginiaAtrialFibrillation.htm
  3. Boos C , More RS, Carlsson J. Persistent atrial fibrillation: rate control or rhythm control. BMJ 2003;326:1411–2.
  4. Gorman, Christine, “A Candidate’s Racing Heart,” TIME, Sunday, Dec. 12, 1999. http://www.time.com/time/printout/0,8816,35831,99.html
  5. VIDEO 2: Me Being Cardioverted YouTube video; Last accessed February 22, 2013; URL: http://www.youtube.com/watch?v=2nsN0vdXZuY&feature=fvw.

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