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
Infographic: A-Fib & Sleep Apnea—The Life-Threatening Risks
Sleep Apnea is common amount Atrial Fibrillation
At least 43% of patients with Atrial Fibrillation suffer from Obstructive Sleep Apnea (OSA) as well.
Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
It is now established that there’s a correlation between Sleep Apnea and A-Fib.
Warning: Do you Acupuncture? Know it’s Not Without Risks
Some A-Fib patients report acupuncture has helped with their symptoms.
If you decide to try acupuncture, be aware that it is not without risks. There have been reports of lung and bladder punctures, broken needles, needles left in after treatment, and allergic reactions to needles containing substances other than surgical steel. There is always the possibility of infection from unsterilized needles.
Acupuncture needles
The best guarantee of safety is to seek treatment from a properly trained and qualified practitioner who is licensed or certified. Always check their credentials. In the U.S., most states require a diploma from the National Certification Commission for Acupuncture and Oriental Medicine. Outside the U.S., check your national Accredited Registers for acupuncture practitioners.
To learn more about A-Fib and Acupuncture, see our articles:
• FAQs Natural Therapies Acupuncture: “What’s the research on acupuncture and Atrial Fibrillation? I’m willing to try it if it will help ease or reduce my A-Fib episodes”
• Acupuncture Helps A-Fib: Specific Acupuncture Sites Identified
Newly Diagnosed Patients: Answers to Frequently Asked Questions
A few of the patients who have submitted questions to A-Fib.com.
For over a decade of publishing A-Fib.com, we have answered thousands of patient’s questions—many times the same questions. Perhaps the same questions you may have right now. In our section FAQ about Living with A-Fib, the first group of answers is For the Newly Diagnosed A-Fib Patient.
Here we share answers to the most often asked questions by the new A-Fib patient and their family. Questions such as, “Did I cause my Atrial Fibrillation? Am I responsible for getting A-Fib?”, “Is Atrial Fibrillation a prelude to a heart attack?”, and “Can I die from my Atrial Fibrillation? Is it life threatening?”
We also answer questions about driving your car, your sex life, and dealing with the fear and anxiety.
We invite you to browse through the lists of questions. Then, just ‘click’ to read the answer. Go to -> Frequently Asked Questions by Newly Diagnosed Patients.
A-Fib Patients: Is Stress Really Bad For You?
Stanford University psychologist Kelly McGonigal, PhD, author of The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It, has challenged the conventional view that stress is bad for you. I found a few insights from her book encouraging for A-Fib patients.
Researchers who followed 30,000 US Americans for eight years found that the risk for death from any cause rose by 43% among participants who had high levels of stress. But that number applied only to people who believed that the stress they were experiencing was bad for their health.
From the Upside of Stress by Kelly McGonigal
Study participants who reported similar levels of stress but who did not consider it to be bad for their health, had survival rates that were actually better than those of people with relatively stress-free lives.
Dr. McGonigal recommends telling yourself “I’m excited” rather than stressed. Try to look at stress as simply your body’s response when something you care about is at stake. The pounding heart or faster breathing is your body’s way of heightening your senses so that you are mentally focused and motivated to do well.
Look at stress as a challenge rather than a looming threat.
So What Does this Mean for A-Fib Patients? Stress, by itself, is not usually a trigger for an A-Fib attack. (You could be totally stress-free, lounging on a swing on a tropical isle and still have an A-Fib attack.)
But stress can play a role in the intensity and duration of your A-Fib attacks.
Beyond the physical, A-Fib has psychological and emotional effects as well. Recent research indicates that “psychological distress” worsens the severity of A-Fib symptoms.
Give Dr. McGonigal’s Advice a Try. So, when feeling stressed, try mentally ‘reframing’ the stress as a ‘challenge’ rather than as a looming threat. Tell yourself “I’m excited” rather than stressed. It may help lessen your A-Fib symptoms. (Let me know if this works for you! Email me.)
Sounds like this approach could help in many areas of our lives.
For other ways to cope with your stress, see our A-Fib.com article, Coping With the Fear and Anxiety of Atrial Fibrillation.
For more about stress from Kelly McGonigal, read her The Washington Post interview, or her book, The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It.
Updated Answer to FAQ About Coping with PVCs & PACs
We’ve update our answer to the Frequently Asked Question: “I have a lot of extra beats and palpitations (PVCs and/or PACs) which are very disturbing and frightful. They seem to proceed an A-Fib attack. What can or should I do about them?”
We’ve added:
Sometimes PVCs Aren’t Always Benign
In patients with other heart problems like Coronary Artery Disease (CAD), frequent PVCs often aren’t “benign.” They can increase chances of a fatal heart attack or sudden death. PVCs have been implicated in the development of cardiomyopathy and LV (Left Ventricular) dysfunction.
But catheter ablation or antiarrhythmic pharmacological agents appear to reverse this cardiomyopathy and LV dysfunction. RF ablation for frequent PVCs in patients without structural heart disease has been shown to completely reverse cardiomyopathy in numerous studies.
To read the entire answer, go to: FAQs Coping with A-Fib: PVCs & PACs.
‘Silent A-Fib’ More Dangerous Than ‘Symptomatic A-Fib’
Dr. John Camm of St. George’s Hospital
Dr. John Camm of St. George’s Hospital in London, England discussed how silent (asymptomatic) A-Fib can have similar long-term effects as A-Fib with symptoms. Silent A-Fib may progress and get worse just like symptomatic A-Fib. But all too often people with silent A-Fib have a stroke and only then find out they have A-Fib.
Doctors today have a wealth of new A-Fib monitoring devices to detect A-Fib, such as the Medtronic Reveal DX which is inserted just under the skin and can monitor the heart for over a year, or the Zio Patch which you wear like a Band Aid for 1-2 weeks, or phone apps like the
AliveCor Heart monitor for SmartPhones.
BUT—how can we get heart monitors to the people who need them the most—people with silent A-Fib? Read more of Steve’s summary of Dr. Camm’s presentation->
Sleep Apnea—New At-Home Testing Option
At least 49% of all patients with A-Fib suffer from Sleep Apnea as well. With untreated Sleep Apnea, you have a greater chance of a more severe form of A-Fib and increased risk of recurrence after a successful catheter ablation. Everyone with A-Fib should be tested for sleep apnea which involves an overnight stay in the sleep lab. Now there’s an alternative—you can test at home with the WatchPAT™ device.
If you have untreated Sleep Apnea, your chances of having a more Read more.
Sleep Apnea: Home Testing with WatchPAT Device, the Philips Respironics, & the Wellue O2Ring
Photo: Itamar Medical patient brochure
by Steve S. Ryan, PhD, Updated June 2021
At least 43% of patients with Atrial Fibrillation suffer from Obstructive Sleep Apnea (OSA) as well.
Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
A-Fib anD Risks of Untreated Sleep Apnea
It is now established that there’s a correlation between Sleep Apnea and A-Fib.
If you have untreated Sleep Apnea, you are a greater risk of having a more severe form of A-Fib or of not benefiting from an A-Fib treatment .
For example, after a successful catheter ablation, patients with untreated sleep apnea have a greater chance for recurrence of their A-Fib.
The In-Lab Sleep Study
In the standard lab test for sleep apnea, you go to a hospital-like room, put on cumbersome sensors, then try to go to sleep in this unfamiliar environment. And this test isn’t cheap ($1100-$2,000).
It requires extensive monitoring to measure airflow, chest/abdominal movements, electromyography, electrocardiography, and oxygen saturation levels. The formal name for this test is polysomnography (PSG).
At Home Sleep Tests (HST)
A home sleep test (HST), also called ‘Unattended Sleep Study’, is a sleep study tool that is used for the diagnosis of obstructive sleep apnea. Most HST devices are portable —about the size of a telephone handset. A home sleep test is more affordable at $250-$300.
Itamar Medical’s WatchPAT™
The WatchPAT is an FDA-approved wrist-worn sleep study device you can use in the comfort of your own bedroom to determine if you have sleep apnea. (PAT is short for Peripheral Arterial Tonometry [pressure measurement].)
It assesses respiratory disturbances and indirectly detects sleep apnea by measuring volume changes in the peripheral arteries along with pulse oximetry (oxygen desaturation) and respiratory arousals. (When you have sleep apnea, your breathing often stops till you have to gasp for breath. This is called “respiratory arousal.”)
Philips‘ Alice™ NightOne
Another HST is the Philips Respironics Alice NightOne, an FDA-cleared Type III device. It features a belt that goes around your chest with a nasal cannula (short two-prong nose tube) which you place in your nostrils and a Pulse Oximeter which you wear on your finger. Read more at SingularSleep.com. Others: Ares by Watermark and ResMed’s ApneaLink™ Plus.
Wellue O2Ring
The Wellue O2Ring is worn on your finger and vibrates when low oxygen levels or abnormal heart rate is detected.
For example, if you start snoring when in a particular position such as on your back, it will vibrate so you can change your sleeping position.
The app provides users with detailed analysis and records of overnight blood oxygen levels, heart rates, and body movements. It records in 4 second intervals.
How to Choose a Home Sleep Test Provider
According to Dr. Joseph Krainin, founder of SingularSleep.com, it’s important your interpreting physician review the entire record to make sure of the proper diagnosis.
Dr. Joseph Kranin
Insist that your interpreting physician be a fellowship-trained, board certified sleep physician (who has one full year of training in sleep medicine and passed a rigorous national examination).
Before signing up with a HST provider, make sure to ask how long it will take to get results. And if your first encounters with a company’s customer service isn’t first-rate, steer clear of this provider.
Note: Dr. Joseph Krainin offers online sleep doctor telemedicine consultations.
What Patients need to know
Everyone with A-Fib should be tested for sleep apnea. It’s now available at a fraction of the cost of an in-lab sleep study ($250-$300 vs. $1100-$2,000). And it’s convenient (especially if being away from home overnight is problematic). Talk to your EP. With OSA home testing now available, there is no excuse for not doing a sleep study.
Learn more about Home Study Tests on the American Sleep Association website: What is a Home Sleep Test or HST.
Return to Diagnostic Testing
Last updated: Friday, June 11, 2021
Research: Catheter Ablation Reduces Stroke Risk even for Higher Risk Patients
Catheter Ablation Reduces Stroke Risk Even for Higher Risk Patients
by Steve S. Ryan, Last updated: March 24, 2018
In a study of nearly 38,000 people, patients with A-Fib who had a catheter ablation had about as many strokes as the people without A-Fib, while people on just medication had about twice as many strokes. (This isn’t a surprising finding. If you no longer have A-Fib, by definition you can’t have an A-Fib stroke.)
But what is surprising is that even patients at greater risk of stroke had a reduced stroke risk after catheter ablation. “Across all CHADS2 profiles and ages, A-Fib patients with ablation had a lower long-term risk of stroke compared to patients without ablation.” Even those at higher risks of stroke had a reduced risk of stroke.
Catheter Ablation Reduces Stroke Risk to That Of A Normal Person
And, more importantly, if someone had a catheter ablation, stroke risk decreased to that of a normal person. “A-Fib ablation patients had similar long-term risks of stroke across all CHADS2 profiles and ages compared to patients with no history of A-Fib…Freedom from A-Fib was the strongest predictor of stroke-free survival.”
Warfarin Not Needed After Successful Catheter Ablation
Some patients after a catheter ablation are still put on warfarin-for-life depending on their CHADS2 score. But research indicates that “A-Fib patients after ablation with moderate to high risk CHADS2 scores in which warfarin was discontinued do not show a higher risk of stroke compared to those in which warfarin is continued.”
Editor’s Comments:
This study is medical breakthrough news, similar to another important study in which a successful catheter ablation reduced by 60% the expected rate of cardiovascular mortality. (See Live Longer—Have a Catheter Ablation.)
For anyone who has had a successful catheter ablation or who is thinking of having one, this study also is a game changer!
Even if you are at a theoretical high risk of stroke (high CHADS2), you don’t have to be on warfarin for the rest of your life after a successful catheter ablation. A successful catheter ablation reduces your stroke risk to that of a normal person (though obviously normal people do have strokes).
We already know that a catheter ablation significantly improves our well being. We certainly feel healthier in sinus rhythm. Few other medical procedures produce such a dramatic and nearly immediate improvement in our quality of life. This study confirms the long-term benefits of catheter ablation even for people who are sicker.
We don’t have to live a life on meds! A-Fib can be cured by a catheter ablation. And when you are made A-Fib free, not only do you feel better, but your risk of stroke is reduced to that of a normal person! This is terrific news for the A-Fib community.
Return to Treatments for A-Fib
Last updated: Saturday, March 24, 2018
FAQ: Natural Therapies & Holistic Treatment for A-Fib
FAQ: Natural Therapies & Holistic Treatment
Many A-Fib patients have questions about treatment alternatives such as naturopathic doctors, complementary or integrated medicine as well as mind/body practices (such as chiropractic, acupuncture, yoga and meditation).
1. Holistic approach: “How do I find a doctor with a more “holistic” approach? I want nutritional counseling and a more integrated approach to my A-Fib treatment plan?
2. Complementary Medicine: “I’ve read that yoga and acupuncture are considered ‘Complementary Medicine‘. What is that? How does it relate to conventional medicine?”
3. Naturopathic Medicine: “A dietitian friend referred me to a Naturopathic doctor. What is naturopathic medicine? Are they ‘real’ physicians?”
Related question: “Have any A-Fib.com readers reported success working with a Naturopathic doctor? Anyone controlling their A-Fib with supplements?”
4. Vagal: “What is the ‘vagal maneuver’? I’ve heard it might help me during an A-Fib episode. What is it and how is it done? Is it safe?”
5. Diet: “Is a whole food or organic diet helpful for patients with Atrial Fibrillation? Is there any research recommending one or the other?”
6. Chiropractic: “Do A-Fib patients find chiropractic adjustment useful? If so, what are their results? In the past, I’ve found it helpful for other ailments. Could it help with my A-Fib symptoms?”
7. Yoga: “I do Yoga. It relaxes me and helps with my stress level. Is there any evidence on Yoga helping with other A-Fib symptoms?”
8. Acupuncture: “What’s the research on acupuncture and Atrial Fibrillation? I’m willing to try it if it will help ease or reduce my A-Fib episodes.”
9. Natural blood thinners: “Have there been any tests comparing natural blood thinners to the new anticoagulants (NOACs) in terms of efficacy and speed of onset?”
“Most people use non-mainstream approaches along with conventional treatments. The boundaries between complementary and conventional medicine overlap and change with time.” ∼ US National Institutes of Health
If you find any errors on this page, email us. Y Last updated: Saturday, February 11, 2017
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