Atrial Fibrillation (AFib) | Q&A

Atrial fibrillation (AFib) is the most common heart rhythm abnormality, affecting more than 33 million people worldwide. Patients with AFib are at a higher risk of stroke if not properly treated. Watch Hugh Calkins, M.D., director of the Johns Hopkins Cardiac Arrhythmia Service, as he discusses the latest developments impacting AFib management, including a review of the recent guidelines, the latest techniques and strategies for stroke prevention. Learn more about the Johns Hopkins Heart and Vascular Institute by visiting http://www.hopkinsmedicine.org/heart_vascular_institute/

Questions Answered:
1. What is atrial fibrillation? What causes it? 0:03
2. How is atrial fibrillation diagnosed? 0:41
3. Once atrial fibrillation is diagnosed, how should it be treated? 1:07
4. Are all people with atrial fibrillation at high risk of stroke? 1:59
5. What other approaches are available to lower the stroke risk in patients with atrial fibrillation? 3:14
6. What techniques are available to remove or occlude the atrial appendage? 4:17
7. How do you decide which approach to use for a given patient? 5:03

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  1. I started to get nosebleeds from the blood thinner and so stopped taking the first prescription from a hospital cardiologist. He sent me to an outside cardiologist who gave me a different, cheaper prescription. However, I felt an extreme shortness of breath while walking after the first time I took this prescription and stopped taking it. I soon lost confidence in this doctor for other reasons as well and didn't go back to him. I'd like to get a third opinion from another cardiologist but trying to get an appointment with one takes forever. I've been taking half an aspirin at night with no apparent problems. What do you think of that? Also I take Magnesium and other vitamins, which you didn't mention. Why not?

  2. Very Common..? Wait.. 🤔
    5million people in the US have it, but their are over 350million in the US…So thats only 1.4%. That seems rare to me..? 🤷‍♂️

  3. Although Dr. Calkins does not directly state that Afib is a heart problem, he is a Cardiologist. What is wrong with that? Stating that atrial fibrillation (Afib) is a heart problem, specifically when referring to a person with an otherwise healthy heart, is like stating that Parkinson’s disease is a hand problem. That’s clearly wrong. Would Parkinson’s specialists be Orthopedic surgeons? No. Would Parkinson’s specialists operate on the patient’s hands to stop them trembling? No. That’s the problem with healthy heart afib treatment and research by Cardiologists. Afib is actually a problem of the Autonomic Nervous System (ANS), not the heart. Therefore, Afib specialty belongs with ANS specialists. Until the problem is focused upon by the right specialists and researchers, new treatments for the problem will still focus on tinkering with the heart. Catheter ablation and pacemaker insertion damage the heart. That’s barbaric, misconceived, is usually not very effective, and can seriously shorten the lifespan of the patient. That makes zero sense. Moreover, in the for-profit medical system in the United States, being branded with a heart problem is to render a person uninsurable or highly expensive to insure. Doctors and medical billing and coders brand you with heart disease if you have Afib. That’s tantamount to an injustice. Nervous system specialists are starting to focus on Afib as originating in the hypothalamus in the brain, part of the command center for the ANS. Because we are starting to discover the complexity of communication between the heart, organs and brain, especially by way of the vagus nerve, locating the origin of the afib may be very complex. DLC; Albuquerque, NM; 18 January, 2019.

  4. I had never heard of this atrial appendage surgery that he mentioned so I learned something today and I'm going to mention this to my doctor even though I only have paroxysmal A-fib I have figured out that alcohol is the chief trigger for me and it used to be sleep apnea until I got a CPAP machine

  5. I had pneumonia 5 years ago in a cold winter in my garage. The lack of oxygen caused my heart to pump harder going into AFIB. Here I am with severe chronic pain, burning like a torch in my lumbar if I bend or stoop my 6' 3" frame. Plus, pinched ulnar nerves in both elbows, 3rd finger on left hand arthritis and feels broken. Green light on metal right elbow, but nothing. 
     
    I am being forced to reduce my hydromorphone 8mg from 5 per day after 3 years, to 4. Now new Dr. required as my solo practice Dr. doesn't have "E-Sript" as to follow state or even Federal laws. So, lets review…I am in pain bad, so I can walk to exercise, can't improve cardio, can't build muscle mass or improve bone density and now, they are going after 5 year old system data to sell Eliquis. 

    Hell, after the farm, and 40 years as dealer tech, and not overweight, not light headed, no passing out, no shortness of breath, but lots of pain. Let reduce his pain killers, even the FRA did not work. Possible spinal stenosis but one 1 income, I don't have $45 for MRI, $45 for Cardio Dr., $45 for Orthopedic surgeon to check spinal stenosis, or a new #5 lumbar fusion. 
    I had 18 cents in the bank for 7 days in July, $5.60 in August, $3.19 for Sept 2019 left.

    My 25 years in the house my wife wanted is where I will die. Yes, hydromorphone 8mg at 5 per day was high, but I was able to function fine over the 3+ years of this dosage. Now, over-night, it is immoral, incorrect or illegal because it works for me? I am not a 5'4" 100 Girl who never had more than a tooth pulled. Been there, done that, got the "TEE" shirt. Come on guys.

    My old Dr. told me he now knows when to retire as the LAW becomes official, Jan 1st, 2021 for all to have $3,500+ software for Electronic Prescriptions of a Controlled Substance or EPCS.
    The August issue of the New England Journal of Medicine, the lady Dr. is mad because the MME assignment numbers where ascending, not descending and is upset as each case is different. Sure, a respiratory depressant but I set mile record running, 1/2 mile, 5 mile cross-country in 25 minutes flat. Don't blame me because I have twice the lung capacity of someone who just turned 61 and worked in a cube farm their entire life, because I worked in hot dealer shops lifting, bending, twisting and running up stairs to parts, burning 6-7k calories per day from 7AM to 9PM at night. No, let's use old records and ask him to pay for Dr, Meds, Specialist I can not afford. No wants to live on a credit card, and yes I make way more in "Disability" than most, but my wife raise her 2 kids and our 2 kids and only got $12.50 per hour as a cashier for 13+ years as of 2019. Hell, new employees start at this rate, but quit when they have to work, can't count back change nor put up with comments from contractors and non-english speaking workers who want to split a purchase into cash, card and check…using a shell game.

    No one will reply to this one I am sure. Oh yea, how did your back get messed up. Well a guy who owned a shop tried for months to get to work there. Then with sinking concrete on his hill-top shop, lost his court case and found out I could run any tractor made. So 20' X 100' hole, 4 feet deep was dug out. Drain got fixed by plumber, then he pulls me off a stater rebuild to have me run a vertical "Jumping-Jack" earth compactor he had rented. It turned to mud and after 5 hours I quit. Woke up with the feeling of the worst sun-burn on my back ever, but not red. Just pulled 2 of the 4 muscle groups in my lumbar. Now, live nerves trapped in scar tissue. I can't even bend over to shave, wash dishes, or work on benches because they are built for short dudes.
    Yep, We are from the Government and we are here to help you! Thanks, but no thanks!
    Retired against my will / ASE Master Tech since 1978

  6. I had a heart attack after being on Fleccanide and Bisopherol for A-fib. Why are so many more young people getting A-fib? Can it be EMF's and a lack of sun light? From what I have read there is less A-fib in the undeveloped pacific regions.

  7. I recently discovered that having lowered cholesterol is a cause of A-Fib
    Taking a Statin will increase your risk of stokes by having low cholesterol
    There are medical studies that confirm what I’m saying
    Why they don’t tell you this I don’t know
    Cholesterol is a neurotransmitter and it affects your heart as well as your brain
    I hope you see the picture here
    More older people get A-fib because more older people are on Statins
    Makes sense when you see the picture

  8. I went in last Saturday because of a problem with my leg. Swelling from a blood clot I got in November. They diagnosed me with AFib and for two days my heart was all over the place. The cardiologist was going to shock my heart but sometime in the night my heart went back to a normal rhythm. I was put on Eliquis and Coreg. My paperwork says I cannot drink. Does that mean I can't drink at all? I like to have a glass of wine now and then. I turned 60 in October and everything has gone downhill ever since. It's so depressing.

  9. Is not blood pressure "medicines" the cause of most " diagnostic " testing result of afib ..i would ask about the possibiliy of lifelong kickback or commissions from prescribing these high priced drugs.. time wasted?..and needs of appointments testings and expesive procedures..forgot stents clottings??

  10. I’m 15, perfectly healthy, my grandma has diabetes and my other grandma has problems with her heart. Sometimes when I lay down to go to bed I have multiple heart palpitations and I can’t go to bed, is it something to worry about?

  11. Me someti a una ablacion de AF por la técnica mini maze es un procedimiento bastante invasivo y de pronósticos reservados..dedpues de dejar de tomar antiarritmico volví a caer en AF ..Proceder fallido me sellaron la Orihuela de la AI fallido también presentó fugas y liqueo
    Necesito otra segunda ablación..cuan seguro es el procedimiento? Evaluar riesgo beneficio..contoloar ritmo o controlar frecuenia? Tomar anticuagulante de por vida o someterse a otra ablacion con los riesgo q conlleva ..gracias

  12. I went into Afib after open heart surgery. Did a Cardioversion to restore the heartbeat, which worked. In Afib, I felt fine, B/P 128/65. They fixed the Afib, now I am at 190/90 and on 4 different B/P meads. I asked them to put me BACK in Afib, they don't know how to.

  13. I am Having Knee Replacement and have A Fib I am currently on Eliquis and I know I have to come off that 3 days before the operation
    what is the alternative and what pain meds can I take

  14. What should have been in this presentation is the effect ALCOHOL has on one's heart. Avoiding all ALCOHOL is the first thing one must do if one has Atrial Fibrillation.

  15. Having trouble for the past year at least with my heart skipping and running fast at times I found out in the last 2 months that I have CKD, I changed my diet , cut down my sugar intake, no dairy, no red meats , loads of veg, Alpro and other vegan products,no salty products,plenty of grapes, apples, more water than I usually would drink, extra vitamins especially B12 B2 C and D. Zinc, magnesium , I'm not sure what has done it but my heart is functioning normal again.😳lost 8 lbs too, try to get as much exercise as I can , mainly walking.

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