Getting Healthy VS. Ablation

I'm curious and surprised I have never read a post that discusses getting healthy vs. an ablation. Nor have I ever had a cardiologist or EP tell me to focus on a healthier lifestyle. From the beginning I was just told to have an ablation. Because it's known that Afib has underlying causes such as drinking, smoking, being overweight, sleep apnea, lack of exercise, in some cases too much exercise, etc., wouldn't it make sense for anyone who fits some or all of that criteria to focus on lifestyle changes BEFORE an ablation? In some cases i'm thinking a healthier lifestyle may help to correct/reverse Afib.

Regardless of whether Afib is Paroxysmal, persistent, long-standing persistent, it would just seem that Cardiologists and EPs would spend more time talking about health and changes people with Afib can make instead of just an ablation. If any of those "triggers" mentioned aren't corrected, isn't an ablation almost a complete waste of time and money because the Afib has a much higher likelihood to return? I know there's a lot of money to be made via medical facilities/EPs, etc. by an ablation. But if someone lived an unhealthy lifestyle and has an ablation and continues the same, unhealthy lifestyle after the ablation, isn't the ablation completely useless?

Yes, of course it makes sense to attempt to improve one's lifestyle. I am only an n of one, and I have been fit and eaten well, never smoked, low alcohol consumption (three drinks a week), but I still developed AF near the end of a 10 km daily run, a type of fitness I had initiated in earnest in early 1978. The AF episode was June of 2017. In my case, it was finally determined to be sleep apnea....severe obstructive. There was nothing I could do except to modify my sleeping which an unconscious person is not likely to accomplish easily. So, I needed CPAP therapy. My AF was given wings, however, and continued to progress until I was becoming very uncomfortable with it. I was referred to an EP who finally got my heart back into NSR.

But yes, if one is obese, staying up all hours to game or other unmentionable pastimes, carousing, doing recreational mood-altering/reality-altering stuff like drugs, smoking....anything that can reasonably be changed within a few weeks, I would urge that approach before an ablation. The procedure isn't risk-free after all, and it costs quite a bit more than stopping boozing and smoking. Or did last I checked the math.

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cornerbax
I'm curious and surprised I have never read a post that discusses getting healthy vs. an ablation.

There are almost 200,000 posts here dating back 22 years, and I would bet at least a couple of thousand of them are exactly on this topic. If there's an approach to lifestyle changes that hasn't been tried and discussed here, I'd be surprised. The trouble is, you'll only find a small handful claiming success, and those usually involved fairly significant time, effort, and dedication. George is probably the best example. He has achieved a significant level of success, but his methods are what most people would consider rather extreme and few would be willing to follow the protocols he does.

The reality is that losing weight, getting in shape, eating right, reducing stress and so on may help reduce afib episodes or lessen them, but I've not seen a single person here or anywhere else ever claim that they took reasonable steps easily followed by anyone that achieved remission of afib. I think that's why you don't see cardiologists preaching it. It simply just doesn't work. Afib is likely a genetic disease, so you can't "healthy" your way out of it. If you had a time machine and could go back to your teens and not do all that unhealthy stuff you probably did for the next 4 decades, then maybe it would make a difference. But I don't think you can undo the ravages of time after the fact.

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Carey

but I've not seen a single person here or anywhere else ever claim that they took reasonable steps easily followed by anyone that achieved remission of afib.

I’ve been on this site since 2004. I speculate the closest person is Dean, a MD, who lives a healthy life in nsr by discovering for his own success in Natto, and years ago his interest in GI health and other suggestions throughout the years.

Thanks Susan d,
I haven’t got time at the moment to respond but I will put the whole journey down shortly.

Briefly, in 2002 my smart GP, after 3 visits to the ER with afib ,sent me to a gastroenterologist and he put me through the ringer with invasive tests. Basically my whole digestive system was stuffed with numerous problems.

If I have any advice for all of you it is to GO TO A GOOD GASTROENTEROLGIST AND HAVE ALL THE TESTS DONE. Your going to the wrong doctors.

Dean

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Dean
Thanks Susan d,
I haven’t got time at the moment to respond but I will put the whole journey down shortly.

Briefly, in 2002 my smart GP, after 3 visits to the ER with afib ,sent me to a gastroenterologist and he put me through the ringer with invasive tests. Basically my whole digestive system was stuffed with numerous problems.

If I have any advice for all of you it is to GO TO A GOOD GASTROENTEROLGIST AND HAVE ALL THE TESTS DONE. Your going to the wrong doctors.

Dean

Here is a post I made below a recent post of Dean's. It includes a link to a compilation of success story posts people made that were marked by then member Peggy Merrill. It gives a good menu of things people can try. Dean's initial story is in it.

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Dean
To George and other long term posters on afibers.org I am still afib free since 2004. Fingers Crossed!!! I still follow this forum as I am under no illusions it might return.

Dean

Great news, Dean!! It has been a long time!

In the early/mid 2000's, we had a member, Peggy Merrill, who would tag success stories. Around Dec 2007, these were compiled in a PDF in our "Conference Room." Dean's story starts on p 27 of the PDF.

Over the years, Dean has posted quite a bit on natto food that he uses to keep his afib at bay. Here is a search on his posts on this topic.

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cornerbax
I'm curious and surprised I have never read a post that discusses getting healthy vs. an ablation. Nor have I ever had a cardiologist or EP tell me to focus on a healthier lifestyle. From the beginning I was just told to have an ablation. Because it's known that Afib has underlying causes such as drinking, smoking, being overweight, sleep apnea, lack of exercise, in some cases too much exercise, etc., wouldn't it make sense for anyone who fits some or all of that criteria to focus on lifestyle changes BEFORE an ablation? In some cases i'm thinking a healthier lifestyle may help to correct/reverse Afib.

Regardless of whether Afib is Paroxysmal, persistent, long-standing persistent, it would just seem that Cardiologists and EPs would spend more time talking about health and changes people with Afib can make instead of just an ablation. If any of those "triggers" mentioned aren't corrected, isn't an ablation almost a complete waste of time and money because the Afib has a much higher likelihood to return? I know there's a lot of money to be made via medical facilities/EPs, etc. by an ablation. But if someone lived an unhealthy lifestyle and has an ablation and continues the same, unhealthy lifestyle after the ablation, isn't the ablation completely useless?

I don't think our system rewards docs who pursue what you suggest (not that there aren't docs who do this, just not the majority). It takes a lot of time (which doesn't fit the time an EP has for an office visit) to coach people to change their lifestyle & many people are resistant & want a quick result. I've gotten quite a few people who approach me privately and have changed their lifestyles, with varying degrees of success with their afib. One notable episode was when I was on a skiing holiday a couple of years ago. A member, who was a former pro US football player, contacted me and told me I was his hero. It turns out he had some congenital heart issues beyond his afib that complicated his situation. I ultimately suggested an ablation with Dr. Natale, which he got and was successful.

I was backpacking a few years ago with a doc friend who is a hand surgeon. He asked me about my afib remission program. After I described it, he said most of his patients were not capable of understanding the program, would not follow what I did, and did not have the attention to detail for the consistency required.

I'm trying my best to improve with lifestyle and health improvements & changes.

Depressing to think my all my efforts are for naught.

I do wonder how both frequency and time length of AF events factor into "live with it" or seek an ablation decisions.

And whether the 'live with it" and take Eliquis and implement as many lifestyle and health improvements is adequate and Then when to surrender to the procedure.

The problem is that, once the electrical pathways have been established, the heart is permanently disordered. From there, it gets progressively worse if left unmanaged. I think some good chunk of management could/should be reformation of one's lifestyle if it makes abundant sense to do that anyway, sort of like growing up finally. The other tools are plenty, but if one is burning the candle at both ends, even those tools will get blunted in time, and that is what so many of us report.

I think counselling about diet and getting more exercise and sleep, and not eating comfort foods for comfort's sake (meaning dealing responsibly with stressors like financial woes or home repairs, or about relationships that have gone south) should be a large component of 'holistic' care. The other components might have to be CPAP machines and anti-arrhythmic drugs, or an ablation. Many of us have had one or more ablations, and now live in at least a long temporary reprieve. I don't know how to put a price on being able to live well, with good quality, vs slowly losing the battle a day at a time with blunting drugs or a bad gut.

Thank you all for the responses, I appreciate it. I don't doubt there are many posts on this stuff but I wouldn't even know the exact title to search to find any of them. And in the 2 years i've been a member here i've never read any posts on this topic. I am asking this because, unfortunately, after 7 months in NSR, i've gone back into arrhythmias. I have some questions on that but that's for a different post. And as many here know, a co-worker of mine passed away recently from an ablation gone wrong so I am definitely not jumping up and down at the immediate moment for another ablation for myself.

All of this is what really got me thinking that if Afib is caused from "underlying" conditions then let's say you have 2 people. Person 1 and person 2 and both people have the same underlying conditions, overweight, heavy drinking, poor diet, lack of exercise, and Person 1 and 2 both get ablations. If person 1 makes drastic changes afterwards on their underlying conditions, while person 2 continues to live the exact same way post ablation. In most, if not all cases, isn't person 2 almost guaranteed AFIB returning? I know person 1 isn't "guaranteed" of anything, but it would seem that Person 1 would have a much better chance of keeping AFIB away while Person 2 would seemingly have done nothing but waste time getting an ablation to begin with as they didn't change a single, underlying issue. So when things are said like most EP's don't discuss lifestyle with patients and only talk about the "Ablation", and that the Patient generally just wants a "quick fix", if they continue the same poor lifestyle post-ablation, there really isn't a "Quick-Fix" or any FIX for that matter, right?



Edited 2 time(s). Last edit at 05/20/2025 05:34PM by cornerbax.

Person 2 isn't guaranteed anything. A properly done ablation will make it impossible for the areas of your heart causing your afib to ever produce afib again. However, afib is a progressive disease and can appear in other areas later in life that are outside the ablation fence. Being overweight, drinking, lack of exercise, etc -- all those things can hasten that happening.

Cornerbax

Have you ever been to a Gastroenterologist and have your upper digestive system thoroughly investigated for abnormalities with tests? Many afibbers on this forum over the years have great suspicions their afib was coming from their stomach.

I did in 2002 and from the results it laid the groundwork for me to change my diet and experiment with different protocols that put my afib into remission to this present day.

I went to my Gastro and explained that myself and my GP thought the afib was originating from my stomach as all my afib attacks happened when I was bent over so these are the tests and results he sent me for:

1. Barium swallow test:

- “On lateral views , after moving Dean supine, prone and then back to erect, (in other words a (“forward roll”) the configuration of the stomach altered with the antrum and duodenum on the erect view now lying above the level of the fudus”

The Gastro explained that this is stomach Volvulus or “ wandering stomach” and 10% of the population has this. The ligaments holding the stomach in place are loose so the stomach moves around far more than normal.

- There was also “slow clearing of both barium and the barium impregnated marshmellow through the mid and distal esophagus”.

2. Gastroesophagel endoscopy:

-Finds Loose Esophagel Sphincter (LES). This is the valve that lets food into the upper stomach.

-Signs of Reflux

3. 24 hr pH Study and esophagus motility test:

-This test was absolute gold and produced the “smoking gun” linking my afib, SVT and ectopics to silent reflux,LES and esophagus motility problems.

Back in 2002 the 24hr pH study was done by inserting a 2 inch metal cylinder on a tube through your nose to locate the cylinder half way between your LES and back of mouth. The tube was taped to your nose so it would not move.
This was then connected to a Holter style monitor strapped to your waist. Very uncomfortable and awkward!

I spent the time at home and mostly watched TV. When I lied down on the couch I noticed the pH on the display monitor went from 6 or 7 (normal body pH) down to 2 (sign of silent reflux). Also at 3 to 4am in the morning it was also down to 2 or 1 (reflux again).

At the time I was on the couch and in bed or even bending over I was having runs of PAC’s and PVC’s when the pH was at 2 so the connection between reflux and arrhythmia was made.

-Esophagus motility test:

At the end of the test they extract the tube and cylinder in stages and measure your esophagus motility (also called peristalsis) and it indicated I could have suspect motility.

The Gastro then referred me to an EP who on reading the Gastro’s report (specifically the graph of the 24hr pH study) agreed that my Afib and ectopics were probably coming from my stomach and reflux.

I won’t go any further as the rest of my story is on the forum.

From my experience I can’t understand why when diagnosed with Afib your not sent to a Gastroenterologist for further follow on checkup’s of your upper digestive system. Many afibbers over the years have suspected this link?

I guess afib is a “heart condition” so is only treated by Cardiologists and EP’s. They don’t won’t other players like Gastroenterologist’s taking their turf.

Cornerbax, I hope the above gives you food for thought and helps you decide how your going to proceed managing your afib.

There are alternatives to ablation if you think out of the box.

Dean

I've read this, link below, on afibbers Gut Connection in the past few weeks which caused me to question the hiatal hernia that showed up in my first colonoscopy back in 2014 to question my Cardiologist and they never acknowledged my inquiry.

I actually had an episode last night starting after midnight. Towards the end @ 3 a.m. all the loud gurgling noises coming from my abdomen reminded me of this information here on afibbers. The noises went on for 5-10 minutes then boom HR back down into the 50's. Although I think PAC's are back again this a.m.

[afibbers.org]



Edited 1 time(s). Last edit at 05/21/2025 01:20PM by Qwackertoo.

That sounds a bit like a Vagus nerve issue, even if temporary. AF can be a problem with Vagal tone and/or with adrenergic response in the heart's substrate.

Dean, thanks for the great breakdown of info. My Afib never came from bending down or any other "specific" movements. I rarely have acid reflux, etc. I was diagnosed by 3 top EP's, including Dr. Natale who all said to have my Mitral Valve Repaired. I was in persistent AFIB for over a year prior to my mitral valve surgery, LAA closure and Cryo-Maze. I was in NSR for 5 days post surgery when I went into Atrial Flutter. Flutter, apparently is very common after heart surgery so it didn't completely surprise me. I then had an ablation for the flutter and was in NSR for most of 7 consecutive months, regardless of what I ate/drank. I did have some episodes of AFIB throughout the 7 months, but no more then 1 a month and which typically lasted for 10 minutes or less before self-converting.

With my situation and this info, you still think there is a chance it could be related to the stomach? And you still think it would be worth while to see a Gastroenterologist?

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gloaming
That sounds a bit like a Vagus nerve issue, even if temporary. AF can be a problem with Vagal tone and/or with adrenergic response in the heart's substrate.

I'll definitely be doing some additional reading on this. I've been trying the past month to practice to breathing exercise to improve my Vagus Nerve tone. Haven't read much on adrenergic responses yet but on my list. Busy working on my Dr. Natale paperwork after my phone call from Norma this a.m. I must admit after my episode last night, 2 1/2 hours in length, that with PAC's this a.m. ? I think, that I was quite jittery after our 5+ minute phone call. Norma was so very kind and helpful, I'm so ready to get back my quality of life and hopefully get past the sense of dread I've been living with for awhile now never knowing when an episode will erupt.

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Dean

I went to my Gastro and explained that myself and my GP thought the afib was originating from my stomach as all my afib attacks happened when I was bent over so these are the tests and results he sent me for:

1. Barium swallow test:

I too will get arrhythmias if I bend over. Picking up something from the floor will immediately trigger it.

Dean, I too don’t understand why doctors don’t connect GI issues with arrhythmias. Also gingivitis issues from my BB side effects are triggering my PVCs. I just saw two dentist who agreed that my meds are the cause of my inflamed gums.

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Dean
2. Gastroesophagel endoscopy:

-Signs of Reflux

I vomit acid. It started after Multaq and I still have GERD after stopping Multaq.

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Dean
3. 24 hr pH Study and esophagus motility test:

Thanks. I try to get it done

I tried really hard with diet, sleeping better, exercise, zero alcohol and my Afib just progressed to have more episodes more frequently. I have always been quite healthy anyway.

Did a bunch of blood tests with my doctor and dietician to no avail. Tried supplements to no avail.

Had a PFA ablation recently and I feel normal again with zero episodes so far! I should have had an ablation sooner.



Edited 2 time(s). Last edit at 05/22/2025 02:26AM by Glen24.

Congratulations Glen!!! It is such a big decision and happy to hear of your results.

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cornerbax
Thank you all for the responses, I appreciate it. I don't doubt there are many posts on this stuff but I wouldn't even know the exact title to search to find any of them. And in the 2 years i've been a member here i've never read any posts on this topic. I am asking this because, unfortunately, after 7 months in NSR, i've gone back into arrhythmias. I have some questions on that but that's for a different post. And as many here know, a co-worker of mine passed away recently from an ablation gone wrong so I am definitely not jumping up and down at the immediate moment for another ablation for myself.

Rec'd yesterday the Updated (2025) Edition of The AFIB Cure which focuses on lifestyle changes as a way to manage AFIB (use of the word 'cure" may be a marketing strategy, but have not read it yet). The authors are both medical experts in AFIB but do not appear to have AFIB themselves. The book also comes with an appreciation by Shannon Dickson.