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


Coping with Atrial Fibrillation

A-Fib Patients: Is Stress Really Bad For You?

Stanford University psychologist Kelly McGonigal, PhD, author of The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It, has challenged the conventional view that stress is bad for you. I found a few insights from her book encouraging for A-Fib patients.

Researchers who followed 30,000 US Americans for eight years found that the risk for death from any cause rose by 43% among participants who had high levels of stress. But that number applied only to people who believed that the stress they were experiencing was bad for their health.

From the Upside of Stress by Kelly McGonigal

From the Upside of Stress by Kelly McGonigal

Study participants who reported similar levels of stress but who did not consider it to be bad for their health, had survival rates that were actually better than those of people with relatively stress-free lives.

Dr. McGonigal recommends telling yourself “I’m excited” rather than stressed. Try to look at stress as simply your body’s response when something you care about is at stake. The pounding heart or faster breathing is your body’s way of heightening your senses so that you are mentally focused and motivated to do well.

Look at stress as a challenge rather than a looming threat.

So What Does this Mean for A-Fib Patients? Stress, by itself, is not usually a trigger for an A-Fib attack. (You could be totally stress-free, lounging on a swing on a tropical isle and still have an A-Fib attack.)

But stress can play a role in the intensity and duration of your A-Fib attacks.

Beyond the physical, A-Fib has psychological and emotional effects as well. Recent research indicates that “psychological distress” worsens the severity of A-Fib symptoms.

Kelly G book cover - Upside of Stress 75 pix wide at 300 res

Buy this book

Give Dr. McGonigal’s Advice a Try. So, when feeling stressed, try mentally ‘reframing’ the stress as a ‘challenge’ rather than as a looming threat. Tell yourself “I’m excited” rather than stressed. It may help lessen your A-Fib symptoms. (Let me know if this works for you! Email me.)

Sounds like this approach could help in many areas of our lives.

For other ways to cope with your stress, see our A-Fib.com article, Coping With the Fear and Anxiety of Atrial Fibrillation.

For more about stress from Kelly McGonigal, read her The Washington Post interview, or her book, The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It.

Israeli Study Contradicts Recent CHA2DS2-Vasc Guidelines: Being Female Not a Risk Factor for Stroke

CHAD2DS2VAC Medium 100 pix at 96 resby Steve S. Ryan, May 2015

This is another powerful study contradicting the recent CHA2DS2-VASc guidelines which gives every women with A-Fib one point on the stroke risk scale because of her female gender, no matter how healthy she is otherwise.

An Israeli study tracked nearly 100,000 patients who developed A-Fib. They were followed for approximately four years between  2004 and 2011. The purpose of this observational study was to re-evaluate the risk of ischemic stroke, major bleeding and death in men and women with A-Fib.

Controversial CHA2DS2-VASc Risk Data and Analyses?

Previous controversial data and analyses showed an increased risk of stroke among women. The recent CHA2DS2-VASc risk score states that being a female is a risk factor for stroke.

“In light of our findings, we suggest to use a similar anticoagulant strategy in [both] men and women with atrial fibrillation over the age of 65.”

But in this Israeli study, “the risk of ischemic stroke was similar in men and women.” Women who developed A-Fib were older than men by four years (74 vs, 70) and had more hypertension, but lower prevalence of diabetes, congestive heart failure and ischemic heart disease. The rates of ischemic stroke were identical between male and female patients, 5.3% for both genders.

Factors associated with increased stroke risk were previous stroke, age older than 65, hypertension, congestive heart failure and diabetes. Adjusting for the age difference between the men and women who developed A-Fib in this study, death risk was associated with male gender, age over 65, previous stroke or heart attack, and diabetes.

Study Conclusion

The authors concluded, “In light of our findings, we suggest to use a similar anticoagulant strategy in men and women with atrial fibrillation over the age of 65.”

Editor’s Comments:

Intuitively it doesn’t make sense that simply being a woman makes you more at risk of having an A-Fib stroke. This study seems to confirm what common sense would indicate.
Women in their child-bearing years are much less at risk of stroke because of the blood-thinning effect of losing blood each month. And even after menopause women have less risk of stroke. But eventually they do have more strokes. But not because of an innate inferiority, but because women live longer than men. Stroke and hypertension are age related. In this israeli study women who developed A-Fib were four years older than men.
Be advised that the original European guidelines were written by doctors with major conflicts of interest. These guidelines may be a not so very subtle form of gender bias. Also, just adding one point to a person’s stroke risk score translates into a huge increase in sales for pharmaceutical companies.
References for this article
Amson, Yoav et al. Are There Gender-Related Differences In Management, And Outcome Of Patients With Atrial Fibrillation? A Prospective National Study. Arrhythmias and Clinical EP. Acc.15. JACC. March 17, 2015, Volume 65, Issue 10S. doi: 10.1016/S0735-1097(15)60469-7 Last accessed March 23, 2016. URL:http://content.onlinejacc.org/article.aspx?articleid=2198096&resultClick=3

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Last updated: Monday, March 28, 2016

Warfarin vs. Pradaxa and the Other New Anticoagulants

by Steve S. Ryan, PhD, Last Updated June 2018
CT scan - Ischemic Stroke - NOAC and Warfarin at A-Fib.com

Most would agree that the worst thing that can happen to a patient with A-Fib is a life-altering stroke. A stroke often causes death or permanent disability. Thus the importance of anticoagulation therapy for A-Fib patients.

Low-Risk Patients: For patients at low or intermediate risk of stroke (including younger patients without any additional stroke risk factors), aspirin may be prescribed, or no anticoagulation therapy at all.

Stroke Prevention With warfarin

For many years, there was only one proven therapy for stroke prevention in A-Fib patients at high or intermediate risk for stroke: the anticoagulant warfarin (Coumadin). It’s readily available and inexpensive.

But maintaining correct warfarin levels is difficult especially over the long haul (studies indicate around 30% of people will stop taking warfarin).

But maintaining correct warfarin levels is difficult especially over the long haul (studies indicate around 30% of people will stop taking it).

Frequent blood tests are required to regulate the dose.

Higher Risk of Bleeding Gene? About a third of the people who take warfarin are at a higher risk of bleeding because their genes make them more sensitive to warfarin. If a family member experienced side effects, talk to your doctor about taking a genetic warfarin sensitivity test.

Drug Interactions: Warfarin also has many interactions with other drugs, herbs, and food sources. If taken incorrectly, warfarin can increase your risk of dangerous bleeding.

Warfarin: Notable Concerns

Taking warfarin over several years may lead to microbleeds in the brain and dementia.

Read about the post-ablation patient on anticoagulation therapy for 10 years who developed cerebral microbleeds and early dementia: The New CHA2DS2-VASc Guidelines and the Risks of Life-Long Anticoagulation Therapy 

“Oral anticoagulants…increase the risk of intracerebral hemorrhages (ICH), a less common but more deadly and disabling type of stroke. Over 50% of patients sustaining a  warfarin-related ICH die within the first three months.” (NOAC-related intracerebral hemorrhages outcomes are similar to warfarin.)

GI intestinal bleeding is another potential risk of Warfarin. “The risk of warfarin-related GI bleeds can range from between 0.8% and 1.5% in patients on long term anti-coagulation.”

Stroke Prevention: NOACs

Novel Oral AntiCoagulants (NOACs) are alternatives for vitamin K antagonists (e.g., Warfarin) for stroke prevention.

For over 20 years there have been extensive efforts to replace warfarin with other drugs. In the US, we have four new anticoagulants to consider: Pradaxa (dabigatran), Xarelto (rivaroxaban), Eliquis (apixaban) and Savaysa (edoxaban)).

The current data on the new anticoagulants comes from three randomized controlled trials involving more than 50,000 A-Fib patients:

RE-LY (dabigatran)
• ROCKET-AF (rivaroxaban)
• ARISTOTLE (apixaban)

Each study compared one drug against warfarin (not against each other). Taken together, these studies consistently revealed that A-Fib patients who took the non-warfarin blood thinners suffered fewer strokes, intracranial bleeds, and serious bleeds than those who took warfarin.

All of these drugs are at least as good as warfarin for preventing stroke and all are better than warfarin in reducing your risk of serious bleeding in the brain.

Questionable Trials Bias: Each of these NOAC trials had a questionable bias toward the new drug when compared against warfarin.

Warfarin users are notoriously non-compliant: Up to 50% are inconsistent in managing their diet, monitoring their INR levels and taking the correct dosage. Each of the three trials compared a group of compliant patients against a group of inconsistent warfarin patients. So results should be viewed with a critical eye.

For a more in-depth look at the clinical trials of the new NOACs, see 2013 BAFS: The New Anticoagulants (NOACs).

But NOACs are not like taking vitamins. They work by causing or increasing bleeding and are considered high risk meds. “For patients with atrial fibrillation, NOACs still pose a major bleeding risk,” according to Dr. Shang-Hung Chang and his colleagues at Chang Gung Memorial Hospital in Taiwan.

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NOACs: Three Notable Concerns

The new anticoagulants offer several advantages over warfarin. They are fast acting. And when stopped (e.g. for surgery), they just as quickly clear your body (a short “half-life). There’s a broad therapeutic window (wide range of safe use), and they have minimal drug or dietary interactions. They can be administered in fixed doses without monitoring, making them potentially more convenient to use than warfarin.

Remember: The goal of anticoagulation therapy is to reduce your risk of life-altering stroke.

Enthusiasm for the new anticoagulants (NOACs), however, must be tempered by three notable concerns in patients taking these drugs:

1. No readily available means for assessing the degree of anticoagulation
2. Life-threatening bleeding complications can occur after an injury
3. Stomach problems and gastrointestinal bleeding

According to Dr. Stephen Kimmel of the Un. of Pennsylvania: “If you have a history of stomach problems or gastrointestinal bleeding, you may want to avoid Pradaxa and Xarelto—both medications have the highest risk for those complications.”

NOACs: No Way to Measure Effectiveness

One of the problems with the newer anticoagulants (NOACs) is we don’t have a good way to measure how effective they are or how much of an anti-clotting effect there is at a given point in time. (For example, in treating trauma patients, ER doctors can use the elapsed time from the last dose to estimate the clotting effect.)

With warfarin (Coumadin), on the other hand, we can measure how effective it is by its level in the blood stream measured in INR (International Normalized Ratio). A person not on anticoagulants will have an INR slightly above 1 (the author’s INR is 1.1). Someone with A-Fib on warfarin should have an INR between 2.0 and 3.0. At this INR level a person will bleed more than someone with an INR of 1.0, but the blood will still eventually clot.

With an INR below 2.0 you are more in danger of having an ischemic (clotting) stroke, the kind that most often occurs in A-Fib. With an INR of 4.0 and above, there is much more risk of blood not clotting and of developing a hemorrhagic stroke.

But the INR blood test doesn’t work with the new anticoagulants which affect only one particular stage in the anticoagulation process. Pradaxa, for example, is a direct thrombin inhibitor, whereas warfarin affects nearly every stage in the anticoagulation process. (Thrombin is an enzyme that converts soluble fibrinogen into insoluble fibrin. Fibrin is a fibrous protein involved in the clotting of blood. It forms a mesh or clot over a wound.)

The lack of a readily available method to determine the degree or current level of anticoagulation is a major challenge for ER physicians and staff treating trauma patients. (You’re probably wondering why they don’t simply take a blood sample and analyze how much of the anticoagulant is in the blood stream [plazma level monitoring]. This is “discouraged for the vast majority of patients due to the lack of outcome data to support such an approach,” according to the 2018 European Heart Rhythm Association Practical Guide on NOACs in AF [p. 1339.) “Routine monitoring of plasma levels and subsequent dose adaptation is generally discouraged.” [p. 1353)

Medical ID: If you’re on any blood thinner, it’s a good idea to carry some kind of medical ID. If you have an accident involving bleeding, EMTs can call ahead to the ER and get the staff ready to help you. To print your own I.D. see: Print a free Medical Alert I.D. Wallet Card

Pradaxa: Too Effective?

Pradaxa, in particular seems to work almost too well.

Pradaxa won the FDA sweepstakes by being the first new anticoagulant to get FDA approval and thus captured a significant market share. 

In some patients there is excessive bleeding that is catastrophic (usually in older or weaker patients). Pradaxa has been associated with deaths in the ER before doctors had Praxbind, the Pradaxa reversal agent, to stop people from bleeding to death. (Warfarin on the other hand has several proven, time-tested reversal or antidote strategies.)

Pradaxa (dabigatran) won the FDA sweepstakes by being the first new anticoagulant to get FDA approval and consequently captured a significant share of the anticoagulant market.

Pradaxa comes in two doses in the United States, 150 mg twice daily or 75 mg twice daily. It’s large and harder to swallow, comes in a bottle with a 30-day shelf life once opened (or in blister packs which eliminates the shelf-life problem.) And it’s expensive.

Questionable Trials Bias: Each of these NOAC trials had a questionable bias toward the new drug when compared against warfarin.

In the RELY trial, Pradaxa was not only equal to warfarin, but it proved to be superior to it in preventing stroke. Bleeding rates in the head were lower than with Warfarin. However, bleeding from the stomach or bowels was higher. The most common side effect was stomach pain.

In addition to the bleeding deaths in the ER mentioned above, Pradaxa’s own fact sheet states common side effects of Pradaxa include:

• Indigestion, Upset Stomach, or Burning
• Stomach Pain

[These statements don’t capture the actual human toll—burning throat, roiling intestines, diarrhea, burning anus, lasting intestinal damage, etc. that Pradaxa can produce in some people.]

Xarelto and Eliquis

Xarelto (rivaroxaban) was the second drug available in the United States. Xarelto comes in two doses, 20 mg daily or 15 mg daily. In contrast to Pradaxa, it is a small pill taken once-a-day. In the Rocket AF trial, Xarelto also significantly lowered the risk of bleeding in the brain and head compared to warfarin. Anecdotally we don’t seem to see a lot of deaths in the ER from Xarelto.

Eliquis (apixaban) was third to be approved, comes in two doses, 5 mg twice daily or 2.5 mg twice daily (the lower for A-Fib patients with kidney dysfunction). Similar to Xarelto, the risk of bleeding in the brain and head was lower versus warfarin.

However, this drug was unique in that bleeding from other sites including the stomach, bowels, and bladder was less. In the Aristotle trial, Eliquis was at least as good and tended to be better than warfarin at preventing stroke. Eliquis is the only drug that can claim that survival improved with its use compared to warfarin.

Xarelto and Eliquis, just like Pradaxa, are also very expensive.

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NOAC Reversal Agents and Bleeding Complications

As of May 2018, there are now FDA-approved NOAC reversal agents: Praxbind for Pradaxa (dabigatran) and Andexxa for the NOACs Xarelto (rivaroxaban) and Eliquis (apixaban). See FDA Approves Antidote for Xarelto and Eliquis).

The reported bleeding events tend to occur mainly in elderly patients (median age of 80) which raises a question regarding safe dosing and monitoring in older patients. Elderly patients often have mild to moderate renal impairment, which can cause plasma levels of the NOAC to increase up to three times those with normal renal function.

“One-size-fits-all” dosage of these new anticoagulants may need to be re-examined for elderly patients. (The FDA rejected the lower 110-mg twice-daily dose of Pradaxa (dabigatran) tested in the RE-LY trial, instead approving a 75-mg twice-daily dose just for patients with severe renal impairment.)

 Eliquis Earns Best Safety Score

Through an analysis of data from the FDA Adverse Event Reporting System by AdverseEvents, Inc., Eliquis has received an “RxScore” safety score of 39.45 on a 100 point scale, with 100 representing the highest risk. In comparison, warfarin had a score of 67.57. Pradaxa (dabigatran) had a score of 67.15, Xarelto (rivaroxaban) 67.08.

The FDA’s database comprises all the reports made by doctors, patients and other healthcare providers, which means it’s not a “scientific” finding with the authority of a clinical trial. AdverseEvents applies logic, math and software to the database to sift out the important data.

For Eliquis, “the rate of suspect cases was lower in every type of adverse-event report, from hospitalization to death.” For example, among Eliquis patients reporting side effects, only 21% cited hospitalization, while Pradaxa had 39%, Xarelto 43% and warfarin 50%.

The results all point to the same general conclusion: Eliquis may be a safer choice among the new NOACs.

Choosing Your anticoagulant

If you’re conscientious and are pretty good at staying in the proper INR range, stick with warfarin (Coumadin) if you can. It may not be as convenient and easy to use as the newer anticoagulants, but we know warfarin generally works if you stay within the proper INR range. And there are proven reversal agents for warfarin. The cost of warfarin is significantly lower when compared to the new anticoagulants. (Your insurance provider may have a direct say about which drug you take.)

Note: There’s no guaranteed way to avoid a stroke altogether.

If you have trouble staying within the proper INR range, can’t juggle the diet restrictions or monthly monitoring, I suggest you talk with your doctor about switching from warfarin (Coumadin) to the NOAC Eliquis (apixaban). Eliquis doesn’t block Vitamin K like warfarin, has no interactions with food (not even spinach), and requires NO monitoring (no more finger stick checks).

Compared to the other NOACs, Eliquis tested better and has the best RxScore safety score. Like all the NOACs, be aware of Eliquis’ much higher monthly price. (For those in the US and on Medicare with Part D coverage, the monthly cost may range from $30 to $50.) You will need to judge if the benefits outweigh the costs.

When choosing an anticoagulant, along with costs, you need to consider which is worse: the risk of uncontrolled bleeding or the risk of a debilitating stroke.

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Resources for this article
• Gurol, M Edip. Brain MRI scans can inform the choice between OACs and LAA closure for non-valvular AF. Cardiac Rhythm News. March 18, 2018, Issue 40. p. 9

• Lakkireddy, Dhanunjaya. Octreotide enables left atrial appendage closure in AF patients with GI bleeding. Cardiac Rhythm News, May 31, 2018, Issue 40. P.1.

• Chang SH et al. Association Between Use of Non–Vitamin K Oral Anticoagulants With and Without Concurrent Medications and Risk of Major Bleeding in Nonvalvular Atrial Fibrillation. JAMA. 2017; doi:10.1001/jama.2017.13883.

• Piccini, JP. Interaction between newer anticoagulants, certain drugs increases major bleeding in AF. Perspective. Arrhythmia Disorders. Healio/Cardiology Today. Oct 2017. https://www.healio.com/cardiology/arrhythmia-disorders/news/online/%7B48813250-e3e1-4a0b-81bc-b2471691e666%7D/interaction-between-newer-anticoagulants-certain-drugs-increases-major-bleeding-in-af

• Connolly SJ, et al. RE-LY Steering Committee and Investigators.  Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139-51. Last accessed July 10, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/19717844

• Patel MR, et al. ROCKET AF Investigators.  Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.  N Engl J Med. 2011;365(10):883-91. Last accessed July 10, 2014, http://www.ncbi.nlm.nih.gov/pubmed/2183095

• Granger CB, et al. ARISTOTLE Committees and Investigators.  Apixaban versus warfarin in patients with atrial fibrillation.  N Engl J Med. 2011; 365(11):981-92 Last accessed July 10, 2014

• Ansell J, et al. Descriptive analysis of the process and quality of oral anticoagulation management in real-life practice in patients with chronic non-valvular atrial fibrillation: the interactional study of anticoagulation management (ISAM) J Thromb Thrombolysis 2007; 23: 83—91. Last accessed July 10, 2014

• Steffel, J et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. European Heart Journal (2018) April 21, 39(16), 1330-1393 (p. 1339). https://www.ncbi.nlm.nih.gov/pubmed/29562325. doi: 10.1093/eurheartj/ehy136 .

• Kimmel, Stephen. The Truth About Blood Thinners, Bottom Line/Health, May 2015, p. 11

• Pradaxa: Highlights of Prescribing Information. Boehringer-Ingelheim website. Last accessed March 13, 2014 URL: http://tinyurl.com/PraxadaInfo

• Examining the Comparative Safety of Blood Thinners: An Analysis Utilizing AdverseEvents Explorer, February 2014, Special Report Download. http://info.adverseevents.com/special-report-blood-thinner Last accessed July 10, 2014

• Staton, Tracy. Eliquis earns best safety score in its class in analysis of FDA adverse event reports. FiercePharma, February 26, 2014. Last accessed July 10, 2014, http://www.fiercepharma.com/story/eliquis-earns-best-safety-score-its-class-analysis-fda-adverse-event-report/2014-02-26

If you find any errors on this page, email us. Y Last updated: Monday, October 14, 2019

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FAQ: Natural Therapies & Holistic Treatment for A-Fib

Complementary & Natural Therapies

Complementary & Natural Therapies

FAQ: Natural Therapies & Holistic Treatment

Many A-Fib patients have questions about treatment alternatives such as naturopathic doctors, complementary or integrated medicine as well as mind/body practices (such as chiropractic, acupuncture, yoga and meditation).

1. Holistic approach: How do I find a doctor with a more “holistic” approach? I want nutritional counseling and a more integrated approach to my A-Fib treatment plan?

2. Complementary Medicine: I’ve read that yoga and acupuncture are considered ‘Complementary Medicine‘. What is that? How does it relate to conventional medicine?

3.  Naturopathic Medicine: “A dietitian friend referred me to a Naturopathic doctor. What is naturopathic medicine? Are they ‘real’ physicians?”

Related question:Have any A-Fib.com readers reported success working with a Naturopathic doctor? Anyone controlling their A-Fib with supplements?”

4. Vagal: What is the ‘vagal maneuver’? I’ve heard it might help me during an A-Fib episode. What is it and how is it done? Is it safe?”

5. Diet: Is a whole food or organic diet helpful for patients with Atrial Fibrillation? Is there any research recommending one or the other?”

6. Chiropractic:  Do A-Fib patients find chiropractic adjustment useful? If so, what are their results? In the past, I’ve found it helpful for other ailments. Could it help with my A-Fib symptoms?”

7. Yoga: I do Yoga. It relaxes me and helps with my stress level. Is there any evidence on Yoga helping with other A-Fib symptoms?”

8. Acupuncture: What’s the research on acupuncture and Atrial Fibrillation? I’m willing to try it if it will help ease or reduce my A-Fib episodes.”

9. Natural blood thinners: “Have there been any tests comparing natural blood thinners to the new anticoagulants (NOACs) in terms of efficacy and speed of onset?”

“Most people use non-mainstream approaches along with conventional treatments. The boundaries between complementary and conventional medicine overlap and change with time.” ∼ US National Institutes of Health

If you find any errors on this page, email us. Y Last updated: Saturday, February 11, 2017
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FAQs: Mineral Deficiencies & Supplements for a Healthy Heart

FAQs: Mineral Deficiencies & Supplements for a Healthy Heart

A-Fib patients often look for non-drug approaches to ease or prevent the symptoms of their Atrial Fibrillation. Here we share answers to the most often asked questions about minerals deficiencies and the use of supplements.

1. Dementia: “I’m scared of getting dementia. Can the right minerals help? I’ve read about the link with A-Fib. What does research reveal about this risk?”

2. Vitamin D: “How can I tell if I’m lacking in Vitamin D? I’m concerned because Vitamin D deficiency has been tied to both A-Fib and Dementia. What is a normal level of Vitamin D?

3. PVCs and PACs: “I have annoying PVCs and PACs with my A-Fib. Are there natural remedies to reduce these extra beats and palpitations? My doctor says to ignore them.”

4. Nutritional Info: I tried to talk with my doctor about magnesium and other nutritional supplements. His response was ‘There’s no proof that they work.’ Why are doctors so opposed to nutrition as a way of helping A-Fib.

Related Question:What’s the best way to take supplements—at the same time each day or spread throughout the day? In one lot or in divided doses?”

Related Question:Where can I find reliable, unbiased research and information on specific vitamins and supplements? (I want an independent resource, not some site trying to sell me their products.)”

5. BCAA+G: “The supplement BCAA+G helps builds muscle. Is it a natural remedy that could help my A-Fib? Are A-Fib patients BCAA-deficient?”

6. Iron levels: “I’m anemic. Is too little iron in the blood (anemia) a cause of Atrial Fibrillation? Any advice on how A-Fib patients can deal with iron deficiency?”

Related Question: Can excess iron in the blood (Iron Overload Disease, IOD) cause Atrial Fibrillation? How do I know if I have IOD? What can I do about it?

7. Chelate: “What does ‘chelate’ or ‘chelated formulas’ mean when talking about vitamin and minerals? Is it important?

8. Magnesium: “Regarding Magnesium, can supplementing and restoring Mg to healthy levels reverse my A-Fib? I’m about to schedule a catheter ablation. But if supplementing can cure my A-Fib, why do an ablation?

9. CoQ10  “Can I take the supplement CoQ10 while on Eliquis for Atrial Fibrillation? On your site it says CoQ10 could be helpful. But on my bottle of CoQ10, it says “do not take if you are on blood thinners.

10. Krill Oil: “I’m interested in the supplement, Krill Oil, that has natural blood thinning properties. I’m taking Eliquis for my risk of A-Fib stroke. Is It OK to take Krill Oil along with Eliquis?”

If you find any errors on this page, email us. Y Last updated: Tuesday, February 14, 2017
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FAQs Understanding A-Fib: Stem Cells & Heart Tissue Research

 FAQs Understanding A-Fib: Stem Cells

FAQs Understanding Your A-Fib A-Fib.com“I’ve read about stem cells research to regenerate damaged heart tissue. Could this help cure A-Fib patients?”

Yes, this fascinating research, though not directed specifically to Atrial Fibrillation, may prove to be very important to A-Fib patients. These groundbreaking studies focus on using stem cells to regenerate damaged heart tissue.

Working with heart attack victims who had suffered major heart scarring, doctors infused into their damaged hearts, stem cells that had been harvested and grown from their own heart.

The results were astounding!

Scar tissue decreased—shrinking between 30% to 47%. New heart tissue was generated—the stem cell recipients grew the equivalent of 600 million new heart cells. Their ejection fraction increased from the low 30% range to almost normal. Patients who received these stem cells had significant improvements in heart function, physical capacity, and scored better on quality-of-life questionnaires. MRI and ultrasound imaging revealed that areas where stem cells were infused showed major improvement which continued for over a year.

Their heart damage was reversed without dangerous side effects.

What does this mean to A-Fib patients? For someone with Atrial Fibrillation, the research studies’ terms of ‘scar tissue’ and ‘heart damage’ translates to ‘fibrosis’, that is, tissue that becomes fibrous and inflexible. Fibrosis in A-Fib patients is linked to enlargement of the heart and the increased threat of stroke.

if injected stem cells can somehow signal the heart to repair itself, this may turn the A-Fib patient’s fibrosis and scarring back into normal heart muscle. The fibrosis and scarring associated with A-Fib would no longer be permanent and irreversible.

Maybe someday we could be cured of A-Fib through stem cell infusion rather than with ablation burns or surgery.

For more read my article: “Stem Cells Reverse Heart Damage—May Repair Fibrosis and Scarring in A-Fib”, and my reports: 2013 BAFS: A-Fib Produces Fibrosis—Experimental and Real-World Data, and BAFS 2014: High Fibrosis at Greater Risk of Stroke and Precludes Catheter Ablation: Lessons Learned from the DECAAF Trial.

Go back to FAQ Understanding A-Fib
Last updated: June 18, 2018

FAQs Understanding A-Fib: Supraventricular Tachycardia

 FAQs Understanding A-Fib: Supraventricular Tachcardia

FAQs Understanding Your A-Fib A-Fib.com“Is Atrial Fibrillation different from what doctors call Paroxysmal Supraventricular Tachycardia?”

‘Supraventricular’ refers to the upper part of the heart, the atria. “Tachycardia” means the upper part of your heart is beating faster than normal. “Paroxysmal” means occasional.

“Supraventricular Tachycardia” in clinical practice commonly refers to atrial tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT), and atrioventricular reciprocating tachycardia (AVRT), an entity that includes Wolff-Parkinson-White syndrome. While Atrial Fibrillation is a distinct entity classified separately.

The term “Supraventricular Arrhythmia” most often is used to refer to Supraventricular Tachycardias and Atrial Flutter. In practice, “Supraventricular Tachycardia” is often used loosely to include all arrhythmias in the Atria, including A-Fib.

Thanks to Sol Yuyitung for this question.

Go back to FAQ Understanding A-Fib
Last updated: June 18, 2018

FAQs Understanding A-Fib: Genetic? Will my children get A-Fib too?

 FAQs Understanding A-Fib: Genetics

FAQs Understanding Your A-Fib A-Fib.com“Is my Atrial Fibrillation genetic? Will my children get A-Fib too?”

Genetic research in A-Fib, though in its preliminary stages, has the potential to be a game changer for patients with A-Fib. But right now we just don’t have a definitive answer to your question.

A-Fib does run in families. Do you have a parent or other family member with A-Fib? Research has found that, if you have any immediate family with A-Fib, 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. Following the logic of this research, your children may be 40% more likely to develop A-Fib.

While the gene that increases the tendency for Familial A-Fib has been identified, there hasn’t been enough research on the genetics of A-Fib to say whether or not you will pass it on to your children.

To learn more about how A-Fib can run in families, read a few of our Personal A-Fib storiesJon Darsee (#68), Pat Truesdale (#63), Jan Claire (#39), Barry Gordon (#22), and James Adams (#13). You may want to read about Roger Meyer and Three Generations with AFib (see our book, Beat Your A-Fib, page 110).

Go back to FAQ Understanding A-Fib
Last updated: June 18, 2018

FAQs from Newly Diagnosed Patient

You are not alone. A-Fib.comFrequently 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)

1.  Cause: Did I cause my Atrial Fibrillation? Am I responsible for getting A-Fib?”

2.  Severity: My doctor says I had an attack of Atrial Fibrillation. How much trouble am I in?”

Related Question:Is Atrial Fibrillation a prelude to a heart attack?”

Related Question: “Can I die from my Atrial Fibrillation? Is it life threatening?”

3.  Anomaly?Could my Atrial Fibrillation go away on its own? I don’t want to take any medication. Can I just wait and see?”

Related Question: “Is it possible to have a single Atrial Fibrillation attack and not have any others? I had a single episode of A-Fib and was successfully converted in the ER with meds.”

Related Question:How can I tell when I’m in A-Fib or just having something like indigestion?”

4.  Sex/Exercise:Should I cool my sex life? Can I exercise if I have Atrial Fibrillation? Should I exercise?”

5.  Driving:Can I drive my car if I have Atrial Fibrillation?”

6.  Nutrition:Is drinking coffee (tea, colas, other products with caffeine) going to make my Atrial Fibrillation worse or trigger an A-Fib attack?”

Related Question: “Is there a diet I could follow which would cure my Atrial Fibrillation?”

7.  Medical ID:Should I carry a wallet card or a medical ID? I have A-Fib and take Coumadin (warfarin). In case of an A-Fib emergency, what information should I include?”

8.  Coping:I have a lot of stress at work. Does this stress cause or trigger my Atrial Fibrillation?”

Related Question:I live in fear of my Atrial Fibrillation. I never know when I’m going to get an A-Fib attack or how long it will last. How do I deal with the anxiety?”

Related Question: “Is there anything I can do to get out of an Atrial Fibrillation episode? How do others deal with their episodes?”

9.  Specialist?Should I see a cardiologist for my Atrial Fibrillation and not just my primary care doctor? (He wants to prescribe medication.) Should I also see an A-Fib specialist?”

10.  Cure?Is Atrial Fibrillation curable? Or can you only treat or control it? Should I seek a cure?”

11. Disability Benefits? “Can I get government social security disability benefits if I have Atrial Fibrillation?

If you find any errors on this page, email us. Last updated: Monday, October 2, 2017
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FAQs Coping With Your A-Fib Day-to-Day Issues

FAQs A-Fib afibFAQs Coping With Your Atrial Fibrillation: Day-to-Day Issues

Coping with your Atrial Fibrillation means a patient and their family have many and varied questions. Here are answers to the most frequently asked questions about dealing with the day-to-day issues of having Atrial Fibrillation. (Click on the question to jump to the answer.)

1.  Specialist: I like my cardiologist, but he has not talked about me seeing an Electrophysiologist [heart rhythm specialist]. Should I ask for a second opinion?”

2.  Forewarning? Is there any way to predict when I’m going to have an A-Fib attack?”

3.  Exercise: Can I damage my heart if I exercise in A-Fib? Should I exercise when in A-Fib or skip it and rest?”

4.  Progression of A-Fib: How long do I have before my A-Fib goes into chronic or permanent A-Fib? I know it’s harder to cure. My A-Fib episodes seem to be getting longer and more frequent.”

5.  A-Flutter:They want to do an Atrial Flutter-only ablation, will that help if I possibly have A-Fib as well?”

6.  Medical Marijuana:Is smoking medical marijuana or using Marinol going to trigger or cause A-Fib? Will it help my A-Fib?

7.  Action Plan:During an A-Fib episode, when should I call paramedics (911 in the US) and/or take my husband to the hospital? I’m petrified. I need a plan.”

Related Question:When my husband has an Atrial Fibrillation episode, what can I do for him? How can I be supportive?”

Related Question:In case I have a 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?”

8.  PVC/PACs:I have a lot of extra beats and palpitations (PVCs or PACs) They seem to proceed an A-Fib attack. What can or should I do about them?”

9.  DIY Monitors:What kind of monitors are available for atrial fibrillation? Is there any way to tell how often I get A-Fib or how long the episodes last?”

Related Question:My mom is 94 with A-Fib. Are there consumer heart rate monitors she can wear to alert me at work if her heart rate exceeds a certain number?”

10.  Heart Rate:Can I have A-Fib when my heart rate stays between 50-60 BPM? My doctor tells me I have A-Fib, but I don’t always have a rapid heart rate.”

Related Question:My doctor says I need a pacemaker because my heart rate is too slow. I’m an athlete with A-Fib and have a naturally slow heart rate.”

11.  Circulation:Is there any way I can improve my circulation? I feel tired and a little light-headed, probably because my atria aren’t pumping properly. Is there a way without having to undergo an Ablation or Surgery? I am in Chronic A-Fib. ”

Updated/Related Question: “I’ve heard about an out-patient heart therapy that improves circulation called EECP (Enhanced External Counterpulsation). Would it help me with my A-Fib?”

12.  Hereditary A-Fib: Both my uncles and my Dad have Atrial Fibrillation. I’m worried. How can I avoid developing A-Fib? Can dietary changes help? Or lifestyle changes?”

13. Treatment choices: “How do I know which is the best A-Fib treatment option for me?”

Related Question:In one of your articles it said that having an ablation was better than living in A-Fib. If your article means all types of A-Fib [including Paroxysmal], then I will consider an ablation.”

If you find any errors on this page, email us. Y Last updated: Monday, June 18, 2018
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BYA ad - A-Fib Alerts discount offer 600 x 500 pix 300 res

FAQs Coping with A-Fib: Monitors for Diagnosing Atrial Fibrillation

FAQs Coping with A-Fib: Monitors

“Is there any way to tell how often I get A-Fib or how long the episodes last? What kind of A-Fib monitors are available? I have silent A-Fib (A-Fib without any obvious symptoms). It was discovered by accident when I was getting an EKG during a physical.”

Holter Monitor

Holter Monitor

Your doctor may use devices such as a Holter, Event or Loop Monitor. A Holter Monitor records your EKG continuously, usually for 24 hours. An Event Monitor can be used for up to 30 days or longer. A Loop recorder is a very small device inserted under your skin beneath your left breast, such as the Medtronic Reveal LINQ. It sends a signal back to your doctor’s office and lasts for 3 years. (I have one. It’s so small it’s hard to tell where it is.) For a more in depth discussion about monitors, see my report A Primer: Ambulatory Heart Rhythm Monitors.

Consumer Heart Rate Monitors by Polar

Consumer Heart Rate Monitors by Polar

To monitor for A-Fib yourself, the Apple Watch (Series 5) can generate an ECG similar to a single-lead electrocardiogram. It’s very sophisticated and can monitor both for A-Fib and for many other health parameters.

Another option is a consumer or DIY sports heart rate monitor available from sporting goods stores. Used by runners and other athletes, they rely on the use of a chest strap to pick up the electrical signals from the heart and transmit to a special wrist watch.

On most you can program a high heart rate zone which you might enter only if you were in A-Fib. That way you could record when and how long you stayed in A-Fib and what your max heart rate was. Some have internal storage recording that can be download to your PC to view data in a graphic form.

We like the “Polar” brand. Check out the array of Polar brand heart rate monitors on Amazon.com. Other companies include Timex, Garmin, Acumen, Nike, and Cardiosport.

For an in-depth review of DIY/sports monitors, see my report: Consumer (DIY) Heart Rate Monitors.

Back to FAQs: Coping with Your A-Fib
Last updated: Friday, September 20, 2019

FAQs Coping with A-Fib: DIY Heart Rate Monitors

 FAQs Coping with A-Fib: DIY Monitors

See MyPulse by Smart Monitors- long range at Amazon.com

MyPulse (long distance) by Smart Monitors at Amazon.com

“My mom is 94 with A-Fib. Are there consumer heart rate monitors she can wear to alert me at work if her heart rate exceeds a certain number?” 

She gets A-Fib attacks maybe once every two weeks and usually in the morning. But I work full time. That way I can be alerted even when I’m at work.”

Yes, MyPulse by Smart Monitors, Inc. has a solution for you. This is a practical alternative to the expense of a medical monitoring service if you are just interested in simple heart rate data. Most consumer heart rate monitors rely on a chest strap which transmits heart rate data to a wristwatch.

The MyPulse Long Range Monitor has a small Repeater device carried by the person wearing the chest strap. The Repeater transmits the data to a Receiver which is connected to a PC/notebook via a USB port. The MyPulse application runs on a PC and provides a graphic display of real time heart rate data.

The software can be configured to provide alerts via email or text message to multiple recipients if a preset heartbeat limit is exceeded.

Here are the cool parts: the software can be configured to provide alerts via email or text message to multiple recipients if a preset heartbeat limit is exceeded (such as might occur if the wearer goes into A-Fib).

For the more tech savvy, a PC mirror app on your smart phone lets you view real time heart rate data at anytime, anywhere. Check out the MyPulse website or see the array of MyPulse the Smart Monitors on Amazon.com. For a more in depth discussion see Treatments/Diagnostics: A Primer: Ambulatory Heart Rhythm Monitors.

(Thanks Julie Skarbeck for this important question and to Ed Webb for doing the research and writing about the Smart Monitor.)

Back to FAQs: Coping with Your A-Fib
Last updated: Monday, June 18, 2018

FAQs Coping with A-Fib: Progression of Disease

 FAQs Coping with A-Fib: Progression of Disease

red-heart-negative 150 pix by 96 res“How long do I have before my A-Fib goes into chronic or permanent A-Fib? I know it’s harder to cure. I’ve had Paroxysmal (occasional) A-Fib for a couple of months, but the A-Fib episodes seem to be getting longer and more frequent.” 

Worst case scenario, Paroxysmal (occasional) A-Fib can progress to permanent in about one year. In a study of 5,000+ A-Fib patients, 54% of those on rate control meds went into permanent A-Fib in one year. However, there are people who’ve had Paroxysmal A-Fib for years and never progress to permanent A-Fib.

But the odds are against you. You are correct that the longer you have Atrial Fibrillation, the harder it can be to cure it. Consider working aggressively to stop your A-Fib as with antiarrhythmic meds or with a Pulmonary Vein Isolation procedure. You don’t want to be part of the 54% whose A-Fib becomes permanent.

To learn about various Treatment options for Atrial Fibrillation, see our Treatments page. Think about your treatment goals. Is managing your A-Fib and increased stroke risk with meds okay with you? Or do you prefer to aim for a cure? Discuss the options with your doctor. Take action as soon as practical.

Resource for this article
O’Riordan, M. RECORD AF: Better Success With Rhythm Control, But No Difference in Outcomes. Heartwire/Medscape Medical News. November 17, 2009. Last accessed March 29, 2014. URL: http://www.medscape.com/viewarticle/712576

Back to FAQs: Coping with Your A-Fib
Last updated: Thursday, September 19, 2019

FAQs Coping with A-Fib: Atrial Flutter Ablation

 FAQs Coping with A-Fib: A-Flutter

red-heart-negative 150 pix by 96 res“They want to do an A-Flutter-only ablation on me. Will that help me? I definitely have A-Flutter and possibly A-Fib as well.”

Probably not. We now know that, in general, A-Flutter originates in the right Atrium, and Atrial Fibrillation originates in the Left Atrium.

Even though a right atrium Flutter ablation is relatively simple and easier to do compared to an A-Fib ablation in the left atrium, a right atrium Flutter ablation does little for A-Fib. If you have both A-Fib and A-Flutter, but have a Flutter-only ablation of the right atrium, it’s estimated the success rate for curing A-Fib is only between 5% and 10%.

You’re probably wasting your time and undergoing needless risk to do an A-Flutter-only ablation when you also have A-Fib. Some A-Flutter may originate in the left atrium, or the A-Flutter may mask A-Fib which may appear later after a successful A-Flutter ablation. As many as half of all patients ablated for A-Flutter may later develop A-Fib.

If someone wants to schedule you for a right atrium Flutter-only ablation and you also have or suspect you have A-Fib as well, you definitely need a second opinion. As long as you’ve gone to the trouble of scheduling a hospital procedure for A-Flutter and the EP will be inside your heart already, most EPs will want to do a left atrium A-Fib ablation at the same time as your Flutter ablation.
Resources for this article
Takahashi Y et al. “How to interpret and identify pulmonary vein recordings with the Lasso catheter.” Heart Rhythm 2006;3:748-750. doi.org/10.1016/j.hrthm.2006.01.017

Philippon, F., et al. The Risk of Atrial Fibrillation Following Radiofrequency Catheter Ablation of Atrial Flutter. Circulation. 1995;92:430-435. August 1, 1995. http://circ.ahajournals.org/content/92/3/430. doi.org/10.1161/01.CIR.92.3.430

Back to FAQs: Coping with Your A-Fib
Last updated: Monday, June 18, 2018

FAQs Newly Diagnosed with A-Fib: Diet Cure?

 FAQs Coping with A-Fib: Diet Cure?

Maze heart You are not alone - with outline 175 pix at 96 res“Is there a diet I could follow which would cure my A-Fib?”

No. Right now, we don’t know of any diet to “cure” your A-Fib. But you may be able to reduce or improve your A-Fib symptoms.

Start with a ‘heart healthy’ diet (and healthy lifestyle). There are lots of on-line resources and books about eating healthy for your heart. The U.S. National Heart, Lung and Blood Institute recommends the DASH” eating plan which reduces the risk of developing cardiovascular disease. Also see our FAQ answer to: “Is a whole food or organic diet helpful for patients with Atrial Fibrillation?

It’s likely you’ll receive little nutritional advice from your doctor or cardiologist.

Learn Your Triggers

For some A-Fib patients, a food or beverage seems to cause or trigger their A-Fib. Heavy consumption of alcohol may trigger A-Fib. Some report that caffeine in coffee is a trigger. You may want to try eliminating other stimulants (tea, chocolate, tobacco, MSG, sodas) and see if that helps your condition. A recent study from England suggests that eggs and poultry meat may cause or trigger A-Fib.

Keep a Food Log

Try keeping a diary of what you eat and drink. If you drink coffee for example, try not drinking any for one or two weeks. (Some patients claim to have been helped by eliminating all dairy products from their diet.)

To read more about possible triggers, see What are the Causes of A-Fib?/Triggers

Resources for this article
¤ U.S. National Heart, Lung and Blood Institute, http://www.nhlbi.nih.gov/index.html ¤ Atrial Fibrillation: Treatment Options, Catheter Ablation. The London AF Centre website. Last accessed March 29, 2014. URL: http://www.londonafcentre.co.uk

Go back to FAQ for the Newly Diagnosed A-Fib Patient
Last updated: Monday, June 18, 2018

FAQs Coping with A-Fib: Electrophysiologists

 FAQs Coping with A-Fib: EPs

FAQs A-Fib afib“I like my Cardiologist, but he has not talked about me seeing an Electrophysiologist. Should I ask for a second opinion?”

Most definitely! But seek a second opinion about your atrial fibrillation and treatment options from a cardiac Electrophysiologist (EP).

A cardiac Electrophysiologist (EP) is a cardiologist who specializes in heart rhythm problems (the electrical functions of the heart). Compared to a Cardiologist, an EP takes an extra year of training to better cope with arrhythmias. In fact, it’s easy to find a local Electrophysiologist yourself. The website of the Heart Rhythm Society has a feature called Finding A Specialist. When you type in your U.S state and city, or country, the site gives you a list of Electrophysiologists in your area. However, not all Electrophysiologists specialize in A-Fib and perform catheter ablations.

For an in-depth discussion about selecting an Electrophysiologist and a step-by-step guide, see the A-Fib.com sections Finding the Right Doctor for You and Your A-Fib, Questions For Doctors and Directory of Doctors and Facilities who perform catheter ablations to fix your A-Fib. We offer many resources to help you select the right Electrophysiologist for you and your treatment goals.

Back to FAQs: Coping with Your A-Fib
Last updated: Thursday, September 19, 2019

 

FAQs Coping with A-Fib: PVCs & PACs

 FAQs Coping with A-Fib: PVCs & PACs

FAQs A-Fib afib“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 seePremature 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.)

Back to FAQs: Coping with Your A-Fib
Last updated: Wednesday, January 30, 2019

References for this article
Cha, Y. et al. Premature Ventricular Contraction-Induced Cardiomyopathy: A Treatable Condition. Circulation: Arrhythmia and Electrophysiology. 2012;5:229-236. http://circep.ahajournals.org/content/5/1/229.full. Last accessed 6/29/2015

Chong, BH et al. “Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events.” Europace (European Society of Cardiology) (2012) 14, 942-947. http://www.ncbi.nlm.nih.gov/pubmed/22183750 doi: 10.1093/europace/eur389

Dave, John. Ventricular Premature Complexes. Medscape Reference Sept. 15, 2014. http://emedicine.medscape.com/article/158939-overview

Moulton, Linda. The PVC and Cardiomyopathy: Which Came First? EP Lab Digest Volume 13, Issue 1, January 2013 (/issue/8207)http://www.eplabdigest.com/articles/PVC-and-Cardiomyopathy-Which-Came-First

FAQs Coping with A-Fib: Best Treatment for Me

 FAQs Coping with A-Fib: Best Treatment

FAQs A-Fib afib“How do I know which is the best A-Fib treatment option for me?”

This is a decision only you and your doctor will make. Some of the factors to consider are:

•  how long you have had A-Fib
•  the frequency and duration of your episodes
•  if your A-Fib is symptomatic
•  your general health
•  if you have other health or heart problems
•  what treatments you have tried (and failed)

Depending on the type of A-Fib you have, here are some guidelines which may help you. Listed below are A-Fib conditions as described by those with A-Fib. Select one (or more) that best describes your A-Fib and read your possible options.

  1. “My A-Fib just started.”
  2. “My A-Fib is occasional (Paroxysmal) with no or mild symptoms (sometimes referred to as “silent’ A-Fib).”
  3. “I have infrequent, short episodes of symptomatic A-Fib.”
  4. “I have Paroxysmal (occasional) A-Fib but am in good health overall.”
  5. “I have Paroxysmal (occasional) A-Fib but also have serious heart and/or other health problems.”
  6. “My A-Fib is Persistent or Chronic (all-the-time).”
  7. “I have Persistent or Chronic (all-the-time) A-Fib but no symptoms (‘silent’) A-Fib.”
  8. “I have A-Fib but am allergic to Coumadin, Heparin, Lovenox and most blood thinners. I’m also very overweight. And I’ve already had one stroke.
  9. “I’ve had two failed left atrium ablations and have tried many different medications.”

Read our in-depth discussion of your treatment options as discussed above: Decisions about A-Fib Treatment options.

In addition, you may want to read about Alternative Remedies and Tips to Consider, about ‘Natural’ Supplements for a Health Heart and our section on mineral deficiencies: Minerals and Supplements

Back to FAQs: Coping with Your A-Fib 
Last updated: Monday, June 18, 2018

FAQs Coping with A-Fib: Being Supportive

 FAQs Coping with A-Fib: Spouse Support

FAQs A-Fib afib“What can I do for my husband when he has an Atrial Fibrillation episode? How can I be supportive?”

First, determine if this episode is typical. If you both know from experience that this A-Fib attack will pass, you can help by getting him to sit or lay down and relax as much as possible. Maybe he needs to be reassured—remind him that this isn’t life threatening. That may help to keep you both calm and to get you through it. (I know how hard it is to “relax” when your heart feels like it’s going to jump out of your chest and is totally out of control.)

You might suggest he try one or more of these tips shared by other A-Fib patients:

•  Putting cold compresses or ice on the back of one’s neck.
•  Laying down and trying to relax in a darkened room.
•  Moderate exercise. For some, moderate exercise may help terminate an A-Fib attack. But for others, exercise may trigger or increase an A-Fib attack.
•  Deep breathing and holding one’s breathe while pressing down hard on the diaphragm.
•  A-Fib is sometimes triggered by body position—lying or leaning on the left side. Lying on one’s back and relaxing the chest may help terminate A-Fib episodes triggered by lying on the left side.
•  Putting one’s head between one’s legs and deep breathing.

If this episode is unusual and your spouse is in great discomfort with his heart beating very rapidly and irregularly, consider calling emergency services (dial 911 in the US.) or drive him to a hospital emergency room. The emergency room staff can use a defibrillator and medications to electrically shock him back into normal sinus rhythm. Or convert him back into sinus rhythm using drugs.

Learn more at: Why & How to Create Your ‘A-Fib Episode Action Plan’

Back to FAQs: Coping with Your A-Fib
Last updated: Monday, June 18, 2018

FAQs Coping with A-Fib: Develop a Plan

FAQs Coping with A-Fib: An Action Plan

FAQs A-Fib afib“During an A-Fib episode, when should I call paramedics (911 in the US) and/or take my husband to the hospital? I’m petrified. My husband’s A-Fib is getting worse. Our doctors say don’t worry unless he shows signs of a heart attack or stroke. I need a plan.”

Keep in mind, as bad as it feels, an A-Fib attack usually isn’t life threatening. (A-Fib doesn’t cause or immediately lead to a heart attack.)

Develop an Action Plan: for your own peace of mind, you and your husband need to work out an ‘A-Fib action plan’ with his doctors.

You and your husband should know:

•  when to contact his doctor
•  your doctor’s cell number or email address for emergencies
•  when to go to the emergency room
•  whether or not to call your doctor from the ER
•  if your doctor will call and talk with the ER staff
•  when your husband should “just ride out” the episode
•  the signs of stroke, and what you should be watching for

You need specific steps and a specific plan of action. Having a plan is reassuring and helps you stay calm. When having an A-Fib attack, you and your husband will be confident you’re taking the right action.

If you feel your doctor isn’t working with you (to develop a specific action plan) and/or if your spouse is getting worse, it may be time to interview and change doctors.

Read more at: Why & How to Create Your ‘A-Fib Episode Action Plan’

Having a plan is reassuring and helps you stay calm… and be confident you’re taking the right action.

Back to FAQs: Coping with Your A-Fib
Last updated: Monday, June 18, 2018

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