this is what the heart of somebody that will have a stroke sounds [Music] like about 8 10 years ago that's what my heart sounded like that irregular heartbeat is caused by the number one hidden heart problem that causes Strokes it's called atrial fibrillation because I was fortunate enough to find out that I had it I was able to control it I avoided having a stroke in this video I'll show you how I did that and how you can do that as well and the main ways to treat or manage or prevent atrial fibrillation we'll discuss
medications yes of course we'll discuss surgical procedures as usual we'll discuss supplements as well but most of all we'll discuss lifestyle because that's where the cause is my name is Dr Ford Brewer I'm a preventive medicine specialist with over 40 years of experience so let's get started what is atrial fibrillation well this is your Atria when they're not fibrillating this is your Atria when they're fibrillating the most common heart arhythmia when it's coordinated a coordinated beat like this it fills the ventricles the major chambers of the heart and adds 20% more boost to what they're
doing when it's doing this it doesn't help in fact it sits there and the blood pools and that pooling blood can cause a clot and that is a big problem because clots have a high chance of being pumped outside of the heart and if you follow the vessel's trail long enough they can go directly to the brain a clot that's big enough and goes to the brain causes a stroke the most common type is called anemic stroke or a clot based stroke in which you lose blood supply to that part of the brain the other
type which is not very common but happens is called a bleeding type of stroke so there's the clot stroke or the bleeding stroke when the clot blocks the blood flow a part of the brain dies resulting in things like slurred speech limb paralysis disability 2third of Strokes are es schic or clot type of Strokes in which there's blood loss to the area of the brain 25% of Strokes are what we call cryptogenic now what does that mean crypto just means we don't know where it came from and genic means where it came from so we
don't know where cryptogenic Strokes came from at least that was what the case was up until a decade or so ago now what's happened is this new research is showing that 2/3 of those quote we don't know where it came from cryptogenic unknown cause Strokes are actually the result of the number one neglected problem heart rhythm and guess which one atrial fibrillation you might be thinking okay well you got me that's scary and it's a problem but the crucial question is this how do you know if you actually have it well let's discuss some signs
and symptoms that might suggest you have atrio FIB because a lot of people have it and don't know it it's sort of like the thing with uh pre-diabetes a lot of people have it and don't know it meanwhile it's causing significant problem for the people that do have symptoms you'll find things like shortness of breath palpitations again palpitations are just a feeling of fluttering in your chest you can feel some dizziness or even fainting sometimes because it decreases the output of the heart chest discomfort other than just fluttering just a a dull achy feeling you
can even have sudden Strokes or what we call mini strokes the docs call them TI a transient esic attacks so it's like an es schic attack like a stroke an es schic stroke but it's only transient it goes away within 24 hours now these are all symptoms of atrial fibrillation here's the thing you don't want to have these symptoms you want to know about that long before you need to have an understanding of your heart rhythm that's one of the first steps while an irregular pulse is highly indicative it's very suggestive of this your doctors
will still require more tests to fully evaluate your condition doctors often use what's called an EKG or electrocardiogram the test is basically a one or two minute picture of your heart's electrical activity if we see specific electrical activity in that EKG we can make a precise diagnosis of atrop FIB sounds simple enough why don't we just screen everybody with an EKG well there's a couple of problems first you want to find this before you're having symptoms and second and most of all if you don't have symptoms when the one minute EKG test is being performed
it may actually miss the problem and therefore we think we've screened for it it's not there and it actually is see there's a variant of atrio FIB it's called peric isal atrial fib parisal type still increases your risk of stroke 5 to 8 times the electrical activities May Come and Go but that clut is still forming EKGs have been proven to be ineffective at screening for this parisal atrio FIB or the atrio FIB that comes and goes so what do you do well there are alternatives for example a halter monitor portable machine that will work
as an EKG but will track your heart rhythm for about 24 hours and up to 28 days that's almost a month that sounds great right why don't we use that well there are a couple of problems with this as well first wearing it is very uncomfortable I wore one for two weeks you can't get a shower you can't really get a bath you just sort of have to wipe down because you're wearing these cords that attached to your body and a big machine the second problem this type of testing can be expensive with or without
insurance so now there's good news here each year we get more and more access to newer better devices take this zo monitor for example it's gaining a lot of popularity with cardiologists and with patients for obvious reasons it's much easier this is not a sponsored video by the way not by zo or iic cardia or Apple watch or any of the other devices that we're going to mention ultimately despite the challenges the halter monitor is still probably the best way to find atrial fib but what if a heart monitor is not an option for you
some wearable devices can still provide valuable insight to these electrical disturbances Within your heart a recent study reports that Fitbit can have a predictive value of about 98% for atrial fibrillation but let's be careful with this evidence since Fitbit the company was involved in the funding of This research in another study comparisons were made with Apple Samsung sense and icardio watches the best detections of aib came from Apple and Samsung watches so there is clear evidence that wearables especially those that include some artificial intelligence software are becoming an excellent option for finding atrio FIB they
may not be totally there yet but they're coming a long way they've come a long way fast especially asymptomatic people that's the problem again you have people that have parisal this come and go type of atro fib and then you have people that never have any symptoms at all so let me tell you a little bit about my story I knew I had risk because I had done some cardiogenetic testing early on that showed that I had two copies of the atrio FIB Gene it's also called 4 q25 I got one from Mom one from
Dad now what does that Gene do it makes the muscles in the Atria the muscle fibers evolve more quickly into conduction fibers so you've got all of these new conduction Pathways if one of those conduction Pathways connects back into a loop you start getting that Loop in the Atria and that's what causes atrial fib so I knew I had some risk there I also knew that I was an endurance athlete I had run gosh countless half marathons I did one of those per week usually for training I did did half dozen marathons I even ran
a an ultra marathon the marathons by the way are 26.2 Mi and the ultra is 40 weekly I was doing 13 and you know 13 and a half miles in addition to playing a couple of hours of hard uh full-court basketball so I had significant risks from a lot of endurance training I had significant risks from genetics and sure enough I had noticed sever several times that I would get into these episodes of palpitations I always wondered if these palpitations might actually be fibrillation so I looked around for ways to detect this the Apple watch
was not quite ready for prime time at that point but you had a lot of devices on even on Amazon I got an i cardia device it had a simple electrode you put both thumbs on it it connected to your iPhone and it gave you what's called a rhythm strip I could see the Rhythm strip of my heart for the most part it looked fine until I woke up one night and knew I had it even before testing it I had this thumping going on in my heart my heart rate was about 160 beats per
minute it was irregular the doctors talk about is an irregularly irregular which I won't explain heartbeat is pretty clearly diagnostic for atrio FIB I put my thumbs on the electrode I saw that I had no p-wave again meaning my Atria were just not connecting on a coordinated basis yep I had it the again the heart rate was about 160 per minute I eventually came out of it but I was also able to document it I went went to see a cardiologist and then a a rhythm uh specialist heart rhythm specialist what's called an electr physiologist
I got a um a uh hter monitor as I mentioned I was in Atri I I developed into atrio FIB 20% of the time you don't want to be in atrio fibrillation that often you want to be a very small percentage 5% or less um either one causes risk for strokes but when you're in it for longer periods of time that Rhythm that you're that pathway that you're using we call it an a Barren pathway that unusual pathway that's taking you in circles that goes on and on and is much more likely to remain unless
you get out of it so I was considering a an ablation we'll talk about those a little bit later in the video um but at the end of the day I wanted to do it with lifestyle because ablation like every other surgical procedure has its own problems and yes we'll talk about those as well I'll tell you a little bit more about my atro FIB story a little bit later but let's talk about you right now let's say you've just found out that you have a fib or maybe you already know you have it or
maybe your one of one or both of your parents have it and you're just wanting to know do I have it even if you know somebody has atrio FIB that's really step one of the question the question is how much of an increase of risk of stroke do they have or do you have there are multiple ways of assessing that risk of stroke the most used one now is is an acronym and it's called Chad 2 Basque 2 I'm not going to go into the details of how to do that so don't worry about that
piece but I am going to tell you the basics because those are very helpful at this stage of learning about this as usual it goes back to Lifestyle and risk factors age gender history of heart failure blood pressure stroke Tia or that Min stroke and vascular disease all are very important in evaluating your risk of stroke from atrial fibrillation but we need to take a look at one last and dangerous factor that contributes to Strokes before we go any further what is it diabetes yep it's known diabetes is a risk factor not only for asri
FIB but for strokes diabetes and metabolic disease metabolic disease disease is pre-diabetes and diabetes it's the only disease that causes more Strokes than atrial fibrillation your doctor will have to assess whether you have this condition now when I say that I cringe because I know that three4 of doctors responsible for detecting metabolic disease in this country the United States talking about family practitioners in ists cardiologists 3/4 of them don't know how to diagnose metabolic disease that is scary and that's one of the biggest challenges we have in medicine today that's what this channel is all
about helping you understand what you need to know because you cannot depend on your doctor to diagnose your metabolic disease and therefore to help you treat it until now you've seen how to detect atrio fib and how to evaluate risk of stroke from atrio fib and how to consider other major risk factors like diabetes but the question Still Remains how do you manage atrial fibrillation well let's get started with the traditional approach and it is still the most important First Step blood thinners you want to protect your brain from a stroke while you're doing the
other things to look at at root cause of atrio Fib so we're going to have to take a few minutes and talk about blood thinners now here are some options starting with Aspirin other blood thinners like clil before you go further let me make sure that you understand this the evidence is clear neither aspirin nor citrail decreases the risk of clots and strokes as well as the other types of medications they're called noax novel oral anticoagulants and you're saying oh no another technical word I'll never remember any of this you'll remember it because most of
you have heard of it here's a couple of examples zerto and elois so they're more effective they are safer than the other old blood thinners like warin aspirin does decrease the risk of heart attacks but it does not decrease the risk of Strokes for people with atrio why is that the case it may get into the fact that these are clots forming inside the Atria but it doesn't matter don't worry about figuring that out so when I found out that I had Atri fibrillation the first thing I did was I said okay aspirin's not adequate
anymore I'm going to have to bite the bullet and take one of those two I started with elois at this point I'm on zerto but uh again those are pretty much the same there are some differences no doubt but on practical purposes for what we're talking about it's elois and zerto the noax there are two problems with these blood thinners the first is that many people deal with bleeding issues taking aspirin or noax would be adding further risk to bleeding issues and you see that with GI bleeding gastrointestinal bleeding like esoph bleeding actually there are
three problems with these things the first is that they add some bleeding risk the second is they are very expensive they're just not cheap like aspirin and I hate it but again aspirin does not work for stroke prevention for atrial fib so that's two of the problems they're expensive they increase bleeding what's the third problem well they are effective treatment for avoiding clots and strokes but they don't solve the original root cause issue you still have the atrio FIB that's the third problem now if you ask a cardiologist you probably know what their answer is
going to be well to solve the root problem you need to have an ablation well let's talk about it what is an ablation it's a procedure the doctor takes a wire puts it inside the artery your femoral artery in your groin drives it up to the upper chambers of the heart the Atria once there it burns or freezes certain areas of those Atria what's it doing it's burning those extra Pathways that are causing that circular pathway for your heart rhythm the idea is that since there are areas of the atrium creating additional nerve impulses or
causing that circular pathway and that causes the additional contractions it causes Rhythm issues burning or freezing those extra Pathways will allow the heart to go back to a normal Rhythm now ablation clearly has been shown to be better than trying to use a medication to return you to a proper heart rhythm especially in people who have developed heart failure so it is better ablation is better but it still hasn't been shown to prevent long-term risk of Strokes any more than anything else so evidence even suggests that the recurrence of atra FIB in the first year
was as high as 50% so that's the bigger issue that I was concerned about I was ready to take my risks if I could get rid of the Atria FIB uh I was going to take my risk that that would decrease my risk for stroke but here was the big problem for me and for most of my patients look at the evidence on ablation it doesn't last as I said and you may have missed it some evidence indicates that the atro FIB is back as often as 50% in a year so that's like a coin
toss you are basically just putting your life your chances of stroke up for a coin toss there's other issues as well recovery from ablation can be very very challenging so what about the other option for treatment it's called cardi aversion it's where they shock your heart you know like they do on the TV shows with the defibrillator except they do this in a controlled environment they take you to the operating room they sedate you and they give you a shock that'll restart the heart trying to get a normal heart rhythm it can have a success
rate of over 90% but that sounds like well you know let's just do that well think about it it also doesn't last forever in fact many people have tried it and found it came back within a matter of months and you might think well it's risk risk- free so let's you know we can try it again anytime you put someone espe especially older people under sedation that's not risk-free here's the other thing when you shock a patient and restart the Rhythm and you already have clots in the Atria so basically what you're doing is putting
those clots into circulation restarting a normal Rhythm can actually pump those clots and cause an emance to the lungs or even cause that stroke so the risk is the highest 7 days after the cardio aversion is performed that's why it's important to start blood thinners and anti rythmic medications as well to decrease these risks and to have those active and on board before you get cardio aversion let's go back and think about root cause the main problem with both ablation and cardio aversion is that it often does not solve the root cause in fact it
usually does not solve the root cause of the problem what causes atra FIB in the first place well that's part of the key question here there are multiple root causes this is not a simple list congenital heart problems structural heart problems valv disease other conditions uh similar to structural problems out alcohol we used to think that alcohol was not a problem in this area but about 5 years ago evidence began to show that alcohol encourages that development of atrio FIB now here are a couple of key Ones high blood pressure and obstructive sleep apnea I'll
tell you why those are key in just a minute because they are what I worked on genetics are important heart inflammation that can be due to infections and metabolic disease if you've had a heart attack damaged heart tissue can cause this now let me go back to my situation and by far the most common situation you remember I mentioned high blood pressure I mentioned sleep disordered breathing or sleep apnea and one thing that I didn't mention that causes both of those an extra five or 10 or 30 or 50 or 100 lb so my BMI
was already low it was 23 but I decided you know what I know that a little bit of weight loss a little bit of uh Improvement in sleep apnea and Improvement and blood pressure all of these things can help dramatically in terms of reducing the time that you're in fibrillation I decided to go the weight loss route even though I was was already thin I could still lose a few more pounds and I did I lost 5 lb then 8 lb and bounced around between 5 and 8 pounds my blood pressure improved my um sleep
improved in terms of sleep disordered breathing and guess what I went from over 20% time in fibrillation down to not noticing any at all we repeated it it was very very unusual for me to go into to a fibrillation um episode so I went way less than 2% from over 20% how did I do it I lost between five and 8 pounds consider that there's a major cause that's actually neglected every day it is the thing that's killing more people than anything else if you follow this channel you probably are already guessing it's that major
cause it's metabolic disease insulin resistance mostly known as pre-diabetes and even diabetes this leads to cardiovascular inflammation inflammation leads to alterations in the Atria and triggers atrial fibrillation now aging is another cause but there's a case to be made that metabolic disease is very involved in aging and in fact I would say you know I I say it all the time growing old's not for sissies metabolic disease in other words pre-diabetes 90% of which is undiagnosed multiplies the rate at which you age some people actually have parodontal disease which is a significant risk factor parodontal
disease fillings Mercury amalgams all of these have been linked to atrio Fib so the bottom line is there is a connection between oral health mouth Health tooth health and multiple types of cardiovascular and cardiac disease if you're in the baline community uh you know that you've been hearing that every time Brad and Amy talk so if you can work with your docs work with your dentists look for root causes for these problems and deal with those again surgery is not the answer procedures are not the answer medications are not the answer lifestyle is the king
here you cannot out prescribe you cannot out procedu you cannot out stint you cannot out oblate a lifestyle and the most important part of lifestyle is diet and the reality is the most important part of diet is staying a healthy weight and having good muscles and and very little body fat what about natural options supplements if you're working on root causes and worried about clots and you don't want to take medications a lot of people say well supplements are a better option they're not as dangerous let's get into that review nyas it's an enzyme that
comes from natto a Japanese dish made of fermented soybeans evidence suggests that it has blood thinner benefits and it appears to be true it can improve arterial plaque the evidence does not yet support that it actually decreases the risk of clots with atrial fibrillation I'm sorry to say that but that's the evidence magnesium it's another popular supplement it has very interesting data and evidence supporting it it's even used in hospital settings to improve life-threatening cases of arthus including atrio FIB however there's just not enough evidence either to support the idea that oral supplementation of magnesium
can improve atrial fibrillation so again sorry to tell you that but that's the evidence at this point in time Hawthorne plant okay if you're a Hawthorne fan it's also very popular there's some good evidence that it can decrease mortality in people with heart failure but similar to the others there's just not enough evidence to indicate that it will save you from atrial fibrillation the next one quatin quatin is a natural flavonoid it's a compound with multiple anti-inflammatory and blood thinning properties some researchers suggests it's used for Atri fibrillation there's no question but it's still not
definitive in terms of managing risk in humans cayenne pepper oh cayenne pepper is very popular it's a spice it has similar effects to other antioxidants and anti-inflammatories even though I believe there is good evidence for pla prevention and cayan pepper most of the evidence suggests that it's just not specific enough it doesn't provide benefit for atrio fib and in high doses and in bad quality supplements Cayenne can actually increase your risk so be careful there now last but not least we have the Omega 3 the fish oils the krill oil they're even more popular recently
however there was an article claiming that Omega-3s can actually increase the risk of atro FIB I've reviewed that article the main takeaways are this there is an increased risk of ATR FIP about 133% but as you dig deeper in this article it decreases the risk of heart attacks in people with atro FIP by 15% and the risk of death by 9% the risk was usually seen at very high doses four grams a day or more and the vast majority of people take 2 grams or per day or less what do I do about Omega-3s I
take omega-3s even though as I've told you I have uh atrial fib or have had atrial fib and I'm now at a low rate of fibrillation and I'm managing it I continue to take uh the Noak I've switched from elois to zerto not for clinical reasons but for payment and insurance access reasons let's talk about some other strategies you'll hear and read about acupuncture yoga biof feedback still the strength of the evidence in those is just not the best I'm sorry to tell you but it's not the best so what's the takeaway here don't rely
on a supplement or even a medication for your prevention you know it's just like every other type of prevention you can't outs supplement it you can't outm medicate a lifestyle look for your rude cause change your lifestyle get it where you need to be and you want to use some supplements okay that's great just be careful about combining them with medications making sure that and most of all making sure that you're not relying on those alone to to get you out of a lifestyle problem as I said before uh if you have atrial fib please
first of all consider blood thinners as I said i' I did and I use medications the noax I don't use aspirin I don't use the vitamin K antagonist like warrin although I use the supplements I don't use them alone most of all I use lifestyle now you have a broader picture of atrial fib what it is the risks behind it and how I even manage my own atrial fibrillation but as I've said before atra FIB was not my main problem it's usually not uh yours or others either what is it metabolic disease insulin resistance pre-diabetes
diabetes they are my main problem that's what causes plaque to build up in my arteries and that's what causes my risk um you know speaking of uh plaque and risk I was able to actually reverse 20 years of arterial plaque believe it or not now you can see how I did it and I think it's uh here