Doctors & patients are saying about 'A-Fib.com'...


"A-Fib.com is a great web site for patients, that is unequaled by anything else out there."

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

"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."

Jill and Steve Douglas, East Troy, WI 

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP. 

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD  Johns Hopkins,
Baltimore, MD


Doctors & patients are saying about 'Beat Your A-Fib'...


"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su,
Cavanaugh Heart Center, 
Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, 
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA


2020 AF Symposium: Pulsed Field Ablation—A Game Changer for A-Fib

This year’s AF Symposium was abuzz about an emerging technology, Pulsed Field Ablation (PFA). It could change everything in the field of catheter ablation for Atrial Fibrillation.

Pulsed Field Ablation and how it works was presented by Dr. Vivek Reddy of Mount Sinai Medical Center, NY, NY. He also narrated a video showing an actual Pulsed Field Ablation procedure.

What is Pulsed Field Ablation? Pulsed Field Ablation (PFA) from Farapulse, Inc. is a non-thermal energy system that uses a series of ultra-short electrical pulses to ablate heart tissue. This series of pulses, or the “waveform”, makes a long-lasting lesion in a manner of seconds compared with hours for radiofrequency.

More importantly, PFA works on the selected cell types while leaving others alone (like the esophagus).

Proximity Not Actual Contact: Unlike standard ablation energy sources such as RF (heat) and Cryo (freezing), the PFA catheter does not require actual physical contact but only needs proximity to the tissue to be ablated. And it doesn’t cause scarring or char formation. …click for full report on PFA.

AF Symposium 2020: My New A-Fib Reports

This year the 25th AF Symposium was held January 23-25th in Washington DC (for this fellow from Malibu it was cold but no snow ).

Atrial Fibrillation: I attended over 75 presentations including Spotlight (short) sessions, learning luncheons and panel discussions with Q/A. The Symposium lets me learn about advances in research and treatments of A-Fib directly from the most eminent medical researchers, scientists, cardiologists and cardiac electrophysiologists.

There are many interesting topics including the controversy of closure of the Left Atrial Appendage. But the many presentations about the new “Pulsed Field Ablation” technology dominated the Symposium.

Read My First Report: Overview: The 25th Annual International AF Symposium 2020 by Steve S. Ryan, PhD

Steve Ryan at 2020 AF Symposium in Washington DC in January.

Steve Ryan at 2020 AF Symposium in Wash, DC.

More reports are coming: I’ve finished a number of my summary reports and will be posting several each week.

Check the menu list on the left for 2020 AF Symposium and click to go to my latest posts.

Remember: All my reports are written in plain language for A-Fib patients and their families. (I’ve done the heavy lifting for you!)

P.S. You may want to browse my reports from the 2019 AF Symposium or the archive to my AF Symposiums Summaries by Year.

Conflicts of Interest—Influencing Doctors for the Price of a Meal

In a 2016 JAMA Internal Medicine report, the authors compared meal payments to doctors with the drugs they prescribed to Medicare patients.

Even doctors who accepted only one free meal were more likely to prescribe the brand name drug.

Not surprisingly, they found that physicians who accept free meals from a drug company are more likely to prescribe that company’s brand name drugs rather than cheaper (and usually more proven) generic drugs. This study only focused on physicians who received meals.

Even doctors who accepted only one free meal were more likely to prescribe the brand name drug. Doctors who accepted four or more meals were far more likely to prescribe brand name drugs than doctors who accepted no meals. Furthermore, doctors who accepted more expensive meals prescribed more brand name drugs.

Steer Clear of Conflicts of Interest

Studies have found that when there is a conflict of interest, it is almost impossible for even well-meaning people to see things objectively.

Dr. Dan Ariely of Duke University described how, if a doctor must choose between two procedures, they are likely to pick the one that has the better outcome for their bottom line (i.e. financial benefit).

“That doesn’t mean the doctor is unethical…it just means he is human. We truly seem to not realize how corrosive conflicts of interest are to honesty and objectivity.”

He advocates that we steer clear of people and organizations with conflicts of interest “because it does not appear to be possible to overcome conflicts of interest.”

When to be Suspicious of Doctors

Doctors are only human. They may not realize a conflict of interest is affecting their recommendations. So be suspicious if your doctor tells you:

In today’s world, you have to do your own due diligence…get a second (or third) opinion.

• to take an expensive new drug
• to just “live with your A-Fib”
• insists that catheter ablation is too dangerous or unproven
• that A-Fib can’t be cured
• that you have to take drugs for the rest of your life

If this happens to you, RUN, DON’T WALK and get a second opinion (and even a third opinion).

In today’s world, you have to do your own due diligence. You know what makes sense and what doesn’t.

For more, see my article: EP’s Million Dollar Club—Are Payments to Doctors Buying Influence?\

Resources for this article
•Husten, Larry. CardioBrief: The Hidden Cost of Free Lunch. Medpage Today. June 21, 2016. https://tinyurl.com/CardioBriefCostFreeLunch

• DeJong, C. et al. Pharmaceutical Industry-Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries. JAMA Intern Med. Published online June 20, 2016. http://archinte.jamanetwork.com/article.aspx?articleid=2520680 doi:10.1001/jamainternmed.2016.2765 Y

• eh, JS et al. Association of Industry Payments to Physicians With the Prescribing of Brand-name Statins in Massachusetts. JAMA Intern Med. 2016;176(6):763-768. http://archinte.jamanetwork.com/article.aspx?articleid=2520680 doi:10.1001/jamainternmed.2016.1709. Ariely, Dan. Why Everybody Is Lying. Bottom Line Personal. Volume 37, Number 14, July 15, 2016. P. 14.

• Husten, L. Dollars for Heart Docs: Analysis of CMS database shows some docs pocketed millions from drug and device makers. CardioBrief, June 23, 2015.  http://www.medpagetoday.com/publichealthpolicy/ethics/52731

• Medpage Today Staff. Hospital-Based Medicine: How Do Policies on Detailing Affect Branded Drug RX?—F. Perry Wilson, MD, digs into recent study. Medpage Today, May 04, 2017. https://tinyurl.com/MedpagetodayBrandedDrugs

 

Our Patient-to-Patient Resources: Help from Others with Atrial Fibrillation

To help you cope with your Atrial Fibrillation, we offer you the resources to educate yourself about A-Fib and your treatment options, and to arm yourself with the skills to navigate a path to a life without Atrial Fibrillation.

Our Personal A-Fib stories of Hope and Courage and our A-Fib Support Volunteers are two resources to help answer your questions and bolster your resolve to Seek Your A-Fib Cure (or best outcome for you).

A-Fib Patient Stories of Hope, Courage and Lessons Learned

Your first experiences with Atrial Fibrillation have changed your life in a number of ways: dealing with your A-Fib symptoms, the emotional toll as well, and the impact on your family.

It’s encouraging to read how someone else has dealt with their A-Fib. In our 99+ Personal A-Fib Stories of Hope, A-Fib patients tell their stories to encourage and offer you hope. (The first story is Steve Ryan’s in 1998). Many writers have included their email address if you want to contact them directly. To browse our patient experiences, go to Personal A-Fib Stories of Hope and Courage.

Offering Hope: Our A-Fib Support Volunteers

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. Our A-Fib Support Volunteers have gone through a lot while seeking their A-Fib cure. They have been helped along the way and want to return the favor. They answer questions and offer you encouragement through exchanging emails and sharing their stories.

Our volunteer listings are organized by geographic locations, within the U. S. and internationally by country and/or region.  Learn how to contact our A-Fib Support Volunteers.

Readers post their stories and volunteer to help you to
Seek your Cure. 

Update: My Post-Abaltion 2-Month Checkup

It’s been almost two months since my catheter ablation August 1, 2019 at St. John’s Hospital in Santa Monica, CA. And I’m feeling fine.

Just had a check-up with my EP, Dr. Shephal Doshi, on Wednesday. I haven’t had an A-Fib episode for a month.

My ECG looks perfect (see below). Notice how good the P-wave looks which often disappears when you have A-Fib. (Want to learn how read an ECG? See my article, Understanding the EKG Signal.)

Steve Ryan, A-Fib.com. ECG on Sept 25, 2019 by Dr Doshi. Verdict: all is normal!

My ECG on Sept 25, 2019 by Dr Doshi. Verdict: all is normal!

My Reveal LINQ Loop Heart rate Monitor Report

When you look at the report from my Reveal LINQ inplanted monitor, you can see I have had some tachycardia (marked in blue). But I think that may have come from the intense 100 meters sprints I do at the track. (Tachycardia is anything over 100 beats/minute.) Not to worry. Tachycardias do sometimes occur after an ablation. But one’s heartbeat usually returns to normal, as did mine.

Steve Ryan, A-Fib.com: My implanted LINQ heart monitor report 9-25-19. Note: Tachy and Pause.

My implanted LINQ heart monitor report 9-25-19. Note: Tachy and Pause.

As I reported before, during my first month post-op, I had one three-second pause at 2:00 am which isn’t of concern to me (marked in red).

Though my EP suggests putting in a pacemaker, I’d rather wait till after my blanking period is over. And even then, I’m against having a pacemaker unless I’m dizzy and feeling faint. Who wants to be burdened with a pacemaker for the rest of one’s life if it isn’t really necessary?

The Best News of All

And perhaps my best news is I don’t have to take my anticoagulant (Xarelto) any more. Yea!

Now it’s just one month to go in my 3-month post-ablation blanking/healing period. If it’s smooth sailing this next month, I’ll report again then.

For all my reports about the return of my Atrial Fibrillation after 21 years, see the following posts:

Sept 2018: Has My A-Fib Returned? I Get an Insertable Wireless Monitor
Oct 2018: Part 2: My Medtronic Reveal LINQ loop recorder21-Day results
Nov 2018: Part 3: PVCs/PACs but No A-Fib; False positives from my LINQ Monitor
July 2019: My 20-year Warranty Ran Out! My A-Fib is Back!
Aug 2, 2019: My Catheter Ablation was a Success—I was Home the Same Day
Aug 5, 2019: My A-Fib RF Catheter Ablations: 1998 vs 2019

Triggering A-Fib at the Dentist: My Post-Ablation Experience

A while back we published a warning by Dr. Sam about how your dentist’s use of local anesthesia containing epinephrine can trigger your A-Fib. I have another warning to add.

My Dental Cleaning After Catheter Ablation

I was reminded of Dr. Sam’s post when I visited my own dentist three days after having my recent catheter ablation (my Atrial Fibrillation returned after 21 years of being A-Fib free).

No-no-no-ultrasonic dental cleaning for me

Upon hearing of my medical procedure, my long-time dentist, Dr. Dave Famili, didn’t want to use the typical ultrasonic type of dental cleaning because it could distrupt my heart rhythm. So, they didn’t use anything electronic. Instead, they did a manual cleaning only, and all was good.

For my chart, he also requested the name and contact information for my EP, Dr. Shepal Doshi, in case he needed to be contacted.

Update Your Medical Records

From my first-hand experience, I remind you to be sure to inform your dentist and other healthcare providers when you have a procedure for your Atrial Fibrillation.

Use of Epinephrine Could Trigger Your A-Fib 

Another concern at the dentist is the use of Epinephrine (Epi or Adrenalin). It is one of the drugs EPs can use when completing a catheter ablation—they try to trigger A-Fib to check that their ablation scars for working. So any local anesthesia with Epinephrine (Epi) potentially can trigger A-Fib.

Local anesthesia (with Epi or Adrenalin) is used by dentists, dermatologists, emergency room personnel and others.

At the Dentist: A retired MD wrote to caution A-Fib patients that local anesthesia containing epinephrine can trigger your A-Fib.

Dr. Sam writes: “I had to have a dental implant and bridgework requiring that I have local anesthesia several times. The dentist uses local anesthesia with Epinephrine (Epi or Adrenalin) to numb your mouth. 

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

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

I found very little info online about this, and no studies had been done about dental anesthesia with Epi & A-Fib.”

Tell Your Doctors: Epinephrine Containing Products Can Trigger Your A-Fib

At the Opthamologist: The drops that the eye doctor uses to dilate your eyes are similar to Adrenalin. Ask for an alternative.

At the Dermatologist: Local anesthesia containing epinephrine is used by your doctor to numb skin and reduce bleeding when they remove cysts, limpomas, moles, skin cancer spots, etc. and to close lacerations. Tell them your concern about triggering your A-Fib.

Your GP and at the Emergency Room: Doctors use local anesthesia with Epinephrine to sew up wounds and/or to do small surgical procedures requiring local anesthesia, because it reduces bleeding locally and lasts longer. Remind your GP and discuss your A-Fib with emergency room caregivers. Express your concern about the use of Epinephrine. Ask for an alternative.

Are You Allergic to Medications? As a Caution Include Epinephrine

Allergic to any medications?

Medical staff routinely ask if you are allergic to any medications.

Tell your doctors you have Atrial Fibrillation and discuss your concern that the use of local anesthesia with Epinephrine may trigger your Atrial Fibrillation.

You might want to add Epinephrine as a medication you are allergic to in your medical records along with an explanation.

A-Fib Pause: To Pace or Not to Pace…That is the Question

I’ve posted about my A-Fib retuning last Fall and subsequently having a Medtronic Reveal LINQ Insertable Cardiac Monitor (ICM)—one of the world’s smallest cardiac monitors—inserted just under the skin near my heart. Each night my Reveal Linq wireless monitor transmits that day’s data by wireless connection to my EP, Dr. Shephal Doshi.

Surprise—I Didn’t Feel a Thing

One morning in the week following my successful RF catheter ablation, at 6:27 am unbeknownst to me, my Linq recorder captured this episode—a seven-second pause:

The ECG signal strip is a graphic tracing of the electrical activity of your heart.

The next morning Dr. Doshi was on the phone telling me to come into the office immediately. He showed me the printout, and I was amazed.

In this second graphic, called a scatter plot, you can clearly see the dots representing the pause (outlined by a red box). The differences between consecutive R-wave intervals reveal patterns in the rhythm.

Scatter plots use horizontal and vertical axes to plot data points. Here the differences between consecutive R-wave intervals are plotted in order to reveal patterns in the rhythm.

Wow, 7-seconds—that’s a huge pause! It’s no wonder Dr. Doshi and his office called me the next day. He wanted to install a pacemaker right away and scheduled it for a week later. He also told me not to drive a car.

Remember: Your Best Patient Advocate is You

Unlike when I had A-Fib back in 1997, this time I wasn’t feeling any dizziness during the day.

At A-Fib.com, we always encourage you to be your own best patient advocate (which can include your spouse or partner. too.) And to not blindly follow your doctor’s advice. Always educate yourself. So I read up on pacemakers.

What is a Pacemaker?

In this instance, pacemakers are used to treat a slow heartbeat in people with A-Fib. It’s a small device that monitors your heartbeat and sends out a signal to stimulate your heart if it’s beating too slowly. The device is made up of a small box called a generator. It holds a battery and tiny computer.

Source: Pacemaker illustration from solarstorms.org

Source: Pacemaker illustration from solarstorms.org

Very thin wires called leads connect the pacemaker to your heart. Impulses flow through the leads to keep the organ in rhythm. There are also “leadless” pacemakers which are entirely installed inside your heart.

Installing a Pacemaker: The doctor programs and customizes the pacemaker for each patient to help keep their heart in rhythm. The surgery to put in the device is safe, but there are some risks, such as bleeding or bruising in the area where your doctor places the pacemaker, infection, damaged blood vessel or collapsed lung. You may need another surgery to fix it.

Life with a Pacemaker: Sometimes the impulses from a pacemaker cause discomfort. You may be dizzy, or feel a throbbing in your neck.

Once you have one put in, you might have to keep your distance from objects that give off a strong magnetic field, because they could affect the electrical signals from your pacemaker like metal detectors, cell phones and MP3 players and some medical machines, such as an MRI

In general, it is a permanent installation—you’ll have it for the rest of your life.

VIDEO: Traditional and Leadless Pacemakers Explained. Peter Santucci, MD, is a cardiologist with Loyola University Medical Center; he describes the traditional pacemaker and it’s installation using graphic animations.Then compares with the miniaturized leadless version. 2:30 min. Posted by Loyola Medical. Go to video.

Considering a Pacemaker: Pros and Cons

Patti and I discussed the pros and cons of a pacemaker.  In this instance, my heart was beating too slowly. But that’s normal for me. Because of years of running and exercise, my resting heart rate is in the high 50s, which is very low compared to others with A-Fib.

The three-month “blanking” period following my ablation is when my heart is healing and learning to once again beat in normal sinus rhythm. That’s why it’s common for A-Fib to recur during this time.

Illustration showing placement of the Medtronic Mica leadless pacemaker

Illustration showing placement of the Medtronic Mica leadless pacemaker

It doesn’t mean your ablation was a failure—think of it like planting a fruit tree. The tree might not produce fruit right way, but give it time to acclimate, absorb the nutrients in the soil, to grow stronger and bask in the sun. So I’m giving my heart some time, too.

Hitting the Pause Button on a Pacemaker for Now

In the meantime, I haven’t had another pause and have remained A-Fib free. I am hoping that this 7-second pause was a one-time thing and that my heart will stay in normal sinus rhythm in the months to come.

Dr. Doshi wants to install a “leadless” pacemaker which would be entirely installed inside my heart. Having that installed is a big step for me, one that I’ll have to live with for the rest of my life.

So, I decided to wait on having it installed. I’ll reconsider a pacemaker after my 3-month blanking period is behind me.

I’ll keep you posted on the status of my A-Fib post-ablation.

A-Fib Patients: How Does Your Doctor Talk to You?

I recall an email sent to me by a woman from England who described her horrendous A-Fib symptoms—palpitations, extreme fluttering, breathlessness, “absolute extreme fatigue.” She recalled how the doctor said her symptoms had nothing to do with A-Fib, that the symptoms were all in her head, and that she was exaggerating her breathlessness and exhaustion.

Wow! First, I reassured her that her symptoms are very real for many A-Fib patients. I then suggested she change doctors. (I also recommended she contact our A-Fib Support Volunteers.)

How’s the Rapport With Your Doctor?

There’s an insightful article in the Journal of Cardiovascular Electrophysiology (I’d like to send a copy to her doctor) “How doctors can provide better treatment by understanding the hearts―and minds―of AF patients.

In brief, it’s a Top 10 list: 5 things A-Fib patients do not want to hear from their doctors and 5 things they do want to hear. (Go to the journal article.)

Five Things A-Fib Patients Do Not Want To Hear

Several research studies tell us that some doctors underestimate the impact Atrial Fibrillation has on a patient’s quality of life. Many doctors treat A-Fib as a benign heart ailment. But patients report how A-Fib can wreak havoc in their lives.

Responding to a survey, A-Fib patients said they do not want their healthcare providers to say:


1. “A-Fib won’t kill you.”
2. “Just get on with your life and stop thinking about your A-Fib.”
3. “Stay off the Internet and only listen to me.”
4. “I’ll choose your treatment, not you.”
5. “You’re just a hysterical female.”


Did anything on this list sound (or feel) familiar to you?

If your doctor is condescending or dismisses your concerns, you’re getting poor care. If a doctor is too busy to talk with you and answer your concerns, he’s probably too busy to take care of you properly.

Like the patient from England, it may be time for you to change doctors.

Five Things A-Fib Patients Do Want To Hear

Those doctors who recognize the serious effects atrial fibrillation can have on patients will foster meaningful and productive partnerships with their patients. From the same survey, here are five things A-Fib patients do want their healthcare providers to say:


1. “I respect you and will listen.”
2. “I want to be sure you understand.”
3. “Let’s customize a treatment that works with your lifestyle.”
4. “I understand your values and preferences.”
5. “Here are some resources about A-Fib.”


Do the comments on this second list sound like your doctor?

When your doctor respects you and listens to you, you’re more likely to collaborate on a treatment plan tailored to you and your treatment goals.

If you don’t have this kind of rapport with your current doctor(s), it’s worth looking elsewhere for a new doctor (even if they’re considered “the best” in their field).

Changing Doctors Can Be Scary: We Can Help

As a researcher in doctor-patient communication, Robin DiMatteo, of U. of Calif.- Riverside, says of changing doctors: ”I really think it’s a fear of the unknown. But if the doctor isn’t supporting your healing or health, you should go.”A-Fib.com Directory of Doctors and Medical Centers Treating A-Fib Patients at A-Fib.com

At A-Fib.com, we can help you. First, learn more about how to Find The Right Doctor For You and Your Treatment Goals.

Then check our Directory of Doctors and Facilities. We list US & international physicians and medical centers treating Atrial Fibrillation patients. This evolving list is offered as a service and convenience to A-Fib patients. (Important: Unlike other directories, we accept no fee to be included.) 

Resources for this article
Mellanie True Hills presentation, 2017 American Heart Association Scientific Sessions in Anaheim, California, November 11-15, 2017.

Recognize AFib Patient Values by Mellanie True Hills. PowerPoint Presentation. From Improving Outcomes for Patients with AFib. American Heart Assoc. Non-CME Webinar. May 3, 2018. https://www.heart.org/-/media/files/health-topics/atrial-fibrillation/improving-outcomes-for-patients-with-afib-ucm_500972.pdf?la=en&hash=CDE25CF86D94CE01B9D5662E45E86619F20FF809

Hills, M T.  The transformative power of understanding and trust in AF care: How doctors can provide better treatment by understanding the hearts―and minds―of AF patients. Journal of Cardiovascular Electrophysiology. Point of View. Volume 29, Issue 4, April 2018. Pages: 641-642. https://doi.org/10.1111/jce.13443

Be Suspicious of A-Fib Info on the Internet―Here’s Why

by Steve S. Ryan

When I attend talks at most A-Fib conferences, the first slide a presenter shows is often a list of their Conflicts of Interest. It’s required of all speakers.

But this is not required of websites! Health/Heart-related websites are not required to be transparent and reveal their conflicts of interest.

Drug Industry Owns or Influences Most Heart/Health Web sites

The drug and device industry owns, operates or influences almost every health/heart-related web site on the Internet!

The fact is most health/heart web sites are supported by drug companies who donate most of their funding.

For example, did you know that the drug company Ely Lilly partially owns and operates WebMD, the Heart.org, Medscape.com, eMedicine.com and many other health web sites?

The fact is that most health/heart-related web sites are supported by drug companies who donate most of their funding. Consider how that may affect the information they put on their web sites―they’re not going to bite the hand that feeds them.

VIDEO: Video: Buyer Beware of Misleading A-Fib Information on the Web and in the Media

Beware of misleading and incorrect A-Fib information published by reputable sources on the internet and in print media. Steve S. Ryan, PhD, gives three specific examples of why you need to be on the lookout for inaccurate statements about Atrial Fibrillation. 3:59 min. Go to video.

Be Suspicious of A-Fib Info on the Internet

Steve Ryan video at A-Fib.com

VIDEO: Buyer Beware of Misleading or Inaccurate A-Fib Information.

In our crazy world, you can’t afford to trust anything you read on the Internet.

At one time I tried to keep track of all the mis-information found on various A-Fib web sites. When we’d find something wrong, we would write the site. I don’t think we’ve ever received a reply. Finally, we gave up.

(See my video: Buyer Beware of Misleading or Inaccurate A-Fib Information.)

In today’s world, you have to do your own due diligence.

Many web sites put out biased or mis-information often for financial gains, but sometimes it’s just out-of-date. Be skeptical.

You can tell if someone is trying to pull the wool over your eyes. Truth will out. If you feel uncomfortable or that something is wrong with a site, it probably is. When you find a good site, the truth will jump out at you.

Whenever you visit a heart health-related website, ask yourself: “Who owns this site?” and “What is their agenda?” (Hint: Check their list of “sponsors” and follow the money!)

How Does A-Fib.com Measure Up?

A-Fib Inc. has earned GuideStar’s highest rating, the GuideStar Exchange Platinum Seal, a leading symbol of transparency and accountability in the non-profit world.

Transparency means that anyone can find out what we have been doing, what we have achieved, and how we are doing in achieving our ultimate goals. You can check the A-Fib.com public listing at GuideStar.org.

A-Fib.com has also earned the Health On the Net Foundation (HON) Certification for quality and trustworthiness of medical and health online information.

For more, you can also read the A-Fib.com Disclosures page.  

Caution - when searching A-Fib websites always ask: who is paying for this site and what is their agenda?

Hint: Check their list of “sponsors” and follow the money!

My A-Fib RF Catheter Ablations: 1998 vs 2019

When I developed paroxysmal Atrial Fibrillation in 1997, I was very symptomatic. This time, in 2019, I didn’t have any symptoms—instead my A-Fib was detected by my tiny, inserted Medtronic Reveal LINQ loop monitor/recorder.

More Differences Between 1998 and 2019

Since 1998, the treatment of A-Fib by catheter ablation has advanced by light years including 3D Mapping and ablation systems and catheter technologies.

My last ablation 21 years ago in Bordeaux, France lasted eight+ hours. This one at St. John’s Hospital in Santa Monica, CA took only 2-3 hours.

In Bordeaux, I was in the hospital for 9 days (mostly for observation, and a “touch up” second EP lab visit). In 2019, I was in and out in 12 hours.

Second Time Around: My A-Fib Catheter Ablation Prep

Steve Ryan pre-op A-Fib ablation

Pre-op: Steve with nurse inserting IV

On Thursday, August 1st, my wife, Patti, and I arrived at St. John’s around 5:30 am.

The nurses did the usual insertion of an IV port. They had trouble getting into my left arm and used the right. Then they shaved not just my groin but my chest and back too so that they could more easily attach the electrode pads for the mapping system (those pads were cold).

Then they wheeled me into the EP lab where it seemed like an army of people were waiting on me (probably around 8 people.) They were very friendly and super-efficient in their gowns and face masks.

Dr. Shephal Doshi of Pacific Heart Institute did my RF catheter ablation. (Both he and the anesthesiologist visited me in pre-op before the ablation.) Dr. Doshi has an excellent rapport with the staff and has a great sense of humor.

Out Like a Light

Before I knew it, they had a mask over my face, and I was out like a light. (Dr. Doshi said I was a “cheap date.”)

Mapping of my A-Fib heart - Steve Ryan August 2019

Mapping screen showing my A-Fib heart – the dots are the ablation lesions – notice the tight arrangement; Steve Ryan August 2019

Thanks to Dr. Doshi, we have loads of photos of my RF catheter ablation taken from the EP lab control room and some from inside the EP lab. (I intend to get an explanation of each screen from him to share with you later.)

Post-Ablation Recovery

I didn’t wake up until in the recovery room. Dr. Doshi said everything went very well. I will give you more technical details as I learn them (I don’t remember much of what he said at the time.)

He told Patti that indeed he could see the ablation lesions from my first ablation in 1998, which were around just two of my pulmonary veins (and some other areas). So, no wonder I needed a “touch-up”.

I don’t know too many details from 1998—I didn’t know to ask for the Operating Room (OR) report back then.

Post op: Dr Doshi and nurse Jamie removing Steve’s groin stitch.

To close the one catheter incision point in my right femoral vein, he used some kind of sliding figure-eight stitch that could be loosened or tightened as needed. That stitch was painful and hurt for a while. It was removed before I left the hospital.

In the recovery room I remember them bringing me a vegetable soup which tasted delicious. Patti fed me bits of a lunch of chicken salad and raw vegetables, low-fat milk and pineapple chunks.

I was discharged about 4:30pm. After a stop at the pharmacy, we were home by 6pm. Amazing compared to my first catheter ablation in 1998. In and out in under 12 hours!

Meds: Pantoprazole and Xarelto

Dr. Doshi said I have a large esophagus so he was concerned about acid reflux damage. To prevent the very rare complication Atrial Esophageal Fistula, I was given a prescription for the Proton Pump Inhibitor Pantoprazole SOD 40 mg to be taken once a day. I did have some acid reflux the first day, but none since I started taking the Pantoprazole. (For more about Atrial Esophageal Fistula , see Dr. David Keane’s AF Symposium 2014 presentation, “Complications Associated with Catheter Ablation for AF”.)

And I’m continuing to take Xarelto 20 mg (rivaroxaban) at night with a meal (I was also on it two weeks prior to my ablation).

Recovering at Home

Dr. Shephal Doshi and Steve Ryan before his A-Fib catheter ablation Aug 1 2019

My wife, Patti, drove me home that evening. I felt terrific. But that wasn’t to last.

No problems with my heart, but the next night (Friday), I developed a low-grade fever and felt very weak and unbalanced the next day. I slept a lot Saturday and felt better.

Sunday I was scheduled to be a lector at our local Catholic church. ­(I tried to get someone to sub for me but couldn’t find anyone.) I did read the scriptures for our congregation and felt fine. But went straight home after (I wouldn’t recommend this for everyone). One needs rest after an ablation.

As I write this Sunday night, I feel fine, just a bit tired. I’ll write more when I talk with Dr Doshi about my fever and after my two-week checkup.

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