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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


General or one use

Overview of Atrial Fibrillation

Beat Your A-Fib: Seek Your Cure T-shirt from A-Fib.com shop at spreadshirt.com

Beat Your A-Fib: Seek Your Cure T-shirt from A-Fib.com shop at spreadshirt.com

This is an overview of Atrial Fibrillation, an introduction to A-Fib concepts, terminology and facts about Atrial Fibrillation. We’ll address the following topics:

A-Fib―The Emerging Epidemic
What is A-Fib?
The types of A-Fib
How serious an illness is A-Fib?
How do you get A-Fib? What causes or triggers it?
Treatments for A-Fib
The Wrap Up
• Additional Reading

A-Fib—an Emerging Epidemic

It’s estimated at least 5.1 million people in the U.S. have A-Fib with 6 million in Europe and 8 million in China. By the year 2050, the number will be 5–16 million in the United States and more than 1 million in Japan.

A-Fib is the most common heart arrhythmia. In 2020 approximately 2.1 million Americans under 65 will be diagnosed with A-Fib. In 2010 there were 1.2 million new cases of Atrial Fibrillation in the US. It’s estimated that in 2030 this figure will double to 2.6 million new cases each year.

A-Fib contributes to more than 80,000 deaths annually. In the U.S. people over 40 have a one in four lifetime risk of developing A-Fib. Worldwide, it’s estimated 71–142 million suffer with Atrial Fibrillation (1–2% of the general population). A-Fib adds $26 billion to our country’s healthcare costs in one year. It has rightly been called an epidemic. “One of eight of us will develop A-Fib, if we live long enough.”

What is A-Fib?

Normal heart showing the four chambers, AV node and Sinus Node. Atrial Fibrillation, a-fib, afib, a fib

Normal heart showing the four chambers, AV node and Sinus Node.

In Atrial Fibrillation (A-Fib) the upper part of your heart beats (quivers) faster than the rest of your heart.

If you could look inside your chest, the top part of your heart would be shaking like Jell-O or beating more rapidly than the lower section of your heart. You feel an uncomfortable flutter in your chest or like your heart is going to jump out of your ribs or that your heart is “flip-flopping around.”

Your pulse is irregular and/or more rapid than normal. Someone described their A-Fib as “…like a motor idling too fast in my chest.” Or “like I had a maniacal bass drummer hidden away in my chest.”

SYMPTOMS OF A-FIB

You may have one or more of the following symptoms: you may feel lightheaded (fainting), very tired, have shortness of breath, sweating and chest pain, swelling in your legs, an embarrassing urgent need to pee.…and you may feel unsettled, frightened and anxious. Or perhaps you have few or no symptoms, and were surprised when the doctor said, “You have Atrial Fibrillation”.

The most common symptom of people in Persistent A-Fib is fatigue.

How your Heart Works

Somewhere in your heart extra electrical signals are being generated which causes the top part of your heart (the atria) to contract and quiver rapidly and irregularly (fibrillate) like a bag of worms. The atria can contract as many as 300-600 times a minute.

Your whole heart, however, does not beat 300-600 times per minute. Your heart is a muscular pump divided into four chambers―two atria located on the top and two ventricles on the bottom.

Animations of normal beating heart and a heart in atrial fibrillation, American Heart Association, a-fib, afib, a fib

Animations of normal beating heart and a heart in atrial fibrillation, American Heart Association

VIDEO 1: Animations of normal beating heart and a heart in atrial fibrillation. Click on image to see animation of a normal beating heart; Then use the ‘Select a condition’ at the bottom right of the page to select Atrial Fibrillation to see the heart beating in A-Fib.

Normally, each heartbeat starts at the top of the right atrium where a specialized group of cells called the Sinus Node generates an electrical signal that travels down a single electrical road called the AV Node (the natural pacemaker of the heart) that connects the atria to the ventricles below. This electrical signal causes the heart to beat. (The Autonomic Nervous System [ANS].}

First, the atria contract, pumping blood into the ventricles. Then, a fraction of a second later, the ventricles contract sending blood throughout the body. Normally the heart beats at 60-100 times per minute. When a doctor or nurse takes your pulse, he/she is counting contractions of your ventricles.

In A-Fib, electrical signals from other parts of the heart disrupt your heart’s normal rhythm and cause the atria to beat or quiver rapidly on their own, 300-600 beats per minute.

Below is a graphic representation of your beating heart: on top is an ECG of a normal heart beat (normal sinus rhythm); notice the regular pattern. Below it is an ECG of a heart in Atrial Fibrillation. Notice the irregular and erratic pattern.

ECG tracings of normal heart beat and heart in atrial fibrillation; Overview of Atrial Fibrillation. Copyright 2012 Patti J. Ryan and A-Fib, Inc.

 © Patti J. Ryan and A-Fib, Inc

However, only a small number of these atrial beats make it through the AV Node which acts like a gate to the ventricles. This is fortunate, because you couldn’t live with a heartbeat that rapid. But some A-Fib beats do make it through the AV Node and make your whole heart beat irregularly and/or faster than normal.

TYPES OF A-FIB

There are three types of Atrial Fibrillation. In casual usage you may hear the three types of A Fib described as occasional, persistent, and permanent or chronic A Fib. Your doctor, however, may use one of the following medical terms:

• Paroxysmal: (pronounced par-ok-SIZ-mal) describes episodes that stop on their own, and last anywhere from seconds or minutes, to hours or up to a week

• Persistent: episodes which last more than a week; or episodes lasting less than a week but only stopped by cardioversion

• Long-standing Persistent: a type of Persistent A Fib that lasts longer than one year; (formerly called Chronic or Permanent)

Note: the terms Paroxysmal and Persistent are not mutually exclusive. You may have several episodes of paroxysmal A Fib and occasional persistent A Fib, or the reverse. Your A Fib is called by whichever occurs most often.

Atrial Flutter (A-Flutter)

Like in A-Fib, extra electrical signals are generated in your heart which make the atria contract faster than the ventricles. But in Atrial Flutter, your heart beats in an organized, predictable pattern. (In Atrial Fibrillation the atria beat chaotically and irregularly.) You may consider Atrial Flutter as a more regular, organized variety of A-Fib.

A-Flutter often, but not always, originates in the right atrium. Whereas A-Fib usually comes from the left atrium. (Someone with Flutter often has A-Fib potentials lurking in the left atrium or the Flutter is a precursor to A-Fib.)

Though this is a controversial subject, anyone getting a Flutter-only catheter ablation should discuss with their EP about also having a left atrium A-Fib ablation at the same time. A thorough left atrium ablation will document whether or not you have PV and non-PV A-Fib potentials and will isolate them from causing A-Fib. The controversy arises because many EPs, working on the principle of doing no harm, will not perform a left atrium ablation unless there is documented Atrial Fibrillation in addition to the Flutter.

If you are on a table in the EP lab and the EP is already inside your heart doing a right atrium Flutter ablation, it takes relatively little extra effort to get to the left atrium.

How Serious An Illness is A-Fib?

Some A-Fib patients may develop an extremely rapid, irregular heart rate which can be life threatening. A very rapid, irregular heart rate can strain your heart, reduce your circulation to dangerous levels, and make you feel like you’re going to faint from lack of oxygen.

Increased Risk of Stroke

If you have A-Fib, just how sick are you? A-Fib may feel weird and can be very frightening, but an attack of A-Fib by itself usually isn’t life threatening. The biggest danger from A-Fib is stroke. Because your heart isn’t pumping out properly, blood can pool in your atria, particularly in the ‘Left Atrial Appendage’. Blood clots can form and travel to the brain causing stroke.

If you have A-Fib and aren’t being treated by a doctor, you are five-to-six times more likely to have a stroke than the general population.

Illustration of A-Fib stroke and brain clot.; Overview of Atrial Fibrillation, a-fib, afib, a fib

Researchers estimate that 35% of patients with A-Fib will suffer a stroke (unless treated). A-Fib is responsible for up to 25% of all strokes, or 140,000 strokes annually. Each year, about 8% of people with untreated A-Fib have a stroke.

(There are two main types of stroke. An “ischemic” stroke is a clot in a narrow blood vessel and is the kind that often occurs in A-Fib. Almost 85% of strokes are ischemic. A “hemorrhagic” stroke occurs when a blood vessel ruptures and leaks blood into the brain.)

An A-Fib stroke is worse than other causes of stroke. Half of all strokes associated with atrial fibrillation are major and disabling. Of A-Fib stroke patients, 23% die and 44% suffer significant neurologic damage. This compares to only an 8% mortality rate from other causes of stroke.

VIDEO 2: Atrial Fibrillation-Clot Formation & Stroke Risks; Animation showing how A-Fib clots can form and travel to the brain causing an ischemic stroke. (1:39) Uploaded by Thrombosis Adviser.

Strokes in women are more disabling than in men. There is also a danger of “silent” A-Fib strokes where stroke effects aren’t evident but may appear like attention deficit, forgetfulness, and senile dementia. Silent A-Fib is common.

More than a half-million Americans every year have an ischemic stroke or clot, but at least a quarter of these cases have no apparent underlying cause. Studies indicate that many of these strokes of unknown origin may come from Atrial Fibrillation. Up to 30%−50% of A-Fib patients are unaware they have A-Fib. Of those who suffered an A-Fib stroke, 25% had no prior diagnosis of A-Fib. 

Talk To Your Doctor About Anticoagulants

If you have A-Fib, it’s most important to talk to your doctor about taking an anticoagulant like aspirin, warfarin (Coumadin), or the newer anticoagulants dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) or edoxaban (Savaysa) to help prevent these clots from forming. (Aspirin is less effective than Coumadin or the newer anticoagulants.)

Warfarin, the most prescribed anticoagulant, reduces the risk of stroke by 60% to 70% in A-Fib patients but is not an absolute guarantee one will never have an A-Fib stroke.

Risk of Bleeding From Anticoagulants

Anticoagulants are not like taking vitamins. Be aware that the anticoagulant warfarin has a 1.8% annual risk of life-threatening bleeding. Anticoagulants may prevent an A-Fib (ischemic) stroke while somewhat increasing one’s chances of a bleeding (hemorrhagic) stroke, particularly among the elderly.

As Thomas J. Moore of the Institute for Safe Medical Practices points out, “Anticoagulation treatment for people with A-Fib ranks as one of the highest risk treatments in older Americans…More than 15% of older patients treated with blood thinners for 1 year have bleeding.” In a 2011 study, 48.8% of all adverse drug events involved anticoagulants (Budnitz. Am Journal of Medicine, 2011).

Warfarin and most other anticoagulants are a trade-off for most patients. The danger of having an A-Fib stroke usually outweighs the risk of a bleeding (hemorrhagic) stroke or other side effects due to taking anticoagulants.

Some with A-Fib may not need anticoagulants at all. If you are young, active, and have an otherwise normal heart, you and your doctor may decide your A-Fib stroke risk is low, and you don’t need to be taking an anticoagulant.

A-Fib Damages Your Heart, Brain and Other Organs

If you have A-Fib, the upper parts of your heart (the atria) aren’t pumping enough blood into the lower chambers of your heart (the ventricles). It’s estimated that this reduces the amount of blood flowing to the rest of your body by about 15%-30%.

You may not be getting enough blood to your brain and other organs which may cause weakness, fatigue, dizziness, fainting spells, swelling of the legs, and shortness of breath.

Recent studies indicate that A-Fib reduces mental abilities and may lead to dementia and to heart failure.

Patients with A-Fib are 44% more likely to develop dementia. Of patients suffering from A-Fib, 20%–50% develop heart failure (congestive heart failure).

Over time a very fast heart rates can strain the heart and cause a heart attack. Inefficient atrial pumping puts an added burden on the ventricles. Prolonged A-Fib episodes may stretch and weaken the heart muscle. A-Fib nearly doubles your chances of death. The mortality rate from atrial fibrillation (as either the primary or an underlying cause of death) has been increasing for more than two decades.

A-Fib often changes or “remodels” your heart. Your left atrium (LA) tends to expand, stretch, dilate and weaken the LA muscles. Your ejection fraction (how well your heart is pumping out blood) tends to decrease. A-Fib produces fibrosis (collagen and scarring in the heart). Fibrotic tissue is scarred, immobile, basically dead tissue with reduced or no blood flow and no transport function. It results in a loss of atrial muscle mass. (For more, see my article: A-Fib Produces Fibrosis.)

Over time it makes the heart stiff, less flexible and weak, overworks the heart, reduces pumping efficiency and leads to other heart problems. Your heart also remodels electrically. A-Fib attacks tend to become longer and occur more often. A-Fib is usually a progressive disease.

[Editor’s comment: Please weigh the above statements carefully; I don’t want to create unwarranted fear.]

PSYCHOLOGICAL AND EMOTIONAL EFFECTS

Your first A-Fib attack is a shock. Something has gone terribly wrong with your heart. There’s the constant threat, fear and anxiety of an ever-possible A-Fib attack, the sense of sickness, the feelings of depression and impending doom.

A-Fib can deeply affect your state of mind and emotional well-being. Research suggests that psychological distress is present in a substantial portion of A-Fib patients and is related to greater A-Fib symptom severity, diminished quality of life, and adverse outcomes. Studies show that patients with paroxysmal A-Fib show signs of depression, sleeping disorders and low levels of physical activity.

Anxiety by itself can produce physical symptoms such as gastrointestinal distress, sleep issues, shortness of breath, exhaustion, muscle aches, shaking and trembling, sweaty palms, difficulty swallowing, a racing heart like in A-Fib, getting colds frequently because of a depressed immune system.

Sometimes there’s a lack of understanding from your family, friends, even from your doctor. And the sense of helplessness and lack of control, the worry about what A-Fib (and all these drugs you have to take) is doing to your heart and body. There’s the mood swings and the need to cry (sometimes worsened by the drugs one has to take)—these are all effects A-Fib can have both on your state of mind and on your social interactions.

Download the FREE report from Steve S. Ryan, PhD

Download the FREE report from Steve S. Ryan, PhD

On top of all this, your A-Fib can also affect your family, friends and colleagues (See Max Jusila’s personal A-Fib story “A-Fib Was Devastating“). Anxiety is the most common effect of A-Fib.

At A-Fib.com, we will give you an understanding of A-Fib and hopefully a sense of control. You will learn what A-Fib is and how to fix it. As terrible as A-Fib makes you feel, it’s a heart problem that’s the easiest to fix (unlike most other heart problems).

Did you recognize any of your symptoms in the above paragraph? Just acknowledging you have some or all of these symptoms is a step in the right direction.

But you may need more than this web site to deal with the psychological and emotional effects of A-Fib. Don’t be scared or ashamed to admit how A-Fib makes you feel (especially if you’re a guy). There’s nothing wrong with seeking counseling and medical help for how A-Fib affects your psyche. Your psyche is just as important as your physical heart. (See Jay Teresi’s story “Anxiety the Greatest Challenge” and Kelly Teresi’s story “A Young Wife Copes with Husband’s A-Fib” in my book, Beat Your A-Fib, pages 101-105.)

And be aware that your heart doctor may not be of much help. Your doctors are often so focused on dealing with your physical symptoms and getting you cured that they often don’t recognize or acknowledge how A-Fib affects your psyche and your quality of life. And they aren’t trained or often have little effective experience in dealing with the psychological and emotional aspect of A-Fib.

Studies show that physicians rate their patients’ health-related quality of life higher than their patients do, both for the mental and the physical component score. (I have yet to go to a medical conference on A-Fib where the emotional and psychological effects of A-Fib are even mentioned, let alone protocols discussed and developed to deal with them.)

And you need to recognize that A-Fib can have significant consequences on your social interactions, with your family, friends and colleagues. Sometimes family and friends, and even your doctor, may not understand what you are going through—that A-Fib has a psychological component in addition to the physical.

A-Fib isn’t like having a broken leg. To your significant others, you may look normal. Sit down with your family, friends, especially with your work colleagues and explain to them what A-Fib does to you. But realize that many will never understand the suffering A-Fib causes. (I fantasize about being able to give people a 10 second shot of A-Fib so that they [especially doctors] could feel what A-Fib is like). (Also see our article: Seven Ways to Cope With Your A-Fib Fear and Anxiety)

One-to-One, our A-Fib Support Volunteers are just an email away at A-Fib.com

Our A-Fib Support Volunteers are just an email away

Would you be helped by talking with or emailing people who have been through the A-Fib ordeal? A list of A-Fib Support Volunteers is available under Resources and Links. Having someone you can turn to for advice, emotional support, and a sense of hope that you can be cured, may bring you peace of mind. It helps to have someone who has “been there” and is there for you.

These volunteers have gone through a lot to be cured of A-Fib, and have been helped along the way. They want to return the favor by offering you support and hope.

A-FIB REMODELS YOUR HEART AND IS A PROGRESSIVE DISEASE

It’s important to be treated as reasonably soon as possible.

In a process called “remodeling,” your heart actually changes if you have A-Fib long enough. The fast, abnormal rhythm in your atria causes electrical changes and enlarges your atria. Your heart develops fibrosis, the formation of fibrous tissue in the heart.

A-Fib Begets A-Fib.

Your A-Fib episodes become more frequent and longer, often leading to continuous (Chronic) A-Fib. In the famous Framingham Heart Study, 25%-40% of people with A-Fib went on to develop continuous “persistent” A-Fib. In a study of 5,000+ A-Fib patients, 54% of those on rate control meds went into permanent “persistent” A-Fib in one year.

However, some people never progress to more serious A-Fib stages.

But even with Chronic A-Fib, people have been cured, and this remodeling of the heart partially or almost completely reversed.

But don’t delay! The longer you wait to be treated, the worse your A-Fib could get. (If you’ve had A-Fib for six weeks, your A-Fib probably hasn’t progressed very much. But if you’ve had A-Fib for six years, you should get treated as reasonably soon as possible.)

How Do You Get A-Fib? What causes, OR Triggers A-Fib?

For many A-Fib patients (around 50%), there is no discernible cause or trigger for their A-Fib.

For the others, the following may contribute to their Atrial Fibrillation:

If you’ve had other heart problems, this could lead to diseased heart tissue which generates the extra A-Fib pulses—possibly because they stretch and put pressure on the pulmonary veins where most A-Fib originates. Up to 40% of patients get A-Fib after open heart surgery.

Heavy drinking may trigger A-Fib. Extreme fatigue, emotional stress, severe infections, severe pain, traumatic injury, and illegal drug use can trigger A-Fib. Low or high blood and tissue concentrations of minerals (electrolytes) such as potassium, magnesium and calcium can trigger A-Fib. Thyroid problems (hypothyroidism), lung disease, reactive hypoglycemia, viral infections, kidney disease, diabetes, and smoking can trigger A-Fib.

A-Fib is associated with aging of the heart. As patients get older, the prevalence of A-Fib increases.

As we put on pounds, our risk of developing A-Fib increases.

A-Fib can run in families.

Some cases have been reported where antihistamines, bronchial inhalants, local anesthetics, medications such as sumatriptan, a headache drug. Tobacco use, MSG, cold beverages, coffee, chocolate, high altitude, GERD, sleep apnea and even sleeping on one’s left side or stomach are said to have triggered A-Fib.

A-Fib is associated with aging of the heart. As patients get older, the prevalence of A-Fib increases, roughly doubling with each decade. This suggests that A-Fib may be related to degenerative, age-related changes in the heart.

For a more in-depth discussion of A-Fib causes and triggers, see Causes of A-Fib.

Review of Treatments

The key to stopping A-Fib is to eliminate the extra electrical pulses A-Fib generates.

Doctors usually start with medications (called drug therapy) to try and control the rhythm and rate of the heart. For most A-Fib patients drugs aren’t very effective (about 40-50% success rate) or have serious side effects. For a more in-depth discussion, see Treatment/Drug Therapies.

Sometimes an electrical shock called a cardioversion is used to return your heartbeat to normal. The benefit is usually temporary. For most A-Fib patients, their A-Fib returns in a week to a month (see Treatments/Cardioversion).

Drug therapy and cardioversion have their roles, but they ‘manage’ your A-Fib. Neither treatment eliminates or ‘cures’ your A-Fib.

But know that Atrial Fibrillation is curable.

An effective treatment to eliminate these extra electrical pulses is Pulmonary Vein Ablation (PVA), a type of catheter ablation. 75,000 to 100,000 A-Fib ablations are performed in the U.S. every year, and this number is rapidly growing.

A soft, flexible tube (a catheter) with an electrode at the tip is inserted into a vein in your groin and moved to the inside of your heart.

Catheter inserted into the heart and through septum wall into Left Atria

Catheter inserted into the heart and through septum wall into Left Atria

The catheter is directed to the precise locations in your heart that produce these extra signals. Using radiofrequency (RF) or other energy sources, these areas are burned off or “isolated”― disrupting the path of the irregular signals.

You are usually under general anesthesia during the PVA which means you don’t feel anything. If you are under “conscious sedation” and are awake during the procedure, you won’t feel the catheter being moved through your veins. There are usually no nerve endings in blood vessels. You also won’t feel a lot of the burns in your heart. There are motor nerve endings but usually no sensory nerve endings in the heart. But the procedure isn’t painless. Most patients can go home the next day. See Treatments/Catheter Ablation.

Surgery can also be an effective option to eliminate or isolate A-Fib pulses. The  open-heart version is the Cox Maze, but it’s usually only performed concurrently with other heart surgery, such as Mitral Valve replacement.

The more frequently performed surgery is the Mini-Maze which accesses the heart through several small incisions in the chest or diaphragm. The catheters and a tiny camera are inserted to locate, then burn or “isolate” the extra signals. All from outside of the heart. A stay in the hospital is necessary to recuperate. See Treatments/Cox Maze and Mini-Maze operations.

Maze incisions

Typical Mini-Maze incisions for surgical ablation of Atrial Fibrillation

For a more thorough discussion of the various treatments for A-Fib, see Treatments.

The Wrap-up

The bottom line is—how do you feel? If you don’t feel any symptoms and your doctor says your heart isn’t enlarging and/or developing poor ejection fraction, etc., then there’s no urgent need to rush out to get a Pulmonary Vein Ablation (or surgery).

Some people decide to simply live with A-Fib (usually while on A-Fib medications) rather than to undergo treatments to make them A-Fib free. (I am personally biased against just living with A-Fib. When I had A-Fib, it drove me nuts!) But realize that A-Fib is a progressive disease that usually harms your heart over time.

On the other hand, if you have bothersome A-Fib symptoms, if it’s impacting your quality of life, if you are miserable, then pursue treatment options that go beyond drug therapy, i.e., a Pulmonary Vein Ablation.

Your next step is to find the best doctor you can afford, who specializes in treating irregular heartbeats (i.e. an electrophysiologist, a type of Cardiologist). For advice in selecting the right doctor, see Finding The Right Doctor.

Additional Readings

Causes of A-Fib
Find the Right Doctor for You
Treatments for A-Fib
FAQs: Coping with A-Fib
Personal A-Fib Stories of Hope
Resources & Links

Remember: You don’t have to “just take your meds and get used to it.” (A quote from one patient’s doctor.) You don’t have to settle for a life on meds. Seek your Cure!

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If you find any errors on this page, email us. Y Last updated: Monday, August 24, 2020  

Resources for this article
•Miyasaka, Yoko, et al. Secular Trends in Incidence of Atrial Fibrillation in Olmsted County, Minnesota, 1980 to 2000, and Implications on the Projections for Future Prevalence.  Circulation, 2006;114:119-125.PubMed PMID: 16818816. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/16818816?dopt=Abstract

•Go, Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. JAMA, 2001:285:2370-2375. PubMed PMID:11343485. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/11343485

•Go, A.S. et al. “Prevalence of diagnosed atrial fibrillation in adults. National implications for rhythm management and stroke prevention: the Anticoagulant and Risk Factors in Atrial Fibrillation (ATRIA) Study.” JAMA 2002;285:2370-2375; PubMed PMID: 11343485. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/11343485

•Colilla, S. et al. “Estimates of Current and Future Incidence and Prevalence of Atrial Fibrillation in the U.S. Adult Population.” The American Journal of Cardiology, July 8, 2013. doi: 10.1016/j.amjcard.2013.05.063. Epub 2013 Jul 4. PubMed PMID: 23831166. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/23831166

•Kim, M. H., Johnston, S. S., Chu, B.-C., et al. (2011). Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circulation: Cardiovascular Quality and Outcomes. URL http://dx.doi.org/10.1161/CIRCOUTCOMES.110.958165

•Lloyd-Jones,  D.M, Wang TJ, Leip E, et al. Lifetime risk for development of atrial fibrillation. Circulation. 2004;110:1042-1046. URL http://dx.doi.org/10.1161/01.CIR.0000140263.20897.42

•Camm, A. J., Kirchhof, P., & Lip, G. Y. H. (2010). Guidelines for the management of atrial fibrillation. European Heart Journal , 31 (19), 2369-2429. URL http://dx.doi.org/10.1093/eurheartj/ehq278

•Kim, M. H., Johnston, S. S., Chu, B.-C., et al. (2011). Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circulation: Cardiovascular Quality and Outcomes.  URL http://dx.doi.org/10.1161/CIRCOUTCOMES.110.958165

•Gonzalez, A. (July 07, 2011). Atrial fibrillation is emerging as the new epidemic. Cardiac Rhythm News. Retrieved August 23, 2011, from http://www.cxvascular.com/crn-latest-news/cardiac-rhythm-news—latest-news/atrial-fibrillation-is-emerging-as-the-new-epidemic

•Gillinov AM, Blackstone EH, et al. “Atrial Fibrillation: Current surgical options and their assessment.” Ann. Thorac. Surg. 2002; 74:2210-17. PubMed PMID: 12643434.Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/12643434

•Blackshear JL, Odell JA. “Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation.” Ann. Thorac. Surg. 1996;61:755-759. Last accessed April 3, 2014. URL: http://www.sciencedirect.com/science/article/pii/S0735109703009537

•Kiser, A C., et al. UNC Cardiac Surgery and Services Convergent Procedure: A Total Solution. Arrhythmia Center, Pinehurst, NC. Last accessed April 3, 2014. http://www.uncheartandvascular.org/index5289_3.html?d=7&p=106

•Stark, Robert Puzzling Palpitations? Bottom Line Health, Volume 28, Number 6, June 2014. •Bottom Line Personal,” July 15, 2003, p. 10.

•Loftus, B. Atrial Fibrillation and Stroke. Bellaire Neurology Last accessed November 5, 2012 http://www.loftusmd.com/Articles/stroke/atrialfibrillation.html

•The Link Between Infections and Inflammation in Heart Disease. Life Extension Vitamins. Last accessed November 5, 2012 http://www.lifeextensionvitamins.com/cadico6otco.html

•ACC/AHA/ESC. 2006 “Guidelines for the Management of Patients with Atrial Fibrillation.” Circulation, 2006;114:700-752. Last accessed April 3, 2014. URL: http://circ.ahajournals.org/content/114/7/700.full.pdf

•Poli D,  et al “Gender differences in stroke risk of atrial fibrillation patients on oral anticoagulant treatment.” J. Thorac Cardiovasc Surg. 2010 Feb;139(2);326-32. PubMed PMID: 19404548. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/19404548

•Feinberg, “Epidemiological features of asymptomatic cerebral infarction in patients with nonvalvular atrial fibrillation.” Arch Intern Med 1990;150:2340-2344. PubMed PMID: 2241443. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/2241443

•O’Connor, Anahad. Longer Heart Monitoring Backed for Stroke Patients. The New York Times, June 25, 2014. http://well.blogs.nytimes.com/2014/06/25/longer-heart-monitoring-backed-for-stroke-patients/?_php=true&_type=blogs&_r=0

•Furberg CD et al. “Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study).” Am J Cardiol. 1994; 74: 236-241.PubMed PMID: 8037127. Last accessed April 3, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/8037127

•Abdon NJ et al. “Is occult atrial disorder a frequent cause of non-hemorrhagic stroke? Long term ECG in 86 patients.” Stroke. 1982; 13: 832-837. PubMed PMID:7147300. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/7147300

•Schuchert A et al. “Impact of long-term ECG recording on the detection of paroxysmal atrial fibrillation in patients after acute ischemic stro1e.” Pacing Clin Electrophyiol. 1999′ 22″ 1082-1084. Last accessed April 3, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/10456638

•Chatterjee, S. et al. “Left Atrial Appendage Occlusion: Lessons Learned From Surgical and Transcatheter Experiences.” Ann Thorac Surg 2011;92:2283-92. doi: 10.1016/j.athoracsur.2011.08.044

•Connolly, S.J. et al. “Dabigatran versus warfarin in patients with atrial fibrillation.” N Engl J Med 2009;361:1139-51. doi: 10.1056/NEJMoa0905561. Epub 2009 Aug 30. Last accessed April 3, 2014 URL: http://www.ncbi.nlm.nih.gov/pubmed/19717844

•Doheney, Kathleen. Blood-Thinner Pradaxa: What You Should Know. WebMD Health News July 25, 2014. http://www.webmd.com/stroke/news/20140725/blood-thinner-pradaxa

•Atrial Fibrillation. Cardiac Arrhythmia Institute/Sidney Peykar, MD. Last accessed Jan 5 2013. URL:http://caifl.com/arrhythmia-information/atrial-fibrillation/

•Skillstat Heartscape/Chambers online educational program. Skillstat Learning, Inc. Last accessed November 5, 2012 http://www.skillstat.com/tools/heart-scape

•Elias, MF. et al. Atrial Fibrillation Is Associated With Lower Cognitive Performance in the Framingham Offspring Men. Journal of Stroke and Cerebrovascular Diseases, Vol. 15, No. 5 (September-October), 2006: pp. 214-222.  DOI:10.1016/j.jstrokecerebrovasdis.2006.05.009. Last accessed April 3, 2014 URL:http://www.strokejournal.org/article/S1052-3057(06)00075-9/abstract

•Bunch, J. J., Weiss, P. P., & Crandall, B. G. et al. Atrial fibrillation is independently associated with senile, vascular, and alzheimer’s dementia. Heart rhythm, 2010:7 (4), 433-437. URL http://dx.doi.org/10.1016/j.hrthm.2009.12.004

•O’Riordan. M. Ablation of AF reduces risk of Alzheimer’s disease and dementia. May 17, 2010.  Heartwire/the Heart.org. Last accessed Jan 5, 2013 URL: http://www.theheart.org/article/1079365.do>

•Camm, “Clinical Relevance of Silent Atrial Fibrillation: Prevalence, Prognosis, Quality of Life, and Management.” Journal of Interventional Cardiac Electrophysiology 4, 369-382, 2000, p. 376. Review. PubMed PMID: 10936003. Last accessed April 3, 2014. URL: http://www.ncbi.nlm.nih.gov/pubmed/10936003

•Lloyd-Jones, D M. Epidemiology and Treatment of Atrial Fibrillation: What Is AF? Medscape Education/Cardiology.2004;8(2) Last accessed Jan 5, 2013. URL: http://www.medscape.org/viewarticle/494006_2

•Atrial Fibrillation. Cardiac Arrhythmia Institute/Sidney Peykar, MD. Last accessed Jan 5 2013. URL:http://caifl.com/arrhythmia-information/atrial-fibrillation/

•What are the risks of Atrial Fibrillation? The London AF Centre. Last accessed November 6, 2012. URL: http://www.londonafcentre.co.uk/what_are_the_risks_of_af

•Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death File 1999-2004. CDC WONDER. Series 20 No. 2J, 2007. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Sep. 25, 2009.

•McCabe, P. J. (2010). Psychological distress in patients diagnosed with atrial fibrillation: the state of the science. The Journal of cardiovascular nursing, 25 (1), 40-51. URL http://dx.doi.org/10.1097/JCN.0b013e3181b7be36

•Ladwig, K. Depression screening in AF clinics recommended. Arrhythmia Watch. European Society of Cardiology. July 30, 2013. http://www.escardio.org/about/press/press-releases/pr-13/Pages/depression-screening-recommended-in-atrial-fibrillation-clinics.aspx

•Lane, D. A., Langman, C. M., Lip, G. Y., & Nouwen, A. (2009). Illness perceptions, affective response, and health-related quality of life in patients with atrial fibrillation. Journal of psychosomatic research , 66 (3), 203-210. URL http://dx.doi.org/10.1016/j.jpsychores.2008.10.007

•Ladwig, K. Quality of life incorrectly assessed in over 50% of paroxysmal atrial fibrillation patients, Cardiac Rhythm News. October 2013, Issue 22; Last accessed April 3, 2014 URL: http://www.cxvascular.com/crn-newspapers-pdfs?DocumentScreen=detail&cl=474&ccs=665

•Van Wagoner, D.R. et al. Molecular Basis of electrical remodeling in atrial fibrillation. J Mol Cell Cardiol. 2000;32:1101-1117. Phrase originally coined by Wijffels & colleagues.

•Bunch, T. Jared. Will My Atrial Fibrillation Get Worse? Latest Research on Reducing Risk. Everyday Health, Rhythm of Life. May 28, 2014. http://www.everydayhealth.com/columns/jared-bunch-rhythm-of-life/will-my-atrial-fibrillation-get-worse-how-to-reduce-your-risk/ Last accessed 12/2/14.

•Lubitz, Steven A. et al. Atrial Fibrillation Patterns and Risks of Subsequent Stroke, Heart Failure, or Death in the Community. Journal of the American Heart Association. 2013;2:e000126, Sept. 3 ,2013.  http://jaha.ahajournals.org/content/2/5/e000126.short?rss=1 doi: 10.1161/JAHA.113.000126

•de Vos CB, et all. Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis. J Am Coll Cardiol. 2010 Feb 23;55(8):725-31. doi: 10.1016/j.jacc.2009.11.040. PubMed PMID: 20170808.

•Allessie M. “Pathophysiology and Prevention of Atrial Fibrillation,” Circulation. 2001;103(5):769. doi: 10.1161/01.CIR.103.5.769 Last accessed April 3, 2014. http://circ.ahajournals.org/content/103/5/769.full

•Frost L., et al. “Atrial fibrillation and flutter after coronary artery bypass surgery: epidemiology, risk factors and preventive trials.” International Journal of Cardiology. 1992;36:253-262. Last accessed April 3, 2014 URL: http://www.sciencedirect.com/science/article/pii/016752739290293C

•O’Riordan, Michael. One in Five CABG Patients Develop New-Onset Atrial Fibrillation: EXCEL. tctMD/the heart beat. February 12, 2018. https://www.tctmd.com/news/one-five-cabg-patients-develop-new-onset-atrial-fibrillation-excel

•Schmidt M, et al. Renal dysfunction and atrial fibrillation recurrence following cardioversion. J Cardiovasc Electrophysiol. 2011 Oct;22(10):1092-8. doi: 10.1111/j.1540-8167.2011.02069.x. Epub 2011 Apr 13. PubMed PMID: 21489032.

•Heeringa J, et al. Cigarette smoking and risk of atrial fibrillation: the Rotterdam Study. Am Heart J. 2008 Dec;156(6):1163-9. doi: 10.1016/j.ahj.2008.08.003. Last accessed Jan 6, 2013 URL: http://www.ncbi.nlm.nih.gov/pubmed/19033014

•Gee, R. Atrial Fibrillation Caused or Worsened by Lasalocid Residue in Eggs 1998 – 2005, Updated 2006 and 2007. Last accessed April 3, 2014 URL: http://www.freewebs.com/lasalocid/lasalocid.pdf

•Brugada R. “Identification of a genetic locus for familial atrial fibrillation,” New England Journal of Medicine 1997;336:p. 905-911. Last accessed: Apri 3, 2014. URL: http://www.nejm.org/doi/full/10.1056/NEJM199703273361302

•Collins, C. What Are the Symptoms of Atrial Fibrillation? Yahoo! Voices/Contributor Network. Mar 22, 2010. Last accessed Dec. 31, 2012. URL:http://voices.yahoo.com/what-symptoms-atrial-fibrillation-5682474.html

•The Link Between Infections and Inflammation in Heart Disease. Life Extension Vitamins. Last accessed November 5, 2012 ttp://www.lifeextensionvitamins.com/cadico6otco.html

•Calkins, H. and Berger, R. “Atrial Fibrillation The Latest Management Strategies.” The Johns Hopkins Medicine Library, p. 9.

•Jais, P. et. al “Ablation therapy for atrial fibrillation (AF) Past, present and future”  Cardiovascular Research 2002. Vol. 54, Issue 2, pp. 337-346. doi: 10.1016/S0008-6363(02)00263-8

•Mansour, Moussa. Letter from the Editor-In-Chief. The Journal of Innovations in Cardiac Rhythm Management. 8 (2017), A7. DO!: 10.19102/icrm.2017.080106.

•Budnitz. DS et al. Emergency Hospitalization for Adverse Drug Events in Older Americans. New England Journal of Medicine, Nov. 24, 2011. 365:2002-2012. http://www.nejm.org/doi/full/10.1056/NEJMsa1103053#t=article. DOI: 10.1056/NEJMsa1103053

Invitation: The Association Between Atrial Fibrillation and Anxiety Survey

The Association Between Atrial Fibrillation and Anxiety Survey

This survey is for research conducted by Sevinc Erdas Uzumcu as partial completion of the Doctor of Health Sciences degree at A. T. Still University. The purpose of this research is to understand of the association between atrial fibrillation and anxiety. Your participation is voluntary and will only involve completing the anonymous, 7–minute questionnaire. The researcher will not place any codes on the questionnaire that could directly identify you. The results of this research might be published, but any research reports or publications will not reveal your name or identity. Your survey completion serves as consent to participate in this research. While there are no direct benefits to you for completing this questionnaire, the results may help improve understanding of prevalence of anxiety among patients with AF and the association between AF symptom severity and anxiety that could contribute to current treatment options and improved patient outcomes.

Thank you for your time,

Sincerely,
Sevinc E. Uzumcu
Doctorate Student
Doctor of Health Sciences Program
T. Still University
Arizona School of Health Science Mesa, Arizona
Email: serdasuzumcu@atsu.edu

AF and Anxiety Survey Link:
https://www.surveymonkey.com/r/8LFN3BJ

Podcast: The Double Whammy? Sleep Apnea and Atrial Fibrillation

Open in a new window: Podcast The Double Whammy? Sleep Apnea and Atrial Fibrillation

Note: If you prefer to read instead of listen, click the transcript graphic bar below for the printed version.

Podcast: The Double Whammy? Sleep Apnea and Atrial Fibrillation

Obstructive Sleep Apnea (OSA), aside from causing or triggering A-Fib, if untreated it can cause many other serious health threats. That’s the topic of this podcast between Steve and our friend, Travis Van Slooten, publisher of LivingWithAtrialFibrillation.com. We discuss the strong connection between sleep apnea and A-Fib, and why it’s so important to have a sleep study if you have atrial fibrillation. (21:33 min)

Highlights from this Podcast

 Over 40% of A-Fib patients also have sleep apnea
Sleep apnea can cause atrial fibrillation
 Anyone can have Sleep Apnea (thin, average or overweight)
If you have A-Fib, you should definitely have a sleep study
Sleep studies: in-lab test vs. in-home test

To Learn More

See our posts: Sleep Apnea: When Snoring Can Be Lethal and Sleep Apnea: Home Testing with WatchPAT Device and the Philips Respironics.

On Livingwithatrialfibrillation.com, see Travis’ post: My In-Lab Sleep Study Experience.

Transcript of this podcast
Travis Van Slooten: Now, I’ve mentioned in previous blog posts on my site and in previous podcasts, about the strong connection between sleep apnea and A-Fib.

And, Steve, before we really dive into that topic specifically, and again, the connection between sleep apnea and A-Fib, I just want to take a step back, and first talk about sleep apnea in general, for those listening to this that aren’t familiar with it.

Because I’m sure everyone’s heard of sleep apnea, but I think, at the end of the day, a lot of people don’t really know what it is. So, with that, Steve, let’s talk about, what is sleep apnea?

Steve Ryan: Yeah, Travis, the technical name is obstructive sleep apnea. Now, what that means is, basically, somehow, the airways are being blocked, when you’re trying to sleep. Your sleep starts, and starts, and you gasp, and… The other one, which we’ll just mention, and then skip over, is central sleep apnea, where the brain is simply not sending signals, the proper signals, for the muscles to control breathing. That’s something we don’t get into very much. Usually, what we have to worry about is obstructive sleep apnea.

Travis Van Slooten: Okay.

Steve Ryan: Now, let me give you an example of what it’s like. My wife has sleep apnea, Patti.

Travis Van Slooten: Oh, she does?

Steve Ryan: Yes. Before she was treated, I’d be sleeping with her, and I’d listen, and she would actually stop breathing. I mean, actually stopped breathing for what seemed like a long time. Then, all of a sudden she’d gasp and start breathing again. And this would go on and on, and this would happen over and over again. And, obviously, she wasn’t sleeping well, and she’d be very sleepy the next day. And, of course, I wasn’t sleeping either, listening to this.

But once she got a CPAP machine, which is simply a medical device, like a breathing apparatus that keeps the airways open, once she started using that, she sleeps like a baby now, and has no more problems. But that’s an example of how sleep apnea can affect you. It disrupts your breathing and your sleeping patterns.

Travis Van Slooten: And for a lot of people that have it, they don’t even probably know they have it, unless they have a sleep partner that is witnessing it. [chuckle] And the other thing is, it’s not just… I think a lot of people have the misconception that it’s all about snoring… It might not be snoring. Like in your case, it sounds like Patty wasn’t snoring. She was literally…

Steve Ryan: Oh, yes, she was.

Travis Van Slooten: Oh, okay, she was snoring too. But the primary symptoms are snoring, and just, like you said, gasping for air. It’s very obvious, if you are sleeping with someone with sleep apnea, and you’re awake, and you witness it, right? It’s pretty obvious.

Steve Ryan: Yes, yes. 43% of patients with A-Fib have sleep apnea. And I’ll tell you, let’s say you’re a guy, and you’re sleeping with your wife, and you get up in the morning, and you’ve got all these bruises on your side. That’s probably because your wife is elbowing you, trying to keep you from snoring. That’s a pretty good sign that you have sleep apnea.

Travis Van Slooten: Yeah.

Steve Ryan: And the good thing about sleep apnea is it’s easily fixed. There’s a number… You can have this mask or you can have these dental devices that can help keep those airways open. It’s relatively easy to fix. Thank God.

Travis Van Slooten: Yeah, absolutely. And you mentioned that the connection, as perfect transition now, into the actual connection here between sleep apnea and A-Fib. Now, you said, what, 43% of people with A-Fib have some form of sleep apnea?

Steve Ryan: Yeah. It’s so prevalent, that I went to a A-Fib center in Louisville, Kentucky, and I was talking with the doctors there. And then I noticed that when a patient comes in, and they have A-Fib, they send ’em down to the next door, and they get a sleep apnea study then and there.

Travis Van Slooten: Oh, wow. Now, that’s…

Steve Ryan: They are so attuned to everyone coming in with A-Fib. Most, well, many people who come in with A-Fib have sleep apnea, that they make it part of their center. They won’t treat a patient, unless they go to the center, and have a sleep apnea study done then and there. And a lot of centers will not do a catheter ablation on you, if you have sleep apnea that you don’t take care of.

Why? Because it recurs. It tends to…you tend to have recurrence because you have the same condition that created the atrial fibrillation in the first place is still there. Because basically any time you’re gasping for breath like that, and any time you’re not breathing properly, that’s a tremendous strain on your heart, and on your lungs, and that irritates the pulmonary veins. And that’s what probably brought on the A-Fib in the first place, so you really need to take care… If you have sleep apnea, you really need to take care of it.

Travis Van Slooten: So sleep apnea… Are you saying then, that sleep apnea can cause A-Fib?

Steve Ryan: Yes. Yes, indeed.

Travis Van Slooten: Okay.

Steve Ryan: There’s been a study done, where they studied 1,000 patients, so seven different studies. And all these patients were treated with Continuous Positive Airway Pressure, that’s CPAP, which is a mask worn. And CPAP cut the risk of A-Fib episodes in half.

Travis Van Slooten: Oh, wow.

Steve Ryan: And people using CPAP were 42% less likely to experience an abnormal heart rhythm, than those not receiving such treatment. Now, we’re not saying that you got to use a CPAP machine. You can maybe change your lifestyle. You could, if you’re overweight, losing that weight would help, quitting smoking. Sometimes, lifestyle choices can get rid of A-Fib, but it’s not necessarily…

Unfortunately, once A-Fib starts, it’s usually pretty hard to stop without something more radical. But some people, just from eliminating A-Fib, are lucky enough that that also gets rid of their… Just by getting rid of their sleep apnea, they also get rid of their A-Fib. But don’t bank the farm on that. It’s something that could happen. And it does happen to some people, but more often than not, you need more radical treatments to get rid of the A-Fib.

Travis Van Slooten: Absolutely. And so I think the key takeaway here, as far as this connection is, if you have A-Fib now, just because you’re a skinny guy or gal doesn’t mean you don’t have sleep apnea. And I made that assumption. I assumed, ’cause I’m not really skinny, and I’m not really obese, or anything either, I’m a normal, average guy weight-wise, but I was like, “There’s no way I have sleep apnea.” And my doctor told me that anybody can get sleep apnea. It’s not necessarily overweight people. Although, that is definitely one of the risk factors, but skinny people can get it as well, right?

Steve Ryan: Yes.

Travis Van Slooten: So, if you’re a skinny guy or gal, and you have A-Fib, don’t just assume, if you’re listening to this, that, “Oh, that’s not me. I can’t possibly have sleep apnea.” Yeah, you definitely could, especially if you have A-Fib.

Steve Ryan: Yeah. We have a story on our website by Kevin Sullivan, age 46, and he describes what happened to him: “My A-Fib seemed to start at night, while I was sleeping. One night, when I woke up, my heart was racing and I felt sweaty. When I asked my doctor about it, he told me that it was unlikely, because I was not overweight and I did not feel tired during the day.” That’s him saying, that’s why he didn’t think he had sleep apnea. “But I went to a sleep lab anyway and it turned out I did have sleep apnea.” And that’s, unfortunately, what happens to a lot of people. Just because you’re thin doesn’t necessarily mean you may not have sleep apnea, or you may not snore, and you may still have sleep apnea.

Travis Van Slooten: Or like you said, that this gentleman wasn’t tired either, which is another common symptom of sleep apnea. Okay, and it’s not common, is it, Steve, for A-Fib centers or clinics to automatically have A-Fib people have a sleep study? I mean, we’re not at that point yet, where it’s part of the protocol.

Steve Ryan: We’re getting there, to the point, where most A-Fib centers now, will not even consider you for a catheter ablation, if you don’t have a sleep study, sleep apnea study. Why? Because A-Fib tends to recur after an ablation, if you still have sleep apnea. Yeah, a lot of centers still don’t have sleep apnea studies connected with them, but they all are referring people for sleep apnea studies to other centers. So it’s becoming much more… Doctors are much more aware of how important sleep apnea is in A-Fib… And they’re making sure that people get treated for it.

Travis Van Slooten: So, if you have A-Fib, and your doctor hasn’t suggested or recommended a sleep study, are you saying it’s probably a good idea to demand one?

Steve Ryan: Yes, indeed. And I know there’s an expense involved. If you go to the overnight sleep study, yeah, that’s… We’re talking $1,100 to $2,000. But they have home testing kits now, that do almost as well. For $200, you can get one of these home things and do a sleep study to, at least, get you in the right ball park, where people can figure out whether you actually have something that needs more work.

Travis Van Slooten: Yeah. And with the sleep, or with the home sleep tests, or the in-home sleep tests, are those… And you may not know this, Steve, but are they as reliable as the in-lab sleep studies?

Here’s why I ask, because I had a sleep study a couple of years ago. And my doctor said, “You can have one or the other. You can do the in-lab or you can do the at-home.” And he told me that the unfortunate thing with the in-home studies or tests, is that you get a lot of false positives with them, particularly if you have mild to moderate sleep apnea. He said, “They’re most accurate or they’re most useful, if you have moderate to severe sleep apnea.”

He looked at me, and like I mentioned, I was not overweight. I don’t have a thick neck. These are common things that doctors look at, when they’re assessing if someone may have sleep apnea. So he said, “I don’t think you have sleep apnea. If you do, it’s probably a mild, maybe a moderate form of it.” So he said, “I wouldn’t recommend for you the in-home sleep study because there’s a chance it’ll say you have it, and then we have to do a in-lab to confirm it anyway.” So he said, “You might as well skip it and do the in-lab,” and that’s what I did. Do you know anything about this? Have you heard any other kinds of thoughts on the in-home versus the in-lab, or not?

Steve Ryan: I haven’t read any definitive studies saying one is worse than the other or one doesn’t work. I know there’s a number of different devices out there. And let’s say you get a false positive, big deal, that means that you get it checked out more thoroughly from your doctor, or maybe from going for a home study test.

Travis Van Slooten: Yes.

Steve Ryan: That’s a good thing. There’s two that I know of. One is Itamar Medical’s WatchPAT, P-A-T. This looks like a watch you put on your wrist, and then there’s also something that goes over your index finger, to measure like pulse oximetry, and it detects sleep apnea by measuring volume changes in peripheral arteries. Now, you’re gonna say, “Well, is that the same thing?” No, it isn’t, but it’s an indication.

Another one is the Philips Alice NightOne. And this also is FDA-cleared. You put a belt around your chest, and it has a nasal cannula that you put… It’s a two pronged thing that you put into your nose, and you put it in your nostrils. And you also have a pulse oximeter, which you wear on your finger. There’s many other different HSTs: ARES by Watermark, ResMed, and others. There’s a lot of different things, and the main thing is, $200, you can get a test. Heck, $200 is not that big a deal for most people to determine whether they have sleep apnea.

Travis Van Slooten: Now, do you know what the…sorry, I don’t mean to interrupt you, but with these HSTs, again, we’re talking home sleep tests. Do you have to… You can’t just get those direct, right? Do you still need to get a prescription form? Do you know how it actually logistically works? Do you know?

Steve Ryan: You got me on that. I’d have to…

Travis Van Slooten: Because, well, just the only reason I point it out is because I think, and I could be wrong, I do think you need to have it prescribed, because I was going to do…because remember, when I talked to my doctor, and he said, “You could do the home sleep test?” And I had looked into it at home, because I was looking at some of these devices. And I think on one of the websites, it might’ve been the WatchPAT website, they had mentioned, “You have to have your doctor call it in.”

Steve Ryan: They have a doctor who specializes in this, Dr Joseph Krainin, and he founded singularsleep.com, and he’s like one of the experts on HST. And if you call him, or get in touch with him, I’m certain he can work out whatever you need, to get you hooked up to a HST. Travis Van Slooten: Oh, perfect.

Travis Van Slooten: Yeah, and the only reason I bring it up, Steve, is just if someone’s listening to this, you may not… It might not be as easy as just going to their website and ordering the device.

Steve Ryan: Right. Exactly.

Travis Van Slooten: And I think you still need to get your doctor involved. But I think, again, this was a couple of years ago, when I was looking into it. I could’ve just called my family doctor and said to him, “Hey, I wanna do this home sleep test, but I need you to call it in.” So it’s not that big of a deal, but it isn’t… You don’t just… It’s not like buying something on Amazon.com. There’s some steps involved.

Steve Ryan: Yeah, right.

Travis Van Slooten: But you’re right, though. For $200 and $300, at the most, you can have the initial test done at home, in the comfort of your home. I went through an in-lab sleep study and it was not fun at all. You’ve got wires all over the place. And I’ll link to my sleep study experience. It’s not painful or anything, but it’s very uncomfortable. So you might actually have a hard time sleeping, which was the case for me. You might actually get a more accurate result, in the sense that, when you’re at your… In the comfort of your own home, in your own bed, you might actually be yourself and sleep better. And so to get a more accurate look, at exactly what goes on when you’re sleeping. So the sleep…

Steve Ryan: It’s more comfortable at home, but even with all those wires and those technicians, they still can get a pretty good reading of whether or not you have sleep apnea. It may sound very… It may feel very uncomfortable, but they still do get good readings…

Travis Van Slooten: Oh, absolutely.

Steve Ryan: In spite of it.

Travis Van Slooten: Yeah, which was the case for me, because I didn’t sleep very well, and I was actually surprised, because when he woke me up, I felt like I didn’t even really sleep. That was the first question I had to him was, “Did I sleep enough for you to get what you needed?” And he said, “Oh, yeah. Yup, we got what we needed.” So yeah, you’re right. The in-lab, it’s like NASA. They’ve got…the technology they have in these labs, they can pick up anything. And so, if you don’t mind going that route, and you have the money, it might be better just to skip the home test, and go right to the in-lab. But, yeah, if you’re tight on money, or you just don’t want to go through that complex of a situation, start with the home sleep test, for sure.

Steve Ryan: Yeah.

Travis Van Slooten: Now, you had mentioned, Steve, earlier, there are some easy ways to treat apnea. What are some of the common treatments, again, for sleep apnea?

Steve Ryan: Well, they have dental appliances that dentists can make for you, to make sure your airways stay open. I’m not saying that that’s gonna be…work for everybody. But it is an option, and it’s certainly a little bit less cumbersome than wearing a CPAP device. And also, there are various CPAP configurations. My wife uses a half one; it just goes over her nostrils. Some people use a full mask that goes over both the nose and the mouth. There’s lots of different variations, and most centers will work with you to find something that’s comfortable for you, that will help you sleep well without being bothered by it.

Travis Van Slooten: And there’s also a third option, and I’ve heard that it’s not a very good option, but there is surgery as well. If you have a real…

Steve Ryan: Oh, yes.

Travis Van Slooten: If you have a really bad form of it, or you just can’t tolerate the CPAP machines, or the dental devices don’t work, surgery is an option, but again, based on my admittedly limited research on it, the success rates of that surgery aren’t that great. But that is also a possibility, because I also… I hear from a lot of people that have sleep apnea, and they just say, “I can’t do the CPAP machines.” And then, I’ll just mention to them, surgery is an option. It’s not something I probably would go for, but that is always an option as well.

Steve Ryan: Yeah. It’s usually considered an option of last resort because they actually go in there, and cut out the muscle or tissue that is blocking the airway.

Travis Van Slooten: Yup.

Steve Ryan: And like you said, it’s major surgery. There’s no doubt about it, it’s major surgery. And it isn’t always as successful as they’d like it to be, but it is an option.

Travis Van Slooten: Yup, yup. Now, and I think you touched on this as well, Steve, but can treating sleep apnea cure A-Fib?

Steve Ryan: In some instances, some lucky people can get rid of their A-Fib and have no more… Can get rid of their sleep apnea and be cured of A-Fib.

Travis Van Slooten: Wow.

Steve Ryan: But those people are few and far between, unfortunately. But for some people, getting rid of sleep apnea does cure A-Fib. But, unfortunately, for most people, once A-Fib starts, it takes a more radical… Something more radical to get it cured. However, you still need to… Even after you’ve… Let’s say you’ve had a catheter ablation and your A-Fib is cured, you still can’t ignore sleep apnea. You still have to keep treating it, keep using the CPAP machine, or whatever device you use. Because if you don’t, that A-Fib can recur.

Travis Van Slooten: Well, and not to mention, just the other health issues that might come, as a result of your untreated sleep apnea.

Steve Ryan: Oh, yes.

Travis Van Slooten: Absolutely. Perfect. Any other wrapping thoughts here on this topic?

Steve Ryan: No, I can’t think of anything. Thank you, Travis.

Travis Van Slooten: Alright, Steve, as always, it’s a pleasure and thanks for joining me today.

Steve Ryan: Glad to be here.

 

AF 2018: New Report on the CASTLE AF Clinical Trial—Most Important Study for Patients

Most people who’ve had a successful catheter ablation can tell you how wonderful it feels to have a heart that beats normally again. Thanks to Dr. Marrouche and his colleagues, we now have hard data that a catheter ablation doesn’t just feel good but lets us live a healthier, longer life.

CASTLE-AF stands for Catheter Ablation versus Standard conventional Treatment in patients with LEft ventricular dysfunction and Atrial Fibrillation.

Dr. Nassir Marrouche & CASTLE AF Clinical Trial

At the 2018 AF Symposium, Dr. Nassir Marrouche presented results of the full CASTLE-AF study. (I reported briefly on initial findings last October (see CASTLE AF Study: Live Longer―Have a Catheter Ablation).

The 9-year, multicenter CASTLE-AF trial started in 2008 and focused on patients with A-Fib and systolic heart failure. The 398 participants were at 31 sites in 9 countries across Europe, Australia and the U.S.

Study participants had A-Fib and advanced heart failure (i.e. low ejection fraction less than 35%) and were randomized to receive either radiofrequency catheter ablation or conventional drug treatment. The median follow-up period was 37.8 months.

Results―Ablation Improves Quantity and Quality of Life

Dr. Marrouche listed key results of the CASTLE-AF Clinical Trial:

▪ Catheter ablation lowered the death rate by 47% vs conventional drug therapy..
▪ Even though 94% of the patients were taking Coumadin, the catheter ablation group’s stroke rate was ½ of the conventional drug treatment group.
▪ Heart failure hospital admissions improved immediatelycontinue reading Dr. Marrouche’s findings

2018: A-Fib.com Again Earns HON Certificate for Quality and Trustworthiness of Health Information

A-Fib.com has again earned the Health On the Net Foundation (HON) Certification for quality and trustworthiness of medical and health online information. (We were first certified in 2009.)

The voluntary HONcode accreditation program sets out a standardized criterion of eight principles of good practice for health information websites. Each applicant is checked for compliance by a review committee including medical professionals.

The Health On the Net Foundation (HON) Code of Conduct helps protect citizens from misleading health information.

Our 2018-2019 Active Certification & Dynamic Seal

Our HON seal is displayed in the footer of our web page and is directly linked to the A-Fib.com HONcode certificate located on the HON website.

Read more about the A-Fib.com HON Certificate on our website. Or learn about the criterion of eight principles of good practice at Health On the Net Foundation (HON) Certification.

When visiting other health-related websites, look for the HON Code of Conduct badge to be assured of the site’s quality and trustworthiness of medical and health online information.

Updated: Print a free Medical Alert I.D. Wallet Card

Last updated: September 1, 2020 Websites change every day. So it’s no surprise when reader Debbie L. emailed us about a non-working link. Thanks to her alert, I’ve updated my links to print your own emergency medical ID wallet cards.

To help you make your medical ID, we have Free online sources for printing your own wallet cards. Here are three sources:

Free printable Med. ID Card at A-Fib.com

• Wallet size medicine ID Card (online form) from CVS Pharmacy
Printable Emergency Medical ID Card (online form) by AllFreePrintable.com
• American Red Cross Emergency Contact Card link on PDFfiller.com site or go directly to PDF form.

Use the PDF form to enter your information. Then, print, trim, fold and add to your wallet or purse. Or print the blank form and fill-in by hand.

Tips to Consider

• Laminate your wallet card to prolong its use (an office supply store can help you)
• Print a card for each member of your family
• If you choose a medic alert bracelet with limited space, add the message “See wallet card,” and carry a wallet card with all your medical details.

Beyond Wallet Cards: Medic Alert IDs

Shoe pocket by Vital ID

Shoe pocket by Vital ID

There are many styles of Medic Alert ID bracelets, necklace pendants, USB-based devices and sports equipment using different materials like waterproof foam, leather and stainless steel. (see Your Portable Medical Information Kit.)

Whichever method(s) you use to carry your emergency medical information, don’t forget to review and update the contents regularly especially when you change doctors, or start (or stop) medications or have a medical procedure. Knowing you have up-to-date medical information gives you a little bit more peace of mind.

For more about how to carry all your medical information in case of emergency, see our article: Your Portable Medical Information Kit.

September A-Fib Awareness Month: Silent A-Fib is a Public Health Issue

GIF: 'That Demon A-FIB ZEBUB' at A-Fib.com

‘That Demon A-FIB ZEBUB’

‘Silent A-Fib’ is a serious public health problem; 30%-50% of those with ‘silent’ Atrial Fibrillation don’t know it.

They may get used to their symptoms or they write off the tiredness, dizziness or mental slowness to growing older, but their heart health may be deteriorating; Untreated, about 35% will suffer a stroke (half of all A-Fib-related strokes are major and disabling).

How You Can Help

To inform the public about this healthcare issue, A-Fib.com offers an educational infographic and awareness posters. See the full infographic.Infographic - September is Atrial Fibrillation Month at A-Fib.com

To help spread awareness, Share it, Pin it, Download it. See the posters here.

Atrial Fibrillation Resources for Writers and Jounalists

For more about Silent A-Fib, go to The Threat to Patients with “Silent A-Fib” How to Reach Them

Visit the A-Fib.com Press Room to learn more about Atrial Fibrillation, videos, get free graphics and other resources.

Lifestyle Changes or Alternative Treatments Working for You? Contribute to 2nd Edition of ‘Beat Your A-Fib’

Amazon.com review of Beat Your A-Fib book at A-Fib.comAll Atrial Fibrillation patients! We need your input!

Share with us! Help us write a new chapter for our book!

We are planning the 2nd edition of our book, Beat Your A-Fib: The Essential Guide to Finding Your Cure.

New chapter: Non-Surgical/Non-Drug Treatments: We need five or six anecdotes or stories for a new chapter to focus on non-drug and non-surgical treatment options.

Have lifestyle changes or alternative methods reduced or eliminated your symptoms? Email us! 

Is exercising or stress-reduction techniques working? Weight-loss or dietary changes? Use of minerals or supplements? Chiropractic treatment or Yoga? Other means of improvement? We’re interested in anything that’s helping you.

You don’t have to be ‘cured’ to share your story. Just actively pursuing your best outcome.

Email us. If something is working for you, we’d love to hear from you! Just email us with your contribution: pattijryan@a-fib.com or ssryan@a-fib.com.

♥ ♥ ♥

Beat Your A-Fib: Continues as a Bestseller on Amazon.com

A-Fib.com Exclusive: Free Offers and Downloads for Our Readers

As a service to A-Fib.com readers, we offer FREE downloads of our own worksheets and reports. In addition, we have also collected useful FREE services or downloads from other organizations or websites serving the atrial fibrillation community. (See the tab on the left subject menu.)

Go to our ‘Free Offers and Links‘ page. You’ll find a short description of each offer including links to related articles.

items on our "Free Offers and Links" page at A-Fib.com

items on our “Free Offers and Links” page

Take Advantage of Our Free Offers

Some links take you from our site to a free online service. Other links generate a .PDF of a free document or worksheet. (Remember to save it to your hard-drive.) Go to ourFree Offers and Linkspage.

Summertime Fun! Shop Amazon.com & Support A-Fib.com Too!

It’s the time of year for vacations and family activities with your kids or grand-kids. When you shop for your summer events, did you know your purchases can support A-Fib.com?

How? Just shop online at Amazon.com using the A-Fib.com Amazon portal link (this link automatically credits us, you don’t have to do anything else).

Help Keep A-Fib.com Independent and Ad-Free

Bookmark this Link—Use it every time!

Your purchases generate a small commission for A-Fib.com—at no extra cost to you. We apply those proceeds toward the monthly costs of publishing this website.

Your Support is Needed and Appreciated

A-Fib.com is a 501(c)(3) nonprofit organization. Our goal is to make A-Fib.com a financially self-sustaining site AND maintain our “no advertising” policy.

Many sites are funded through third-party advertising like Google ads. You’ll find none of those ads breaking up our articles or crowding our webpages. So help support A-Fib.com—use the A-Fib.com Amazon portal link every time you shop online. We appreciate your support.

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