I appreciate the feedback! Thank you!! Unfortunately, I've noticed that lack of explanations has been worsening over the twenty years I've done this. I believe that as Medicare keeps cutting physician reimbursement and private insurances keep looking for ways not to pay us on technicalities, it is causing more and more docs to feel that they just have to see as many patients as possible and sometimes, unfortunately do as many procedures as possible even if not always necessary, in order to keep up their income. Their rationale is: if the government and insurances are going to screw me then I have to do what I have to do. Unfortunately, the patients get stuck in the middle. This is also the reason why I created this channel and website. Because there is a lot of misinformation and lack of information out there, by giving pt's the correct information hopefully they can be empowered to know if a doctor is practicing 30 year old medicine and not offering all treatment options versus on the other extreme a less scrupulous Electrophysiologist that spends less than 5 minutes and then tries to bully you into an ablation making you think that without one you will die, because he/she makes more money to do a procedure than to use a medication. Please feel free to watch my other videos on Afib such as “8 Myths in Afib?” ,“What is an Arrhythmia?” And “4 Basic Facts in Afib.”
I know young people are more likely to post on Reddit than older people but there are a lot of young people with afib on Reddit. Me 67 m. 2 PFAs this year. Afib in remission. So far. I wish you would have started your channel a few years earlier when i was doing my year of research.
I think you need to be careful about terms like “vagal” AFib. Remember, the basic premise is that AFib is made up of abnormal cells/sources that form in the walls of the left upper chamber of your heart, the left atrium, and these cells wake up randomly and take over control of your heart electrically away from your normal source of electricity that you are born with that is located in the right upper chamber of your heart. When the AFib cells are in control they make your heart go at faster speeds that can be symptomatic. They also increase the chances of a blood clot forming in your heart that can break loose, go to your brain, and cause a stroke. As one gets older the AFib cells/triggers/sources keep developing, growing, and spreading to more and more walls of the left atrium. The more walls you have AFib cells on, the more AFib cells you have total, the stronger they become, the more they want to wake up, and the longer they stay awake before going back to sleep. When you have them on all 6 walls of that chamber they are strong enough to be awake 100% of the time and that is when your AFib is called "Permanent AFib" because no medication, no ablation no matter how advanced, and even a simple electrical shock (cardioversion) won't get the AFib gone or back to sleep. You will be in AFib 100% from that point forwards, but as long as one stays on their anticoagulation and doesn't have a stroke, you will never directly die from AFib because it is not directly life threatening. However, symptom-wise the best we can do at that point is just use a simple medicine to slow the AFib down to a point where the pt can tolerate the palpitations. This means that at any given Stage of AFib the AFib is waking up more or less based on how much of it you have in the walls of the left atrium. Now in the early stages when you don’t have that much AFib, maybe half a wall to 1-2 walls worth, your AFib isn’t waking up very much. That is the stage where “triggers” of AFib make the most difference. Things like stress, stimulants, caffeine, and alcohol can often wake up your AFib more than it would otherwise. Avoiding these agents will definitely decrease the amount of "triggered" AFib episodes, but remember based on whatever stage of progression of AFib you are currently at (early, mid, late) will determine how many AFib cells you have inside your heart presently and they can wake up randomly on their own even without a "trigger" with the more AFib cells you have on the more walls of that left upper chamber of the heart (the more advanced stage of AFib progression) leading to you having more AFib episodes and a greater percentage of time spent in AFib overall. It is true that there are “non-stress” triggers that sometimes wake up AFib. These would be the so-called “vagal” triggers. Remember, your brain controls everything in your body through your autonomic nervous system which is comprised of either sympathetic stimulation (the “Fight or Flight response” where you see a Tiger and your heart rate increases, pupils dilate to take in more light to see the Tiger better, and blood pressure increases to be ready for action) or parasympathetic or vagal stimulation (this is the rest response where your body gets you ready to sleep or eat by slowing your heart rate, decreasing your blood pressure, constricting your pupils to take in less light, and increasing digestive juices to breakdown food). While AFib is usually woken up by sympathetic stimulation that “revs” the body up, in some people it is woken up more by vagal/parasympathetic stimulation that “slows” the body down. Vagal AFib refers to the “triggers” that wake up your AFib, not the speed the AFib makes your heart speed up to when it is awake. Whether your heart rate is “slow” when your AFib is awake has more to do with whatever speed your AFib chooses to make your heart rate go to at that moment or whether you are on rate controlling meds to artificially slow your heart rate down in AFib. So if you are in an early stage of AFib and notice that your AFib seems to be triggered more by sympathetic stimulation triggers, then avoiding those could mean you have less AFib episodes overall. If you notice your AFib seems to be triggered more by vagal/parasympathetic stimulation triggers like resting, eating, etc. then avoiding those triggers could mean you have less AFib episodes overall. But remember, avoiding triggers is not the same as “reversing” your AFib or curing it. If you have AFib cells/sources in your heart even at an early stage, they can wake up on their own based on how much of them you have in your heart at that particular stage. By avoiding known triggers of AFib, you are simply not waking them up more than they would wake up otherwise. But this only helps in the early stages of AFib. In the later stages of AFib when they are waking up a lot on their own already, they avoiding the triggers may be less helpful. For example, if you are at an early stage of AFib and it is normally waking up 1-2% of the time on it’s own but you do certain triggers that wake it up 10-15% of the time, then obviously avoiding those triggers will markedly reduce how much AFib episodes you are having. But if you progress over time to a later stage where your AFib is waking up 50-60% of the time on its own then doing triggers and waking it up 70% of the time may make less of a symptomatic difference at that point because it is mostly awake already. I hope this helps!
@ thank you very much for taking the time to explain this to me. I’m working on getting myself as healthy as possible and also working on reducing my anxiety that initial stages of afib has brought on.
Since AFib cells grow and develop just by getting older, they tend to naturally progress over time. However, there are things that can cause the AFib cells to grow and spread faster on top of just aging. These would be things like poorly controlled high blood pressure, untreated sleep apnea, poorly controlled diabetes, being overweight, and being too sedentary. Losing weight, even 10% of your current body weight, has been proven to not only slow the rate of progression of AFib, but can sometimes cause some remodeling of your heart walls such that your AFib may even regress to an earlier stage. Although trying to “reverse” your AFib back to zero is unlikely and the amount of regression is likely dependent on what stage of AFib you are currently at. Please see my videos on “Can I Prevent Afib?” and “Stages of AFib Explained.” In terms of marijuana use, studies showed that patients who took medical cannabis had twice the risk of developing Afib. Not only did it increase the development of Afib cells/sources/triggers, it might also trigger awake existing Afib. Plus, marijuana use has been linked to an increased risk of heart attacks, or blocked plumbing. I hope this helps!
Priceless information! One we do not get in a 5 minute doctors' visit.
I appreciate the feedback! Thank you!! Unfortunately, I've noticed that lack of explanations has been worsening over the twenty years I've done this. I believe that as Medicare keeps cutting physician reimbursement and private insurances keep looking for ways not to pay us on technicalities, it is causing more and more docs to feel that they just have to see as many patients as possible and sometimes, unfortunately do as many procedures as possible even if not always necessary, in order to keep up their income. Their rationale is: if the government and insurances are going to screw me then I have to do what I have to do. Unfortunately, the patients get stuck in the middle. This is also the reason why I created this channel and website. Because there is a lot of misinformation and lack of information out there, by giving pt's the correct information hopefully they can be empowered to know if a doctor is practicing 30 year old medicine and not offering all treatment options versus on the other extreme a less scrupulous Electrophysiologist that spends less than 5 minutes and then tries to bully you into an ablation making you think that without one you will die, because he/she makes more money to do a procedure than to use a medication. Please feel free to watch my other videos on Afib such as “8 Myths in Afib?” ,“What is an Arrhythmia?” And “4 Basic Facts in Afib.”
Brilliant information you are simply the best
Thank you so much 😀
I know young people are more likely to post on Reddit than older people but there are a lot of young people with afib on Reddit. Me 67 m. 2 PFAs this year. Afib in remission. So far. I wish you would have started your channel a few years earlier when i was doing my year of research.
What about vagal afib issues? Is there a difference?
I think you need to be careful about terms like “vagal” AFib. Remember, the basic premise is that AFib is made up of abnormal cells/sources that form in the walls of the left upper chamber of your heart, the left atrium, and these cells wake up randomly and take over control of your heart electrically away from your normal source of electricity that you are born with that is located in the right upper chamber of your heart. When the AFib cells are in control they make your heart go at faster speeds that can be symptomatic. They also increase the chances of a blood clot forming in your heart that can break loose, go to your brain, and cause a stroke. As one gets older the AFib cells/triggers/sources keep developing, growing, and spreading to more and more walls of the left atrium. The more walls you have AFib cells on, the more AFib cells you have total, the stronger they become, the more they want to wake up, and the longer they stay awake before going back to sleep. When you have them on all 6 walls of that chamber they are strong enough to be awake 100% of the time and that is when your AFib is called "Permanent AFib" because no medication, no ablation no matter how advanced, and even a simple electrical shock (cardioversion) won't get the AFib gone or back to sleep. You will be in AFib 100% from that point forwards, but as long as one stays on their anticoagulation and doesn't have a stroke, you will never directly die from AFib because it is not directly life threatening. However, symptom-wise the best we can do at that point is just use a simple medicine to slow the AFib down to a point where the pt can tolerate the palpitations. This means that at any given Stage of AFib the AFib is waking up more or less based on how much of it you have in the walls of the left atrium. Now in the early stages when you don’t have that much AFib, maybe half a wall to 1-2 walls worth, your AFib isn’t waking up very much. That is the stage where “triggers” of AFib make the most difference. Things like stress, stimulants, caffeine, and alcohol can often wake up your AFib more than it would otherwise. Avoiding these agents will definitely decrease the amount of "triggered" AFib episodes, but remember based on whatever stage of progression of AFib you are currently at (early, mid, late) will determine how many AFib cells you have inside your heart presently and they can wake up randomly on their own even without a "trigger" with the more AFib cells you have on the more walls of that left upper chamber of the heart (the more advanced stage of AFib progression) leading to you having more AFib episodes and a greater percentage of time spent in AFib overall. It is true that there are “non-stress” triggers that sometimes wake up AFib. These would be the so-called “vagal” triggers. Remember, your brain controls everything in your body through your autonomic nervous system which is comprised of either sympathetic stimulation (the “Fight or Flight response” where you see a Tiger and your heart rate increases, pupils dilate to take in more light to see the Tiger better, and blood pressure increases to be ready for action) or parasympathetic or vagal stimulation (this is the rest response where your body gets you ready to sleep or eat by slowing your heart rate, decreasing your blood pressure, constricting your pupils to take in less light, and increasing digestive juices to breakdown food). While AFib is usually woken up by sympathetic stimulation that “revs” the body up, in some people it is woken up more by vagal/parasympathetic stimulation that “slows” the body down. Vagal AFib refers to the “triggers” that wake up your AFib, not the speed the AFib makes your heart speed up to when it is awake. Whether your heart rate is “slow” when your AFib is awake has more to do with whatever speed your AFib chooses to make your heart rate go to at that moment or whether you are on rate controlling meds to artificially slow your heart rate down in AFib. So if you are in an early stage of AFib and notice that your AFib seems to be triggered more by sympathetic stimulation triggers, then avoiding those could mean you have less AFib episodes overall. If you notice your AFib seems to be triggered more by vagal/parasympathetic stimulation triggers like resting, eating, etc. then avoiding those triggers could mean you have less AFib episodes overall. But remember, avoiding triggers is not the same as “reversing” your AFib or curing it. If you have AFib cells/sources in your heart even at an early stage, they can wake up on their own based on how much of them you have in your heart at that particular stage. By avoiding known triggers of AFib, you are simply not waking them up more than they would wake up otherwise. But this only helps in the early stages of AFib. In the later stages of AFib when they are waking up a lot on their own already, they avoiding the triggers may be less helpful. For example, if you are at an early stage of AFib and it is normally waking up 1-2% of the time on it’s own but you do certain triggers that wake it up 10-15% of the time, then obviously avoiding those triggers will markedly reduce how much AFib episodes you are having. But if you progress over time to a later stage where your AFib is waking up 50-60% of the time on its own then doing triggers and waking it up 70% of the time may make less of a symptomatic difference at that point because it is mostly awake already. I hope this helps!
@ thank you very much for taking the time to explain this to me. I’m working on getting myself as healthy as possible and also working on reducing my anxiety that initial stages of afib has brought on.
Any thoughts on how marijuana affects A-fib?
Since AFib cells grow and develop just by getting older, they tend to naturally progress over time. However, there are things that can cause the AFib cells to grow and spread faster on top of just aging. These would be things like poorly controlled high blood pressure, untreated sleep apnea, poorly controlled diabetes, being overweight, and being too sedentary. Losing weight, even 10% of your current body weight, has been proven to not only slow the rate of progression of AFib, but can sometimes cause some remodeling of your heart walls such that your AFib may even regress to an earlier stage. Although trying to “reverse” your AFib back to zero is unlikely and the amount of regression is likely dependent on what stage of AFib you are currently at. Please see my videos on “Can I Prevent Afib?” and “Stages of AFib Explained.” In terms of marijuana use, studies showed that patients who took medical cannabis had twice the risk of developing Afib. Not only did it increase the development of Afib cells/sources/triggers, it might also trigger awake existing Afib. Plus, marijuana use has been linked to an increased risk of heart attacks, or blocked plumbing. I hope this helps!
@@afibeducationThank you! You are a light in the darkness, when it comes to this subject!
You are very welcome! Thanks for the feedback!!