This is an amazing article. I will ask my EP what he thinks of it when I meet with him next month to decide whether to go ahead with AV node ablation and pacemaker. I am not overweight and my blood pressure is normal. I exercise moderately, eat well (besides cookie addiction), I am getting old, and have stress and worry about my children's life. Thank you for posting it. Marya

The cookie cutter diagnosis from my EP drives me up a wall. I literally have to break into his dissertation to inject my comments. Very frustrating!!!. Interesting theory of treating the whole package and how they are related versus just going for the Afib.

While I think addressing your other health problems is a good thing for afib, I don't buy off on the idea that weight alone, or mild to moderate sleep apnea or blood pressure, etc. is the real answer as the "cause". There are almost 325 million people in the US and only 3 million have afib.

2/3s of the US population is overweight and about 1/3 are obese. 20% of older people have sleep apnea. 60% of the adult population have GERD symptoms with 7 million having chronic symptoms. 1/3 of adults have high blood pressure. An estimated 27 million Americans have thyroid disease. About 20 million people in the US are alcoholics.

There must be something else going on that is causing the afib. I really haven't seen any extremes of disease in those with afib. Why do a select few get it and why aren't those that do EXTREMELY sick (really high BP, really fat, really bad/excessive drinking, really extreme sleep apnea, really extreme GERD or resulting in Barrett's Esophagus...)

No... something else is going on, these are just aggravating factors in my opinion.


petey

Oh and here are some stats on hiatal hernia:

"Hiatal hernias are becoming far more common in an aging and overweight population. Some estimates put prevalence at 50 percent of people over the age of 60.
Hiatal hernias are the most common type of hernias caused by pregnancy and occur in 15 to 20 percent of pregnant women. The symptoms usually present in the second trimester.
Despite their prevalence, less than 10 percent of people with hiatal hernias experience any symptoms, or their symptoms, such as heartburn, are mild. Generally, the symptoms of hiatal hernias can be controlled with lifestyle changes and medication such as eating meals three to four hours before lying down and using over-the-counter antacids."

petey

Petey,
I totally agree with you but if one has the inherent atrial substrate that can cause AF then only those will get the disease. That's why so many with those risk factors never get AF as the substrate is just not able to sustain any AF? Unless the presentation showed that all the sheep with weight gain or sleep apnea and other risk factors all were shown to get fibrosis? I'll have to re-watch the video when I have time.....
Just a thought as I was always led to believe for example those of European Ancestry were more prone to have inherented that type of atrial substrate that can cause AF..

McHale

McHale:
Inherent Atrial Substrate... IAS... that's the answer... we'll call it McHale's IAS... now we are getting somewhere... those that have an inherent (inborn, built in, congenital, structural) atrial (pertaining to the atria, the upper chambers of the heart) substrate (a substance or layer that underlies something, or on which some process occurs) are prone to atrial fibrillation in environments that wouldn't produce atrial fibrillation in the general population. Those individuals, that small minority, are sensitive to anything that puts physical, chemical, or electrical stress on the heart. As they age, they become more and more prone to the arrhythmia. Things like certain foods, stimulants, sudden environmental changes like temperature, altitude, or even bending or lying on the left side, as well as big meals, lack of sleep, overexertion, etc. can also trigger an event.

Maybe certain people are just going to get it and you can only delay its onset or put it in remission by playing with the body chemistry, altering health habits, or burning/freezing the bad areas of the substrate until new bad areas form.


OK, that brings us back to square one in the search for a cure.
petey

Thanks Marikay for the link. I didnt understand a lot of what was said, so Ill have to watch it again.

I found this about the AF Symposium 2015. Its from the a-fib.com site. It looks like Steve S. Ryan, PhD goes to these symposiums every year. He presents his take on the different topics presented.

http://a-fib.com/af-symposium-2015-report/

atp

Petey,
Wise guy you know I meant inherited atrial substrate!

That's why Natale likes to break up the posterior wall, with a roofline lesion and extra lesions to break up the area that can cause and sustain more afib in many. Extra burns but well worth it if this disease is truly more progressive!

McHale

Ha!

Perhaps on the next study, Dr Pash can use Hogs instead of sheep. I was disappointed with the lack of research on the lifestyle and historical data on the sheep. Facts were excluded in this study like, Were the juvenile sheep verbally abused by herders, was there any bullying by larger aggressive sheep in some herds to provoke more stress later in life, Did some have an identity crisis due to darker colored wool, or imperfections in the wool, were all sheep sheared the same way, etc? Very vague study I believe, nothing new to see here, move along, blah blah blah, or is it baa baa baa?

What Petey said originally. There has to be more at play here or there would be millions more with afib.

We're also forgetting that there is definitely a genetic link. My father has afib and so do I. It will be interesting to see if my younger brother gets this when he gets older.

It seems like afib tends to "run in the family."

Bottom line...we are a long way from truly understanding what causes it.

Travis

Travis, I have a large family on both sides, and Im the first and only one with this. Tho there have been plenty of heart issues, no known AF going back 100 years. So for me, I cant say genetics is definitive. Of course I have always taken issue with this subject because most follow the same diet and lifestyle in families leading to the same conditions.Hope kid brother breaks the pattern.