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
New! 2 Free Worksheets: Doctor’s Visit Prep and Medication Inventory List
Free Offers & Downloads: As a service to Atrial Fibrillation patients, we offer FREE downloads of our own worksheets and special reports as well as useful FREE services or downloads from others serving the atrial fibrillation community. Click to visit the page to access all our FREE stuff.
Doctor’s Visit Prep Worksheet
I’m especially pleased to find this worksheet as I have long felt the need for patients to carry in a list of topics to discuss with their doctors.
For A-Fib patients, we encourage everyone to take notes during their appointments in a designated “A-Fib Notepad“. This prep worksheet helps you identify and list goals before your visit!
Doctor’s visits can be stressful, especially when you have a list of concerns or questions and want to make sure you don’t forget them.
This Doctor’s Visit Prep worksheet from SingleCare.com encourages you to organize your thoughts, questions, and symptoms before hand. It helps to make the best use of your and your doctor’s time for a productive, efficient office visit. Download this free .PDF worksheet. Keep several copies in your A-Fib binder or folder.
Keep an Inventory List of Your Medications
During office visits, your doctor or other medical healthcare providers often ask you to verify or update your medication list.
This FREE form from wordtemplatesonline.net helps you keep an up-to-date inventory of your medications. And because they may interact, you should also list over-the-counter drugs, vitamins and mineral supplements, too.
Download the Medication Inventory List worksheet and remember to save to your hard-drive.
Because your medications can change over time, print several copies of the blank form so you will always have a clean copy ready to use. (Keep with your A-Fib binder or folder.)
Be Ready for a Medical Emergency: Carry a copy of your medication inventory in your wallet as part of your Portable Medical Information ‘Kit’.
What medical information should you carry with you? To learn what and how to carrying your information, see our article, Your Portable Medical Information Kit.
Which Comorbid Risks Do You Have That Make Your A-Fib More Severe? And What To Do
Most A-Fib patients have at least one concurrent medical condition, i.e., comorbidity, that makes Atrial Fibrillation symptoms more severe and makes treating A-Fib more difficult with increased risk of complications. They can also affect the longevity of a treatment such as a catheter ablation.
Concurrent Medical Conditions
Concurrent conditions, or comorbidities, are risk factors that can interfere with the biological mechanisms or processes (pathogenesis) of your A-Fib. The leading concurrent conditions affecting Atrial Fibrillation patients are:
• Obstructive Sleep Apnea
• Diabetes
• Hypertension (high blood pressure)
• Heat Failure
• Air pollution
• Respiratory Disease
• Chronic Kidney Disease
• Mental health disorders
Comorbidities and the Impact on Your Atrial Fibrillation
Obstructive Sleep Apnea (OSA): At least 43% of patients with Atrial Fibrillation also suffer from Obstructive Sleep Apnea. …->Continue reading about each of the concurrent conditions on our list and the risks for Atrial Fibrillations and learn what to do…->Go to read my full article.
Smartphones: Emergency Medical ID Info Access, No Passcode Required
Early cell phone users were able to list critical medical condition information (such as Atrial Fibrillation) as an “In Case of Emergency” (ICE) contact in their Contacts folder. But today’s smartphones are passcode protected. So, is there a work around for today’s smartphones? Yes!
Smartphone Can Still Offer Emergency Medical ID
In an emergency—if you are in an accident, fall ill or unconscious—your smartphone can still provide your critical medical information such as medication you are taking (i.e., a blood thinner or anticoagulant), your known allergies, and your blood type.
You can set up your smartphone so that first responders can access this information without needing your phone passcode. As they say…there’s a app for that (or built-in) on your iPhone or android phone!
iPhone Medical ID access button
Apple iPhone
The Apple iPhone has this feature built directly into the iOS Health App under the Medical ID section. After you enter your personal medical data and other facts, you can toggle “Show When Locked”.
Your keyboard will then display a “Medical ID” button to reach your preset medical information. First responders simply press the button.
How to: For step-by-step instructions for an iPhone, go to Set up your Medical ID in the Health app to learn how.
Android Smartphone
Android smartphone Medical ID access message
To add this emergency medical info feature to Android smartphones, you have several options depending on the specific phone.
• For Android phones, go to Settings and select “Emergency Info” or “Medical”. (For the Google Pixel phone, use the dedicated app called “Safety”)
• Or, you can download the free Medical ID app from the Google.com app store.
Watch the video: To make setup easier, you may want to watch a how-to video:
• How to Create a Medical ID on an Android Device (Did You Know?) from BridgingApps (2:12 min)
• How to Set Up Medical ID on Android (Samsung Galaxy & Google Pixel) by Quick Tutorials (1:56 min)
Setup it Once and You’re Prepared
Whether you are using an iPhone or an Android smartphone, and whether you are using a built-in feature or downloading an app, either way you are prepared.
Emergency first responders will be able to view your medical details despite using a passcode protected smartphone.
What medical information should you compile and carry with you?
See our article: Your Portable Medical Information Kit.
How A-Fib Robs You of Your Heart Health: Let Me Count the 11 Ways
A-Fib is like a thief in the night robbing you of your heart health.
I first published this as a post in 2021, but we all (especially newer A-Fib readers) should be reminded of the cost of staying in Atrial Fibrillation (instead of seeking your cure). Remember: Aim for a cure, not a life on medication.
Atrial Fibrillation is a disease of the heart but affects your overall health as well. It is often said, “A-Fib begets A-Fib”. It’s a progressive disease and is self-perpetuating.
Here are the many ways A-Fib can rob you of your heart health:
1. Risk of stroke. The biggest danger from A-Fib is stroke. Because your heart isn’t pumping out properly, blood can pool in your atria then form clots that travel to the brain causing stroke. Use of anticoagulant drugs reduce, but don’t eliminate, the risk of an A-Fib stroke. Anticoagulants are high risk drugs. They don’t cure or improve your A-Fib.
2. Reduced Blood Circulation. A-Fib reduces your heart’s pumping ability by 15%–30%, decreasing blood flow to the brain and to the rest of the body. This may cause weakness, fatigue, dizziness, brain fog, fainting spells, swelling of the legs, and shortness of breath. Over time, reduced blood circulation contributes to many other health issues.
3. Fibrosis (Structural Remodeling). Over time A-Fib produces fiber-like scar tissue in place of the normal smooth walls of the heart. Fibrosis makes the heart stiff, less flexible and weak with a loss of atrial muscle mass. It overworks the heart, reduces pumping efficiency, and leads to other heart problems. Fibrosis is considered permanent and irreversible.
4. Atrial stretch/expansion (Structural Remodeling). When in A-Fib, your left atrium has to work harder than normal. Over time, the left atrium tends to stretch or dilate thereby weakening the heart muscle. An enlarged left atrium can be diagnosed and measured using an echocardiogram (ECHO). (A normal size is 2.0-4.0 cm; over 5.5 cm is considered chronically enlarged.)
5. Electrical Remodeling. A-Fib causes electrophysiological changes in the heart which are self-perpetuating, make the heart more prone to go into and remain in A-Fib. This Remodeling develops quickly, is progressive, and may be persistent. For instance, an A-Fib episode once a month may escalate to once a week and might become longer than before.
6. Heart Failure. Researchers have found that A-Fib is strongly associated with heart failure which is five times more likely in people with A-Fib. When in A-Fib, your heart isn’t pumping properly. So it’s not surprising that A-Fib leads to heart disease, heart failure, and sudden death. A-Fib affects your whole body. It damages your heart, brain, and other organs.
7. Coexisting Conditions (Comorbidities). The symptoms of one illness can predispose a person to another. Most A-Fib patients have at least one comorbidity such as diabetes, hypertension or sleep apnea. A somewhat surprising association with A-Fib is kidney disease and peripheral arterial disease.
8. Dementia. A-Fib has been independently associated with dementia. Leaving patients in A-Fib doubles the risk of developing dementia. Current drugs, even statins, don’t work or have mixed results in preventing dementia. Because your heart is being remodeled electrically, your A-Fib may eventually worsen to Long-standing Persistent A-Fib (which is harder to cure).
9. Brain Atrophy, Reduced Brain Volume and Cognitive Function. Research shows A-Fib patients experience loss of both grey and white brain matter, as well as white matter brain lesions. Cognitive function and processing speed decline significantly.
Mental skills and memory are also affected. Max Jussila, a Finnish executive, recalls his challenges. “I have never been mentally so incapable. My memory was gone, my speech was gone (I speak five languages), even the simplest work-related problems seemed impossible for me to handle, let alone solve.”
10. Reduced Quality of Life. For many patients, A-Fib disrupts both work and family life. They are often preoccupied about the next A-Fib attack. When will it hit? How bad will it be? Where will I be at the time? When you travel, you first research the location of the nearest emergency room.
A-Fib can have significant consequences on your social interactions with loved ones, friends and colleagues. The patient’s livelihood may be impacted. Family life may be unsettled. In one study the partners of A-Fib patients reported a significant reduction in their quality of life, to the same degree as the patient.
11. Psychological and Emotional Effects. A-Fib wreaks havoc with your head as well as your heart. Anxiety, fear, frustration, worry, confusion, depression and anger can be as debilitating as the disease itself. Psychological distress worsens A-Fib symptoms’ severity. Physical ailments like colds may be more frequent because of a depressed immune system.
How Much Will You Pay to Stay in A-Fib?
A-Fib costs you in many ways. Beyond the physical, mental and emotional toll, staying in A-Fib is costly to your wallet too. Besides the annual costs of your medications, ER visits, etc., the odds of your being hospitalized increases (each year 750,000 hospitalizations in the U.S. are due to A-Fib).
According to the Centers for Disease Control and Prevention (CDC), just in terms of dollars and cents, A-Fib on average costs you an additional $8,700 a year.
When you add up all the costs (physical, emotional and monetary) of living in A-Fib, doesn’t it make sense to ‘Seek you Cure’?
Don’t Settle for a Lifetime on Meds―Seek your A-Fib Cure
Today’s TV advertisements for anticoagulants talk about “living with A-Fib”. They show patients living happy, healthy, care-free lives while still in A-Fib. That’s a Pollyanna fantasy―just take an A-Fib pill and live happily ever after.
Contrary to today’s media, your goal shouldn’t be to just ‘manage’ your A-Fib. For patients with A-Fib, it isn’t enough to simply take an anticoagulant.
Your goal should be to get your A-Fib fixed and have your heart beat again in normal sinus rhythm (NSR). Educate yourself. Learn all your treatment options.
Don’t just settle. Seek your A-Fib cure.
A-Fib and Sleep Apnea: At-Home Testing Approved by FDA
Many patients with Atrial Fibrillation also suffer with obstructive sleep apnea (OSA). Diagnosis of OSA and its treatment is essential if you have A-Fib.
What is OSA?
If you have sleep apnea, relaxation of throat muscles combine with a narrowed airway to interrupt breathing. The episodes of breathing cessation can last more than twenty seconds (reducing oxygen to the brain).
Nearly 22 million Americans suffer from sleep apnea, and more than half of cases go undiagnosed.
In-Lab Testing
To determine if you have obstructive sleep apnea (OSA), you must be tested.
Conventional testing for sleep apnea has been done at a sleep lab at a medical center or facility. You have a dozen or so electrical sensors attached to your body. You then try to sleep in a hospital-like environment. The people doing the testing may interrupt you during the night. At the end of the testing (at 6 am), you don’t feel rested at all.
At-Home Testing for Sleep Apnea Approved by the FDA
At-Home Testing for Sleep Apnea Approved by the FDAHome testing was FDA approved in 2022 and available by prescription.
A home sleep apnea test is an overnight, unattended study performed in the comfort of your own home. You pick up the kit or it is mailed to you.
While not as detailed as an in-clinic sleep study (it only measures breathing, not actual sleep), at-home sleep apnea testing can be used to diagnose or monitor obstructive sleep apnea (OSA).
At-home sleep apnea tests are best suited for people who are suspected of having moderate to severe sleep apnea that isn’t complicated by other disorders.
Home testing is available by doctor prescription. There are some testing companies who offer their own physicians to evaluate your test results. (If you don’t have a prescription, I wonder if the cost is covered by the patient’s health insurance.)
Home Testing Not for Everyone
For those with a more severe sleep apnea, an in-lab sleep experience may be required to rule out other medical conditions. Unlike a home sleep test, which looks only for sleep apnea, an overnight sleep study checks for conditions like insomnia, restless legs syndrome, periodic limb movements disorder, narcolepsy, and sleepwalking.
Editor’s Comments:
Personal experience: My wife, Patti, has had sleep apnea for years (but not A-Fib). She’s had in-labs testing and last October 2022 had an at-home sleep apnea test. I went by a UCLA facility to pick up the kit for her.
She carefully read the instructions and watched a how-to YouTube video by her healthcare provider. She set it all up and slept through the night quite comfortably (She’s been sleeping with a CPAP (Continuous positive airway pressure) facemask for years.) I returned the kit the next day. The results were then sent to her doctor.
Home-testing option: The at-home testing for Sleep Apnea may be a major advance in treating A-Fib. It may now be much easier, faster, (and perhaps cheaper) to test for Sleep Apnea which is one of the most common causes or symptoms of A-Fib (comorbidity).
Book Review: The AFib Cure by John D. Day and T. Jared Bunch
Review by Steve S. Ryan, PhD
The AFib Cure by Drs Day and Bunch
The AFib Cure: Get off Your Medications, Take Control of your health, and Add Years to Your Life was written by Drs. Day and Bunch for patients with Atrial Fibrillation. The center theme of The AFib Cure is “Food is the best medicine.”
The AFib Cure Focused on Diet
Their list of food prohibitions is more extensive than even by the most fanatical diet gurus. Though the authors acknowledge that this diet doesn’t work well enough. They admit that “about half of our patients can’t reach a drug-free goal (i.e., being A-Fib free) with lifestyle and biomarker optimization (diet) strategies alone.”
An only 50% success rate isn’t acceptable for most Atrial Fibrillation patients, particularly when it comes at such a cost. The authors require superhuman efforts and absolute dedication to their diet.
Food Prohibitions: The AFib Cure diet prohibits a lot. The list includes:
| • Alcohol • Sugar • Flour, Bread, White Rice • Coffee/Caffeine • Stimulants • Marijuana/THC | • Packaged Processed Food • Fast Food • Meat (wild meat OK) • Fish (limited [5] exceptions) • Supplements |
Is Food a Medicine?
How does the AFib Cure diet work to cure A-Fib? The authors fail to show how physically and/or chemically their diet can cure Atrial Fibrillation. As doctors know, food is not a medicine.
Book Review: “Your Complete Guide to AFib” by Percy Morales, MD
Review by Steve S. Ryan, PhD
I received an advance copy of “Your Complete Guide to AFib―The Essential Manual for Every Patient With Atrial Fibrillation” by Dr. Percy Morales and was asked for a review. The opinions given are my own.
Caveat: $149.95 to be Cured of AFib
Abbreviations for Atrial Fibrillation include: AFib, A-Fib and AF.
Dr. Morales’ book encourages readers to sign up for his “takecontroloverafib.com” program at $149.95 a pop. It’s very surprising to see a medical doctor engage in a direct marketing-type sales hustle. His “Guide to Healthy Living” reads like a Tony Robbins motivational presentation but applied to AFib.
[I personally was very discouraged and depressed reading Dr. Morales’ work.]
Style of Dr. Morales’ Book
“Your Complete Guide to AFib” is written by a working Electrophysiologist (EP). It’s a thin book, 119 pages, without a lot of content. But what’s there is clear and based on Dr. Morales’ own experience.
In terms of style, Dr. Morales’ book is a dull read with too many proofreading errors for such a small volume.
Instead of standard footnotes, he cites actual web sites which doesn’t work well. (Website addresses and pages change every day. As a solo source, they are not a reliable one.)
Is There No Cure for AFib?
A major shortcoming of Dr. Morales’ book is he doesn’t acknowledge that AFib can be cured, that you don’t have to live in AFib. This is discouraging and a turn-off for many readers. He isn’t big on hope.
Causes of AFib
Under “Causes of AFib” Dr. Morales doesn’t discuss or acknowledge Lone AFib where people who are perfectly healthy get AFib and don’t have any comorbidities (around 50% of AFib cases, including me) (p. 16). But on page 99 he does acknowledge that, “some younger patients will be diagnosed with AFib where there is no clear cause for it.”
Most people who develop AFib are not sick with other diseases. And even if one is sick with, for example, high blood pressure, we can’t say for sure that high blood pressure “caused” a particular person’s AFib.
Is AFib Your Fault?
Dr. Morales implies that it’s a patient’s fault that they developed AFib, because they let themselves get sick with “comorbidities” which brought on their AFib (p. 16). … Continue reading this book review..->
Copy of FAQs Coping with A-Fib: Pacemaker for Too Slow a Heart?
FAQs Coping with A-Fib: Pacemaker
“Now my doctor says I need a pacemaker, because my heart rate is too slow and because I’m developing pauses.
I’m an athlete with A-Fib and have a naturally slow heart rate. Since I developed A-Fib, I was put on atenolol (a beta blocker) which really slows down my heart rate. What should I do?”
Get a second opinion. It’s crazy to go through the risks and lifestyle disruptions of having a pacemaker implanted just to be able to continue taking atenolol.
Because you are an athlete, your heart rate is naturally slow. But it’s normal for you.
As long as you feel fine and aren’t fainting from lack of blood flow, don’t be talked into getting a pacemaker. A slow or even very slow heart rate usually doesn’t cause any harm. As for heart rates, “normal” is indeed a wide swath.
In the words of Dr. John Mandrola:
“Do not implant pacemakers in patients with nonsymptomatic bradycardia (slow heart rate).The same holds for pauses, though they are certainly of more concern than a slow heart rate. Nonsymptomatic slow heart rate or pauses don’t justify exposing patients to the risks of implanting a pacemaker.”
Do not implant pacemakers in patients with nonsymptomatic bradycardia. This includes the wide spectrum of sinus node dysfunction (SND), asymptomatic pauses in patients with permanent AF, and young patients with medication-induced bradycardia. Humans exhibit tremendous variation of heart rate, and impressively slow heart rates frequently cause patients no harm. As for heart rates, ”normal” is indeed a wide swath. Unlike the more sinister high-degree AV block, SND is not immediately fatal. In 2012, there exist many strategies for the treatment of arrhythmia that do not include exposing patients to the risks of implanting a permanent intravascular device.
Back to FAQs: Coping with Your A-Fib
Last updated: Wednesday, August 26, 2020
Update->FAQs Coping with A-Fib Stroke: What Your Family Should Learn Now
FAQs Coping with A-Fib: Stroke Action Plan
“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.
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).
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.
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.
Back to FAQs: Coping with Your A-Fib
Last updated: Wednesday, August 26, 2020
A-Fib Impacts Quality of Life for the Spouse and Family of Patients
Research verifies that the loved ones living with someone in Atrial Fibrillation may be about as stressed as actually having the condition.
In one study the partners of A-Fib patients reported a significant reduction in their quality of life, to the same degree as the patient. (Note: Most severely impaired was a couple’s sex life.)
Educate the Family, Not Just the Patient
One simple solution might be to make sure the spouse comes to office visits, particularly during the early visits around the time of diagnosis, says Dr. Bruce A. Koplan of Brigham and Women’s Hospital in Boston.
Educational programs and other interventions to eliminate some of the unknowns may relieve the anxiety for the patient and their partner leading to improved quality of life for both.
Get all Your Loved Ones Involved
One of the most frequently asked questions I get is from the patient’s partner: “What can I do for my spouse during an A-Fib attack?”
Perhaps, just as important, A-Fib patients should be asking “How can I help my family cope with the stress and anxiety of my Atrial Fibrillation?”
A Momentary Pause: When I talk with an A-Fib patient, I always ask how their spouse or partner is doing―how they are coping. This often elicits a momentarily pause while the patient stops and ponders the impact of A-Fib on their family.
My best advice to patients is to get all your loved ones involved! Knowledge is empowering and reduces stress and anxiety.
Talk with them, answer their questions. To help you, download my free report, “Top 10 Questions Families Ask about Atrial Fibrillation”.
Be Confident & Stay Calm
In addition, for your family’s peace of mind, learn Why & How to Create Your ‘A-Fib Episode Action Plan’. During an A-Fib attack, an A-Fib Action Plan with specific steps is reassuring and helps everyone stay calm. Your family will be confident they’re supporting you in taking the right action at the right time.
Discuss your A-Fib Action Plan with your loved ones and answer their questions. Post a copy in a prominent place where your family can find it easily.
Knowledge Empowers, Reduces Stress and Anxiety
