Doctors & patients are saying about 'A-Fib.com'...
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Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN
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Jill and Steve Douglas, East Troy, WI
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Faye Spencer, Boise, ID, April 2017
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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
Catheter Ablation Reduces Stroke Risk Even for Higher Risk Patients
by Steve S. Ryan, Last updated: March 24, 2018
In a study of nearly 38,000 people, patients with A-Fib who had a catheter ablation had about as many strokes as the people without A-Fib, while people on just medication had about twice as many strokes. (This isn’t a surprising finding. If you no longer have A-Fib, by definition you can’t have an A-Fib stroke.)
But what is surprising is that even patients at greater risk of stroke had a reduced stroke risk after catheter ablation. “Across all CHADS2 profiles and ages, A-Fib patients with ablation had a lower long-term risk of stroke compared to patients without ablation.” Even those at higher risks of stroke had a reduced risk of stroke.
Catheter Ablation Reduces Stroke Risk to That Of A Normal Person
And, more importantly, if someone had a catheter ablation, stroke risk decreased to that of a normal person. “A-Fib ablation patients had similar long-term risks of stroke across all CHADS2 profiles and ages compared to patients with no history of A-Fib…Freedom from A-Fib was the strongest predictor of stroke-free survival.”
Warfarin Not Needed After Successful Catheter Ablation
Some patients after a catheter ablation are still put on warfarin-for-life depending on their CHADS2 score. But research indicates that “A-Fib patients after ablation with moderate to high risk CHADS2 scores in which warfarin was discontinued do not show a higher risk of stroke compared to those in which warfarin is continued.”
Editor’s Comments:
This study is medical breakthrough news, similar to another important study in which a successful catheter ablation reduced by 60% the expected rate of cardiovascular mortality. (See Live Longer—Have a Catheter Ablation.)
For anyone who has had a successful catheter ablation or who is thinking of having one, this study also is a game changer!
Even if you are at a theoretical high risk of stroke (high CHADS2), you don’t have to be on warfarin for the rest of your life after a successful catheter ablation. A successful catheter ablation reduces your stroke risk to that of a normal person (though obviously normal people do have strokes).
We already know that a catheter ablation significantly improves our well being. We certainly feel healthier in sinus rhythm. Few other medical procedures produce such a dramatic and nearly immediate improvement in our quality of life. This study confirms the long-term benefits of catheter ablation even for people who are sicker.
We don’t have to live a life on meds! A-Fib can be cured by a catheter ablation. And when you are made A-Fib free, not only do you feel better, but your risk of stroke is reduced to that of a normal person! This is terrific news for the A-Fib community.
• Bunch, T.J. et al. Patients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation. J. Cardiovasc Electrophysiol. 2011;22:839-845. http://www.ncbi.nlm.nih.gov/pubmed/21410581. doi: 10.1111/j.1540-8167.2011.02035.x. Epub 2011 Mar 15.
• Hunter, RJ et al. Maintenance of sinus rhythm with an ablation strategy in patients with atrial fibrillation is associated with a lower risk of stroke and death. Heart. 2012;98:48-53. http://www.ncbi.nlm.nih.gov/pubmed/21930724. doi: 10.1136/heartjnl-2011-300720.
• Kornej, J. et al Renal Dysfunction, Stroke Risk Scores (CHADS2, CHA2DS2-VASc, and R2CHADS2), and the risk of Thromboembolic Events After Catheter Ablation of Atrial Fibrillation. Circ Arrhythm Electrophsiol, 2013;6:868-874. http://circep.ahajournals.org/content/6/5/868.abstract. doi: 10.1161/CIRCEP.113.000869
• Oral, H. et al. Risk of thromboembolic events after percutaneous left atrial radiofrequency ablation of atrial fibrillation. Circulation. 2006;114:759-765. http://circ.ahajournals.org/content/114/8/759.short.
• Themistoclakis, S. et al. The risk of thromboembolism and need for oral anticoagulation after successful atrial fibrillation ablation. J Am Cardiol. 2010;55:735-743. http://content.onlinejacc.org/article.aspx?articleid=1140481 doi:10.1016/j.jacc.2009.11.039 Posted January 2015