Dr. Day is a cardiologist/electrophysiologist at the Intermountain Medical Center Heart Institute in Salt Lake City, Utah. He graduated from Johns Hopkins Medical School and completed his residency and fellowships in cardiology and electrophysiology at Stanford University. He is the former president of the Heart Rhythm Society and currently serves as the president of the Utah chapter of the American College of Cardiology.
The Most Important Factor to Cure A-Fib
Do you or a loved one suffer from A-Fib? A-Fib, which is also known as atrial fibrillation or “AF,” is the most common heart arrhythmia and affects 1 in 4 adults. In A-Fib the heart typically beats very fast and irregularly leading to strokes, heart failure, dementia, and even premature death.
Just what exactly is the most important factor to cure A-Fib? In this article we will explore the most important factor to cure A-Fib.
A-Fib 20 Years Ago
I can hardly believe it but 20 years have now passed since I graduated from Johns Hopkins Medical School. I remember seeing my first case of A-Fib as a fresh young intern at Stanford University Medical Center in 1995.
John was an overweight 52 year old man who suddenly developed severe chest pain and palpitations while staying late at work one night to meet a stressful deadline. Panicked he dialed 911 and was brought to the Stanford Hospital emergency room. As I was the intern on call for the ER that night my pager went off and I was called to see John.
Seeing how severe his condition was we quickly shocked his heart back into normal rhythm. It was just like what you might see on TV except his body did not jump off the table when we shocked his heart.
While this temporarily corrected his arrhythmia it was just a matter of time before I would see him again for more episodes of A-Fib. In those days we really did not understand what caused A-Fib and all we had available to treat A-Fib were medications.
A-Fib Treatment in the Last 10 Years
Fast forward to the last 10 years. Now, if you or a loved one has suffered from A-Fib then you have undoubtably heard about the very popular catheter ablation procedure.
As a cardiologist specializing in the treatment of heart rhythm disorders I personally have done more than 4,000 of these catheter ablation procedures for patients suffering from atrial fibrillation. A catheter ablation procedure is where we go into the heart with catheters through a vein in the leg.
This procedure is so minimally invasive that all it requires is an IV. No cutting or stitches are needed. Once catheters are in the heart we can 3-dimensionally map out the source of A-Fib and then either cauterize or freeze those areas of the heart.
While this treatment approach has been very successful in treating A-Fib, unfortunately the arrhythmia often comes back a few years later. When A-Fib recurs the ablation procedure is done again. Some patients may even have three or more of these catheter ablation procedures performed.
Is there a better way to treat A-Fib?
As I have been involved in helping to develop the catheter ablation procedure for A-Fib since it was first developed in 1998, it has always troubled me that so many of these “successfully” treated patients have had their A-Fib come back. Why is this the case?
Fortunately, we now have a much better understanding of the various causes of A-Fib. For example, the obesity epidemic in the U.S. has made the U.S. the A-Fib capital of the world! In fact, A-Fib is nearly 10 times more common in the U.S. than in Asian countries.
It is not just the obesity epidemic but also high blood pressure, a poor diet, stress, lack of exercise, and sleep apnea, among other conditions, which is driving the A-Fib epidemic. Based on our new understanding of the causes of A-Fib we now know that while a catheter ablation procedure can be very effective in treating today’s A-Fib, if aggressive lifestyle changes are not made then it is just a matter of time before new A-Fib areas develop.
This new understanding of A-Fib led my good friends and fellow colleagues in Australia to perform a landmark study in the cardiology world to see if aggressive lifestyle modification changes can improve the long-term success of catheter ablation.
The ARREST-AF Study
In the ARREST-AF Study, my good friends in Australia recruited 149 overweight A-Fib patients who had recently undergone an A-Fib ablation procedure. Of these 149 patients, 61 volunteered to participate in an aggressive lifestyle modification program. The 88 patients that were unwilling to “change their ways” after this heart procedure served as the control group.
This aggressive lifestyle modification program consisted of the following:
1. Weight loss
2. Aggressive control of blood pressure, lipids, and diabetes
3. Treatment of sleep apnea
4. Smoking cessation
5. Decreasing alcohol intake
The group of patients who signed up for lifestyle modification did very well in “changing their ways.” They were able to lose 29 pounds (13.2 kg), stop smoking, limit alcohol intake, and get their blood pressure, lipid, diabetes, and sleep apnea under control. Many of these conditions were even reversed.
With these changes, the group that participated in lifestyle changes were 3 times more likely to have their procedure work long-term. Unfortunately, for the group unwilling to make changes, most had their A-Fib come back within two years of their heart procedure.
Take Home Message of this Study
The big picture or take home message of this study is that modern medicine is not a “fix” for poor lifestyle choices. We simply cannot undo years of damage with a pill or a procedure.
If you want to beat A-Fib, or for that matter any heart condition, the most important factor is to adopt a healthy lifestyle. Indeed, studies show that 80% of all heart conditions are completely preventable or reversible with a healthy lifestyle.
It is not just heart disease either. A healthy lifestyle can prevent cancer, Alzheimer’s Disease, diabetes, and most other medical conditions.
We are not victims of the genes we inherited from our parents. Whether or not we will suffer from long-term medical conditions in this life, to a large extent, is based on the daily decisions we make.
Even if you have abused your body in the past it is never too late to change. The body has a remarkable ability to heal itself if we will just give it a chance. Make the commitment today to make healthy decisions!
Do you want to learn more about how to prevent atrial fibrillation naturally? Here is a recent presentation I delivered at the most recent Stop Afib symposium in Dallas, Texas.
What positive changes have you made in your life? Please share with me your comments below.
Please do not self diagnose or treat based on anything you have read in this article. Please work with your individual physician in deciding what treatment strategy is best for you.
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.