Doctors & patients are saying about ''...

" 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



A-Fib Q&A: Can I qualify for Medicaid, too?

Q: I have A-Fib and since I turned 65, I’ve been covered by Medicare. What about Medicaid? Can I qualify for Medicaid, too? Should I?

A: As a U.S. citizen, yes, you may qualify. One in five Americans is eligible for Medicaid as well as Medicare. This is known as “dual eligibility”. If you qualify and choose to enroll in both programs, the two can work together to help cover most of your health care costs. (Medicare is the primary coverage and pays first. Medicaid pays second for anything that isn’t covered.)

Medicaid provides free or low-cost health coverage…. Continue reading my answer->

Read the A-Fib Patients Top 10 List of Hard-Learned Lessons

A-Fib Q&A: I’m on Medicare, can I qualify for Medicaid, too? Should I?

Q&As: Newly Diagnosed: Medicaid Eligibility?

I have A-Fib and since I turned 65, I’ve been covered by Medicare. What about Medicaid? Can I qualify for Medicaid, too? Should I?

As a U.S. citizen, yes, you may qualify. One in five Americans is eligible for Medicaid as well as Medicare. This is known as “dual eligibility”. If you qualify and choose to enroll in both programs, the two can work together to help cover most of your health care costs. (Medicare is the primary coverage and pays first. Medicaid pays second for anything that isn’t covered.)

Medicaid provides free or low-cost health coverage to those with low-income, people with disabilities, some Medicare beneficiaries, and others who do not have access to affordable health insurance.

Medicaid also provides benefits not covered by Medicare, such as help with long-term care needs, some medications, or eyeglasses. And once you are enrolled in Medicaid, you are automatically eligible for “Extra Help”, a Medicare program to help pay for drug costs like premiums, copays, and deductibles.

Find out if you qualify and learn how to apply by contacting your state Medicaid program.

Medicaid Info

Medicaid is a joint federal and state health program administered by the state. Each state has different rules about eligibility and how to apply. You need to contact your state Medicaid program. You can apply for Medicaid at any time. There are no specific enrollment dates.

For further info see, Eligibility

(Thanks to Kathy Smith for alerting us to this useful information.)

• Medicaid Eligibility. URL:

• Medicaid: How to contact your state. URL:

• “Extra Help” Do You Qualify? Social Security Administration. URL:

• Affordable Health Insurance. Medicare vs. Medicaid: What’s The Difference? URL: Accessed June 29, 2022.

Go back to FAQ for the Newly Diagnosed A-Fib Patient

Original Medicare or Medicare Advantage Plans? Which is Better If You have A-Fib?

An reader emailed me that he has A-Fib and is turning 65. He has to decide whether to sign up for Original Medicare or a Medicare Advantage plan. (Open Enrollment is between October and December each year). This decision will affect how much he pays for coverage, what services he gets, what doctors he can use, and his overall quality of care.

Medicare coverage options is a complicated business. I’m not qualified to give you advice. My intent is to point out areas of interest to A-Fib patients. Remember these comments are only my opinion.

Choice of Doctors?

Which is better if you have A-Fib?

With the Medicare Advantage plans, your choice of doctors is limited. Usually you can only use doctors in the plan’s network. This may be fine for a primary care doctor or family doctor.

What if you need a specialist? To see a specialist, you’ll need a referral from your primary care doctor. These referrals are often hard to obtain. You also need prior approval for most services.

Choice of Electrophysiologists (EPs)?

If you have A-Fib, your choice of EPs in Medicare Advantage plans is severely limited. All too often Medicare Advantage plan administrators seem more motivated to reduce your choices.

In one instance, I found only a single EP listed as available for someone I was trying to advise.

Referrals Out of Network. And it’s nearly impossible to get a referral to an industry leader, no matter how good a doctor is or how great a reputation they have. The administrators make it incredibly difficult. And there is usually no appeal.

Not All EPS Are Equal. Most EPs in Medicare Advantage plans would not be considered world beaters (i.e., best in their field). Though most of my experience with Advantage Plans is anecdotal, I’ve never seen an EP industry leader listed in these types of plans.

Not all EPs are equal. Some are low volume operators with high complication rates. You want to avoid these types of EPs at all costs.

When You Need the Best: If your A-Fib is difficult to treat or you have comorbidities (i.e., hypertension, obesity, diabetes) that complicate your treatment, your choice of EP is vital. You need an EP with a track record in successfully treating difficult A-Fib cases.

Shameful: I know of one person who was diagnosed with A-Fib under a Medicare Advantage plan. She was never told about Electrophysiologists who are specialists in arrhythmias, and she was never told about treatments like catheter ablation. This is all despite her facility having well-respected EPs and an active catheter ablation lab. The staff knew but didn’t discuss it with her.

In the end, she had to visit our website to learn about Electrophysiologists and catheter ablation options.

Medicare Gives You Real Choices

Compared to Medicare Advantage plans, with Original Medicare you can use any doctor or hospital that takes Medicare, anywhere in the US.

This is really important if you have A-Fib. You want to be able to go to the best EP you can find.

Fees or Fines for Seeing an EP in Medicare Advantage Plans

Another factor to be considered in Medicare Advantage plans is you pay a fee or fine for every time, for example, when you see an EP. One person told me his fee was $45.00 for one visit to an EP. Those fines or fees can add up pretty fast, especially when you have comorbidities and see multiple doctors for specialized tests.

In contrast, Original Medicare covers routine doctors’ visits. They send payment to the doctor, and the doctor cannot charge the person more than the plan allows. (Check your coverage before making any coverage decision.)

Be Prepared to Fight Advantage Plan Administrators

Having to interact with a Medicare Advantage plan administrator can be a very frustrating experience. Knowing you’re not being taken care of properly can be very depressing.

You often have to be very assertive and fight them ‘tooth and nail’ to get the care and treatment you need. It can take weeks, months, even years until you finally see the right doctors and receive the treatment you need.

Medicare: More Choices and Better for Psychological Health

The bottom line for most A-Fib patients is that Original Medicare not only gives you more choices but is also better for your psychological health. Also, with Original Medicare if you disagree with a coverage or payment decision, you have the right to appeal. (See Your Medicare Benefits booklet.)

Under Original Medicare, it’s tremendously liberating to know you can go to any doctor or facility you want. The last thing you want in your life is some bureaucrat dictating to you what treatments or doctors you can access.

Though obviously many personal and individual factors may influence your choice of Medicare plans, in general, Original Medicare is probably a better choice for many patients with A-Fib.

Medicare coverage options is a complicated business. To learn more, see the downloadable booklet, Your Medicare Benefits.

Are My Comments Too Negative?

Your choice of health coverage is a tricky subject. People tend to email me when they have negative experiences. So, my anecdotally-based comments may be more negative than warranted. There are many different Medicare Advantage plans. Some may be better than others.

If anyone has any clinical studies on this subject or more positive experiences, please let me know.

Cloud graphic - Michele Straube, A-Fib-free after 30 years -

Q&A: Can Catheter Ablation Be a First-Choice Option?

Q: “I was told that I can’t have a catheter ablation to fix my A-Fib until after at least a year of trying different medications. Is that right? I don’t want to live in A-Fib for a year. I’m very symptomatic. I hate being in A-Fib.”

A: Catheter Ablation Can Be a First-Choice Option. Current Guideline for the Management of Patients with Atrial Fibrillation say you don’t have to wait before getting a catheter ablation. You can have a catheter ablation right away as a first-choice option.

Here is the actual wording of the guidelines:

“The role of catheter ablation as first-line therapy, prior to a trial of a Class I or III antiarrhythmic agent, is an appropriate indication for catheter ablation of AF in patients with symptomatic paroxysmal or persistent AF.”

Guidelines Level of Confidence: Catheter Ablation has a Class IIa Level of Evidence (LOE) indication. This means the “weight of evidence” is in favor of this treatment as useful and effective. (To read more, see Catheter Ablation of AF as First-Line Therapy (p. e307.), in the 2017 HRS/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.)

Drugs First? Your doctor may talk about first trying antiarrhythmic meds. This can waste valuable time as most “antiarrhythmic” drug therapies are only effective about 40% of the time, can have bad side effects, and often become less effective day by day. And, you will most likely still have A-Fib.

Catheter Ablation as a First Choice? If you want to skip the drug therapies, ask your doctor about catheter ablation. If your electrophysiologist won’t talk to you about catheter ablation, seek a second opinion (or change doctors).

As an A-Fib patient, know your rights and be assertive.

Copy of FAQs Coping with A-Fib: Pacemaker for Too Slow a Heart?

 FAQs Coping with A-Fib: Pacemaker

FAQs A-Fib afib“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.

But be advised that pacemakers tend to have bad effects over the long term, “…long-term morbidity (is) associated with a pacemaker.”
 Another consideration is that implanting pacemaker ‘leads’ in the veins of the upper chest often prevents or hinders future procedures that require vascular access like a PVI. A pacemaker usually isn’t implanted unless your heart rate is too slow or you have Sinus Node and/or Atrioventricular (AV) Node problems.

Resources for this article
¤  Mandrola, John “Choosing wisely: The electrophysiology list of five don’ts.”

¤  Atrial Fibrillation Educational Material” University of Pennsylvania. 2002, p. 3.

¤  “Should atrial fibrillation ablation be considered first-line therapy for some patients?” Circulation 2005;112:1214-1231, p. 1228.

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

FAQs A-Fib afib“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.

Only a fraction of the 5,800 acute-care hospitals in the U.S are certified as providing state-of-the-art stroke care.

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).

What about your workplace? Locate the nearest Certified Stroke Center to your job, too, and post a copy.

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.

The only guarantee of not having an A-Fib stroke is to no longer have A-Fib.

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.

References for this article
Chen ZM, et al. Indications for early aspirin use in acute ischemic stroke: A combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups. Stroke. 2000 Jun;31(6):1240-9

Why Choose Comprehensive Stroke Center Certification. The Joint Commission. June 20, 2014.

Emergency Telephone Numbers Around the World. URL:

Find A Certified U.S. Stroke Center Near You. NPR News. Updated October 29, 2015. URL:

Find a Certified Comprehensive Stroke Center: Search by US state. The Internet Stroke Center.  URL:

Back to FAQs: Coping with Your A-Fib
Last updated: Wednesday, August 26, 2020

Atrial Fibrillation and PVCs, How Do They Compare?

An reader sent me an email asking about the difference between Atrial Fibrillation and PVCs. To start, PVC stands for Premature Ventricular Contraction.

What is a PVC?…

A Premature Ventricular Contraction (PVC) is like an extra beat or a missed beat that comes from the lower part of your heart, the ventricles. Not to worry. We all get them occasionally.

EKG showing a PVC spike; (source: Wikipedia)

EKG showing a PVC spike; (source: Wikipedia)

Surprisingly, PVCs can be a forecaster of A-Fib. In fact, PVCs can precede an episode or predict who will develop A-Fib.

…Compared to Atrial Fibrillation?

During A-Fib, the upper part of the heart, the atria, go crazy and start beating out of sync which causes the ventricles (the lower part) to beat irregularly.

(A-Fib is usually much more disturbing than an occasional PVC missed or early beat.)

However, if you have a lot of PVCs, they can be just as disturbing as A-Fib.

When are PVCs Dangerous?

If you experience 5+ PVCs per minute or 10-̵30 per hour, you probably should see your Electrophysiologist (EP).

To read how one patient dealt with his PVCs, see John Thorton’s story, PVC-Free After Successful Ablation at Mayo Clinic.

In particular, PVCs can be dangerous if they amount to over 20% of your heart beats. This can weaken your heart muscle. The Mayo Clinic calls them “high density PVCs”.

Can Life-Threatening PVCs be Treated?

Yes, one treatment for excessive PVCs is a PVC ablation. During this ablation the PVCs are mapped and isolated in much the same way A-Fib signals are isolated during an A-Fib ablation.

If you are looking into an ablation for your PVCs, know that not as many EPs perform PVC ablation compared to A-Fib. (Ask your EP for referrals.)

For more about A-Fib with PVCs see, FAQs Coping with A-Fib: PVCs & PACs.

New FAQ: What is Atypical Flutter?

“I have Atrial Flutter that my EP describes as “atypical”. What does that mean? Is it treated differently than typical Flutter? (I’ve had two ablations, many cardioversions, and a Watchman installed to close off my LAA.)”

Atrial Flutter is similar but different from Atrial Fibrillation. Atrial Flutter is characterized by rapid, organized contractions of individual heart muscle fibers (see graphic below).

In general, there are two types of Atrial Flutter:

• Typical Flutter (from the right atrium)
• Atypical Flutter (can come from anywhere)

Typical Flutter originates in the right atrium (whereas A-Fib usually comes from the left atrium).

Atypical Flutter can come from anywhere and is one of the most difficult arrhythmias to map and ablate.

To learn more, read my full answer, go to: I have Atrial Flutter that my EP describes as “atypical”. What does that mean?”

A-Flutter usually comes from the right atrium (A-Fib usually comes from the left atrium).

FAQ: A-Fib and the Two Types of A-Flutter

FAQs Coping with A-Fib: A-Flutter

“I have Atrial Flutter that my EP describes as “atypical”. What does that mean? Is it treated differently than typical Flutter? (I’ve had two ablations, many cardioversions, and a Watchman installed to close off my LAA.)”

A-Flutter usually comes from the right atrium.

Atrial Flutter is similar but different from Atrial Fibrillation. Atrial Flutter is characterized by rapid, organized contractions of individual heart muscle fibers (see ECG graphic).

In general, there are two types of Atrial Flutter:

Typical Flutter (from the right atrium)
Atypical Flutter (can come from anywhere)

Typical Flutter

Typical Flutter originates in the right atrium (whereas A-Fib usually comes from the left atrium). Typical Flutter is an organized right atrium rhythm which usually travels around the tricuspid valve annulus, either in a counterclockwise or clockwise manner. This is the most common form of atrial Flutter.

The tricuspid valve forms the boundary between the right ventricle and the right atrium. Deoxygenated blood enters the right side of the heart via the inferior and superior vena cava.

An ablation for Typical Flutter is one of the easier and more effective forms of catheter ablation. The electrophysiologist (EP) makes what is called a Cavo-Tricuspid Isthmus line in the right atrium to block Flutter signals.

If combined with an ablation for A-Fib (highly recommended), the EP makes this lesion set or line either before going through the septum to the left atrium or on the way out.

This blocking line can be made in as little as 20 minutes and usually stops Typical Flutter. It’s highly successful (95%) with low risk.

Atypical Flutter

Atypical Flutter can come from anywhere and is one of the most difficult arrhythmias to map and ablate. Atypical Flutter includes any other Flutter circuit (not traveling around the tricuspid valve), from either the left or right atrium.

These Atypical Flutter circuits are often associated with scar tissue from prior A-Fib catheter or surgical procedures, but can arise from spontaneous left and/or right atrial scar. One form can travel around the mitral valve annulus, but many other Atypical Flutter circuits are possible. These can be difficult to map and ablate, and there can be multiple Atypical Flutter circuits in a single patient.

Atypical Flutter often appears, as probably in your case, after a successful ablation for A-Fib. It’s often the last arrhythmia circuit that needs to be ablated to restore a patient to sinus.

Treatment for Your Atypical Flutter

Antiarrhythmic Drugs? Today’s antiarrhythmic drugs leave a lot to be desired. They are effective for only about 40% of patients, tend to lose their effectiveness over time and have bad side effects. While they aren’t considered a “cure” for A-Fib, they can be helpful to improve A-Fib symptoms on a temporary basis.

For more about ablation for Atypical Flutter, see my 2020 AF Symposium report, Live Case of Difficult A-Fib Ablation of Atypical Flutter performed by Dr. Kevin Heist, Mass. General Hospital.

For Atrial Flutter, in particular, antiarrhythmic drugs are even less effective. In fact, they sometimes make Flutter worse by slowing conduction which favors the organization of Flutter circuits.

Master EP for Complex Ablation: Treating your Atypical Flutter is often a complex ablation procedure and isn’t for the faint of heart. You need to find a top “master” EP, a highly skilled EP with a high success rate with difficult A-Fib cases, and Atypical Flutter, in particular.

This complex ablation requires an EP with both the experience and the tenacity to find and ablate these often-elusive Atypical Flutter signals. (Email me, I can suggest several “master” EPs.)

Don’t just go to the EP whose office is near you. Go to the best, most experienced EP you can reasonably find. Be prepared to travel.

I know it’s a lot of effort. But you have to work at finding the right EP for you and your Atrial Flutter.

Learn more about Flutter: Most of the information on applies to Atrial Flutter too. But I have also written specifically about Atrial Flutter.

So, I offer you a list of my top articles about Atrial Flutter. See My Top 5 Articles About Atrial Flutter.

Reference for this article
Thanks to Embry Rucker for this excellent question.

Update-re-post: FAQs Understanding A-Fib: Local Anesthesia Can Trigger A-Fib

 FAQs Understanding A-Fib: Local Anesthesia

FAQs Understanding Your A-Fib“I read that the local anesthesia my dentist uses may trigger my A-Fib. Why is that? What can I do about it?”

Dr. Sam, a retired MD, wrote to caution A-Fib patients that local anesthesia containing epinephrine can trigger your A-Fib. Local anesthesia (with Epi or Adrenalin) is used by dentists and emergency room personnel.

Dr. Sam writes:

At the Dentist:This past year I had to have a dental implant and bridgework requiring that I have Local Anesthesia several times. The dentist uses local anesthesia with Epinephrine (Epi or Adrenalin) to numb your mouth.

Epinephrine (Epi or Adrenalin) is one of the drugs EPs can use when completing a catheter ablation—they try to trigger A-Fib to check that their ablation scars for working.  So dental local anesthesia with Epinephrine (Epi) potentially can trigger A-Fib. I found very little info online about this and no studies had been done about dental anesthesia with Epi & A-Fib.

My EP said he thought it would be OK to use. So I had it, and within 30 minutes I was in A-Fib which lasted about 20 minutes and then I went back into NSR.

From then on I requested that my dentist use only local anesthesia without Epi, and I had no more A-Fib episodes. Dentists like to use local anesthesia with Epi because it lasts longer and reduces bleeding locally.

Discuss with your dentist if you think you’re sensitive. Tell him/her you have A-Fib.”

At the Opthamologist: “The drops that the eye doctor uses to dilate your eyes are similar to Adrenalin.  Discuss with your eye doctor if you think you’re sensitive. Tell him/her you have A-Fib.”

At the Emergency Room: In the ER doctors use local anesthesia with Epi to sew up lacerations and/or to do small surgical procedures requiring local anesthesia, because it reduces bleeding locally and lasts longer. Tell your doctor you have A-Fib and discuss your concern that the use of local anesthesia with Epi may trigger your Atrial Fibrillation.”

Thanks Dr. Sam for sharing this warning about Epinephrine containing products.

Go back to FAQ Understanding A-Fib
Last updated: April 8, 2020

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