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Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

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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


AF Symposium ’21—New Report with Dr. Pierre Jais on Pulsed Electrical Field Ablation for Atrial Fibrillation

Pierre Jaïs, MD

My next report from the 2021 AF Symposium is on the short side.

Dr. Pierre Jais of the French Bordeaux Group (LIRYC) covers two topics; first, he briefly discusses pre-clinically testing of Pulsed Electrical Field ablation (PEF), Then he briefly covers the BEAT AF 5-year study which compares the effectiveness of PEF to standard RF ablation. Read it now, go to my report.

2021 AF Symposium Reports: More to Come

You’ll find my growing list of reports on the 2021 AF Symposium page. (You’ll find the link of the left menu of the website,)

As always, I write these summary reports to offer A-Fib.com readers the most up-to-date research and developments that may impact their treatment choices. All my reports are written in plain language for A-Fib patients and their families.

Help Prevent and Cure Heart Rhythm Diseases–Support the LIRYC Institute

The LIRYC Institute of Bordeaux, France, is asking for the support of our A-Fib.com readers. This institute is headed by Professor Michel Haissaguerre, who along with cardiology teams at the University Hospital of Bordeaux, France, is responsible for curing my A-Fib in 1998.
LIRYC stands for L’Institut de RYthmologie et Modélisation Cardiaque (in English: Electrophysiology and Heart Modeling Institute)

The LIRYC Institute: Entirely Dedicated to Heart Rhythm Disorders

Heart rhythm disorders affect millions of people worldwide and account for 30% of all cardiovascular disease, which is the leading cause of death in the world.

The LIRYC Institute is the only research, care, innovation and teaching Institute fully dedicated to heart rhythm disorders (atrial fibrillation, ventricular fibrillation and heart failure) arising from compromised electrical activity within the heart. It was established ten years ago in France to seek solutions to this major public health.

The Institute espouses a focused multi-disciplinary approach to understanding and treating these disorders. So far, this international team of experts has helped 400,000 patients worldwide suffering from atrial fibrillation. (Including Steve Ryan)

LICYR Innovations

Entirely dedicated to heart rhythm disorders, LIRYC has chosen to focus on four distinct but interrelated objectives:

research to better understand the mechanisms underlying the disorders;

innovation to invent and develop the therapies of the future;

patient care to continue to improve patient management thus reducing morbidity and mortality rates;

training and education to promote and promulgate best practices for physicians and institutions around the world.

LIRYC Institute Capital Campaign: Supports the Prevention and Cure of Heart Rhythm Diseases

In 2020, LIRYC Institute launched a ten-million-euro capital campaign for the purpose of continuing and broadening the fight on the ravages caused by heart rhythm disorders.

LIRYC Institute is a 501c3 international Non-profit Organization.

Funds raised will be applied to underwriting new research projects and to the purchase of new technology as well as supporting educational and training programs for medical professionals across the globe.

Thanks to the generosity of donors, 35% of the goal has already achieved!

Consider Making a Donation to Support the LIRYC Effort

If you would like to help continue the fight to save lives lost to heart rhythm disorders, you can make a donation via the Friends of the LIRYC Foundation or email LIRYC directly at adele.lasne@ihu-liryc.fr or telephone +33 (0)5 35 38 19 97.

To read the LIRYC Mission and Key Areas of Focus, visit the LIRYC site (this is the English version)

You can also join the LIRYC community on Facebook and LinkedIn.

VIDEO: Mission of the LIRYC Institute (1:15)

My First Reports: 26th International AF Symposium 2021–A Virtual Experience

The 2021 AF Symposium was held from January 29-31. Because of the COVID-19 virus, the AF Symposium was virtual, streamed live with over 6,200 attendees. (That’s got to be some kind of a record!)

The AF Symposium is a major scientific forum at which health care professionals (and journalists, like me) have a unique opportunity to learn about advances in research and treatment of Atrial Fibrillation directly from leading medical scientists, clinicians and researchers.

If you are new to reading my reports and summaries from the AF Symposium, I recommend you look at: “What is the Annual ‘AF Symposium’ and Why it’s Important to Patients.”

My First Two Reports

As always, my reports will be written in plain language for A-Fib patients and their families.

Overview: 26th Annual International AF Symposium 2021–A Virtual Experience.

It’s a privilege to be able to attend presentations by the best clinicians and researchers working in A-Fib today. I learn more in three days than in a year of reading the various A-Fib research reports. Read my Overview of the 2021 AF Symposium.

Challenging Cases #1: “Torrential” Near Death Catheter Ablation Case

Challenging Cases is a popular forum where leading EPs talk frankly about their most difficult cases in past year. My first report is a near death catheter ablation complicated by the patient directive: in no case could blood transfusions be used. Read more.

Did you notice the new menu tab on the left? We’ve add: 2021 AF Symposium Reports. Click on the tab any time for a list of all my reports.

More of My Reports to Come

Look for more of my reports from the 2021 AF Symposium in the next weeks and months.

I will share the current state of the art in A-Fib research and treatments and what’s relevant to patients with Atrial Fibrillation.

Atrial Fibrillation and PVCs, How Do They Compare?

An A-Fib.com 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.

Lorrie’s Catastrophic Mini-Maze Surgery and Its After-Math

Lorrie was an informed Atrial Fibrillation patient. She did everything right.

Lorrie C.

She researched her disease, she studied the choices of surgical treatments. With input from her EP, she thoughtfully decided on a Mini-Maze surgery.

She chose a highly skilled cardiac surgeon with an outstanding reputation. She and a companion interviewed the surgeon and asked loads of questions—twice. And chose one of the top 100 hospitals in the country for her surgery.

It’s a shame she had to endure so many complications.

The first part of Lorrie’s Atrial Fibrillation story was written in 2012 from her hospital room upon re-admission after Mini-Maze surgery. She then jumps to the present and writes about the aftermath. She begins:

“As I sit in my hospital bed on my seventh consecutive day of my second admission, I have finally mustered the strength and clarity of mind to write about my exasperating experience of an elective surgery… .
My A-Fib started when I was in my early 60’s with only a few episodes a year. The story of my Mini-Maze surgery began about four years later when my electrophysiologist felt it was time to put an end to my increasing episodes of Atrial Fibrillation.
Due to having paroxysmal A-Fib (meaning every now and then for unknown reasons) as well as my good health and stamina, at 66 years of age I was the perfect candidate for either a catheter vein ablation or Mini-Maze surgery. Because I was only having about 3 episodes a year and in good health, my EP felt that I would have a success rate of over 95%.
After much research, I decided the Mini-Maze would be the best procedure for me. (My EP felt it would be a better choice than an ablation, for he felt I would have a good outcome, which I did not.)
He also warned me that the Mini-Maze wouldn’t be a “walk in the park.” That was an understatement! …

…Continue reading Lorrie’s story about her mini-maze surgery and learn her advice to others with A-Fib.

Interview with Michele Straube on Results of Survey of A-Fib Patients and Wearable Devices

by Steve S. Ryan

We are happy share the results of Michele Straube’s survey of A-Fib patients on consumer wearable/portable devices/apps which many of you participated in April 2019. She received a great response―315 replies! You can review the actual survey and tabulated results at: Survey Questions and the Results.

You may want to re-read Michele Straube’s 2010 A-Fib story, Cured after 30 years in A-Fib. She recently had a second catheter ablation June 11, 2020  and is doing fine, “Went for a walk in the mountains yesterday with 500’ elevation gain, and felt good.”

Michele Straube

Interpreting the Survey Data

I asked Ms. Straube to share her insights and conclusions about her survey data and how it might or should affect A-Fib treatment strategies.

“What do you think is important in your survey’s responses?”

It’s important how many people responded, and the fact that these AFib patients are very interested in having data about their condition.

It’s clear that AFib patients are interested in being an active part of the team managing their condition. Doctors should welcome this (but see below).

For device and apps developers: there’s a huge market for wearables with apps that help inform AFib patients and gain peace of mind when making treatment decisions. Current devices don’t necessarily give us all the information we’re seeking.

There should be greater collaboration between the device developers and patients in future research and design.

Review the actual survey and tabulated results at: Survey Questions and the Results.
 “What information were you looking for?”

I wanted to know if AFib patients use wearable devices? And if so, why and how they use the data. What device or apps would they like someone to design for them.

 “Were you surprised by any of the results?”

I was surprised how many different devices there are that give some kind of relevant data (over 45 different brands), yet virtually none of the A-Fib respondents were 100% satisfied with their device’s capabilities.

About 10% of the respondents said that their doctors were not interested in seeing the data from wearable devices!!!

Many of the respondents wished for device capabilities that already exist; i.e., the devices are not being marketed to the right audience.

 “What results do you think should be published?”

I wanted to know how AFib patients currently use the data available and what they wish would be developed.

“How do you think your results should influence A-Fib treatment strategies?”

Educate: AFib patients should be educated about the various types of consumer devices and encouraged to use them to help manage their AFib.

Medical providers: doctors should welcome this independently collected additional data (especially for patients who experience AFib episodes when they’re not in the doctor’s office).

Treatment costs: A patient’s use of wearables and apps can reduce the overall expense of AFib treatment.

Michele shared how she used a wearable device:

Using myself as an example, I take an ECG reading on my device, email it to the doctor’s office, and we discuss what to do about a “bad” reading via email or phone. 

The one time my device was not working correctly, I had to go into the office for an official EKG reading, which took up much more of everyone’s time and cost oodles of money … and the end result (modification of my meds) was the exact same had I emailed a reading from my device.

We appreciate Michele’s survey work and sharing the results and her conclusions with A-Fib.com readers.

Review the actual survey and tabulated results at: Survey Questions and the Results.

Michele expressed her gratitude to all who participated in this survey, and to A-Fib.com and other sites that solicited A-Fib patients to take the survey. Michele Straube can be reached at mstraube@mindspring.com

AVNRT Diagnosed, 2nd Ablation—Finally A-Fib Free

Prior to 2015, I was an active 67-year old male who had taken up running in my late 30’s…I had never experienced any heart issues. Late in September 2015, my heart was racing and a local Spokane hospital ER informed I was experiencing atrial fibrillation. Approximately 12 hours later, with meds, I was back in normal sinus rhythm.

Bob Thompson, Spokane, WA

Over Three Years A-Fib, Bouts Become More Frequent

Over the next few years, I went into A-Fib over 50 times with each bout lasting on the average 10 to 12 hours.Taking metoprolol while in A-Fib, got me back in normal sinus rhythm. I never needed to have a cardioversion.

After dealing with A-Fib for over three years and with the occurrences becoming more frequent, I opted to have a heart catheter ablation in September 2018. Result: the ablation was a complete failure. The EP was only able to ablate three of the four pulmonary veins.

Ablation Fails—Exploring Mini-Maze Procedure

After my failed ablation, my occurrences of A-Fib rapidly increased. I began to explore another option, a mini-maze procedure.

The cardiac surgeon in Spokane suggested I try one more catheter ablation before I opted for the mini-maze procedure.

I met with a cardiac surgeon in Spokane who suggested I try one more catheter ablation before I opted for the mini-maze procedure. The surgeon informed me that the best EP in Spokane was Dr. Mark Harwood whom he would be seeing later in the day.

Best EP in Spokane Calls Me the Next Day!

One day after meeting with the cardiac surgeon, I received a call from Dr. Harwood’s office. Upon meeting with Dr. Harwood, he informed me that he was confident of his ability to ablate all four of my pulmonary veins.

Scheduled for Ablation But Stress Test Reveals AVNRT

I was scheduled to have my second ablation in March 2019, but it was contingent on the results of a stress test.

A few days later, at the end of the stress test, I went into A-Fib. An irregularity (tachycardia) was detected requiring an AVNRT Ablation as well. Continue reading Bob’s story…->

After 50 years of Irregular Heartbeats and PVCs, Finally an A-Fib Diagnosis and Treatment

Cecelia Hender, 72, shares about her life with Atrial Fibrillation. She writes that heart arrhythmias have been a part of her life since she was a young woman.

I was about 20 years old when I first experienced irregular heartbeats. My doctor back then told me it was “nerves” and to relax.

This was how most women were treated by doctors back then. Everything was “nerves”.

Cecelia Hender from Abington, MA with her granddaughter.

In my 30’s, I told another doctor how my heart would take off like a race horse, I could not breathe. He said, “try not to think about it.”  What????

I fought with these irregular heartbeats for many years. I was never told to see a cardiologist or have a doctor investigate just what was going on.

Sent to a Cardiologist Almost By Accident

About 15 years ago, I worked for a medical facility, and one day a young doctor came in and was waiting for an interview…when he said he was an electrophysiologist [cardiac specialist], I asked about my irregular heartbeats.

He was so kind and intelligent…It was this young doctor who told me that I should see a cardiologist. So, I did. And I was treated with medications and wore many heart monitors.

Hard to Document the Arrhythmia

But it was always hard to catch the arrhythmias on an ECG or heart monitor.

My whole life was spent afraid and never going anywhere alone for fear that my heart would act up and I’d be stranded someplace unable to breathe – unable to move. 

Finally, in 2017 I had another [heart] monitor, and it showed a series of irregular heartbeats.

But on this one particular day, I had a very irritating rhythm. It was very fast, then irregularly fast, and I could barely breathe. I went to my PCP [Primary Care Physician] office where they did an EKG and said, “You are in A-Fib”.

They sent me immediately to my cardiologist who confirmed this. I was put on a different kind of med (Metoprolol at first and also Coumadin). And “fingers crossed” I would convert on my own. It took almost two weeks…Continue to read how two ablations brought Cecelia Hender relief from A-Fib and PVCs, and about a recent setback ->

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).

2020 AF Symposium: 5 Abstracts on Pulsed Field Ablation

The 2020 AF Symposium abstracts are one-page descriptions of A-Fib research, both published or unpublished. The abstracts are supplemental to the Symposium live presentations, panels discussions and spotlight sessions. This year the printed digest contained 55 abstracts. I choose only a few to summarize.

My Summaries of Select PFA Abstracts

Pulsed Field Ablation (PFA) was the single most important topic at this year’s Symposium. I summarized five of the PFA abstracts of most interest to A-Fib patients.

Lesion Durability and Safety Outcomes of Pulsed Field Ablation
The durability of PFA lesions is the focus of Dr. Vivek Reddy’s abstract. His research study followed 113 patients who each received a PFA ablation.

Pulsed Field Ablation with CTI Lesions Terminates Flutter in a Small Study
The use of Pulsed Field Ablation (PFA) may significantly improve CTI ablation lesions to block the Flutter signal. (CTI: Cavo-Tricuspid Isthmus)

Durability of Pulsed Field Ablation Isolation Over Time: Preliminary Study
Pulsed Field Ablation (PFA) is a new treatment. This study asked the question of whether PFA electrical isolation (lesions) regresses over time.

Pulsed Field Ablation vs RF Ablation: A Study in Swine 
PFA is “tissue-specific”. This study tested if surrounding non-heart tissue (the esophagus) would be affected. PFA ablation was compared to RF ablation. Swine (pigs) were used so tissue could be dissected and examined.

Using MRI to Check Pulsed Field Ablations (PFA)
Normally, during a RF or cryo ablation, doctors move the esophagus as far away as possible from where they are ablating. In this study they took no such precautions.

My Summary Reports

For more from the 2020 AF Symposium, go to My Summary Reports Written for A-Fib Patients. Remember, all my reports are written in plain language for A-Fib patients and their families.

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