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Home > Health
Conditions > Atrial Fibrillation
Atrial Fibrillation/Cardiac Arrhythmia
Alternative News:
-
FDA Approves Fitbit's AFib-Detection
Software - Medscape, 4/12/22 - "The algorithm will
be the basis of an upcoming Fitbit feature called Irregular Heart Rhythm
Notifications ... The algorithm works by using an optical measurement method
called photoplethysmography (PPG), along with heart rate input from the Fitbit's
photodetector device ... The upcoming Irregular Heart Rhythm Notifications
feature will complement the existing ECG app, providing two ways to detect AFib
... Undiagnosed atrial fibrillation can lead to strokes, and early detection of
atrial fibrillation may allow doctors to prescribe medications that are
effective at preventing strokes" - See
Fitbit at Amazon.com.
-
Effects of Vitamin D
Supplementation and 25-Hydroxyvitamin D Levels on the Risk of Atrial
Fibrillation - Am J Cardiol 2022 Mar 31 - Am J Cardiol 2022 Mar 31 -
"vitamin D (Vit-D) deficiency and Vit-D treatment (VDT)
... individuals with low 25-hydroxy-Vit-D ([25-OH]D) levels (<20 ng/ml) were
divided into group-A (untreated, levels ≤20 ng/ml), group-B (treated, levels 21
to 29 ng/ml), and group-C (treated, levels ≥30 ng/ml) ... Among the individuals
receiving VDT for ≥6 months, the risk of AF was significantly lower in group-B
(hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.80 to 0.98, p = 0.03]
and group-C (HR 0.84, 95% CI 0.73 to 0.0.95, p = 0.007] than in group-A. A
subgroup analysis of men >65 years showed individuals with hypertension had a
significantly lower risk of AF in group-C than in group-B (HR 0.79, CI 0.65 to
0.94, p = 0.02) and group-A (HR 0.78, CI 0.64 to 0.96, p = 0.012). A similar
result was found in men >65 years with diabetes mellitus in group-C compared
with group-B (HR 0.69, CI 0.51 to 0.93, p = 0.012) and group-A (HR 0.63, CI 0.47
to 0.84" - See vitamin D at Amazon.com.
-
Good
news for coffee lovers: Daily coffee may benefit the heart - Science Daily,
3/24/22 - "Drinking coffee -- particularly two to three
cups a day -- is not only associated with a lower risk of heart disease and
dangerous heart rhythms but also with living longer ... Participants' average
age was 57 years and half were women. In general, having two to three cups of
coffee a day was associated with the greatest benefit, translating to a 10%-15%
lower risk of developing coronary heart disease, heart failure, a heart rhythm
problem, or dying for any reason ... The second study included 34,279
individuals who had some form of cardiovascular disease at baseline. Coffee
intake at two to three cups a day was associated with lower odds of dying
compared with having no coffee. Importantly, consuming any amount of coffee was
not associated with a higher risk of heart rhythm problems, including atrial
fibrillation (AFib) or atrial flutter, which Kistler said is often what
clinicians are concerned about. Of the 24,111 people included in the analysis
who had an arrhythmia at baseline, drinking coffee was associated with a lower
risk of death. For example, people with AFib who drank one cup of coffee a day
were nearly 20% less likely to die than non-coffee drinkers ... coffee beans
actually have over 100 biologically active compounds. These substances can help
reduce oxidative stress and inflammation, improve insulin sensitivity, boost
metabolism, inhibit the gut's absorption of fat and block receptors known to be
involved with abnormal heart rhythm ... In a third study, researchers looked at
whether there were any differences in the relationship between coffee and
cardiovascular disease depending on whether someone drank instant or ground
coffee or caffeinated or decaf. They found, once again, two to three cups a day
to be associated with the lowest risk of arrhythmias, blockages in the heart's
arteries, stroke or heart failure regardless of whether they had ground or
instant coffee ... Decaf coffee did not have favorable effects against incident
arrhythmia but did reduce cardiovascular disease, with the exception of heart
failure"
-
Only
alcohol -- not caffeine, diet or lack of sleep -- might trigger heart rhythm
condition - Science Daily, 11/24/21 - "Participants
in the randomized clinical trial utilized a mobile electrocardiogram recording
device along with a phone app to log potential triggers like drinking alcohol
and caffeine, sleeping on the left side or not getting enough sleep, eating a
large meal, a cold drink, or sticking to a particular diet, engaging in
exercise, or anything else they thought was relevant to their AF. Although
participants were most likely to select caffeine as a trigger, there was no
association with AF. Recent research from UCSF has similarly failed to
demonstrate a relationship between caffeine and arrhythmias -- on the contrary,
investigators found it may have a protective effect ... The new study
demonstrated that consumption of alcohol was the only trigger that consistently
resulted in significantly more self-reported AF episodes."
-
High-Dose Omega-3s Tied to
Higher Risk for Atrial Fibrillation - Medscape, 10/11/21 -
"Overall, use of omega-3 fatty acids was associated with
a 25% increased risk for AF"
-
Omega-3 fatty acids in
adipose tissue and risk of atrial fibrillation - Eur J Clin Invest 2021 Jul
7 - "Participants in the highest vs. the lowest quintile
of EPA experienced a 45% lower risk of AF (men HR 0.55 (95% CI 0.41-0.69); women
HR 0.55 (0.41-0.72)). For DHA, no clear association was found in men, whereas in
women, participants in the highest quintile of DHA in adipose tissue had a 30%
lower risk of incident AF (HR 0.70 (0.54-0.91)) compared to participants in the
lowest quintile" - See omega-3 supplements at Amazon.com and
iHerb.
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Athletes Face Twice the Odds for A-Fib - WebMD, 7/13/21 -
"Overall, athletes had about a 2.5 times higher risk of
a-fib than non-athletes. But when the researchers focused on participants
without heart disease risk factors (such as type 2 diabetes and high blood
pressure), they found that athletes had nearly four times the risk of a-fib
compared to non-athletes"
-
One
small alcoholic drink a day is linked to an increased risk of atrial
fibrillation - Science Daily, 1/17/21 - "The study,
published today (Wednesday) in the European Heart Journal [1], found that,
compared to drinking no alcohol at all, just one alcoholic drink a day was
linked to a 16% increased risk of atrial fibrillation over an average (median)
follow-up time of nearly 14 years. This means that while four teetotallers in
100 might develop atrial fibrillation over the period of the study, five per 100
might develop the condition if they consumed alcohol starting with slightly more
than an alcoholic drink a week and more than 75% of them consumed up to one
drink a day [2]. The researchers categorised one alcoholic drink as containing
12 g of ethanol, which is the equivalent of a small (120 ml) glass of wine, a
small beer (330 ml) or 40 ml of spirits ... These findings are important as the
regular consumption of alcohol, the 'one glass of wine a day' to protect the
heart, as is often recommended for instance in the lay press, should probably no
longer be suggested without balancing risks and possible benefits for all heart
and blood vessel diseases, including atrial fibrillation"
-
Coffee Drinking Linked
With Fewer Arrhythmias - Medscape, 5/8/20 - "on
average each additional daily cup of coffee that people said they drank reduced
the incidence of arrhythmic episodes by a statistically significant 3%, compared
with those who drank fewer daily cups. The relationship held for people who
reported drinking as many as five or six cups of coffee daily"
-
Coffee Drinking Linked
With Fewer Arrhythmias - Medscape, 5/8/20 - "on
average each additional daily cup of coffee that people said they drank reduced
the incidence of arrhythmic episodes by a statistically significant 3%, compared
with those who drank fewer daily cups. The relationship held for people who
reported drinking as many as five or six cups of coffee daily"
-
Higher Protein Intake
Linked to Lower Risk of AF - Medscape, 4/3/20 - "the
average American eats an estimated 3600 calories/day — 50% from carbohydrates,
35% from fat, and only 15% from protein ... This translates to 540 calories per
day from protein, which is 135 g (since 1 g of protein has 4 calories), "which
is more than enough protein for the average person ... There does appear to be a
'sweet spot' with regard to protein intake, at around 58 to 74 grams per day,
along with a 'ceiling effect' above 74 grams per day, where more protein intake
is no longer beneficial ... most people would be far healthier and leaner by
reducing their total caloric intake from carbohydrates and fats while eating a
proportionally higher protein diet closer to 25% of their total calories.""
- Not sure if that quote makes sense. The average is 135 but best is 58 to
74 so we need to increase it? - See whey
protein at Amazon.com.
-
Effects of Omega-3 Fatty
Acid Supplements on Arrhythmias - Medscape, 3/13/20 -
"In conclusion, evidence from large trials now suggests
that omega-3 FA supplementation may have a dose-related protective effect on
coronary events. However, systematic reporting of arrhythmia outcomes in
existing and future trials is required to clarify whether supplementation also
has any adverse effects on nonfatal arrhythmias" - See
omega-3 supplements at Amazon.com.
-
Brush
your teeth to protect the heart - Science Daily, 12/2/19 -
"Tooth brushing three or more times a day was associated
with a 10% lower risk of atrial fibrillation and a 12% lower risk of heart
failure during 10.5-year follow up ... While the study did not investigate
mechanisms, one possibility is that frequent tooth brushing reduces bacteria in
the subgingival biofilm (bacteria living in the pocket between the teeth and
gums), thereby preventing translocation to the bloodstream"
-
Randomized study of the
effects of cocoa-rich chocolate on the ventricle-arterial coupling and vascular
function of young, healthy adults - Nutrition. 2019 Feb 27;63-64:175-183 -
"Half of the participants ingested a 20-g dose of lower cocoa
chocolate (LCC;
~55%; 12.6 +/- 1.4 mg equivalent of epicatechin/g) and the others ingested a daily
dose of 20 g of higher cocoa chocolate (HCC; ~90%; 18.2 +/- 2.6 mg equivalent of
epicatechin/g) ... A statistically significant improvement was depicted over the
brachial and central systolic and pulse pressures in the HCC group, and a trend
for improvement in the reflected waves component (Aix) and the FMS was also
observed in the HCC, but not in the LCC group ... regular consumption of HCC has
beneficial effects on the cardiovascular system in young, healthy adults,
improving vascular function by reducing central brachial artery pressures and
promoting vascular relaxation, and thus enhancing the matching of the arterial
system with the left ventricle" - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz.,
86% Cacao (Pack of 4) at Amazon.com
 .
-
Fitness Linked to Lower
Ventricular Arrhythmia Risk Later - Medscape, 4/26/19 -
"That better aerobic fitness apparently protects against
potentially fatal arrhythmias in the future, and that it can be easily assessed
clinically during an exercise test, supports respiratory gas exchange
measurement of CRF as a routine part of patient assessments"
-
Melatonin's heart protective effects not related to its antioxidant properties
- Science Daily, 4/9/19 - "Antiarrhythmic agents
are substances that treat irregular electrical activity in the heart. Melatonin
has previously been shown to have antiarrhythmic effects, with the assumption
that this was due to its known antioxidant properties ... One group of rats was
given 10 mg of melatonin daily for seven days, while another received a placebo.
Researchers then measured the electrical activity in the rats' hearts before,
during and after a cardiac event. They later examined the hearts for measures of
oxidative stress and antioxidant activity ... Ventricular tachycardia (VT) and
ventricular fibrillation (VF) are two kinds of dangerous irregular electrical
activity in the heart that can result from a heart attack. Incidence of both VT
and VF was reduced in melatonin-treated rats. A marker of antioxidant activity
was also higher in the treated rats. However, there was no association between
the presence of oxidative stress and incidence of irregular electrical activity
... In previous work, the research team observed that blocking
melatonin-specific receptors removed the antiarrhythmic benefit of melatonin.
When taken together with this current study, these results suggest that
melatonin's protective effects for the heart "are related to its antiarrhythmic
action, and this effect is related not to antioxidative properties but to
melatonin receptor stimulation,"" - See
melatonin at Amazon.com
 .
-
Novel
electrocardiogram uses signals from ear and hand to check heart rhythm -
Science Daily, 3/17/19 - "Mobile ECG devices present a major opportunity to
detect atrial fibrillation, the most common heart rhythm disorder, and thereby
prevent strokes and reduce hospitalisations. All commercially available portable
ECG devices require both hands, but what if symptoms happen while driving?" -
See heart rate monitors at Amazon.com.
-
Low-carb
diet tied to common heart rhythm disorder - Science Daily, 3/6/19 -
"People getting a low proportion of their daily calories
from carbohydrates such as grains, fruits and starchy vegetables are
significantly more likely to develop atrial fibrillation (AFib), the most common
heart rhythm disorder ... People with AFib are five times more likely to have a
stroke than people without the condition. It can also lead to heart failure ...
Restricting carbohydrates has become a popular weight loss strategy in recent
years. While there are many different low-carbohydrate diets including the
ketogenic, paleo and Atkins diets, most emphasize proteins while limiting intake
of sugars, grains, legumes, fruits and starchy vegetables ... Low carbohydrate
diets were associated with increased risk of incident regardless of the
type of protein or fat used to replace the carbohydrate ... Participants
reporting low carbohydrate intake were the most likely to develop AFib. These
participants were 18 percent more likely to develop AFib than those with
moderate carbohydrate intake and 16 percent more likely to develop AFib than
those with high carbohydrate intake"
-
9 Signs of Magnesium Deficiency You
Should Know - YouTube - Doctor claims that low magnesium can contribute to
AFib.
-
The citrus flavanone
hesperetin preferentially inhibits slow-inactivating currents of an LQT3
syndrome Na+ channel mutation - Br J Pharmacol. 2019 Jan 16 -
"lethal
ventricular arrhythmias in the Long QT syndrome subtype 3 (LQT3) ... HSP
preferentially inhibits the slow inactivation phase of INa , more markedly in
the mutant R1623Q. HSP could be used as a template to develop drugs against
lethal cardiac arrhythmias in LQT3" - See
hesperidin at Amazon.com.
-
Too Much Salt Might Help Spur A-Fib - WebMD, 12/7/18 -
"Those with the highest levels of salt in their diet had
a higher rate of atrial fibrillation than those with the lowest salt intake.
After accounting for several other risk factors -- including age, body fat,
blood pressure and smoking -- the researchers found that salt consumption was
independently associated with the risk of atrial fibrillation"
-
Poor
sleep quality linked to atrial fibrillation - Science Daily, 6/26/18 -
"individuals with more frequent nighttime awakenings
while trying to sleep more often carried a diagnosis of AF ... Within a subset
of these individuals who had undergone formal sleep studies, they found that
less REM sleep in particular predicted future AF ... These results provide more
evidence that sleep quality is important to cardiovascular health and
specifically to AF ... While there are several available treatments for AF,
prevention of the disease would be ideal. The good news is that sleep quality
can be modifiable and is something that at least to some degree is under the
control of the individual. It's possible that improving sleep hygiene, such as
performing regular exercise, getting to bed at a reasonable hour on a regular
basis, and avoiding viewing screens before bed as well as caffeine later in the
day, might help stave off AF"
-
Substance in Chinese medicine can cause cardiac arrhythmia - Science Daily,
5/2/18 - "A medicinal plant frequently used in
Traditional Chinese Medicine (TCM) -- Evodia rutaecarpa -- contains substances
that can cause cardiac arrhythmia ... investigated the effect of Evodia extracts
in collaboration with pharmacologists and toxicologists from the University of
Vienna. The natural substances dehydroevodiamine (DHE) and hortiamine isolated
from the plant in Basel proved to be very potent inhibitors of potassium
channels in the heart muscle. If these channels are blocked, the excitation
processes in the heart muscle change, which can trigger severe heart rhythm
disturbances -- so-called Torsade de pointes (TdP) -- and ventricular
fibrillation and lead to sudden cardiac death" - But if you search
Amazon for Evodia extracts, it doesn't look like a popular product.
-
Vitamin D Status at ICU
Admission May Predict A-Fib and Bedsores - Medscape, 2/28/17 -
"Patients with Vitamin D levels below 20 ng/mL were
nearly four times as likely to develop new-onset atrial fibrillation, with an
odds ratio of 3.59 (95% CI, 1.01–12.70). On regression analysis, the risk for
the condition decreased by 15% for each unit increase in vitamin D ... A second
study of 402 surgical ICU patients found that 11 percent developed
hospital-acquired pressure ulcers. Patients with vitamin D levels below 20 ng/mL
were more than twice as likely to develop the ulcers (OR 2.51; 95% CI,
1.06–5.97). On regression analysis, the risk of ulcers fell by 11% with each
unit increase in vitamin D" - See
vitamin D at Amazon.com.
-
Vitamin
C may decrease risk of atrial fibrillation after cardiac surgery - Science
Daily, 2/1/17 - "The single study on the recurrence of
AF after a successful cardioversion, which was carried out in Greece, found that
vitamin C decreased the risk of AF recurrence by 87% ... In the non-US cardiac
surgery trials, vitamin C decreased the length of hospital stay by 12.6% and
intensive care unit stay by 8.0% ... Oral administration of vitamin C decreased
the occurrence of post-operative AF by 73%, whereas intravenous administration
decreased it by 36%. On the other hand, oral administration shortened the length
of hospital stay by only 7% (0.4 days), whereas intravenous administration
decreased it by 16% (1.5 days). Thus, the effect of intravenous vitamin C
administration was greater for the length of hospital stay, but less for the
occurrence of post-operative AF" - See
American Health Products - Ester C W/Citrus Bioflavonoids, 1000 mg, 180 veg tablets at Amazon.com
 .
-
Metformin and Lower AF Risk
Among Patients With T2DM - Medscape, 10/13/14 -
"After adjusting for co-morbidities and medications, metformin independently
protected the diabetic patients from new-onset AF with a hazard ratio of .81
(95% confidence interval 0.76–0.86, p < 0.0001). Metformin significantly
decreased the extent of pacing-induced myolysis and the production of reactive
oxygen species" - [Abstract]
- See
metformin at The Antiaging Store.
-
U-shaped
curve revealed for association between fish consumption and atrial fibrillation
- Science Daily, 6/24/13 - "The study found a U-shaped
association between consumption of marine n-3 polyunsaturated fatty acids (n-3
PUFA) and the risk of developing AF, with people who have both low and high
intakes found to suffer more from AF than those with median intakes. The lowest
risk of AF was found in those who consumed around 0.63 g marine n-3 PUFA per
day, which corresponds to around two servings of fatty (oily) fish per week ...
Earlier studies have reported that regular consumption of fish can exert
beneficial effects in preventing the development of AF. Notably, in the
Cardiovascular Health study², which included 4,815 participants, a 28% lower
risk of AF was observed among people who consumed fish one to four times per
week compared with those who ate fish less than once per month. However, such
observed associations have not been confirmed in all cohort studies"
-
CKD and Low
Magnesium: Pay Attention - Medscape, 2/6/13 - "When
adjusted for differences in age and sex among quartiles, the lowest magnesium
group had the highest incidence of new atrial fibrillation events (9.4 episodes
per 1000 person-years). The rates for the other 3 quartiles were quite similar
(6.9, 7.1, and 6.3 events per 1000 person-years for the second, third, and
fourth quartiles, respectively). In multivariable models controlled for the
multiple potential differences including glomerular filtration rate, those with
the lowest levels of magnesium continued to be at highest risk for the
development of atrial fibrillation (hazard ratio, 1.48; 95% confidence interval,
1.02- 2.14; P = .04)" - See magnesium supplements at Amazon.com.
-
Low Serum
Magnesium and the Development of Atrial Fibrillation in the Community: The
Framingham Heart Study - Circulation. 2012 Nov 21 -
"We studied 3,530 participants (mean age, 44 years; 52% women) from the
Framingham Offspring Study who attended a routine examination, and were free of
AF and cardiovascular disease ... 20 years of follow-up ... The age- and
sex-adjusted incidence rate of AF was 9.4 per 1,000 person-years (95% confidence
interval, 6.7 to 11.9) in the lowest quartile of serum magnesium (≤1.77 mg/dl),
compared with 6.3 per 1,000 person-years (95% confidence interval, 4.1 to 8.4)
in the highest quartile (≥1.99 mg/dl). In multivariable-adjusted models,
individuals in the lowest quartile of serum magnesium were approximately 50%
more likely to develop AF (adjusted hazard ratio, 1.52, 1.00 to 2.31; P=0.05),
compared with those in the upper quartiles ... Because hypomagnesemia is common
in the general population, a link with AF may have potential clinical
implications" - See Jarrow
Formulas, Magnesium Optimizer Citrate, 100 Easy-Solv Tablets at iHerb.
-
Association
of Plasma Phospholipid Long-Chain Omega-3 Fatty Acids with Incident Atrial
Fibrillation in Older Adults: The Cardiovascular Health Study - Circulation.
2012 Jan 26 - "In multivariable Cox models adjusted for
other risk factors, the RR in the top versus lowest quartile of total n-3 PUFA
(EPA+DPA+DHA) levels was 0.71 (95%CI=0.57-0.89, P-trend=0.004); and of DHA
levels, 0.77 (95%CI=0.62-0.96, P-trend=0.01). EPA and DPA levels were not
significantly associated with incident AF. Evaluated non-parametrically, both
total n-3 PUFA and DHA showed graded and linear inverse associations with
incidence of AF" - See
Mega Twin EPA at Amazon.com
and
Jarrow Max DHA at Amazon.com.
-
Effect of
Dietary Fish Oil on Atrial Fibrillation After Cardiac Surgery - Am J
Cardiol. 2011 Jul 13 - "Two hundred patients were
randomized to receive fish oil (providing 4.6 g/day of long-chain ω-3 fatty
acids) or a control oil starting 3 weeks before surgery; 194 subjects completed
the study, with 47 of 97 subjects in the control group and 36 of 97 subjects in
the fish oil group developing AF (odds ratio 0.63, 95% confidence interval [CI]
0.35 to 1.11). There was a nonstatistically significant delay in time to onset
of AF in the fish oil group (hazard ratio 0.66, 95% CI 0.43 to 1.01). There was
a significant decrease in mean length of stay in the intensive care unit in the
fish oil group (ratio of means 0.71, 95% CI 0.56 to 0.90). In conclusion, in a
mixed cardiac surgery population, supplementation with dietary fish oil did not
result in a significant decrease in the incidence of postsurgical AF. However,
there was a significant decrease in time spent in the intensive care unit"
- See
Mega Twin EPA at Amazon.com
and
Jarrow Max DHA at Amazon.com.
-
Slowing a Speedy Heart Rate? - Dr. Weil, 4/29/10
-
Influence of coffee and caffeine consumption on atrial fibrillation in
hypertensive patients - Nutr Metab Cardiovasc Dis. 2010 Feb 16 -
"Coffee and caffeine consumption influence
spontaneous conversion of atrial fibrillation. Normotensive non-habitual
coffee consumers are more likely to convert arrhythmia within 48h from the
onset of symptoms. Hypertensive patients showed a U-shaped relationship
between coffee consumption and spontaneous conversion of AF, moderate coffee
consumers were less likely to show spontaneous conversion of arrhythmia.
Patients with left ventricular hypertrophy showed a reduced rate of
spontaneous conversion of arrhythmia"
-
Omega-3 fatty acid
supplementation reduces one-year risk of atrial fibrillation in patients
hospitalized with myocardial infarction - Eur J Clin Pharmacol. 2008 Feb
29 - "N-3 PUFA reduced the relative risk of the
hospitalization for AF [hazard ratio (HR) 0.19, 95% CI 0.07-0.51] and was
associated with a further and complementary reduction in all-cause mortality
(HR 0.15, 95% CI 0.05-0.46)" - See Mega Twin EPA at Amazon.com.
-
N-acetylcysteine for
the prevention of postoperative atrial fibrillation: a prospective,
randomized, placebo-controlled pilot study - Eur Heart J. 2008 Feb 8 -
"The result of this study indicates that NAC
treatment decreases the incidence of postoperative AF" - See
n-acetyl cysteine at Amazon.com.
-
Recurrence of Atrial Fibrillation Reduced With Alpha-Linolenic Acid-Enriched
Diet - Doctor's Guide, 10/17/07 - "The survival
rate was 25.52% in the control group versus 63.09% in the ALA group at the
end of the 12-month period" - Note: ALA is the shorter chain omega-3
found in vegetable sources such as flaxseed.
-
Fish Intake and Risk of Incident Atrial Fibrillation - Circulation. 2004
Jul 19 -
"Among elderly adults, consumption of tuna or other
broiled or baked fish, but not fried fish or fish sandwiches, is associated
with lower incidence of AF"
- Fish Containing N-3
Fatty Acids Reduce Risk of AF - Medscape, 7/19/04 -
"Intake of fatty fish containing N-3 fatty acids
reduces the risk of atrial fibrillation (AF), but fish sandwiches or fried
fish are not protective"
- See Mega Twin EPA at
Vitacost
or
iHerb.
Other News:
-
Outrunning AFIB: A Testimonial -
YouTube - Hit me in the heart because he's an athlete like me. It took three
ablations. I'm waiting for my first.
-
A
Life Without Afib: Victor’s Story - YouTube - A retired
military officer like me who also worked out all his life.
-
First-Line Catheter Ablation
of Monomorphic Ventricular Tachycardia in Cardiomyopathy Concurrent with
Defibrillator Implantation: The PAUSE-SCD Randomized Trial - Circulation
2022 May 4 - "Among patients with cardiomyopathy of
varied etiologies, early catheter ablation performed at the time of ICD
implantation significantly reduced the composite primary outcome of VT
recurrence, cardiovascular hospitalization, or death. These findings were driven
by a reduction in ICD therapies"
-
Impact of early ablation of
atrial fibrillation on long-term outcomes: results from phase II/III of the
GLORIA-AF registry - Clin Res Cardiol 2022 Apr 29 -
"A total of 25,963 patients (11733 [45.2%] females; median age 71 [IQR 64-78]
years; 17424 [67.1%] taking non-vitamin K antagonist oral anticoagulants
[NOACs]) were included. Over a follow-up period of 3.0 (IQR 2.3-3.1) years,
after adjustment for confounders, early AF ablation was associated with a
significant reduction in the composite outcome of all-cause death, stroke and
major bleeding (HR 0.50 [95% CI 0.30-0.85]) and all-cause death (HR 0.45 [95% CI
0.23-0.91]). There were no statistical differences between the groups in terms
of CV death, non-CV death, stroke and major bleeding"
-
Late Potential Abolition in
Ventricular Tachycardia Ablation - Am J Cardiol 2022 Apr 15 -
"Lack of use of a high-density mapping catheter (odds
ratio 6.2, 1.2 to 38.1; p = 0.028), the septal substrate (odds ratio 9.34, 2.27
to 38.4; p = 0.002), and larger left ventricular mass (190 ± 58 g vs 156 ± 46 g,
p = 0.002) were predictors of incomplete LP abolition"
-
Substrate Ablation vs
Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia - J Am
Coll Cardiol 2022 Apr 19 - "Patients were 1:1 randomized
to complete endocardial substrate-based catheter ablation or antiarrhythmic
therapy (amiodarone + beta-blockers, amiodarone alone, or sotalol ±
beta-blockers) ... After 24 months, the primary outcome occurred in 28.2% of
patients in the ablation group and 46.6% of those in the AAD group (hazard ratio
[HR]: 0.52; 95% CI: 0.30-0.90; P = 0.021). This difference was driven by a
significant reduction in severe treatment-related complications (9.9% vs 28.8%,
HR: 0.30; 95% CI: 0.13-0.71; P = 0.006). Eight patients were hospitalized for
heart failure in the ablation group and 13 in the AAD group (HR: 0.56 ... In ICD
patients with ischemic cardiomyopathy and symptomatic VT, catheter ablation
reduced the composite endpoint of cardiovascular death, appropriate ICD shock,
hospitalization due to heart failure, or severe treatment-related complications
compared to AAD"
-
Pulsed Field Ablation
Treats AF With Few Complications - Medscape, 4/14/22 - "In
an unselected population of patients with paroxysmal or persistent atrial
fibrillation (AF), the pentaspline pulsed field ablation (PFA) catheter achieved
pulmonary vein isolation with 99.9% success and good procedure times. ...
However, the investigators observed what they called a significant rate of
generic catheter complications, often seen with other AF catheter procedures ...
The relatively new PFA technology uses trains of microsecond-long,
high-amplitude electrical pulses. Rather than destroying tissue with heating as
with radio frequency ablation or with cold as with cryoablation, PFA creates
microscopic pores (electroporation) in the sarcolemma membrane of the myocardium
to ablate without significant heating ... If we look at the effectiveness, the
mean acute PVI success rate was quite high, 99.9%. The median was 100%. If you
look at the range, the lowest was 98.9%"
-
VT Ablation After First
ICD Shock - Medscape, 4/11/22 - "After a first
appropriate ICD shock, the primary composite endpoint of all-cause death or
hospitalization for worsening heart failure occurred over 2 years of follow-up
in 4.3% of 24 patients who underwent VT ablation within 2 months compared with
41.7% of 24 patients who received ablation only after an electrical storm"
-
Protective Effect of
Catheter Ablation of Atrial Fibrillation on the Renal Function in Patients With
Hypertrophic Cardiomyopathy - Am J Cardiol 2022 Apr 6 -
"During a mean follow-up period of 34 ± 27 months, sinus
rhythm was maintained in 36 patients (80%) after 1.7 ± 0.8 ablation procedures.
The eGFR significantly decreased from baseline to 3 months (p <0.01) and from
baseline to 1 year (p <0.01) in the control group, whereas the eGFR in the
ablation group was maintained both from baseline to 3 months (p = 0.94) and from
baseline to 1 year (p = 1.00) after the CA. The change in the eGFR between
baseline and 12 months was significantly smaller in the ablation group than in
the control group (p <0.01). After logistic regression analysis, CA of AF was
the independent predictor of an improvement of eGFR (odds ratio 2.81"
-
Liver failure caused by
intravenous amiodarone and effective intervention measures: A case report -
J Clin Pharm Ther 2022 Mar 23 - "Amiodarone is a highly
effective antiarrhythmic agent for the treatment and prevention of atrial and
ventricular arrhythmias. Acute liver damage after intravenous amiodarone is rare
but potentially harmful. Amiodarone loading should be adapted to the necessity
of an immediate effect of the drug, and liver function should be monitored
closely in critically ill patients. Timely stopped suspected drug and
anti-inflammatory liver therapy may reduce the occurrence of drug-induced
diseases"
-
Comparative effectiveness
and safety of non-vitamin K antagonists for atrial fibrillation in clinical
practice: GLORIA-AF Registry - Clin Res Cardiol 2022 Mar 16 -
"Patients treated with dabigatran had a 41% lower risk
of major bleeding compared with rivaroxaban, but similar risks of stroke, MI,
and death. Relative to apixaban, patients treated with dabigatran had similar
risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban
had increased risk for major bleeding, but similar risks for stroke, MI, and
death"
-
SGLT2 Inhibitor Use Tied
to Fewer Atrial Arrhythmias - Medscape, 12/2/21 -
"treatment with an SGLT2 inhibitor was tied to a significant 23% relative
reduction in atrial arrhythmia events and a 44% relative drop in all-cause death
... "We think that a reduction in left atrial pressure" produced by treatment
with an SGLT2 inhibitor "may be linked to the reduction in atrial arrhythmias."
- See
dapagliflozin at reliablerxpharmacy.com.
-
Long-term exposure to low levels of air pollution increases risk of heart and
lung disease - Science Daily, 2/22/21 - "Researchers
examined hospitalization records for more than 63 million Medicare enrollees in
the contiguous Unites States from 2000 to 2016 to assess how long-term exposure
to air pollution impacts hospital admissions for specific cardiovascular and
respiratory issues. The study measured three components of air pollution: fine
particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3). Using
hundreds of predictors, including meteorological values, satellite measurements
and land use to estimate daily levels of pollutants, researchers calculated the
study participants' exposure to the pollutants based upon their residential zip
code ... Data also showed there were surges in hospital admissions for all of
the health outcomes studied with each additional unit of increase in particulate
matter. Specifically, stroke rates increased by 2,536 for each additional ug/m3
(micrograms per cubic meter of air) increase in fine particulate matter each
year ... There was an increased risk of stroke and atrial fibrillation
associated with long-term exposure to nitrogen dioxide"
-
Randomized Trial of
Empagliflozin in Non-Diabetic Patients with Heart Failure and Reduced Ejection
Fraction - J Am Coll Cardiol 2020 Nov 9 -
"Empagliflozin administration to non-diabetic HFrEF patients significantly
improves LV volumes, LV mass, LV systolic function, functional capacity, and
quality of life when compared with placebo. Our observations strongly support a
role for SGLT2 inhibitors in the treatment of HFrEF patients independently of
their glycemic status"
-
SCORED and FIDELIO-DKD:
Time for Cardiologists to Help, Not Hurt, the Kidney - Medscape, 11/20/20 - 20 minute video on
empagliflozin (Jardiance).
I doubt if most cardiologists are even aware of this yet. -
"In terms of heart failure with reduced EF, these are
really well-tolerated medicines. I've been using dapagliflozin and empagliflozin
in my patients and found them to have good clinical outcomes and to be
clinically well tolerated, with minimal side effects"
-
Diabetes drug can treat and reverse heart failure and reduce hospitalizations
- Science Daily, 11/16/20 - "Empagliflozin, a recently
developed diabetes drug ... this medication can improve the heart's size, shape,
and function, leading to better exercise capacity and quality of life, which
will reduce hospitalizations for heart failure patients" - Note:
It's a $500/month medication.
-
EMPEROR-Reduced:
Empagliflozin's HFrEF Benefit Holds Steady on Top of Sacubitril/Valsartan -
Medscape, 10/7/20 - "When there are two very
effective treatments, it's common for people to ask: Which should I use?' The
goal of my presentation was to emphasize that the answer is both. We shouldn't
choose between neprilysin inhibition [sacubitril inhibits the enzyme neprilysin]
and SGLT2 [sodium-glucose transporter 2] inhibition; we should use both"
-
Which is the best pulse oximeter for home use? - consumerlab.com, 9/22/20 -
"As nicely summarized in an article on MedPage Today by Dr. Anthony Pierson, a
cardiologist, a model that has performed relatively well in studies is the
Contec CMS50DL (or a similar model the Contec CMS50D, from Contec Medical
Systems, China), currently sold on Amazon by a distributor (ClinicalGuard) for
just $19.95. As Dr. Pierson points out in his article, the
Contec CMS50DL has been shown to be fairly
accurate at normal oxygen saturation levels above 90% but, like similar
products, it may be less accurate below 90%" - See
oximeters at Amazon.com.
-
How Accurate Are Home Blood Oxygen Monitors? -
medpagetoday.com, 9/17/20 - "This
study has been widely reported as demonstrating that NMU
pulse oximeters are inaccurate and unreliable. However,
although four of the six oximeters did not meet FDA
standards for accuracy, the authors wrote that two
"unexpectedly" did meet accuracy standards defined by the
FDA and International Organization for Standardization: the
Beijing Choice C20 and
Contec CMS550DL."
-
Identifying, preventing and managing heart rhythm side effects of medicines
- AHA, 9/15/20 - "During the COVID-19 pandemic,
chloroquine, hydroxychloroquine and azithromycin have been used to manage the
novel coronavirus disease, noted the writing group. These medications can cause
heart rhythm disturbances, and there have been some clinical trials to assess
their effectiveness to treat COVID-19, including one National Institutes of
Health trial that was halted in June. In June and July, the U.S. Food and Drug
Administration revoked emergency use and issued a warning against the use of
hydroxychloroquine or chloroquine for the treatment of COVID-19 outside of a
clinical trial or hospital ... Heart rhythm disorders have been reported as a
side effect of hydroxychloroquine alone and in combination with azithromycin
among patients with COVID-19. Other medications proposed for managing COVID-19
such as lopinavir/ritonavir also have the potential to interfere with the
heart’s normal rhythm"
-
SAVE-ICD: For Some,
Sacubitril/Valsartan May Obviate Need for ICD - Medscape, 7/3/20 -
"After 6 months of therapy with the combination drug
sacubitril/valsartan (S/V; Entresto, Novartis), one quarter of primary
prevention patients with left heart failure and an implantable cardioverter
defibrillator (ICD) had a left ventricular ejection fraction (LVEF) > 35% with
no arrhythmic events"
-
FDA Approves Dapagliflozin
(Farxiga) for Low-EF Heart Failure - Medscape, 5/6/20 -
"In that study, treatment with dapagliflozin led to
about a one fourth reduction in risk of a primary endpoint consisting primarily
of CV death or heart-failure hospitalization in patients with chronic HFrEF, in
both those with and without diabetes ... The latest approval for patients with
NYHA functional class 3-4 HFrEF makes dapagliflozin the only SGLT2 inhibitor to
be indicated for heart failure in the absence of diabetes ... We have to think
of this as a drug that you would prescribe like an ACE inhibitor, or a
beta-blocker, or a mineralocorticoid receptor antagonist, or sacubitril/valsartan
[Entresto, Novartis]"
-
VICTORIA: Vericiguat Seen
as Novel Success in Tough-to-Treat, High-Risk Heart Failure - Medscape,
3/28/20
-
FDA Approves New Form of Device Therapy for Heart Failure, the Barostim Neo
- Medscape, 8/16/19 - "The approved FDA indication includes adults with
medically refractory advanced HF and an ejection fraction ≤ 35%who aren't good
candidates for other device therapies, especially cardiac resynchronization
therapy."
-
Beta
blockers can block the effects of stress and anger in patients prone to
emotion-triggered atrial fibrillation - Science Daily, 6/4/19 -
"patients taking beta blockers experienced anger
and stress as often as those not taking these medications, however, these
emotional episodes increased the odds of AF by just four times compared with 20
times in those not taking beta blockers. In participants taking beta blockers
not including anti-arrhythmic properties the effect was even stronger,
completely blocking the pro-arrhythmic effect of anger or stress"
-
Should ICDs in Primary
Prevention Go the Way of Aspirin? - Medscape, 5/19/19 -
"Over nearly 6 years of follow-up, implanting an ICD did
not result in a statistically significant reduction in the primary endpoint of
death ... The impetus for this research came from a meta-analysis of 12 heart
failure trials spanning a 20-year period that showed a statistically significant
44% decline in the rate of sudden death from old to new trials ... Relative to
the older trial, the rate of ventricular tachycardia (VT)/ventricular
fibrillation (VF) and death decreased by roughly 30% and 60%, respectively in
the newer trials ... They observed ICD-related complications in 195 (13.5%)
patients, including 113 (7.8%) with major complications. Nearly half the
complications occurred after 30 days; 106 (7.3%) patients required surgery to
deal with a complication. Five patients died of ICD-related complications ...
ICD proponents might push back and cite a systematic review of ICD complications
that found a lower 9% rate of complications in randomized, controlled trials
(RCTs) and a 3% rate in the National Cardiovascular Data Registry (NCDR).[15]
Two reasons you should favor the Dutch and Danish data are that RCTs typically
underestimate harms, in part because of the careful selection of "healthier"
patients, and the NCDR describes only complications around the time of the
implant ... At the same time, real-world data from reliable, contemporary
sources suggest significant harms from the device. As the population ages and
patients with heart failure live with more comorbid conditions, ICD complication
rates will likely increase" - Note: One of my pet peeves is
cardiologists that push ICDs and demonize supplements when the supplements show
better results. Here's an example:
-
Glucosamine Supplements
Linked to Lower CVD Event Risks - Medscape, 5/14/19 -
"Glucosamine use was associated with a 15% lower risk
for total CVD events and a 9% to 22% lower risk for stroke, coronary heart
disease (CHD), and CVD death after adjustment for age, sex, body mass index,
race, lifestyle factors, diet, medications, and other supplements ... A few
other cohort studies have raised this question including the Vitamins and
Lifestyle (VITAL) cohort study, in which high glucosamine use (at least 4 days
per week for at least 3 years) was associated with a 17% lower adjusted total
mortality risk ... the associations may be driven by the anti-inflammatory
properties of glucosamine or that the popular supplement may mimic a low
carbohydrate diet by decreasing glycolysis and increasing amino acid catabolism"
- [New
York Times] - See
glucosamine products at Amazon.com.
- That said, something they they're not looking at in these trials are
that many of the patients who get ICDs have a very low pulse and I'm
not convinced that the slow pulse is sufficient enough to keep the
organs, skin and hair healthy.
-
Association between
depression and the risk of developing ventricular arrhythmias: A meta-analysis
- Int J Clin Pharmacol Ther. 2019 Apr 16 - "Overall, participants with
depression, as compared to those who had no depression, experienced a
significantly increased risk of developing ventricular arrhythmia (combined HR,
1.33; 95% CI, 1.02 - 1.73; p = 0.037). In a subgroup analysis, a
statistically-significant relation between depression and risk of ventricular
arrhythmia was observed in coronary heart disease (CHD) patients and in studies
with adjustment for confounding factors, with pooled HR at a 95% CI of 1.78
(1.31 - 2.42) and 1.52 (1.11 - 2.08), respectively"
-
Treatment to restore natural heartbeat could be on the horizon for heart failure
- Science Daily, 5/10/19
-
ECG Challenge: Why Is His
Pulse so Slow? - Medscape, 4/26/19
-
Association between
depression and the risk of developing ventricular arrhythmias: A meta-analysis
- Int J Clin Pharmacol Ther. 2019 Apr 16 - "Overall, participants with
depression, as compared to those who had no depression, experienced a
significantly increased risk of developing ventricular arrhythmia (combined HR,
1.33; 95% CI, 1.02 - 1.73; p = 0.037). In a subgroup analysis, a
statistically-significant relation between depression and risk of ventricular
arrhythmia was observed in coronary heart disease (CHD) patients and in studies
with adjustment for confounding factors, with pooled HR at a 95% CI of 1.78
(1.31 - 2.42) and 1.52 (1.11 - 2.08), respectively"
-
DHS issues warning about Medtronic implantable defibrillator flaws -
Engadget, 3/22/19 - "The vulnerabilities allow bad
actors to change or inject data sent between a defib and its programming device.
Medtronic's affected products don't use use formal authentication or
authorization protections, which means attackers can alter the implant's
settings and potentially harm the patient"
-
Systolic blood pressure
increases in patients with atrial fibrillation regaining sinus rhythm after
electrical cardioversion - J Clin Hypertens (Greenwich). 2019 Feb 14 -
"Systolic BP increased by 9 (±16) mm Hg (P < 0.01) and
diastolic BP decreased by
3 (±9) mm Hg (P < 0.01) after conversion to SR. In the group of patients with
restored SR, there was a 40% increase in the proportion of patients with a
hypertensive BP level (≥140/90 mm Hg) after DC cardioversion compared to before.
Patients still in AF had no significant change in BP. Systolic BP increases and
diastolic BP slightly decreases when persistent AF is converted to SR"
- Note: I think it's saying that a pacemaker will raise your systolic blood
pressure by 9 points and lower diastolic by 3. It doesn't know the reason
but it makes sense. If you have all chamber firing at the same time there
is going to be more systolic and less diastolic.
-
Doctors: Newer Blood Thinners Best Against A-Fib - WebMD, 1/28/19 -
"The newer drugs are called non-vitamin K oral
anticoagulants (NOACs). Examples include dabigatran (Pradaxa), rivaroxaban (Xarelto)
and apixaban (Eliquis). They don't require the same frequent monitoring of
blood-clotting levels as the older clot-preventing drug warfarin (Coumadin)
does. They also don't have the same drug and food interactions that warfarin
does"
-
Can 'Normal' T4 Levels
Increase AF Risk? - Medscape, 12/11/18 - "After
adjustment, the relative risk for prevalent AF in the highest normal free T4
quartile group was double that of the lowest group. No similar associations were
seen between the quartiles for free T3. Thyroid-stimulating hormone (TSH)
results were mixed."
-
Have an
irregular heartbeat? You may have an increased risk of dementia - Science
Daily, 10/10/18 - "those who had atrial fibrillation had
a faster rate of decline in thinking and memory skills than those without the
condition and were 40 percent more likely to develop dementia ... Assuming that
there was a cause-and-effect relationship between using blood thinners and the
reduced risk of dementia, we estimated that about 54 percent of the dementia
cases would have been hypothetically prevented if all of the people with atrial
fibrillation had been taking blood thinners"
-
Ideal Blood Pressure in
Patients With Atrial Fibrillation - J Am Coll Cardiol. 2018 Sep 11 -
"BP of
120 to 129/<80 mm Hg was the optimal BP treatment target for patients with AF
undergoing hypertension treatment"
-
Stressful jobs are associated with a higher risk of heart rhythm disorders
- Science Daily, 6/4/18 - "The study found that
being stressed at work was associated with a 48% higher risk of atrial
fibrillation, after adjustment for age, sex, and education"
-
Moderate alcohol use associated with increased risk for atrial fibrillation
- Science Daily, 7/14/14 - "Consistent with previous
research, the study found an association between high alcohol consumption,
defined as more than three drinks per day, and increased risk for atrial
fibrillation and a strong association with binge drinking ... the risk for
atrial fibrillation increased 8 percent with each additional drink per day"
-
Thyroid problems linked to irregular heart rhythm - Science Daily,
11/28/12
-
Moderate alcohol consumption may increase risk of atrial fibrillation in
people with heart disease - Science Daily, 10/1/12 -
"Moderate alcohol consumption was measured as one to
14 drinks a week for women and one to 21 drinks a week for men. Binge
drinking was classified as five or more drinks a day ... The incidence rate
of atrial fibrillation rose to 6.3% of the low intake group, 7.8% in the
moderate and 8.3% in the high intake groups"
-
Irregular Heart Rhythm Linked to Mental Problems - WebMD, 2/27/12 -
"More people with AF than without showed signs of
mental decline and had problems performing activities of daily living, such
as showering, dressing, and feeding themselves. They were also at greater
risk for being diagnosed with dementia than their AF-free counterparts"
-
Moderate-to-heavy alcohol intake may increase risk of atrial fibrillation
- Science Daily, 2/14/11
-
Better treatment of atrial fibrillation and its risks - Science Daily,
8/31/10
-
Cardiac procedure significantly reduces risk of Alzheimer's disease and
stroke, researchers find - Science Daily, 5/13/10 -
"patients with atrial fibrillation treated with
catheter ablation are less likely to develop Alzheimer's disease or other
forms of dementia, and have a significantly reduced risk of stroke and death
compared to A-fib patients with who are not treated with ablation"
-
People with diabetes are at higher risk of atrial fibrillation - Science
Daily, 4/25/10
-
High
prevalence of atrial fibrillation found among cross-country skiers -
Science Daily, 2/9/10
-
Study: Ablation Beats Drugs for Atrial Fibrillation - WebMD, 1/26/10
-
Atrial Fibrillation Linked To An Increased Risk Of Death In Diabetic
Patients - Science Daily, 3/11/09
-
Low Testosterone Levels Associated With Lone Atrial Fibrillation in Men
- Medscape, 2/20/09 - "Mean testosterone levels in
men with lone AF were significantly lower than those in healthy controls,
the authors report, but mean estradiol levels did not differ significantly
between the 2 groups"
-
Surgeons Announce Advance In Atrial Fibrillation Surgery - Science
Daily, 4/7/08
-
Reduced incidence of new-onset atrial fibrillation with angiotensin II
receptor blockade: the VALUE trial - J Hypertens. 2008 Mar;26(3):403-411
- "These findings suggest that angiotensin II
receptor blockers may result in greater benefits than calcium antagonists in
hypertensive patients at risk of new-onset AF"
-
Elevated IL-6 Levels Associated With Increased Atrial Fibrillation Risk
- Medscape, 2/26/08 - "a doubling of IL-6 level was
independently associated with a 49% increase in the odds of developing AF"
-
Focus On Atrial Fibrillation Recognizes Growing Importance Of Common
Arrhythmia - Science Daily, 2/18/08
-
High
Blood Pressure Or Irregular Heartbeat Linked To Alzheimer's Disease
Progression - Science Daily, 11/5/07 - "10 with
high blood pressure (systolic pressure over 160) at the time of AD diagnosis
showed a rate of memory loss roughly 100 percent faster than those with
normal blood pressure ... 10 with atrial fibrillation at the time of the
diagnosis showed a rate of memory decline that was 75 percent faster than
those with normal heartbeats"
-
Incidence of Atrial Fibrillation Significantly Reduced by Candesartan
Cilexetil Therapy in Heart Failure Patients - Doctor's Guide, 7/5/06
-
Dabigatran Etexilate Has Long-Term Safety and Efficacy in Patients With
Atrial Fibrillation - Doctor's Guide, 5/19/06
-
Taller People More Likely To Develop Atrial Fibrillation - Science
Daily, 4/13/06
-
Magnetically Guided Catheter Zaps Atrial Fibrillation - Doctor's Guide,
3/31/06
-
Atrial Fibrillation Undertreated in the Elderly - Doctor's Guide,
3/15/06
-
One in Four Adults Over 40 Could Develop Irregular Heartbeat - Doctor's
Guide, 8/17/04
-
Rate Control May Edge Out Rhythm Control For Atrial Fibrillation -
Doctor's Guide, 12/5/02
-
Simpler Way To Treat Abnormal Heart Beat - Intelihealth, 12/5/02
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