Doctors & patients are saying about ''...

" 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

Understanding A-Fib

11 Ways A-Fib Robs You of Your Heart Health

Atrial Fibrillation is a disease of the heart but affects your overall health as well. It is often said, “A-Fib begets A-Fib”. It’s a progressive disease and is self-perpetuating.

Here are the many ways A-Fib can affect you:

1. Risk of stroke. The biggest danger from A-Fib is stroke. Because your heart isn’t pumping out properly, blood can pool in your atria then form clots that travel to the brain causing stroke. Use of anticoagulant drugs reduce, but don’t eliminate, the risk of an A-Fib stroke. Anticoagulants are high risk drugs. They don’t cure or improve your A-Fib.

A-Fib reduces your heart’s pumping ability by 15%–30% decreasing blood flow to the brain….

2. Reduced Blood Circulation. A-Fib reduces your heart’s pumping ability by 15%–30%, decreasing blood flow to the brain and to the rest of the body. This may cause weakness, fatigue, dizziness, brain fog, fainting spells, swelling of the legs, and shortness of breath. Over time, reduced blood circulation contributes to many other health issues.

3. Fibrosis (Structural Remodeling). Over time A-Fib produces fiber-like scar tissue in place of the normal smooth walls of the heart. Fibrosis makes the heart stiff, less flexible and weak with a loss of atrial muscle mass. It overworks the heart, reduces pumping efficiency, and leads to other heart problems. Fibrosis is considered permanent and irreversible.

Over time, the left atrium tends to stretch, weakening the heart muscle.

4. Atrial stretch/expansion (Structural Remodeling). When in A-Fib, your left atrium has to work harder than normal. Over time, the left atrium tends to stretch or dilate thereby weakening the heart muscle. An enlarged left atrium can be diagnosed and measured using an echocardiogram (ECHO). (A normal size is 2.0-4.0 cm; over 5.5 cm is considered chronically enlarged.)

5. Electrical Remodeling. A-Fib causes electrophysiological changes in the heart which are self-perpetuating, make the heart more prone to go into and remain in A-Fib. This Remodeling develops quickly, is progressive, and may be persistent. For instance, an A-Fib episode once a month may escalate to once a week and might become longer than before.

6. Heart Failure. Researchers have found that A-Fib is strongly associated with heart failure which is five times more likely in people with A-Fib. When in A-Fib, your heart isn’t pumping properly. So it’s not surprising that A-Fib leads to heart disease, heart failure, and sudden death. A-Fib affects your whole body. It damages your heart, brain, and other organs.

Most A-Fib patients have at least one comorbidity such as diabetes, hypertension or sleep apnea.

7. Coexisting Conditions (Comorbidities). The symptoms of one illness can predispose a person to another. Most A-Fib patients have at least one comorbidity such as diabetes, hypertension or sleep apnea. A somewhat surprising association with A-Fib is kidney disease and peripheral arterial disease.

8. Dementia. A-Fib has been independently associated with dementia. Leaving patients in A-Fib doubles the risk of developing dementia. Current drugs, even statins, don’t work or have mixed results in preventing dementia. Because your heart is being remodeled electrically, your A-Fib may eventually worsen to Long-standing Persistent A-Fib (which is harder to cure).

“I have never been mentally so incapable…even the simplest work-related problems seemed impossible for me to handle.” — Max Jussila

9. Brain Atrophy, Reduced Brain Volume and Cognitive Function. Research shows A-Fib patients experience loss of both grey and white brain matter, as well as white matter brain lesions. Cognitive function and processing speed decline significantly.

Mental skills and memory are also affected. Max Jussila, a Finnish executive, recalls his challenges. “I have never been mentally so incapable. My memory was gone, my speech was gone (I speak five languages), even the simplest work-related problems seemed impossible for me to handle, let alone solve.”

10. Reduced Quality of Life. For many patients, A-Fib disrupts both work and family life. They are often preoccupied about the next A-Fib attack. When will it hit? How bad will it be? Where will I be at the time? When you travel, you first research the location of the nearest emergency room.

A-Fib can have significant consequences on your social interactions with loved ones, friends and colleagues. The patient’s livelihood may be impacted. Family life may be unsettled. In one study the partners of A-Fib patients reported a significant reduction in their quality of life, to the same degree as the patient.

11. Psychological and Emotional Effects. A-Fib wreaks havoc with your head as well as your heart. Anxiety, fear, frustration, worry, confusion, depression and anger can be as debilitating as the disease itself. Psychological distress worsens A-Fib symptoms’ severity. Physical ailments like colds may be more frequent because of a depressed immune system.

How Much Will You Pay to Stay in A-Fib?

A-Fib costs you in many ways. Beyond the physical, mental and emotional toll, staying in A-Fib is costly to your wallet too. Besides the annual costs of your medications, ER visits, etc., the odds of your being hospitalized increases (each year 750,000 hospitalizations in the U.S. are due to A-Fib).

Don't Settle for a lifetime on medication - Seek your A-Fib Cure

According to the CDC, just in terms of dollars and cents, A-Fib on average costs you an additional $8,700 a year.

When you add up all the costs (physical, emotional and monetary) of living in A-Fib, doesn’t it make sense to ‘Seek you Cure’?

Don’t Settle for a Lifetime on Meds―Seek your A-Fib Cure

Today’s TV advertisements for anticoagulants talk about “living with A-Fib”. They show patients living happy, healthy, care-free lives while still in A-Fib. That’s a Pollyanna fantasyjust take an A-Fib pill and live happily ever after.

Contrary to today’s media, your goal shouldn’t be to just ‘manage’ your A-Fib. For patients with A-Fib, it isn’t enough to simply take an anticoagulant.

Your goal should be to get your A-Fib fixed and have your heart beat again in normal sinus rhythm (NSR). Educate yourself. Learn all your treatment options.

Don’t just settle. Seek your A-Fib cure.

FAQ: A-Fib and the Two Types of A-Flutter

FAQs Coping with A-Fib: A-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.)”

A-Flutter usually comes from the right atrium.

Atrial Flutter is similar but different from Atrial Fibrillation. Atrial Flutter is characterized by rapid, organized contractions of individual heart muscle fibers (see ECG graphic).

In general, there are two types of Atrial Flutter:

Typical Flutter (from the right atrium)
Atypical Flutter (can come from anywhere)

Typical Flutter

Typical Flutter originates in the right atrium (whereas A-Fib usually comes from the left atrium). Typical Flutter is an organized right atrium rhythm which usually travels around the tricuspid valve annulus, either in a counterclockwise or clockwise manner. This is the most common form of atrial Flutter.

The tricuspid valve forms the boundary between the right ventricle and the right atrium. Deoxygenated blood enters the right side of the heart via the inferior and superior vena cava.

An ablation for Typical Flutter is one of the easier and more effective forms of catheter ablation. The electrophysiologist (EP) makes what is called a Cavo-Tricuspid Isthmus line in the right atrium to block Flutter signals.

If combined with an ablation for A-Fib (highly recommended), the EP makes this lesion set or line either before going through the septum to the left atrium or on the way out.

This blocking line can be made in as little as 20 minutes and usually stops Typical Flutter. It’s highly successful (95%) with low risk.

Atypical Flutter

Atypical Flutter can come from anywhere and is one of the most difficult arrhythmias to map and ablate. Atypical Flutter includes any other Flutter circuit (not traveling around the tricuspid valve), from either the left or right atrium.

These Atypical Flutter circuits are often associated with scar tissue from prior A-Fib catheter or surgical procedures, but can arise from spontaneous left and/or right atrial scar. One form can travel around the mitral valve annulus, but many other Atypical Flutter circuits are possible. These can be difficult to map and ablate, and there can be multiple Atypical Flutter circuits in a single patient.

Atypical Flutter often appears, as probably in your case, after a successful ablation for A-Fib. It’s often the last arrhythmia circuit that needs to be ablated to restore a patient to sinus.

Treatment for Your Atypical Flutter

Antiarrhythmic Drugs? Today’s antiarrhythmic drugs leave a lot to be desired. They are effective for only about 40% of patients, tend to lose their effectiveness over time and have bad side effects. While they aren’t considered a “cure” for A-Fib, they can be helpful to improve A-Fib symptoms on a temporary basis.

For more about ablation for Atypical Flutter, see my 2020 AF Symposium report, Live Case of Difficult A-Fib Ablation of Atypical Flutter performed by Dr. Kevin Heist, Mass. General Hospital.

For Atrial Flutter, in particular, antiarrhythmic drugs are even less effective. In fact, they sometimes make Flutter worse by slowing conduction which favors the organization of Flutter circuits.

Master EP for Complex Ablation: Treating your Atypical Flutter is often a complex ablation procedure and isn’t for the faint of heart. You need to find a top “master” EP, a highly skilled EP with a high success rate with difficult A-Fib cases, and Atypical Flutter, in particular.

This complex ablation requires an EP with both the experience and the tenacity to find and ablate these often-elusive Atypical Flutter signals. (Email me, I can suggest several “master” EPs.)

Don’t just go to the EP whose office is near you. Go to the best, most experienced EP you can reasonably find. Be prepared to travel.

I know it’s a lot of effort. But you have to work at finding the right EP for you and your Atrial Flutter.

Learn more about Flutter: Most of the information on applies to Atrial Flutter too. But I have also written specifically about Atrial Flutter.

So, I offer you a list of my top articles about Atrial Flutter. See My Top 5 Articles About Atrial Flutter.

Reference for this article
Thanks to Embry Rucker for this excellent question.

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 disrupt 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 Ophthalmologist: 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, lipomas, 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.

Our Video Library and My Top 5 Picks for the Newly Diagnosed

We have screened hundreds of A-Fib-related videos over the years and have carefully selected a short list for you. Our A-Fib library of videos and animations are for the reader who learns visually through motion graphics, audio, and personal interviews. These short videos are organized loosely into three levels:

Browse our curated A-Fib Video Library

♥ Introductory/Basic Level is for the newly diagnosed patient. Fundamentals of the heart’s electrical system, stroke risk and anticoagulation therapy, ECG/EKG, and catheter/surgical treatments. Helpful for the family and friends of an A-Fib patient, too.

♥ Intermediate Level is for the more informed patient. Videos offer details of the heart’s functions, types of heart monitoring devices, specifics of catheter ablation, maze and hybrid surgeries, and closure of the Left Atrial Appendage.

♥ Advanced Level videos offer a more extensive look at cardioversion, ECGs/EKGs, ejection fraction, catheter ablations/EP lab and maze/mini-maze surgeries. (May requires basic understanding of cardiac anatomy and A-Fib physiology.)

We invite you to browse our A-Fib library of videos and animations and try out a few of our titles.

Top 5 Videos for the Newly Diagnosed Patient

The newly diagnosed A-Fib patient has lots of questions. What is A-Fib? How do I deal with my symptoms? What are my treatment options? How does it impact my family? For answers, start with these videos.

1. Introduction to How a Normal Heart Pumps Blood

Heart Pumps

A short video about the path of a red blood cell through the heart’s four chambers to deliver oxygen to the body and then return to be re-oxygenated. Animation with narration. (Don’t worry about remembering the terminology, just follow the flow of the red blood cell). By The Children’s Hospital of Philadelphia.  (1:00 min.) Go to video.

2. Stroke Prevention in A-Fib and Anticoagulant Therapy

Treatment for stroke prevention in AFThrough interviews and animations explains how atrial fibrillation can cause stroke and why anticoagulation is so important; Discussion of: warfarin (Coumadin), the required monitoring, interactions with food, alcohol and other drugs: newer anticoagulants (NOACs) that do not require regular testing, aren’t affected by foods [but are expensive]. On-camera interviews with AF Association CEO, Trudie Lobban MBE and other experts (5:36)  Developed in association with the drug maker, Boehringer Ingelheim. Go to video.

3. The EKG Signal and Conduction System of the Heart

A-Fib EKG Signal video at

The EKG signal

Excellent illustration of the heart and a fully labeled graphic of theConduction System of the Heart’. Descriptive text accompanies each step in the animation. First a normally beating heart, the electrical signal path and corresponding EKG tracing. Then the same heart in Atrial Fibrillation with EKG tracing of the heart in A-Fib. Go to video on the American Heart Association website.

4. About Magnesium Deficiency with Dr. Carolyn Dean

C. Dean, MD

C. Dean, MD

Most A-Fib patients are deficient in Magnesium.The Best Way to Supplement Magnesium with Dr. Carolyn Dean, the author of The Magnesium Miracle. Getting nutrients through food is not always possible; discusses side effects of too much and how you can tell if you have a deficiency. (3:39). Go to video. See also: Importance of Balancing Calcium & Magnesium“ (1:00)

5. When Drug Therapy Fails: Why Patients Consider Catheter Ablation Drug Therapy Fails-Catheter Ablation

Why Ablation?

Dr. Susan M. Sharma discusses why patients with atrial fibrillation turn to ablation when drug therapy doesn’t work. Presenting research findings by David J. Wilber MD; Carlo Pappone, MD, Dr. Sharma discusses the success rates of drug therapy versus catheter ablation. Transcript of the narration is provided. (3:00 min.) From Go to video.

Disclaimer: Videos provided for your convenience only; we make no endorsement of a specific treatment, physician or medical facility.

For more videos,
visit our Video Library

Steve Ryan Videos

We’ve edited Steve’s most interesting radio and TV interviews to create several short (3-5 min.) videos. Check out Videos Featuring Steve S. Ryan, PhD, publisher of

Updated Article: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors

We’ve updated our Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I) with new models of chest bands/wristwatches sets, Bluetooth versions and wearable technologies.

A consumer heart rate monitor (HRM) is useful when Atrial Fibrillation patients want to monitor their heart rate and pulse when exercising or when performing physically demanding activities.

To our section on handheld real-time ECG monitors, we added the Contec PM-10. Our recent review read in part:

Illustration: Three ways to hold the Contec PM-10 when taking an ECG scan at

Three ways to hold the Contec PM-10 when taking an ECG scan

“The Contec PM10 (about $79 on is a very easy-to-use small 4 oz. unit that can track a single channel ECG waveform. You can observe the scan live, then download the recordings (up to 30) to your computer or smartphone for review and print to share with your doctor.” Read the full review.


From Sensoria Fitness

“Wearable technology” offers a new option for those who find a chest strap uncomfortable or chafing. Instead of the chestband, these workout clothes have sensors built-in. Just snap on your heart rate sensor from your chestband. Starting at $75.

♥  Sensoria Fitness Men’s T-Shirt with standard sensor snaps (no heart rate sensor)
♥  Sensoria Fitness Sports Bra with standard sensor snaps (no heart rate sensor)

To read the updated article, go to: Guide to DIY Heart Rate Monitors (HRMs) & Handheld ECG Monitors (Part I)

Not to be Confused with Optical Fitness Wristbands

Optical LEDs on inside of fitness wristband

The HRM sensors/monitors in our guide work by being in contact with the skin. Don’t confuse DIY/consumer heart rate monitors with fitness bands like Fitbit or running/sport watches.

This group of fitness wristbands use an optical sensor to shine a light on your skin illuminating your capillaries to measure your pulse. Optical sensor wristbands are not accurate enough for A-Fib patients.

For more, see my article: When Tracking Your Heart: Is a Wrist-Worn Heart Rate Monitor Just as Good as a Chest Strap Monitor?

Does Size Matter? What’s the Size of Your Left Atrium?

When in A-Fib, your left atrium has to work harder than normal and tends to stretch and dilate over time. Thus, an enlarged heart, specifically your left atrium, can be one symptom of living with Atrial Fibrillation.

Other contributors to an enlarged left atrium are obstructive sleep apnea (OSA) and high blood pressure. Also, people with a naturally large or tall body size often have an enlarged left atrium (ELA).

Consequences of an Enlarged Left Atrium

One study showed that Persistent A-Fib was associated with left atrium size (but not the number of years that a patient had A-Fib).

Left atrium size is a predictor of mortality due to cardiovascular issues.

Left atrium size has been found to be a predictor of mortality due to both cardiovascular issues as well as all-cause mortality (although other factors may contribute).

As a result, some medical centers won’t do a Pulmonary Vein Ablation (Isolation) procedure if the left atrium is enlarged (over 5.5 cm). However, with the newer ablation techniques, other centers will. Surgeons also are reluctant to operate on someone with an enlarged heart.

Normal left atrium: 2.0-4.0 cm

Left Atrium Size: Normal vs Enlarged

An enlarged left atrium can be diagnosed and measured using an echocardiogram (ECHO). A normal left atrium measures around 2.0-4.0 cm (20 mm–40 mm).

Ranges: Left atrial enlargement can be mild, moderate or severe depending on the extent of the underlying condition.

Note: Measurement of the volume is preferred over a single linear dimension since enlargement can be different for different directions.

Why You Need to Know Your Measurement

If you’ve had A-Fib for a while with significant symptoms, we often advise you to ask your doctor for this measurement to see if your left atrium is being enlarged.

To rank the size of your atrium, see TABLELeft Atrial Size
It will be described in either centimeters (i.e. 2.0 cm) or millimeters (i.e. 20 mm).

Store this info with your other A-Fib test results and other papers in your A-Fib Binder or folder. This will be your benchmark for future comparison.

To rank the size of your atrium, go to TABLE: Indexing the Left Atrial Size

Resources for this article
• Margolese, R G, et al. Cancer Medicine (e.5 ed.). Hamilton, Ontario: B.C. Decker. ISBN 1-55009-113-1. Retrieved 27 January 2011.

• Allen NE, et al. (March 2009). “Moderate alcohol intake and cancer incidence in women”. Journal of the National Cancer Institute. 101 (5): 296–305. doi:10.1093/jnci/djn514.

• Lang RM, et al. “Recommendations for chamber quantification”. European Journal of Echocardiography. (2006) 7 (2): 79–108.  PMID 16458610. doi:10.1016/j.euje.2005.12.014. Retrieved 2012-08-26.

• Left atrial enlargement. Wikipedia, the free encyclopedia. Last edited 20 March 2018,

My Top 5 Articles About Atrial Flutter

You can have A-Fib without Flutter and A-Flutter without A-Fib. But more often than not, they are linked.

Atrial Flutter can be considered as a milder or more ‘organized’ form of A-Fib. But A-Flutter is still as dangerous as A-Fib. If you have A-Flutter, A-Fib often lurks in the background or develops later.

While most of the information on applies to Atrial Flutter too, I offer you a list of my top articles about Atrial Flutter.

• FAQ: Does your information about atrial fibrillation apply to a-flutter, as well?

• Research: Atrial Fibrillation and Atrial Flutter: Cause and Effect? 

• Q & A: They want to do an A-Flutter-only ablation on me. Will that help me? I definitely have A-Flutter and possibly A-Fib as well.”

• Patient Advice: Reader With A-Flutter Advises Two Lifestyle Changes.

•  FAQ: A-Fib and Flutter—I have both. Does one cause the other?

Additional reference: For an in depth article about Atrial Flutter see the post by Dr. John Mandrola, Atrial Flutter—15 facts you may want to know. Published on

New Video: Impact of Lifestyle Factors on Patients with Atrial Fibrillation with John Mandrola, MD

We’ve posted a new video with Dr. John Mandrola, MD, a cardiac electrophysiologist from Louisville, KY (Patti’s hometown).

Dr Mandrola on Impact of Lifestyle Factors on A-Fib

In this interview, Dr Mandrola talks about the impact of lifestyle factors on patients with atrial fibrillation. He explains how in the past 5–10 years doctors have started to understand that A-Fib can be caused through “upstream” factors that affect atrial health, things that stretch the atrium like high blood pressure, obesity, diabetes, even stress and anxiety, and over exercise like endurance exercise.

He describes how managing these risk factors can reduce the patient’s risk of stroke, and make a significant impact on the patient’s heart rhythm and overall health. (5:29) Go to video->

Dr John Mandrola is the chief cardiology correspondent for Medscape—a web resource for health professionals (see ‘Trials and Fibrillations with Dr John Mandrola’). In addition, he maintains a general health and fitness blog, Dr John M, and is active on social media, especially Twitter, where he can be found @DrJohnM.

The Costs and Consequences of Living with Atrial Fibrillation

Our mission at is, in part, “to empower patients to find their A-Fib cure or best outcome.” We often advise:

Don’t listen to doctors who want to just control your symptoms with drugs. Leaving patients in A-Fib overworks the heart, leads to fibrosis and increases the risk of stroke. The abnormal rhythm in your atria causes electrical changes and enlarges your atria (called remodeling) making it work harder and harder over time. Seek your Cure.

A Few CDC Facts About A-Fib

I was recently reminded of the other costs of living with Atrial Fibrillation when I re-read the  A-Fib Fact sheet from the U.S. Centers for Disease Control and Prevention.

In part it reads: “More than 750,000 hospitalizations [in the U.S.] occur each year because of Atrial Fibrillation (A-Fib). The death rate from A-Fib as the primary or a contributing cause of death has been rising for more than two decades.”

The A-Fib stat that jumped out at me was:

“Medical costs [in the U.S.] for people who have A-Fib are about $8,705 higher per year than for people who do not have A-Fib.”

How disconcerting! A-Fib costs you in many ways. Beyond the physical, mental and emotional toll, staying in A-Fib with medication is costly to your wallet. Besides the annual costs of your medications, the odds of your being hospitalized increases. Just in terms of dollars and cents, A-Fib on average costs you an additional $8,700 a year.

To learn more, read my editorial, Leaving the Patient in A-Fib—No! No! No!

How Much Will You Pay to Stay in A-Fib?

Remember: ‘A-Fib begets A-Fib.’ The longer you have A-Fib, the greater the risk of your A-Fib episodes becoming more frequent and longer, often leading to continuous (Chronic) A-Fib. (However, some people never progress to more serious A-Fib stages.)

When you add up all the costs (physical, emotional and monetary) of living in A-Fib, doesn’t it make sense to ‘Seek you Cure’?

Don’t let your doctor leave you in A-Fib. Educate yourself. Learn all your treatment options.

Resources for this Article

• Agency for Healthcare Research and Quality. Weighted national estimates. HCUP National Inpatient Sample [online]. 2012. [cited 2015 Feb 9]. Available from:

• Centers for Disease Control and Prevention. About multiple cause of death 1999–2011. CDC WONDER Online Database. 2014. [cited 2014 Oct 2]. Available from:

• January CT, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. Journal of the American College of Cardiology. 2014;64(21):2246–80.

• Mozaffarian D, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–e322

• Atrial Fibrillation Fact Sheet. Last reviewed August 2017. National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention.

Causes: How Do You Get Atrial Fibrillation? What Triggers A-Fib?

Expanding your understanding of A-Fib is a core mission here at Atrial Fibrillation: Resources for Patients ( In that effort, one of our core content pages is Causes of A-Fib.

(A ‘core page’ answers one of the basic questions you [and your family] have about developing or being diagnosed with Atrial Fibrillation.)

Causes of A-Fib at

Causes of A-Fib

Review of Causes and Triggers

Expand or fill in any gaps in your understanding of A-Fib. Our basic review of the various causes of Atrial Fibrillation covers: Heart Problems, Alcohol Consumption, Severe Body Distress, Mental Stress, Being Overweight and Genetics.

After the list of causes, we then review some of the Triggers that can bring on your A-Fib. We cover: Food-Related Triggers, Sleep Apnea, Mechanically-Induced A-Fib, Physical and Gender Characteristics, Aging and ‘No Known Cause’. Go to What Causes A-Fib?

The Pursuit of Knowledge

The more you understand about Atrial Fibrillation, the better you can cope with your symptoms—and the better you can strive to Seek Your Cure! 

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