PODCAST: Marijuana—Good, Bad or Ugly for Patients with Atrial Fibrillation?

Marijuana and Atrial Fibrillation

Into: The host of this podcast is not a medical doctor. The information provided is not intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician prior to starting any new treatment or with any questions you have regarding a medical condition. Now on to the show. Welcome to the Afib podcast, where we provide information, inspiration, and support for afibbers. And now your host, Travis Van Slooten.

Travis Van Slooten: I have a special guest for this episode of the afib podcast. His name is Dr. Steve Ryan. Steve is a former afib patient who was cured of his afib back in April 1998 via catheter ablation. He’s a publisher of one of the most popular afib websites, a-fib.com and he’s the author of the best-selling book Beat Your A-Fib: The Essential Guide to Finding Your Cure.

In this episode Steve and I discussed the topic of marijuana use and atrial fibrillation. We discuss recreational pot smoking versus medical marijuana and how many marijuana may or may not be beneficial for people with afib. So without further ado, let’s roll the tape.

All right, Steve, so I want to talk to you about something that it was a very interesting topic that I honestly had not thought about before. I got an email from one of my readers who wanted to know if it was safe to smoke marijuana while they had afib. First I thought this has got to be some kind of a joke because I honestly had never thought about this before, but it makes sense, you know, recreational marijuana is definitely becoming a morbid thing, it’s currently legal in nine states, and medical marijuana use is legal in 29 States.

Recent poll shows that 64% of Americans support the legalization of marijuana. So this is going to be become – if it hasn’t already – become a more kind of important topic. And then ironically, a week later I got another email from someone that had the same question, so I’m like, “Wow, this is really kind of a big deal.”

So I found an article on your site, Steve, that you just recently wrote about this very topic, marijuana use and afib. And in that article you had discussed a little bit about the differences of recreational marijuana and the prescription form of marijuana which is called marinol, and you kind of discussed that there was some key differences between these two. So what are the differences between the two? .

Steve Ryan: Travis, I apologize that we do not have a lot of clinical data on this subject simply because it’s so new and the answers I give aren’t going to be definitive, but we’re doing the best we can with the information that we have. The marinol is the prescription form of cannabis, and the makers of it have a blanket disclaimer saying “Don’t use this with any kind of heart problem…” you know, it’s kind of legal thing. They haven’t done any clinical studies on this subject to say that but they’re just protecting themselves. There have been some research saying that smoking marijuana might lead to the development of afib and it may affect the cardiovascular system, but this is general data without a whole lot of really hard studies indicating that.

Now, what I’ve done on our website is – since I don’t know enough about it to really give a definitive answer –  I have asked people to tell me their experiences and they vary all across the board. Some say that this is the best thing I’ve ever taken, some people say as soon as I start smoking marijuana I get afib. Now, the reason for that might be the different in the pot they’re smoking or the edibles they’re taking. THC is a component found in the marijuana plant stavia. That’s what makes you feel high.There is a CBD is a component found in the marijuana plant indica. That works better to reduce pain and anxiety and induce sleep. Now the problem is the manufacturers of pot – every state has their own little companies, and some produce CBD and a tincture and an oil, in edibles; but some just mix it all together and it’s really hard depending on the state to find something that is just CBD that you can use to get rid of anxiety and get to sleep, that kind of thing.

Now what is the best product for afib patients? Probably CBD in edible form. Smoking marijuana unfortunately produces a lot of problem just like smoking does because there are a lot of bad things in the cigarette smoke as there is in the marijuana smoke. So people tend to want to use marijuana for medical purposes, they’re probably better off using an edible form with more CBD and THC. Does that make any sense?

Travis Van Slooten: Yeah, absolutely. I mean looking at again that article you wrote and I’ll link to it here to in the show notes so people can reference it. If they have experience smoking marijuana or taking it medically, they can surely reach out to you and share their experience with it. But as I look at your article you do have some anecdotal stories there, and it doesn’t seem that the few that are there that I’ve had that experiences with it were people smoking it. And one of the gentleman that wrote, a guy named Jim, said that it was like a life savior for him, but again, he was taking the medical prescription form of it, so that seems to back up kind of what we’re talking here.

Steve Ryan: Yeah. He has a great statement. He’s the guy who is very under a lot of stress, he has his own business. He comes home at night and his brain was throbbing on a mile a minute and he couldn’t get to sleep. So he use marijuana edibles and the stress goes right away and he seems to sleep very well at night. Just to be honest with you, I’m also some kind of like him. I’m very wound, very tight.

Travis Van Slooten: You’re a Type A?

Steve Ryan: I tend to think of all of the things about afib. I’m thinking about, you know… And to tell you the truth, I take edible marijuana and it gets me really relaxed and I go right to sleep.

Travis Van Slooten: Let’s talk about— for people that aren’t familiar with medical marijuana, I am one of those, by the way, I know nothing about this stuff which is why I find it so fascinating, but when we talk edibles, like, what is it? Is it literally like a brownie, a piece of cake? Is it like a gum? I mean what is it? When you say edible, what is it?

Steve Ryan: There are a lot of different products, and unfortunately every state has their own different companies. We don’t have companies that are nation-wide to put out a standard product, but a lot of them are like a brownie that comes in a package like a cookie. It comes in like 100 mg and you cut it into 10 mg slices. To me that’s a pain, but a lot of people use that. Another way is they have product like this one product is blueberry based. They make the marijuana in with blueberries and you just take one, and one is 5 mg and I usually take two at night. Other forms, let see, brownies.

Travis Van Slooten: Now you mentioned and oil-based, a tincture base…

Steve Ryan: What?

Travis Van Slooten: You mentioned a tincture based. That isn’t edible but that’s a different form.

Steve Ryan: Yeah, the way they do with that is they develop a tincture with CBD in an oil, and you put it on your body and let it absorb into your body, and that’s another… I’ve never tried that. I have no idea how well that works or how good it is.

Travis Van Slooten: And that tincture that isn’t something you… You don’t put it in your mouth; you put it on your skin.

Steve Ryan: Yeah, you put it on your skin. But again, I am not an expert in this field and we’re just doing the best we can with little knowledge that we have, and I beg all the listeners to be aware that this is not something that is definitive and written in stone and this is the way to go. Everything I say may completely change when we get more information on medical marijuana.

Travis Van Slooten: Yeah, absolutely. Like you said, I think it’s just starting to explode right now. Do you know, are there any studies underway right now? Do you know of any?

Steve Ryan: Well, there was a really interesting study that just came out where they studied patients with heart failure. And what they found was that– first of all, patients with heart failure are really in deep doo-doo, we’re talking like an ejection fraction of like low or below 35% normally is 50 to 75. These patients, if they have really serious heart failure it’s like they’re suffocating to death. It’s a terrible way to go if you’re ill and you have congestive heart failure, you just feel terrible from what I understand. I’ve never had it. So what they did was they followed 6 million in US hospitals with heart failure. About 1200 used and depended on marijuana. About 2300 used marijuana, but were not depended on it. So the non-dependent marijuana users were 18% less likely to develop afib. And the dependent users were 31% less likely to experience afib.

Now what that means is that marijuana prevented these patients who had heart failure from developing afib. Now, why is that important? Basically a combination of heart failure and afib is a killer. One is bad, two together like that is much worse. These people are much more apt to die, and marijuana basically prevented these people from developing afib even though they had heart failure. This is really big news because sure, now we’re applying it to heart failure, but what about normal people, would marijuana prevent them from developing afib? We don’t know. But the study indicate that. In study would say definitely that anyone who has heart failure should consider marijuana use in some form because it does seem to prevent them from going into a atrial fibrillation. Now can we go further and say everybody should smoke marijuana to prevent them from developing afib? No, we can’t say that.

Travis Van Slooten: Yeah, absolutely. And the other thing is I suppose we don’t have the details of the study either like what form they were taking, how much they were taking every day. We don’t have that information, do we, from that study? I mean you might not have it on hand, but…

Steve Ryan: I don’t have it on hand but there would probably be some indication of that, and I’d have to look that up and maybe get back to you. Those are some good questions. But you know, in general they usually do these things it’s usually 10 mg a day. That’s a general rule of thumb. But again, I don’t really know the specifics. But people who are dependent, those are probably smokers, and they were probably doing much more smoking of pot than the other group. That worked for them and prevented them from developing afib more so than the other people.

Travis Van Slooten: Now, did that study say they were pot smokers or they were taking the medical prescription form of marijuana? Because we talked earlier that smoking was probably not the good form or as the medicals…

Steve Ryan: Since this is done between 2007 and 2014 we can assume they were smokers.

Travis Van Slooten: And that to me is kind of promising because it’s saying — of course, that leads to more questions, right? Because what’s more effective, the recreational smoking pot or the medical form of it, you know, like the edibles? I mean all these things are still — we have no idea here.

Steve Ryan: We just don’t know yet, we just don’t know. Another part of this study that was interesting was people using marijuana were 46% less likely, and dependent users 58% less likely to die in the hospital. Now that’s good news because one of the main problems with afib is you’re in the hospital so often, and that’s really good news and something that is worth looking into. By the way, this study that I’m talking about hasn’t been published yet.

Travis Van Slooten: Oh, it hasn’t, okay.

Steve Ryan: So that’s why we don’t have the information on all the details of the study. As soon as the study get published we’ll get that information.

Travis Van Slooten: That’s good to know in case someone is listening this and they’re trying to Google this they’re not going to find it right now.

. Steve Ryan: Yeah, right, I don’t think so.

Travis Van Slooten: So the bottom line with this topic then is what’s your bottom line message to someone that would pose that question that was posed to me which is, “Hey, I have afib and I smoke pot, is this good or bad?” Mypersonal response to them Steve is kind of what you said Steve “We don’t know much of anything on this topic right now because it’s kind of so new.” And the other thing is I just told them I would approach it kind of like smoking or drinking; that it’s probably not best to do it heavily on a regular basis. And more importantly, if you smoke pot and you have an episode that’s probably an indication that’s a trigger so you should probably avoid it. But likewise if you are a moderate smoker and it seems to keep your afib episode at bay, then it might be okay to continue to smoke. That was kind of the way I handled it. Is that kind of the way you handle that answer or that question is well?

Steve Ryan: Yes. Some of the people like John wrote to me and said “99% of these afib attacks occurred when I’m under the influence of marijuana.”

Travis Van Slooten: Okay, the obvious trigger.

Steve Ryan: Yeah, and Jonathan writes “I tried a tiny bit of brownie for the first time since being diagnosed with afib. It was okay until about two hours later. I went into afib and a bit later came the closest I ever have to blacking out. I don’t think it’s for me anymore.” On the other hand, Jim writes that he uses it every night and it work for him fine.

Travis Van Slooten: Yeah, so it kind of gets back to the whole what’s trigger, what’s not. And so yeah, I think it’s all fascinating. Definitely I think this is going to become more and more of an issue as I said in the opening here with the marijuana legalization kind of sweeping across the country here. This is going to become a very hot topic, I think.

Steve Ryan: Yes, definitely.

Travis Van Slooten: Well, Steve, I just want to thank you for your time to discuss this topic, and I look forward to talking to you in the next week’s episode. We’re going to be talking about the real cost of living with afib. So Steve, thanks again for your time.

Steve Ryan: You’re welcome.

Outro: Thanks for listening to the podcast.Be sure to visit livingwithatrialfibrillation.com for more information, inspiration and support. Be well, and please join us next time.