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


California Heart Rhythm Symposium

My Summary Reports: California Heart Rhythm Symposium 2017

Held at the UCLA Luskin Conference Center in Los Angeles from November 17-18, the California Heart Rhythm Symposium is a regional symposium focused on the latest advances in the field of cardiac arrhythmias (Atrial Fibrillation and Ventricular Arrhythmias).

The one and one-half day Symposium was well attended and featured presentations by recognized leaders in the field. (I only attended the sessions on A-Fib.)  I attended as a journalist representing A-Fib.com.

The following are 15 brief descriptions of the presentations that made the most impression on me.

Recurrence Rates Have Improved

Dr. Greg Michaud from Vanderbilt described how recurrence rates have improved with the use of newer treatments such as contact force sensing catheters and CryoBalloon ablation (and the new Laser balloon). The focus now is where else to ablate besides the Pulmonary Veins (PVs). In his ablations Dr. Michaud tends to ablate or fill in the posterior wall with ablation burns.

“The focus now is where else to ablate besides the Pulmonary Veins (PVs).” Dr. Greg Michaud

A-Fib and Dementia

Dr. Jared Bunch of the Intermountain Heart Institute in Utah shocked the attendees with the statements: one in three of us will develop A-Fib in our lifetime; A-Fib doubles the risk of developing dementia; and Dementia has become the third leading cause of death in the U.S.

He also pointed out that being on warfarin causes microbleeds in the brain which increase dementia. The younger you are when you develop A-Fib, the more likely you are to develop dementia. (See my article A-Fib Doubles Risk of Dementia.) But a catheter ablation reduces the risk of developing dementia to that of a normal person.

“…when he went into A-Fib, he lost the ability to speak because he was in dementia. Dr. Jared Bunch”

Dr. Bunch gave the striking example of a patient who would speak normally when in sinus rhythm. But when he went into A-Fib, he lost the ability to speak because he was in dementia.

Ablating LAA Increases Ablation Success Rate

Dr. Andrea Natale of the Texas Cardiac Arrhythmia Institute in Austin, TX, described his current ablation strategy. Of special note, he showed how ablating the Left Atrial Appendage (LAA) increases ablation success rates. During an ablation, he also concentrates on the posterior wall between the PVs. He also pointed out there is currently no standard, agreed-upon protocol for mapping and ablating non-PV triggers.

Contact Force Sensing Catheters & CryoBalloon Ablation

“Contact force sensing catheters have lower recurrence levels.” Dr. Jocob Koruth

Dr. Jocob Koruth of Mount Sinai Medical Center in New York described how contact force sensing catheters have lower recurrence levels. But CryoBalloon ablations seem more durable. He mentioned that the FIRM and CardioInsight ECGI vest systems have not been proven.

Editor’s Comments: The FIRM system has received a good deal of negative press and research papers. See Firm Mapping System  and FIRM Research.  But the CardioInsight ECGI vest system, though very new, seems to have great potential.

Flutter As Risky as A-Fib

Dr. Kim Rajappan from Oxford University in Oxford, UK discussed A-Fib and A-Flutter. Both carry the same risks for patients. Rate control is harder for Flutter. Most EPs would do a Flutter ablation even if the patient were not in A-Fib at the same time.

Editor’s Comments: Flutter can be considered as a milder or more organized form of A-Fib. It may feel slightly better than A-Fib and be better tolerated. But it’s still as dangerous as A-Fib.

Importance of Isolating the LAA

“… the importance of measuring flow velocity out of the LAA after isolating it.” Dr. Luigi Di Biase

Dr. Luigi Di Biase of the Albert Einstein College of Medicine in New York echoed Dr. Natale in stressing the importance of the LAA (Left Atrial Appendage) in A-Fib. But he also pointed out the importance of measuring flow velocity out of the LAA after isolating it. If LAA flow velocity is low, it’s necessary to keep a patient on anticoagulants for life or remove the LAA such as by using the lariat device. … Continue reading this report…->

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