In September, I was the only patient invited to present at MAM 2016 in Zurich, Switzerland. After dinner the first night, I spoke to over 200+ surgeons and electrophysiologists (EPs).
I tried to describe for the doctors what it’s like to live in Atrial Fibrillation. Here is what I told them.
You Never Forget Your First A- Fib Attack
“As most A-Fib patients will testify, you never forget your first A- Fib attack.
Mine was 19 years ago, but I can remember it like it was yesterday. All of a sudden my heart started going crazy! It felt like my heart was trying to jump out of my chest or like there was a live fish flopping around in there. I can still feel the sheer terror, fear, confusion, anxiety and worry it created.
I remember thinking, “Am I going to die?” “Is this a heart attack?” It was one of the most terrifying experiences of my life.
Most symptomatic A-Fib patients have a similar story.
Psychological and Emotional Effects of A-Fib
A-Fib doesn’t just affect you physically, it affects you emotionally as well.A-Fib affects not just your heart—but also your head—and your quality of life.
It affects not just your heart—but also your head—and your quality of life.
By the way, I’ve never been to a medical conference where this aspect of A-Fib was studied. (Today is a first, I guess.)
I wish there were some way to give you a one-minute episode of A-Fib. It would change your perception of A-Fib forever. The psychological and emotional aspects of A-Fib can be as bad as or even worse than the physical.
Living in Fear (and Anger)—A-Fib Wrecked My Life
In my case, I lived in fear of the next A-Fib attack. I went through all the emotional gamut—anxiety, fear, worry, confusion, uncertainty, frustration, depression, and finally anger at my own heart.I went through all the emotional gamut—anxiety, fear, worry, confusion, uncertainty, frustration, depression, and finally anger at my own heart.
I’m a passionate runner. I used to run along Venice Beach. But my heart would go crazy and beat too fast. I’d have to stop and walk back to our apartment. Talk about frustration!
And A-Fib affected my work. I had a great job on the soap opera “Days Of Our Lives” as part of the technical crew. But I’d get dizzy and light headed and nearly lost my job. A-Fib wrecked my life!
Research—Then Going to Bordeaux for an Ablation
To make a long story short, I locked myself in a medical library and read everything I could find about Atrial Fibrillation. During this time, I tried every drug known to man including the dreaded amiodarone which made me cough up blood. Nothing worked.
I found that doctors in Bordeaux, France, had discovered how to make people A-Fib free.
One of the doctors who treated me with catheter ablation is here today, Dr. Dipen Shah. Thanks to him, Dr. Haissaguerre and Dr. Jais I’ve been A-Fib free for 18 years. I was their first US patient.
My Challenge to Doctors treating A-Fib Patients
Today I want to challenge you. Just ask yourself:
What are you doing to help your patients deal with the Fear and Anxiety of A-Fib?
What are you doing to help them cope with the Psychological and Emotional effects of A-Fib?
Helping Your Patients Deal With Stress and Anxiety
Knowledge is Power and Control! Learning about A-Fib relieves worry and anxiety. Two ways to help your patients:
1. Reference books and websites. Give your patients a short list of web sites and books which you have read and recommend. If you do this, think of how much better informed your patients will be! Knowledge is Power and Control! Learning about A-Fib relieves worry and anxiety.
Hint: For distribution, list your recommendations on the back of a business card. If it comes from you, your patients will devour them.
2. Counseling and medication. You should have a list you can give out of several psychiatrists who understand A-Fib and how it affects patients.
You’ll know who needs this kind of help. Men, especially, may not admit to themselves that they need help.
Thanks for Making Us A-Fib Free
Finally, I want to thank you on behalf of all the patients you’ve made A-Fib free. There are few medical procedures as transformative and life changing as going from A-Fib to Normal Sinus Rhythm.
There is simply no comparison between living in A-Fib and being A-Fib free! Normal Sinus Rhythm is wonderful!
There’s nothing like having a heart that beats normally again. No more tiredness, dizziness. being light headed. Your body feels alive. Your brain works. You can run and exercise again. [See the photo at right of me doing the high jump at age 75!]
Thank you for giving me my life back!”
After my talk I received enthusiastic complements and ‘fist bumps’.
I think I really made an impression. I don’t think anyone had ever talked to these doctors like that before.
My hope is that the effects of my talk will trickle down to helping others with Atrial Fibrillation.
If you find any errors on this page, email us. ♥ Last updated: Thursday, October 6, 2016
For a substantial portion of A-Fib patients, the impact on their ‘quality of life’ extends beyond their beating heart. Atrial Fibrillation wreaks havoc with your head as well as your heart. Anxiety, fear and worry. And at times, anger.
The psychological and emotional effects of Atrial Fibrillation can be debilitating. Recent research indicates that “psychological distress” worsens the severity of A-Fib symptoms.
Read my article Coping With the Fear and Anxiety of Atrial Fibrillation for seven ways to fight your fears and ambush your anxiety! Atrial Fibrillation may be in your heart but it doesn’t have to be in your head.
Frequently Asked Questions by Newly Diagnosed Patients
Newly diagnosed Atrial Fibrillation patients have many questions about living with A-Fib. These are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer)
Last updated: Monday, July 13, 2015
8. “I have a lot of extra beats and palpitations (PVCs and/or PACs) which are very disturbing and frightful. They seem to proceed an A-Fib attack. What can or should I do about them?”
Most A-Fib doctors aren’t overly concerned about extra beats (Premature Ventricular Contractions—PVCs) or Premature Atrial Contractions—PACs), because they are considered 100% benign. Everybody gets them, not just people with A-Fib.
PACs Often Precede or Forewarn of an A-Fib Attack
However, studies indicate that PACs often precede or forewarn of an A-Fib attack. A-Fibbers seem to have more problems with extra beats than normal people. In a very important study, doctors from China showed how frequent PACs (more than 100 beats/day) actually predict who will develop A-Fib.
Also, after a successful A-Fib PVA(I) ablation, people seem to have more extra beats which tend to diminish over time as the heart heals and gets used to beating properly.
Sometimes PVCs Aren’t Always Benign
In patients with other heart problems like Coronary Artery Disease (CAD), frequent PVCs often aren’t “benign.” They can increase chances of a fatal heart attack or sudden death. PVCs have been implicated in the development of cardiomyopathy and LV (Left Ventricular) dysfunction. But catheter ablation or antiarrhythmic pharmacological agents appears to reverse this cardiomyopathy and LV dysfunction. RF ablation for frequent PVCs in patients without structural heart disease has been shown to completely reverse cardiomyopathy in numerous studies.
Catheter Ablation Can Be Performed to Free You of PACs/PVCs
If these extra beats cause you problems, beta blockers and antiarrhythmic meds may help. But sites in the heart that produce PACs/PVCs can also be mapped and ablated.
A catheter ablation, in addition to removing A-Fib producing spots in the heart, can also map and ablate areas producing PACs/PVCs. For some, frequent PACs/PVCs can be as damaging and troublesome as A-Fib. Ablations are done not just to fix A-Fib, but can also be for the sole purpose of freeing someone from frequent PACs/PVCs. They are an option patients with frequent PACs/PVCs should be aware of.
Try the Valsalva Maneuver
On the anecdotal side, some people recommend the ‘Valsalva maneuver’ (one type of Vagal maneuver) to stop PVCs/PACs—closing one’s mouth and pinching one’s nose shut while forcing exhalation, or sticking one’s head in a sink of really cold water (constricting blood vessels). For details about the Valsalva Maneuver see: FAQs Natural Therapies: The Vagal Maneuver.
For more about PVCs and PACs see: Premature Atrial Contractions (PACs) Predict A-Fib.
For ‘natural’ remedies see: FAQ Minerals Deficiencies: PVCs & PACs.
(Thanks to John Thornton for calling our attention to this research on PVCs.)
Last updated: Monday, June 29, 2015
14. “I live in fear of my A-Fib. I never know when I’m going to get an A-Fib attack or how long it will last. How do people deal with this constantly lurking fear and anxiety?”
Don’t be ashamed to admit how A-Fib makes you feel (especially if you’re a guy). A-Fib has psychological and emotional effects as well as physical. Recent research indicates that “psychological distress” worsens A-Fib symptoms’ severity.
Seven WAYS TO COPE WITH YOUR A-FIB FEAR AND ANXIETY
1. Knowledge is Power and Control!
Read about your treatment options, learn about your A-Fib. Read how others have dealt with their A-Fib. Search the list of Personal Experiences published on his site. With over 90 stories, you’re sure to find a few patients with similar symptoms as yourself. Knowing others have beaten their A-Fib is a tremendous psychological relief. This helps replace fear with hope!
2. Anxiety Thought Log
Confront your A-Fib fears directly. Don’t let them mill around in your subconscious. Former A-Fib patient, Anthony Bladon, suggests you keep an ‘anxiety thoughts log.’ Write down word-for-word what the anxious thought was, when, and what was the trigger. Confront each fearful thought and try to re-state it in a more reasonable frame of mind, thereby reducing the anxiety. (See Anthony Bladon and his anxiety log.)
This may sound a bit bizarre, but try repeating anxious thoughts to yourself. Express a fear to yourself over and over. Let the monotony make your mind wander to more enjoyable thoughts. Or set aside a 20 minute worrying time during the day and refuse to think about troubling fears at any other time.
3. Yoga, Relaxation Techniques and Meditation
In preliminary studies, Yoga has been demonstrated to improve A-Fib symptoms and to reduce A-Fib attacks, as well as improve quality of life, depression and anxiety.2 (See also FAQ #8 “I do Yoga. It relaxes me and helps with my stress level. Is there any evidence on Yoga helping with other A-Fib symptoms?“)
Relaxation techniques and meditation may also offer you relief from your anxieties.
A specific type of meditation called ‘Mindfulness’ is recommended by Harvard Pilgrim nurse case manager Linda Bixby. The technique is to ‘Observe and Feel the Physical Sensations’ of the A-Fib Episodes. At first this may seem counter-intuitive and may not work for you. The idea is to observe rather than resist or worry. You allow a frightening health event like an A-Fib attack to just run its course. For example, Neil Blanchette was diagnosed with A-Fib when he was 17. Meditation and “mindfulness” was a great help to him. “Just taking it in and letting myself feel the physical A-Fib experience was actually relaxing.”3(Thanks to David Holzman for calling our attention to this article.)
4. Natural Remedies:
Lavender Oil Aromatherapy: the light, soothing fragrance of lavender oil has long been used to ease anxiety (and insomnia). One example of many is Nature’s Way Calm Aid. “It contains Silexan, a type of lavender oil shown in clinical studies to ease anxiety as effectively as the benzodiazepine drug lorazepam (Ativan).”4
PharmaGABA: is a bioidentical form of GABA (gamma-aminobutyric acid), which serves as a critical calming agent in the central nervous system, works on the same chemical pathways as Xanax, Valium, and other drugs—without all the negative side effects; helps combat stress and anxiousness.5 One example is Natural Factors PharmaGABA
Relora: a blend of two botanical extracts (Magnolia officinalis and Phellodendron amurense) that helps reduce cortisol levels and promotes feelings of relaxation.6
5. Counseling and Meds
Recognize that you may need professional help. Don’t be embarrassed to seek counseling. In addition, discuss if anxiety medication would be appropriate or helpful. (See Jay Teresi’s story, “Anxiety the Greatest Challenge” and Kelly Teresi’s story “A Young Wife Copes with Husband’s A-Fib” in my book, Beat Your A-Fib, pgs. 101-105)
6. Our A-Fib Support Volunteers
It might calm your fears to talk with or email someone who knows first-hand how A-Fib makes you feel. Each of our A-Fib Support Volunteers has gone through a lot to be cured of their A-Fib. They were helped along the way and now they want to return the favor by offering you support and hope. Learn more on our A-Fib Support Volunteers page (under Resources and Links).
7. Enlist Support From Your Loved Ones
Recognize that A-Fib can have significant consequences on your social interactions with your family and colleagues. Sit down and have a talk with your significant other, your friends and co-workers. Explain what A-Fib is, how it affects you and how it makes you feel. Ask for their understanding. They will want to help you, so be prepared to answer their questions.
Takeaway: Fight your fears! Ambush your anxiety! Atrial Fibrillation may be in your heart but it doesn’t have to be in your head. Seek your freedom from anxiety and improve the quality of your life.
Other ideas? If you have suggestions or programs that helped reduce your A-Fib-related anxiety, please email me and let me know.
Last updated: Friday, August 21, 2015
References (↵ returns to text)
- Gehi AK at al. Psychopathology and symptoms of atrial fibrillation: implications for therapy. J Cardiovasc Electrophysiol. 2012 May;23(5):473-8. doi: 10.1111/j.1540-8167.2011.02264.x. Epub 2012 Mar 19. http://www.ncbi.nlm.nih.gov/pubmed/22429764↵
- Neale, T. Yoga May Calm Afib. MedscapeToday.com. Jan 23, 2013. Last accessed Jan 23, 2014. URL:http://www.medpagetoday.com/Cardiology/Arrhythmias/37121↵
- Harvard Pilgrim Health Care. Your Health, Fall 2014.↵
- Lucile, H. (DrHollyLucille.com) Natural remedy for anxiety, Bottom Line Health, April, 2014, p. 16.↵
- Whitaker, J. PharmaGABA Chewables for Immediate Stress Relief. Whitaker Wellness Institute website. Last accessed March 29, 2014. URL: http://www.whitakerwellness.com/pharmagaba/↵
- Whitaker, J. Innovations in Wellness Medicine, Natural Solutions for Stress Relief. Dr. Whitaker’s Health & Healing, March 2015, Vol. 25, No. 3.↵
Last updated: Wednesday, December 7, 2016
What are the Causes of A-Fib?
It’s estimated as many as 5.1 million people in the U.S. have A-Fib. By the year 2050, the number will be 12-16 million.1 Each year there are over 340,000 new cases in the US. A-Fib is the most common heart arrhythmia.2 In the U.S. people over 40 have a one in four lifetime risk of developing A-Fib.3
HOW DO YOU GET A-FIB?
If you’ve had other heart problems, this could lead to diseased heart tissue which generates the extra A-Fib pulses. Hypertension (high blood pressure), Mitral Valve disease, Congestive Heart Failure, coronary artery disease, and obesity6 seem to be related to A-Fib, possibly because they stretch and put pressure on the pulmonary veins where most A-Fib originates. Coronary artery disease reduces blood flow and oxygen (stagnant hypoxia) which can trigger A-Fib.
A lot of A-Fib seems to come from uncontrolled high blood pressure. Many EPs recommend that all hypertension patients get a home BP monitor and aggressively work at controlling their blood pressure.
About 25% to 35% of stroke survivors experience atrial fibrillation;7 Up to 40% of patients8 get A-Fib after open heart surgery. “Pericarditis”—inflammation of the pericardium, a sack-like membrane surrounding the heart—can lead to A-Fib.
Heavy drinking may trigger A-Fib, what hospitals call “holiday heart”—the majority of A-Fib admissions occur over weekends or holidays when more alcohol is consumed. No association was found between moderate alcohol use and A-Fib.9 (Heavy drinking reduces the ability of cells to take up and utilize oxygen [histotoxic hypoxia] which in some people may produce or trigger A-Fib. [Thanks to Warren Stuart for this insight.]) See the personal A-Fib story by Kris: “Binge Drinking Leads to Chronic A-Fib, Amiodarone Damages Eyesight” pp. 144-150 in my book, Beat Your A-Fib.
See the personal A-Fib story by Kris: “Binge Drinking Leads to Chronic A-Fib, Amiodarone Damages Eyesight” pp. 144-150 in my book, Beat Your A-Fib.
But if you already have A-Fib, even moderate use may trigger an A-Fib attack, “…people with atrial fibrillation had almost a four and a half greater chance of having an episode if they were consuming alcohol than if they were not.”10 (Thanks to David Holzman for calling our attention to this article.)
Otherwise healthy middle-aged women who consumed more than 2 drinks daily were 60% more likely to develop AF.11
Steve Walters writes “that red wine brings on A-Fib attacks for him, but not beer, white wine, or cordials. Has anyone else had similar experiences with red wine?” E-mail: bicwiley(at)gmail.com.
Neville writes that “taking a heavy dose of Magnesium/Potassium tablets and bananas for breakfast kept him out of A-Fib during a golfing weekend with significant drinking.” He uses the same strategy to get out of an A-Fib attack. email@example.com
Severe Body & Mind Stress
Severe infections, severe pain, traumatic injury, and illegal drug use can be a trigger. Low or high blood and tissue concentrations of minerals such as potassium, magnesium and calcium can trigger A-Fib. Thyroid problems (hyperthyroidism), lung disease, reactive hypoglycemia, viral infections and diabetes.
To learn the impact of anxiety and emotional stress on A-Fib, see Jay Teresi’s personal story “Anxiety the Greatest Challenge”
Extreme fatigue, anxiety and emotional stress can trigger A-Fib.
Smoking can trigger A-Fib. Smoking reduces the ability of the blood to carry oxygen (anemic hypoxia). Smoking cigarettes raises the risk of developing A-Fib even if one stops smoking, possibly because past smoking leaves behind permanent fibrotic damage to the atrium which makes later A-Fib more likely.12
As we put on pounds, our risk of developing A-Fib increases. In recent studies overweight adults were 39% more likely, and obese adults 87% more likely, to develop A-Fib than their normal-weight counterparts.13
Health problems linked to obesity, like high blood pressure and diabetes, can contribute to A-Fib. And obesity may put extra pressure on the pulmonary veins and induce A-Fib. Left atrial hypertension is a common finding in obese patients.
14 Do you have a parent or other immediate family member with A-Fib? Research says you have a 40% increased risk of developing A-Fib yourself. And the younger that family member was when they got A-Fib, the more likely you are to develop A-Fib.
According to Dr. Dan Roden of Vanderbilt University, genetic research may become important to A-Fib patients. He postulates that “Lone A-Fib” (A-Fib without a known cause) may actually be caused by genetics.
We’ve had reports that A-Fib can be triggered by antihistamines, bronchial inhalants, local anesthetics, medications such as sumatriptan, a headache drug,15 tobacco use, MSG, cold beverages and eating ice cream, high altitude, and even sleeping on one’s left side or stomach. One person writes that hair regrowth products seem to trigger his A-Fib.
I used to include caffeine (coffee, tea, sodas, etc.) in this list, but some research suggests that coffee and caffeine in moderate to heavy doses (2-3 cups to 10 cups/day) may not trigger or induce A-Fib.16 Coffee (caffeine) may indeed be antiarrhythmic and may reduce propensity and inducibility of A-Fib both in normal hearts and in those with focal forms of A-Fib.17
Possible Food-Related Triggers
Chocolate in large amounts may trigger attacks. Chocolate contains a little caffeine, but also contains the structurally related theobromine, a milder cardiac stimulant.
Another reader writes that the natural sweetener and sugar substitute Stevia seems to trigger her A-Fib.
GERD (heartburn) and other stomach problems (like H. pylori) may be related to or trigger A-Fib. If so, antacids and proton pump inhibitors like Nexium may help your A-Fib. A report from England suggests that the veterinary antibiotic “Lasalocid” found in eggs and poultry meat may cause or trigger A-Fib.18
Recent research indicates sleep apnea (where your breathing stops while you are sleeping) may contribute to A-Fib, probably by causing stress on the Pulmonary Vein openings and/or by depriving the lungs and body of adequate oxygen supply (Hypoxemic Hypoxia).
Over 25 million Americans currently have sleep apnea, but 80% of these people don’t know they have it
In one study of patients with A-Fib, 43% had sleep apnea. (An additional 31% had “central sleep apnea/Cheyne-Stokes respiration” which is a different type of sleep apnea.)19
If you have A-Fib, it’s wise to have yourself checked for sleep apnea. You can do a “quick” check of how much oxygen is in your blood with a Pulse Oximeter, such as the Contec Pulse Oximeter for about $20 from Amazon.com and in drug stores. A reading below 90% would indicate you need to have a sleep lab study.
You may want to check out the web site, MySleepApnea, http://www.myapnea.org, an online community for people with sleep apnea to s hare health info and personal experiences. (The Shaquille O’Neal video is terrific!)
Gail writes that “both her sleep apnea and her A-Fib were cured by a CPAP [Continuous Positive Airway Pressure] breathing machine.” (E-mail her: gail(at)bonairwine.com.)
Mechanically Induced A-Fib
Be careful if you work around equipment that vibrates. Certain frequencies and/or vibrations may possibly trigger or induce A-Fib. (If anyone has any info on how or why high frequencies and/or vibrations may possibly affect A-Fib, please let me know.)
Jerry writes that “high powered magnets, such as the N50, may trigger A-Fib due to the electromagnetic fields they generate.” (If you have any info on this, please email me.)
Physical and Gender Characteristics
Men get A-Fib more than women. But women may have more symptoms.
Men get A-Fib more than women. But women may have more symptoms.
Men get A-Fib more than women. But women fail more antiarrhythmic drugs therapies than men and may have more symptoms. For more see my article: The Facts About Women with A-Fib: Mother Nature and Gender Bias.
A-Fib is associated with aging of the heart. As patients get older, the prevalence of A-Fib increases, roughly doubling with each decade. 2-3% of people in their 60s, 5-6% of people in their 70s, and 8-10% of people in their 80s have A-Fib.21,22,23Approximately 70% of people with A-Fib are between 65 and 85 years of age.24 This suggests that A-Fib may be related to degenerative, age-related changes in the heart. Inflammation may contribute to the structural remodeling associated with A-Fib.25
No Known Cause
But in many A-Fib cases (around 50% of Paroxysmal A-Fib26), there is no currently discernible cause or trigger (called “Lone” or “Idiopathic A-Fib”).27 (Some research suggests that inflammation may initiate Lone A-Fib.)28
Last updated: Sunday, April 10, 2016
- Miyasaka, Yoko, et al, Secular Trends in Incidence of Atrial Fibrillation in Olmsted County, Minnesota, 1980 to 2000, and Implications on the Projections for Future Prevalence Circulation, 2006;114:119-125. Last accessed Feb 15, 2013. URL: http://www.circ.ahajournals.org/cgi/content/full/114/2/119↵
- Nelson, Bryn. “Places In The Heart,” NYU Physician. Spring, 2009, p. 8.↵
- Van Wagoner, David “Atrial selective strategies for treating atrial fibrillation.” Drug Discovery Today: Therapeutic Strategies Vol 2, No. 3, 2005. “We have detected increased levels of the systemic inflammatory marker C-reactive protein (CRP) in patients with A-Fib.”↵
- S. S. Chugh, et al. Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study. Circulation, 2013; DOI: 10.1161/CIRCULATIONAHA.113.005119↵
- Camm, “Stroke in atrial fibrillation: Update on pathology, new antithrombotic therapies, and evolution of procedures and devices.” Annals of Medicine, 39:5, 371-391, 2007↵
- The Link Between Infections and Inflammation in Heart Disease. Life Extension Vitamins. Last accessed November 5, 2012 http://www.lifeextensionvitamins.com/cadico6otco.html↵
- Bottom Line Personal, October 15, 2014, p. 11. Kallmunzer, Bernd et al. Peripheral pulse measurement after ischemic stroke. Nuerology, Published Online May 6, 2014 http://www.neurology.org/content/83/7/598.abstract?sid=f532228b-5314-46d3-bdca-a7db9bc7fa7d↵
- Frost L., et al. “Atrial fibrillation and flutter after coronary artery bypass surgery: epidemiology, risk factors and preventive trials. International Journal of Cardiology. 1992;36:253-262.↵
- Calkins, H. and Berger, R. “Atrial Fibrillation The Latest Management Strategies.” The Johns Hopkins Medicine Library, p. 10.↵
- Alcohol May Trigger Serious Palpitations in Heart Patients. American Journal of Cardiology (August 1, 2012) http://www.newswise.com/articles/alcohol-may-trigger-serious-palpitations-in-heart-patients↵
- Conen D, Tedrow UB, Cook NR, Moorthy MV, Buring JE, Albert CM (December 2008). “Alcohol consumption and risk of incident atrial fibrillation in women”. JAMA 300 (21): 2489 96.
doi:10.1001/jama.2008.755. PMID 19050192. PMC 2630715. http://jama.ama-assn.org/cgi/content/full/300/21/2489.↵
- Heeringa J, et al. Cigarette smoking and risk of atrial fibrillation: the Rotterdam Study. Am Heart J. 2008 Dec;156(6):1163-9. doi: 10.1016/j.ahj.2008.08.003. Last accessed Jan 6, 2013 URL: http://www.ncbi.nlm.nih.gov/pubmed/19033014↵
- Vivek Y. Reddy, M.D., Joins The Mount Sinai Medical Center as Director of Electrophysiology Laboratories.Â May 6, 2009 . http://www.prweb.com/printer/2396634.htm↵
- Brugada R. “Identification of a genetic locus for familial atrial fibrillation,” New England Journal of Medicine 1997;336:p. 905-911. Ellinor et al., 2005, 2008. Sinner et al., 2011.↵
- The Link Between Infections and Inflammation in Heart Disease. Life Extension Vitamins. Last accessed November 5, 2012 http://www.lifeextensionvitamins.com/cadico6otco.html↵
- Katan, M, Schouten, E. Caffeine and arrhythmia1,2,3. Am J Clin Nutr March 2005 vol. 81 no. 3 539-540. Last accessed November 5, 2012 http://www.ajcn.org/cgi/content/full/81/3/539↵
- Rashid, Abdul et al. “The effects of caffeine on the inducibility of Atrial fibrillation.” J Electrocardiol. 2006 October, 39(4): 421-425. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257921/↵
- Barclay, L. Caffeine Not Associated With Increased Risk of Atrial Fibrillation. Mar 10, 2005. Medscape News Today. Last accessed November 5, 2012. http://www.medscape.com/viewarticle/501279?src=search↵
- Bitter, T. et al. Sleep-disordered Breathing in Patients With Atrial Fibrillation and Normal Systolic Left Ventricular Function. Dtsch Arztebl Int 2009; 106(10): 164-70 http://www.aerzteblatt.de/pdf/di/106/10/m164.pdf. DOI: 10.3238/arztebl.2009.0164↵
- “The tallest patients in a recent study were 32% more likely to have A-Fib than the shortest ones. Doctors estimate that for every six-inch increase in height, the risk for A-Fib increases by 50%.” Bottom Line Health, July, 2006, p. 14.↵
- Go, “Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention.” JAMA, 2001:285:2370-2375.↵
- Philip A. et al. Atrial Fibrillation: A Major Contributor to Stroke in the Elderly, : The Framingham Study. Arch Intern Med 1987;147:1561-1564.↵
- Feinberg, “Prevalence, age distribution, and gender of patients with atrial fibrillation: analysis and implications.” Arch Intern Med 1995;155:469-473.↵
- Laish-Farkash, A. et al. Atrial Fibrillation in the Elderly—To Ablate or Not to Ablate, J Cardiovasc Electrophysiol. 2013;24(7):739-741. http://www.medscape.com/viewarticle/807303.↵
- Van Wagoner, David “Atrial selective strategies for treating atrial fibrillation.” Drug Discovery Today: Therapeutic Strategies Vol 2, No. 3, 2005. “We have detected increased levels of the systemic inflammatory marker C-reactive protein (CRP) in patients with A-Fib.“↵
- Allessie, Maurits A. et al. “Pathophysiology and Prevention of Atrial Fibrillation.” Circulation. 2001;103:769.↵