Dr. John Day
Dr. Day is a cardiologist specializing in heart rhythm abnormalities at St. Mark’s Hospital in Salt Lake City, Utah. He graduated from Johns Hopkins Medical School and completed his residency and fellowships in cardiology and cardiac electrophysiology at Stanford University. He is the former president of the Heart Rhythm Society and the Utah chapter of the American College of Cardiology.
10 Ways to Cure A-Fib without Drugs or Procedures
Atrial fibrillation (A-Fib) is up to 10 times more common in North America than in Asia according to a recent medical study published by my good friend, Dr. Sumeet S. Chugh, at Ceaders-Sinai based on a grant from the Bill and Melinda Gates Foundation.
Interestingly, according to research by Dr. Gregory M. Marcus from the University of California at San Francisco, when Asians immigrate to the U.S., they lose their protected status against A-Fib and soon develop rates of A-Fib similar to other Americans.
How can we explain the fact that A-Fib is 10 times more common in North America? Is A-Fib under reported in Asia or is there something different about our lifestyles?
Is A-Fib Under Reported in Asia?
When most physicians hear Dr. Chugh’s work that A-Fib is up to 10 times more common in North America, they naturally assume that this condition is under reported in Asia. While it is possible that there is a component of under reporting going on, other studies suggest that this may not be the case.
The easiest study to answer this question is to just do an EKG on everyone in a specified population and count up the cases of A-Fib. If you don’t miss anyone with a screening EKG, then there will be no underreporting of the disease. As A-Fib is more common as people age, why not just do an EKG on everyone over age 100 as these people will represent the highest rates of A-Fib in a population?
A-Fib in Centenarian Studies
When researchers did just this, an EKG on everyone over age 100, they came up with the following results.
1. A-Fib in U.S. centenarians: 27%
Clearly, even when there is no underreporting of A-Fib, the rates of A-Fib are still much higher in the U.S. than in Asian or Europe, consistent with the findings of Dr. Chugh’s study. As the U.S. is a “melting pot” country where people come from around the world to live, why is it that their A-Fib risk goes up dramatically once they move here?
Based on these studies that I have presented thus far, this naturally begs the question, is 80-90% A-Fib preventable? From my experience as a cardiologist treating thousands and thousands of A-Fib patients, the answer is a resounding “Yes!” Even for people who have already been diagnosed with A-Fib, if A-Fib is diagnosed early enough and if aggressive lifestyle changes are made fast enough, it has been my experience that many cases of A-Fib will simply go into remission.
10 Ways to Cure A-Fib without Drugs or Procedures
As I have spent a lot of time researching the question of is 80-90% of A-Fib preventable, I would like to share with you 10 ways to cure A-Fib without drugs or procedures. These approaches work as I have seen the results first hand in my cardiology practice.
Not only will these 10 strategies help your A-Fib but it will also help to prevent or reverse many other chronic medical conditions that afflict so many of us in the United States. Even my 80 and 90 year old patients have taught me that it is never too late to change!
1. Change Your Genes
Genes certainly play a role in A-Fib, like most other medical conditions. Studies do show that Caucasians have a slightly higher risk of A-Fib when compared to people of other ethnicities.
Despite what your “genes may say,” recent studies have shown that your lifestyle can determine which genes get turned on or off based on epigenetic markers. Thus, even if you did inherit the “A-Fib gene,” this gene can be silenced through a molecular “tag” that comes from a healthy lifestyle which can attach to the outside of the gene.
As I have long had an interest in treating A-Fib, I wanted to know if I inherited any A-Fib genes. Thus, for $99 I had my genome tested by 23 and Me at home by simply spitting into a test tube and mailing it back to the company. Then, for an additional $5, I had my raw genetic data from 23 and Me interpreted by a different company called Promethease. Interestingly, 23 and Me used to give you a detailed interpretation of your genetic results until the FDA became concerned that Americans would not be smart enough to know what to do with this genetic information.
Fortunately, I learned that I have the Gs273 gene which means I have the lowest risk of A-Fib among Caucasians. Whew, at least my chances of A-Fib are reduced by 18% because I have this gene which protects me against A-Fib.
Even if I did test positive for the A-Fib genes, I know that I could turn these genes off by closely adhering to the next 9 lifestyle strategies that I discuss below.
2. Don’t Smoke
If you have ever smoked or are currently smoking then you are at a significantly increased risk of A-Fib. Indeed, studies have shown that if you are currently smoking you are 2.1 times more likely to develop A-Fib. If you are no longer smoking then your risk of developing A-Fib is 1.3 times higher.
Smoking likely causes A-Fib through a process known as oxidative stress, also known as “rusting of the body,” in which free radicals damage our heart cells and DNA. The message though is very clear, if you can stop smoking now then you can decrease your risk of A-Fib by 36%!
3. Lower Your Blood Pressure
High blood pressure has long been known to raise the risk of A-Fib. As the heart has to pump against a higher load it causes stretching and thickening of the heart, ultimately leading to scarring and enlargement of the left atrium. As a result of heart scarring and enlargement, the electrical pathways are disrupted thereby causing A-Fib.
Studies have shown that having a history of high blood pressure can increase the risk of A-Fib by 56%! Unfortunately, new treatment guidelines for high blood pressure have now become very lax, especially in older individuals.
Thus, even if you have high blood pressure, your doctor may now decide not to treat it. The concern is that if blood pressure is not aggressively managed in A-Fib patients then their arrhythmias may become even more difficult to treat in the future.
Fortunately, if caught early, I have found that most cases of high blood pressure can be treated without medications. I know this was the case with me. To learn more about how to lower your blood pressure naturally, please read my article How to Lower Your Blood Pressure with These 8 Steps.
4. Don’t Drink Alcohol
I realize that you have probably heard that a little alcohol is good for the heart. While newer studies challenge whether alcohol is healthy or not for the heart, certainly when it comes to A-Fib any alcohol can be dangerous.
In a large study of 79,019 people with no prior history of A-Fib, researchers found that over the following 10 years, even just 1 alcoholic drink a day increased their risk of A-Fib by 8%. This risk then went up to 39% for those people having 3 or more alcoholic drinks each day.
This large study showed for the first time that there is no safe level of alcohol that you can drink when it comes to A-Fib. The more you drink the higher your risk of A-Fib.
5. Minimize Stimulants
Any drug which stimulates the body also stimulates the heart and may increase the risk of A-Fib. As a cardiologist treating patients with A-Fib, I am seeing more and more cases of A-Fib from energy drinks, like Red Bull, especially in young men.
It is not clear yet if this increased risk of A-Fib from energy drinks is from the caffeine, sugar, taurine, or other chemicals in these drinks. Ongoing studies will hopefully answer these questions.
While there are no reliable studies yet on the subject, I am also seeing many cases of A-Fib from patients taking Attention Deficit Hyperactivity Disorder (ADHD) medications. The amphetamine compounds in ADHD medications are causing a wide array of arrhythmias in my patients.
When it comes to caffeine and A-Fib, the data are not so clear. Some studies suggest there is an increased risk of A-Fib with coffee while others do not. At the end of the day, you need to find out for yourself whether or not caffeine is triggering your A-Fib. If you find that you go into A-Fib on the days you have caffeine then it just may be a trigger for you.
6. Get Restorative Sleep
Sleep is critical when it comes to preventing or reversing A-Fib. Unfortunately, as a society we are sleeping less and less. For example, we now sleep 2 hours less than in the 1960s. Studies show that not getting enough sleep can increase your risk of A-Fib by 3.4 fold!
One of the biggest problems for A-Fib patients struggling with getting enough sleep is sleep apnea. Unfortunately, many patients with A-Fib are also overweight which then leads to sleep apnea.
In sleep apnea, the extra fat in the neck and in the back of the tongue can obstruct your airway while sleeping. Usually, the spouse or sleeping partner can make the diagnosis as these patients tend to snore and occasionally stop breathing while sleeping.
If you think you might be suffering from sleep apnea then get tested. Depending on what study you look at, your risk of A-Fib is about 4 times higher with sleep apnea. In my practice we offer sleep apnea screening for most patients with A-Fib.
As of the time I am writing this article, there are no studies yet showing that getting treated for sleep apnea with a CPAP machine will reduce or reverse A-Fib. However, in patients who have had an A-Fib ablation, one study has shown that CPAP therapy can double their chances of a successful ablation.
7. Reverse Your Diabetes
Diabetes is another epidemic striking the U.S. Indeed, studies show that diabetes has increased by 75% over the last 20 years in the U.S.!
Diabetes is another important A-Fib risk factor. As with high blood pressure, if aggressive lifestyle changes are made early enough, most cases of diabetes can be reversed.
In one of the most insightful studies on the role of diabetes in A-Fib, researchers reported that diabetes increases your risk of A-Fib by 40%. Even more interesting was the finding that the higher your average blood sugar and the more years you are diabetic, the higher your risk of A-Fib.
Like with smoking, the reason why diabetes increases A-Fib is likely due to oxidative stress, or “rusting” of the body. If you now suffer from diabetes, there are likely lifestyle changes that you can make to either put your diabetes in remission or significantly reduce the amount of medications you need for this condition. Your heart will definitely thank you for these lifestyle changes!
8. Lower Your Stress Levels with Yoga
Probably one of the main questions patients ask me on their first clinic visit for A-Fib is “did stress cause my A-Fib?” If you have asked this same question of your doctor they likely downplayed this link between stress and A-Fib.
The truth is that the heart and the brain are intimately connected. Any stress you may be feeling will be felt by your heart as well.
In an interesting study, Swedish researchers randomly selected 7,494 men and asked them if they had a “stressful job.” They defined a “stressful job” as a job in which there were high demands and low autonomy. To me, this sounds like most jobs including my own job.
Researchers then followed these 7,494 Swedish men for the next 7 years. At the end of the 7 years they found that those who reported having a stressful job were 32% more likely to develop A-Fib.
It is not just a stressful job that can cause A-Fib but any negative emotions as well. In a fascinating study by my friend, Dr. Rachel Lampert at Yale University, she found that feeling sad, angry, stressed, impatient, or anxious increased your risk of going into A-Fib on that day by 3 to nearly 6 fold! Even more interesting was that at least when it comes to feeling angry or stressed, this increased risk of A-Fib is carried over to the next day.
Perhaps this explains why my good friend, Dr. Dhanunjaya Lakkireddy, showed in a well designed clinical study that yoga can reduce your A-Fib burden by 24%. It is for this reason that I now recommend yoga for my A-Fib patients.
9. Exercise Moderately for Life
It has long been known that exercise is good for the heart. The same, when done in moderation, is also true when it comes to A-Fib treatment.
In an interesting study, Australian researchers were able to show that when they could get men to go from “couch potatoes” to at least some limited form of exercise that they could reduce their A-Fib burden by 50%. When it comes to exercise, even just a little bit can have a huge benefit when it comes to the heart.
However, those people who carry exercise to the extremes like in the case with competitive long distance cross country ski racers, marathon runners, or Ironman triathletes, the risk of A-Fib can increase significantly in these people. Indeed, studies show that the faster your times in these endurance events and the more you of them you do, the higher your risk of A-Fib.
The cause of A-Fib is endurance athletes is likely due to fibrosis (scarring of the heart) due to pushing their hearts beyond what they were designed to do. For many of these endurance athletes, if they would simply back off on their training or stop competing competitively, their A-Fib would go away. However, this is something most of these patients cannot do as they have become “addicted” to extreme levels exercise.
These endurance athletes also cannot take medications for A-Fib as they are unable to compete effectively on cardiac drugs. Thus, I have found that for most of my competitive endurance athletes with A-Fib, we have had to move toward an A-Fib ablation procedure so that they can continue to compete.
10. Lose the Extra Weight
Since the landmark Framingham A-Fib study in 2004, it is well known that obesity is a powerful risk factor for A-Fib. In this study, people who were overweight had up to a 52% increased risk of A-Fib. Researchers identified that the increased risk of A-Fib in overweight people is likely due to enlargement of the left atrium. Today, from the same ongoing Framingham Heart Study, we also know that extra fat accumulation around the heart and scarring of the heart from obesity are also to blame for the increased risk of A-Fib.
Recent studies have shown that if people can get off the extra weight they can reverse their A-Fib. For example, my friend Dr. Yong-Mei Cha at the Mayo Clinic, showed that gastric bypass surgery can prevent A-Fib. Another friend, Dr. Prashanthan Sanders from the University of Adelaide, showed that by simply losing 32 pounds in an overweight person they could dramatically reduce their A-Fib burden.
This is something I have also seen in my own A-Fib practice. Weight loss seems to be the most effective way to reverse A-Fib without drugs or procedures in my overweight patients with A-Fib. It doesn’t take much weight loss to see a clinical benefit. Even just losing 5 to 10 pounds can have a significant benefit.
I recently gave a presentation to an A-Fib audience on this exact blog article. Here is a link to this presentation.
If you have A-Fib and want to drive it into remission without drugs or procedures, please work under the close supervision of your physician to achieve this goal. This goal is certainly possible as I have seen it for many of my patients.
With this article I am not providing any medical advice. All information shared is general information based on published medical studies and information that has been shared at medical conferences. In addition, do not self diagnose or treat based on anything that you have read in this article.
Disclaimer Policy: This website is intended to give general information and does not provide medical advice. This website does not create a doctor-patient relationship between you and Dr. John Day. If you have a medical problem, immediately contact your healthcare provider. Information on this website is not intended to diagnose or treat any condition. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions.