Get Your Life Back in Rhythm

Dear readers, Recently I went on the Wise Athletes Podcast to discuss how to exercise without getting AFib. We covered all topics related to exercise, AFib, and why athletes seem to be particularly at risk for AFib. If you love to exercise as much as I do this is definitely a podcast you won't want to miss! Thanks for listening! John Wise Athletes Podcast episode website

The 12 Best Ways to Fix Atrial Fibrillation with Sleep Whenever people try to get healthier, and no matter what the underlying reason for that effort, they almost always start with diet and exercise. Those are two very important factors, but without addressing a third factor—sleep—they are almost assuredly doomed to fail in their efforts to eat better and exercise more. In this article, I'm going to give you my 11 best ways to fix atrial fibrillation with sleep. Most of Us Are Really Bad at Sleep Let's face it, most of us are really bad at sleeping. And as a global community, it would appear, we’re actually getting worse at it, even as the science that demonstrates its importance to our lives has gotten more and more compelling. The World Health Organization has raised the possibility that sleep problems are an emerging global epidemic. In the United States, 70 percent of adults report insufficient sleep at least once a month, and 11 percent report insufficient sleep every night. For a while, it did seem like we were getting the message about the importance of sleep to our health. After a century of consistently diminishing sleep, researchers who study the way we slumber noticed something promising. From 2004 to 2012, the number of people who were getting less than six hours of sleep each night finally started to level out. Maybe, some thought, we were finally getting the message. Or maybe, others argued, we’d simple hit rock bottom. Either way, it seemed, we could finally start working to move the needle in the other direction. But when demographic sociologist Connor Sheehan and his collaborators dove into the subject in the late 2010s, they were dismayed by what they found. Yes, there had been a leveling out starting in 2004, but between 2013 and 2017 there was a significant shift. Far more people were reporting far less sleep. We hadn’t hit rock bottom after all. What changed? Among the most important factors are the devices we increasingly carry in our pockets, purses, and person. Closely coinciding with the quickly falling rate of adequate sleep was the rapidly rising rate of smartphone ownership, which went from 35 percent in 2011 to 77 percent in 2016. “Americans now spend more time looking at a screen,” Sheenan and his collaborators wrote, “and, due to the mobile nature of these devices, technology has increasingly entered the bedroom.” This isn’t just happening in the United States. More than 5 billion people around the world now have mobile devices, and more than half of those devices are a smartphone. Leading the way in the adoption of tiny, glowing screens is South Korea, where 95 percent of adults have a smartphone and where, perhaps not coincidentally, adults get nearly 40 minutes less sleep each night, on average, than their global counterparts. Because smartphones may be a cause of poor sleep, and also because these devices are increasingly equipped to detect the health consequences that result from poor sleep, it should come as no surprise atrial fibrillation diagnoses have skyrocketed in Korea in recent years. Why is Sleep so Critical for Atrial Fibrillation? The impact of poor sleep on AFib has been well documented. Even small interruptions of sleep quality and duration can increase the risk of atrial fibrillation by 18 percent, and people who experience insomnia are 30 to 40 percent more likely to develop atrial fibrillation. People who do not reach deep levels of sleep—the sort of sleep that is key to recovery—have an 18 percent increased risk of atrial fibrillation, and it worsens each time they wake up at night. It’s even worse for people with sleep disorders such as sleep apnea; they have a 200 to 400 percent increased risk of AFib over individuals without a sleep breathing disorder. And the problem is compounded once AFib actually develops; the presence of an abnormal rhythm can increase the risk of poor sleep quality, or short sleep, by three to four times. It’s a vicious cycle. That makes complete sense. In addition to the miserable experience of simply not feeling well-rested, sleep deprivation causes the release of excess cortisol and adrenaline. The former hormone causes you to retain water, lose potassium, have a high blood sugar, and have a higher blood pressure. The latter also increases your blood pressure, forcing your heart to work harder. In fact, when we want to trigger an atrial fibrillation episode during procedures intended to identify the trouble spots within a patient’s heart, we give our patients a form of intravenous adrenalin. The 12 Best Ways to Fix Atrial Fibrillation with Sleep Now that we know why sleep is so critical to maintaining normal sinus rhythm, below are my 11 best ways to fix atrial fibrillation with sleep. 1. Go to Bed at the Same Time Every Night Studies show that just one night of bad sleep can increase your risk of an AFib attack the next day by more than three-fold! And the best way to get the sleep your heart needs is to actually put it on your calendar. Then, just like you do everything you can to avoid being late to work, you should do everything you can to avoid being late to bed. This is a simple and powerful step: Studies show that the mere act of setting a bedtime, and sticking to it, results in an entire additional hour of sleep each night. And remember, seven hours is the target for actual sleep—not for time in bed. If it takes you 30 minutes to fall asleep and you typically have a middle-of-the night awakening to use the bathroom, get a drink of water, check the locks on the doors, or whatever, then you should probably schedule at least eight hours. For me, I have a strict bedtime of 10 pm. And for most people suffering from AFib, studies now show that a 10 pm bedtime (or at least before 11 pm) is best to prevent AFib and other heart problems. 2. Wake Up at the Same Time Every Morning At the same time you schedule going to bed in your calendar, you also should schedule the time you’ll get up in the morning—and rise no later than that time. This can be a tall order in a world in which more people than ever before are working remotely, with flexible hours and start-of-the-day times that are all-too-often aspirational rather than required. That can make it seem like hitting the snooze button is a harmless choice. But, contrary to popular belief, getting a few extra minutes of sleep in this way doesn’t actually result in restorative sleep. In fact, waking, dozing off again, and abruptly waking again can result in sleep inertia—a period of up to four hours of lowered functionality. This doesn’t mean that you should stay in bed if you have woken up and feel rested. If you wake up and are ready to go, there’s no reason not to greet the day. Conversely, if you need an alarm clock to wake up in the morning then you likely didn’t get enough sleep the night before. Our bodies are designed to wake once we’ve gotten the amount of sleep we need. So once you’ve figured out how much sleep your body truly needs, you can set your bedtime accordingly. Alarm clocks should be like insurance policies; they are there to put our minds at ease just in case we oversleep but best when they are never really needed. Our bodies function best when we are able to wake up naturally, and that is most likely to happen when we schedule our bedtime and steadfastly adhere to that schedule. In my experience, people can train their bodies when to fall asleep and when to rise. If your body learns, for example, that you go to bed every night at 10 pm and arise by 5 or 6 am then sleep can become effortless. 3. Create the Perfect Sleeping Room Scheduling a bedtime is important, but once you get to bed, everything needs to be in order so that you can do what you’re supposed to be doing there. This includes maintaining a clean, quiet and cool room with plenty of fresh air. If little sounds awake you, consider some background "white noise" for better sleep. It also means remembering the most important purpose for your bed: Sleep. Everything else can be done somewhere else, and most things should be done somewhere else. To be very clear on this point: Our beds are not the right place for eating. They’re not the right place for working. And they’re absolutely not the right place for “screen time” of any sort. 4. Bright Natural Light in the Mornings and Dim Lights in the Evenings Just as bright lights in the morning, especially bright natural light, is perfect to energize your day, keeping things dim in the evening can prepare you for sleep. And that is why electronic devices before bed can be especially problematic. If you absolutely must use an electronic device as bedtime approaches, don’t do it in the bedroom, and make sure the blue light filtering feature is on. Most televisions don’t have a built-in blue light filtering option, so if you are going to watch a television program after dinner, do so while wearing glasses, which are designed to filter blue light. Indeed, most prescription eyeglasses now offer blue light filtering. And for your bedroom, you want it dark. Really dark. The darker the better when it comes to restful sleep. The reason why light timing is critical for sleep is that light works with natural melatonin production to set your circadian rhythm. Keeping your circadian rhythm in rhythm is the key to not only a great night of sleep but a long life free from cardiovascular disease as well. 5. Have a Caffeine Curfew Most people are already aware that caffeine can impact sleep, but they tend to underestimate its effects. Caffeine isn’t just a mild stimulant; it’s a very powerful drug that can stay in your body for more than a day. For many people, the majority of the effects of this drug are gone in about five hours, but about 50 percent of people have a variant of a gene known as CYP1A2 that lowers the amount of a certain liver enzyme that causes their bodies to metabolize caffeine

The 11 Worst Medications Causing Atrial Fibrillation Could one of your medications actually be causing your AFib? Over the years I've seen a number of patients either significantly decrease their AFib episodes or even put their AFib into remission for a few years just by getting off an AFib causing medication. For those who needed a particular medication, catheter ablation was very helpful in eliminating the AFib so that they could continue to take their necessary medication. Below are my 11 worst medications causing atrial fibrillation. 1. Diuretics With the exception of spironolactone (Aldactone) and triamterene, diuretics can be problematic for atrial fibrillation patients. The reason is that most diuretics are well-known to cause mineral depletion in the body. Depletion of those key minerals, especially potassium and magnesium, is often enough to trigger atrial fibrillation. 2. NSAIDs Non-steroid anti-inflammatory drugs, or NSAIDs, can also induce AFib. NSAIDs are relatively common drugs like ibuprofen and naproxen that are often used to fight pain. NSAIDs are particularly troublesome for AFib patients because they also increase the risk of heart and kidney failure. For those who are also on a blood thinner, NSAIDs increase the risk of an emergency room visit for a life-threatening gastrointestinal bleed. 3. Proton Pump Inhibitors Proton pump inhibitors, which suppress stomach acid, can also atrial fibrillation by blocking magnesium absorption or possibly by changing a person’s gut microbiome. These drugs include omeprazole, lansoprazole and pantoprazole, which are often sold under the brand names Prilosec, Prevacid, and Nexium, respectively. 4. Steroids Steroids, like prednisone and Solu-medrol, can cause atrial fibrillation, too, by raising blood glucose levels to very high levels and increasing blood pressure through fluid retention and weight gain. Over my career, I've even seen many cases of steroid injections triggering AFib. 5. Any Stimulant Cardiac stimulant medications, like albuterol inhalers or theophylline for asthma, have long been associated with AFib. Even over-the-counter decongestants such as pseudoephedrine, which is sold as Sudafed, or medications for attention deficit hyperactivity disorder can trigger an AFib attack. The bottom line is that anything that revs up the cardiovascular system has a risk of causing AFib. 6. Digoxin, Diltiazem, Verapamil, and Beta-Blockers Perhaps a bit counterintuitively, some if the classic drugs used to treat abnormal heart rhythms such as digoxin, calcium-channel blockers such as verapamil and diltiazem, and beta-blockers have all been associated with an increased risk of AFib. While the exact mechanisms whereby these drugs may increase the AFib risk aren't entirely clear, plenty of cases have been documented in the medical literature. We’ve even seen beta-blockers, which are often used to treat AFib, linked to AFib episodes due to associated weight gain, particularly with women. 7. Fish Oil As many readers know, there is prescription-strength fish oil, like Lovaza, as well as the over-the-counter fish oil. Prescription-strength fish oil is used to treat high triglycerides whereas the over-the-counter version is used to treat a myriad of complaints. Regardless of which form it is, fish oil has now been implicated as a potential cause of AFib. If fish oil has been particularly helpful for you, try keeping the dose under 1 gram per day to minimize the risk of AFib. Or, alternatively, you can do what I've done and go back to eating wild-caught fish high in omega 3s instead of taking a supplement. Interestingly, since stopping fish oil for myself, I've noticed a lot fewer palpitations. 8. Antiarrhythmics like Amiodarone, Flecainide, and Propafenone Another surprise to many readers is that the antiarrhythmic drugs, the ones that are supposed to prevent AFib, have been linked to AFib. For example, amiodarone is well-known to cause hyperthyroidism which can then result in AFib. Flecainide and propafenone both slow the sodium electrical channels in the heart which, in some cases, may trigger AFib. It is also well known that these 3 antiarrhythmics may also increase the risk of atrial flutter which could be even worse than the original AFib. 9. Antidepressants If depression wasn't bad enough, one study showed a 3-fold increased risk of atrial fibrillation when starting an antidepressant. Fortunately, much of this risk goes away after you have been on the antidepressant for more than a month and then declines even further after you have been on the antidepressant for a year. Like many of the other drugs on this list, antidepressants alter the electrical conduction channels of the heart. 10. Opiates As if it weren't bad enough that so many people are dying from opioid pain killers, the AFib risk has been reported to be up to 4-times higher in people taking these drugs. And just as opiates change the electrical properties of the heart to cause long QT and cardiac arrest, they can also rewire your heart to trigger AFib. 11. Too Much Vitamin D When you do talk to your doctor, make sure that you don’t forget to mention any supplements you are taking; people don’t always think of vitamins and supplements as drugs, but just like any form of therapy, these substances should only be taken for the right reasons and at the right doses. One of our studies, for example, found that the risk of developing atrial fibrillation was two and a half times greater among individuals who were taking excessive amounts of vitamin D. Should You Panic if One of Your Medications is on this List? Just because a medication you take might be associated with AFib doesn’t mean it shouldn’t be taken. All medications have potential side effects, after all. The best way to make decisions about the medications you have been prescribed is in consultation with your doctor. Under no circumstances should you come off a drug you have been prescribed on your own volition; you should always do so in consultation with a physician. If you have an atrial fibrillation diagnosis or if you have concerns that AFib might be on your horizon, you should immediately engage in a conversation with your doctor about all of the medications you are taking, both regular prescriptions and once-in-a-while over-the-counters. You don’t have to wait for an appointment to start gathering the information you need, though. The common and less frequently known side effects of all medications are available from a variety of reputable sources, including the U.S. FDA, and a simple internet search for “AFib” and the name of the drug you are taking can tell you whether there is a possible connection. Consider an Ablation If there is a particular medication on this list that is very helpful for you, catheter ablation can be a very effective way to get rid of the AFib problem. Indeed, catheter ablation in conjunction with a healthy lifestyle, including weight control, is often curative for our patients as we described in our book, The AFib Cure. The procedures take less than 2 hours to perform and patients are usually able to go home 3 hours later. There is no cutting and no stitches with the procedure. Five days later most of our patients are able to return to full exercise at the gym. Also, if you liked the photo attached to this article, it is a picture my daughter took of my running shoes during one of our sunset runs on Laguna Beach over the Thanksgiving Day weekend.

The 7 Most Important AFib Triggers to Avoid A new study was just published identifying the most important AFib triggers to avoid. Avoiding AFib triggers is incredibly important for AFib patients and something we covered in our best-selling book, The AFib Cure. In this article, I discuss the 7 most important AFib triggers to avoid based on published medical studies and my 30 years of experience caring for AFib patients. What are your AFib triggers? While most of my patients can identify at least one specific AFib trigger, many cannot. For some of my patients, AFib attacks are 100% random events so they don't have any clearly identifiable triggers. If you can identify one or more AFib triggers, then avoiding these triggers can be a very effective way of putting your AFib into remission naturally. 1. Alcohol At the top of every published study of AFib triggers is alcohol. Sadly, there is no safe dose of alcohol for AFib patients. And that shouldn’t come as a big surprise as any emergency room doctor can share many stories of high school or college students who have presented with AFib after binge drinking. 2. Exercise Exercise is the most natural way in the world to shift our hearts into a higher gear, so it’s no shock that, if your heart is already prone to beating erratically, a quick burst of exercise could push it over the edge. But avoiding exercise is simply not an option as not exercising at all dramatically increases your risk of AFib and an early death. For those suffering from exercise-induced AFib, many of my patients have found that simply decreasing the intensity or duration of their exercise can help tremendously. For others, they can still exercise vigorously without AFib provided they have slept well, are well hydrated, and have their electrolytes in check. When nothing prevents exercise-induced AFib, it is time to consider an ablation. Indeed, I have countless patients, including elite world-class athletes, who have all successfully returned to high levels of exercise free of AFib with an ablation procedure. 3. Dehydration/Electrolyte Depletion It always amazes me how so many of my patients' AFib attacks come from when they aren't drinking enough water. Indeed, many of my patients fail to realize that their fatigue, dry skin, headaches, muscle cramps, urinary tract infections, constipation, dizziness, brain fog, or their AFib all happen because they aren't drinking enough water. And proper hydration is especially important for AFib patients before exercising. In addition to adequate hydration, optimization of electrolytes is also necessary to keep the heart beating right in sinus rhythm. For example, potassium and magnesium depletion are well documented AFib triggers in the medical literature. Fortunately, both can easily be replenished with a diet high in vegetables, fruit, nuts, seeds, legumes, etc. Indeed, many of my patients report that magnesium supplementation has been essential to keeping their AFib in remission. When it comes to optimizing your electrolytes, please don't turn to sports drinks. Sport drinks are nothing more than sugar water or artificial sweetener water with chemical dyes and a trace amount of electrolytes. If your goal is to optimize for sinus rhythm and longevity, get all the electrolytes your body needs from natural food sources like vegetables, fruit, nuts, seeds, legumes, etc. 4. Poor Sleep A bad night of sleep is another big AFib trigger. Bad sleep could be from sleep deprivation or sleep apnea. Indeed, studies show that a bad night of sleep increases your risk of AFib 3x the next day and sleep apnea quadruples your AFib risk. Make restorative sleep a priority! While sleeping on your left side is often uncomfortable for AFib patients, a recent study did not show an increased risk. So, while you may feel more palpitations when sleeping on the left side from gravity pulling your heart toward your chest wall, it probably won't cause an AFib attack. 5. Stress/Anxiety When you're stressed your blood pressure is up and adrenalin is pounding through your veins. So it should come as no surprise that on the days you wake up stressed or anxious studies show your risk of AFib on these days is 5 times higher! If you suffer from AFib, find ways to manage your stress. Good sleep, sunlight, and a great workout in the mountains always cures me of any stress. For others, prayer, meditation, yoga, or spending time with a friend can also be incredibly helpful. Find what works for you and optimizes your stress levels. 6. Unhealthy Foods, Over Eating, and Cold Foods/Drinks Stuffing your belly full of food or eating junk may also trigger an AFib attack. Why would food be a trigger? Perhaps the high salt and sugar load of processed or fast foods trigger the attack from a blood pressure spike or fluid retention. Or perhaps it is because specific foods may irritate gastrointestinal problems. And GI problems are known to stimulate the vagus nerve, which connects your gut, brain, and heart. We don’t understand this vagus nerve connection in-depth, but our research has shown that gastrointestinal diseases are associated with atrial fibrillation. Also, when those gastrointestinal issues have been resolved, the AFib usually settles down as well. And cold foods and cold drinks are well known to stimulate the vagus nerve in ways that might put you at risk for an AFib attack. As I often tell my patients, in my 30 years of caring for AFib patients I've yet to meet a patient who reported that broccoli triggered an AFib attack!  7. Energy Drinks While most of my patients are convinced that caffeine is an AFib trigger, the studies simply don't support this. While I'm sure some of my patients are truly caffeine sensitive, most are not. If you are caffeine sensitive then it is best to avoid it. However, there is one form of caffeine that is particularly problematic for all of my patients. And that is energy drinks. There is something bad about combining a bunch of chemicals with sugar/artificial sweeteners and massive doses of caffeine that send hearts into AFib. Conclusion If your goal is to beat AFib, you'll need to avoid your AFib triggers. Even if you have had a successful ablation, you still should avoid your triggers. As alcohol can cause a perfectly normal teenagers' heart to go into AFib, why should it be any different if you are 50 and have had an ablation? If you want to learn more about stopping AFib, be sure to check out our best-selling book, The AFib Cure. Also, if you liked the photo attached to this article, it is another picture of an evening run I just went on with my daughter. We are standing on the old pipeline remnants of the Pipeline Trail up Millcreek Canyon overlooking Salt Lake City, Utah.

Is Caloric Density the Secret to Eating as Much as You Want without Gaining Weight? By Kate Clemens with John Day Is there a way to never feel hungry again and not gain weight? One answer is to mostly eat only those foods with the absolute lowest caloric density. In other words, a low caloric density means you want the most food you can get on your plate with the least amount of calories. And in this article, we'll teach you everything you need to know about the low caloric density eating approach. Dr. Day's Experience with Low Caloric Density Eating Focussing primarily on foods with the lowest caloric density has been something Dr. Day has done for the last 10 years to maintain his 30-pound weight loss. For him, pilling up his plate high with food not only fills his belly but also psychologically convinces his brain that he is full. As vegetables have the lowest caloric density this is what fills up most of his plate. And because oils have the highest caloric density, he avoids them whenever possible. For example, when making a salad he puts berries, beans, nuts, and seeds on his salad, rather than salad dressing, because berries, beans, nuts, and seeds have a much lower caloric density (see chart). In general, Dr. Day keeps his caloric density below 780 calories per pound unless he is eating nuts, seeds, or some very dark chocolate (>70% cacao and usually stevia-sweetened). Of note, his wild salmon measures in at about 780 calories per pound. On rare occasions, he will just put a small taste of salad dressing on a fork (he never puts the dressing on the salad) if berries, beans, nuts, or seeds are not available to flavor his salad. Caloric Density Works Caloric density is a straightforward approach to weight management that works. The idea is to increase the amount of food on your plate while decreasing your total caloric intake. You do this by paying attention to the calories per pound in the food you choose to eat. The best part of it is that you eat for satiety and optimize the amount of nutrients you take in at each meal. 5 Key Findings from Weight Loss and Caloric Density Research What does research tell us about the caloric density eating approach? Below is a summary of the best studies: 1. People can eat freely foods that are about 300 calories per pound or less and not gain weight. 2. People can consume relatively large portions of foods that are between 400 and 800 calories per pound and still lose or maintain their weight depending on their individual activity levels and metabolism. 3. Foods with a calorie density of 800-1,800 should be limited as these can contribute to weight gain and interfere with efforts to lose weight. 4. Foods over 1,800 calories per pound should be extremely limited as these foods can very easily contribute to weight gain and obesity and can also greatly interfere with efforts to lose weight. 5. In 2007, the American Cancer Institute and the World Cancer Research Fund published a report which recommended the average calorie density of the American diet be lowered to 567 calories per pound. This can easily be achieved if one eats freely of unrefined, unprocessed fruits, veggies, starchy veggies, and intact whole grains and legumes. It is important to note that this means without the addition of salt, sugar and/or fat/oil to them. Never Diet Again by Following the Caloric Density Eating Approach Using the caloric density approach is one that is truly simple and based on common sense. Better yet, it is easy to stick with which allows you to manage your weight for the rest of your life without dieting. Because you essentially end up eating more food with fewer calories, you will feel satiated and happy. In a nutshell, by having a rough idea of how many calories there are in a given weight of food, one can enjoy a larger amount of food without increasing their total daily caloric intake. Foods that fall in this category tend to be whole, natural foods that leave us satiated for longer. Also, while low in caloric density, they are high in nutrient density. So it’s a win-win. Kate's 6 Tips to Healthy Eating 1. Get in tune with hunger and satiety: Eat only when you are hungry, and avoid eating past the point of satiety. Remember to eat slowly and chew your food well. 2. Order matters: Start all meals with foods that are lower on the calorie density scale. This will help increase satiety and ensure you are eating nutrient-dense foods that will optimize your health. 3. Form matters: Solid foods fill you up more than liquids of equal calories. Be mindful of your beverage choices and avoid any drinks with added sugars. 4. Dilution Solution: Minimize the caloric density of your meals and increase the nutrient density with the 50/50 visual. Half of your plate by visual volume should be filled with non-starchy veggies. 5. Facts on Fats: We need healthy fats to survive. No need to completely eliminate fats. However, keep in mind that even small amounts of healthy fats will greatly increase the caloric density of your meals. Be mindful of serving size when you are using avocados and olive oil, etc. 6. Less High Dense: When you incorporate high calorically dense foods into your meals make sure the meal is already made up mainly of low calorically dense foods. The real goal is to keep your average caloric density as low as possible. Also, if you liked the photo attached to this article, it is a picture I took this week on a night run in the mountains with my daughter overlooking the Salt Lake City valley.

8 Scientifically Proven Ways to Lower Your Blood Pressure Naturally Studies show that up to 90% of all Americans will have high blood pressure by age 50! But yet isolated groups of people cut off from our modern lifestyles have normal blood pressures in the range of 110/70 mmHg throughout their lives without the need for medications. If your goal is to optimize for normal sinus rhythm, a heart free of disease, and a long healthy life, you have to maintain a healthy blood pressure throughout your life. In this article, I will share my 8 scientifically proven ways to lower your blood pressure naturally. My Struggle with High Blood Pressure Ten years ago my blood pressure typically ran 140/90 mmHg. And as a cardiologist knowing of the cardiac dangers of high blood pressure, I put myself on a blood pressure-lowering medication. However, as I lived among the centenarians in the remote Longevity Village area of China, my goal was to naturally reverse all of my medical conditions, including high blood pressure. And by adopting a 99% natural plant-based diet, including a 30-pound weight loss, in conjunction with regular daily exercise, time with my family, and optimization of my sleep and stress levels, my unmedicated blood pressures now consistently run 110/90 mmHg! Below are the 8 scientifically proven ways I lowered my blood pressure. But if you are currently taking high blood pressure medications, please speak with your doctor first before trying anything in this article. My concern is that on one hand stopping blood pressure medications could be life-threatening. But yet, on the other hand, getting super healthy while taking blood pressure medications could drop your blood pressure to dangerously low levels. If your goal is to get off blood pressure medications, it will take exceedingly close monitoring while at the same time working with your doctor as you wean off medications. 1. Cut the Sodium First, you’re going to need to eat a low-sodium diet. This can offer a 4-point reduction in your systolic blood pressure, an effect equivalent to about half a typical blood pressure-lowering medication. 2. Eliminate any Added Sugars Second, you’ll need to eliminate any added sugars. That’s generally worth a 7-point reduction. 3. Commit to a Daily Workout Next, it’s time to commit to a daily workout for a 6 to 7 point reduction. 4. Drop Some Weight The fourth thing is really hard to do by itself, but a ton easier if you’ve done the first three things: You’ve got to drop some weight. How much? Broadly speaking, for every 2 pounds you lose you could expect a 1 point reduction. So, dropping 20 pounds could get you a 10 point reduction. 5. Embrace a High Fiber Diet Next, you’ll want to embrace a high-fiber diet. And to get there you'll need to eat a lot of vegetables, legumes, and high fiber fruit like berries. My personal goal is 100 grams of fiber daily but something much less than that could still be worth another 6 point reduction. 6. Learn to Eat Plant-Based Sixth, eating a mostly natural plant-based diet that is high in potassium and magnesium with limited saturated fats has been shown to drop your blood pressure by 6 points. 7. Get More Nitric Oxide from Greens and Root Vegetables Next, you need to get some more nitric oxide from greens and root vegetables. Eat enough of that molecule, the intake of which causes blood vessels to relax and dilate, and you could enjoy a 5 point reduction in your systolic blood pressure. 8. Lower the Stress Levels Finally, you’ve got to do something about your stress, which you already know is a key driver of high blood pressure. That can help drive a 5 point reduction in your systolic blood pressure. Disclaimer The content provided in this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. The suggestions, tips, and recommendations outlined in this article for lowering blood pressure naturally are general in nature and may not be suitable for everyone. Individual responses to lifestyle changes and natural remedies may vary based on specific health conditions, medications, and other individual factors. Before making any significant changes to your diet, exercise routine, or lifestyle, especially if you have a pre-existing health condition or are on medication, it is crucial to consult with a healthcare professional or a qualified healthcare provider to ensure the methods suggested are appropriate for your specific health needs. About the Photo Chasing sunsets and wellness with one of my favorite running partners, my daughter, along the Pipeline Trail in Millcreek Canyon overlooking Salt Lake City. Embracing the calming views and miles of joyous runs – the perfect recipe to keep our blood pressure in check.

13 Simple Weight Loss Tips That Actually Work Authored by Kate Clemens with Dr. John Day As Dr. Day revealed in his book, The Longevity Plan, he has struggled to maintain a healthy weight since high school. Indeed, 84% of all Americans report that they have tried to lose weight. Below are our 13 simple weight loss tips that actually work for us and our patients. 1. Diets Don't Work, Lifestyles Do You go on a diet and then you go off the diet--Diets were never meant to be long-term solutions. The goal is to find a way of eating that you can maintain for the rest of your life. So the next time you commit to "eating healthy," ask yourself can I eat like this for the rest of my life? If the answer is "no," then you're doomed to fail. You need a lifestyle or way of eating that you can easily maintain until you turn 100. 2. Faithfully Follow Dr. Day's 3 Rules to Eating As there is so much confusion as to what is healthy eating, Dr. Day's approach is to give his patients 3 simple rules to follow. And if you can just follow these 3 easy rules to eating, then you are 90% of the way there to healthy eating. First, minimize or avoid any added sugars. We do not need these! Real whole fruits are naturally occurring sugars, these do not count. Second, minimize or avoid processed foods. If it comes from a box, can, package, fast food window, etc. it is processed. You do not need these "foods." The more natural you eat the better. Third, eat as many non-starchy vegetables as you can. The more variety in the color of your vegetables the better. 3. Find What Works for You There is no one perfect diet for everyone. Just because "keto" worked for your friend doesn't mean it will work for you. For example, everyone says exercising first thing in the morning is best as it will help you to eat healthy all day long. Dr. Day found that exercising in the morning just made him hungry all day long. So for Dr. Day, he can control his eating by exercising late in the afternoon or after dinner. You are so wonderfully individual. While there are certainly a lot of health "guidelines" out there, these guidelines may or may not help you. Have fun, experiment, and be true to yourself. Remember the ONLY person you should ever compare yourself to is the person you were yesterday. 4. Crash Diets Crash Your Metabolism Have you ever wondered what happens to the “biggest losers” on reality TV shows? When the cameras stop rolling, do their incredible transformations stick? Not usually. Researchers have found, in fact, that these contestants’ crash diets send their metabolism into a tailspin, making long-term weight maintenance nearly impossible. In most cases, the weight comes right back and, even six years later, their metabolism is slower than it was before they started filming. This is what scientists call “metabolic adaptation” and is something you definitely want to avoid. No matter where you are in all facets of your life, getting to where you want to be is not supposed to happen overnight. After all, you probably put the weight on at a pace of 1 to 2 pounds a year. Do not be afraid of achieving your goals slowly and mindfully, just be sure you are moving forward! We are aiming for progress, not perfection. 5. Have a Daily Plan We do not plan to fail, we fail to plan. This is a well-known quote for a good reason. Set yourself up for success! Figure out 5-minute ‘planning window’ either each Sunday or the night before to sketch out what your food week or food day will look like. For example, as Dr. Day is surrounded by unlimited free treats at every nurse station or the doctor's dining lounge in the hospital, he has to plan out a daily "healthy treat." Without a prepared "healthy treat" in his laptop bag, he'll feel deprived and devour the unhealthy ones at his hospital. Prioritize self-care as much as you prioritize work. Believe me, it will make you that much more efficient! 6. Schedule at least a 12-Hour Daily Fast A daily 12-hour fast is an easy health habit if you simply use the hours you sleep. For instance, if you finish eating dinner at 7 pm then don't eat anything more until your 7 am breakfast. Intermittent fasting is very beneficial for our health. It aids in weight management, boosts mitochondrial health, reduces inflammation, and enhances the body’s natural detoxification process. Dr. Day reports that just last week he met with an atrial fibrillation patient who started daily 14-hour fasts with her husband 5 months ago. She shared that without any changes in her food choices, she was able to lose 12 pounds and her husband lost 17 pounds from intermittent fasting. The best part was that just this 12-pound weight loss from daily 14-hour fasts was enough to put her atrial fibrillation into remission and get off her flecainide! 7. Dairy is Personal Decision There is no scientific proof that your bones will be brittle if you don't eat your 3 daily servings of dairy. In fact, cultures with the lowest risk of fractures eat little to no dairy at all. The goal is to find what works for you as dairy’s effects on people vary greatly. You shouldn’t feel like you have to eliminate dairy from your diet if you can tolerate it well and enjoy it. On the other hand, dairy is not essential to our diet. For instance, while one of milk’s claim to fame is its calcium content, 1 cup of cooked spinach provides almost the exact same amount of calcium as 1 cup of milk. If you do choose dairy, opt for sources as natural as possible with no added sugar and ideally fermented. Dr. Day's decision to eliminate almost all dairy came from his dairy-induced high LDL, acid reflux, and eosinophilic esophagitis. In carefully tracking his calcium intake from eating massive quantities of broccoli, kale, lettuces, etc. he easily achieved his daily recommended allowance of calcium from plant-based sources. 8. Keep Your Meat Wild As with dairy, meat is also a personal decision. If you do choose to eat meat, make it wild. Since wild animals feed on natural vegetation, their meat contains more omega-3 fatty acids and less saturated fat than grain-fed, factory-farmed animals. They are considered a source of “lean meat” which means they are low in fat, high in protein, and have a low-calorie content ratio. And when it comes to fish, wild-caught is also best. In general, wild-caught fish is healthier, leaner, and less polluted. And it is for this reason that Dr. Day periodically enjoys wild-caught Alaskan salmon. Indeed research shows that a mostly plant-based diet with wild meat can be incredibly healthy. For example, the Tsimane people living in the Bolivian rainforests don't get cardiovascular disease and don't get atrial fibrillation likely in part from their wild meat and vegetable diet. To learn more about the Tsimane people, please check out this article from Dr. Day. 9. The More Fiber the Better Fiber is a key nutrient that keeps our blood sugar stable and our appetite in control by regulating the way our body processes sugar. It is unique as it cannot be broken down into sugar molecules for digestion like other carbohydrates can. Instead, fiber remains undigested as it passes through our digestive tract. And it is for this reason that science tells us that the more fiber you consume the lighter you'll probably be. In the past century, the amount of fiber we eat has decreased by about 90%! In fact, most Americans are only getting about 15g of fiber per day when Dr. Day argues the goal should be somewhere near 100 grams daily. To learn more about how fiber can help you to maintain a healthy weight, please check out this article from Dr. Day. 10. Be Accountable for Your Food Choices Whether you are a numbers person like Dr. Day or take a mindful approach with no counting like Kate, you need some way of keeping yourself honest! This may mean resorting to a tracking app such as Lose It!, a trainer at the gym, learning to become a mindful eater, or finding another way to hold yourself accountable. To learn more about Kate's approach to mindful eating, follow this link. As the mindful eating approach hasn't worked so well for Dr. Day, his approach is to "gamify" his "food stats" using various charts and apps. For him, it is all about maintaining a daily high score with his food choices. 11. Eat the Right Carbs Carbohydrates are vital for many functions in our body, but it is important to make sure we are smart when selecting our carbs. Don't believe for a minute the reports you may see on the internet that all carbs are bad. After all there is a big difference between a slice of white bread and raw broccoli. Low glycemic index, complex carbohydrates, like most vegetables and berries, will give your body a slow release of energy and keep you feeling fuller for longer. Indeed, all of the healthiest and longest-lived groups of people around the world have thrived on eating the right carbs. While many of Dr. Day's patients have reported that poor food choices have triggered an atrial fibrillation attack, Dr. Day is fond of saying that he has yet to see a patient go into atrial fibrillation from eating too much broccoli. Still not sure what carbs are best? Here is a document Kate has prepared with some excellent carbohydrate options. 12. Use Breathing Techniques to Help with Stress Eating In modern-day society, we tend to get stuck in fight or flight mode (sympathetic state). This leads to unnecessary stress and also takes away from our digestive power. A free tool we have 24/7 to slide back into rest and digest mode is our breath. Check out this document from Kate to learn how to use this powerful tool to your advantage. Be sure to always aim to eat when you are in a parasympathetic state! (rest and digest mode). 13. Relationships May Be More Important than Food Choices In The Longevity Plan, Dr. Day shares the following: "Confucius once said, we should “not,...

Can You Exercise with AFib? Can you exercise with AFib? And if so, how high can your heart rate go before it is unsafe? We all know that exercise is good for you but does that still hold if you're in AFib? If you or a loved one has AFib, read on to learn more. Does Exercise Cause AFib? Most of my patients are shocked to learn that people who run marathons, competitively cycle, or do Ironman triathlons are five times more likely to develop AFib! What is particularly perplexing, however, is that studies have not tended to show higher rates of arrhythmias in athletes who participate in other strenuous forms of exercise, such as boxing, wrestling and weight-lifting. There is something particular about endurance sports that increases the risk of AFib. One exception to this may be football. Among former NFL athletes, the risk of AFib is six times higher, although this may be due to the use of performance-enhancing substances or the weight these athletes put on to compete at a professional level. Also, it bears noting that while aggressively competing in endurance sports might put you at a greater risk of AFib, participation in these activities certainly does not guarantee you’ll get AFib. It is reassuring to note that non-competitive recreational participation in endurance sports, even if it is a marathon or triathlon, doesn’t seem to put you at risk of AFib. I have found over the years that almost all of my athletes with AFib have opted for an early ablation. They simply can't or don't want to exercise with the usual cocktail of AFib drugs that are prescribed. And fortunately for athletes, we typically get excellent results as studies show that the AFib ablation success rates are up to 3 times higher with athletes! Does Exercise Prevent AFib? Regular exercise in general isn’t risky at all. In fact, for 99.9% of my patients it’s exceptionally protective. To put things into perspective, for every thousand patients I see with atrial fibrillation, perhaps one may be at risk due to overexercising. The biggest problem, by far, is that most patients aren’t exercising enough. There is far greater risk to not exercising enough than to exercising too much. People who live sedentary lifestyles are at significant risk of AFib, not to mention all of the other health consequences of not getting enough exercise. Indeed, one study showed that not exercising at all increased your risk of AFib by more than four times! A big problem for many of my AFib patients is that they want to exercise but either the AFib or their medications make them so tired that they simply can't exercise. And for those people who can't exercise with AFib, we typically end up treating them with an ablation as the health benefits of exercising are too great to ignore. How High Can Your Heart Rate Go when Exercising in AFib? As exercise drives the heart rate up, how high can you let the heart rate go when exercising in AFib? For the vast majority of my patients, they are perfectly okay driving their heart rates up to their maximally predicted heart rate. And your maximally predicted heart rate is 220 minus your age. So if you are 40 years old, I would expect you to hit a heart rate of 180 with high levels of exercise. Of course, if you get chest discomfort or shortness of breath with exercise then you need to notify your cardiologist immediately as your life could be at risk. How Hard Can You Push Your Heart with Exercise and AFib? If you love endurance sports, it is perfectly fine to participate as long as your cardiologist is in agreement and your heart feels great during exercise. And if you want to be safe running that marathon, try slowing your running pace. Indeed, among my "plodder" patients, or those who exercise at slow non-competitive speeds, I rarely see AFib. Dr. Day's 3 Thoughts on Exercise and AFib 1. The health benefits that come from exercise are too great to ignore. Everyone should exercise every day. If AFib gets in the way of your exercise then you need to get it treated immediately. 2. Ultra-endurance athletic competitions are problematic for my AFib patients. And, in general, the only way my endurance athletes can get around this is by getting the AFib "fixed" with an ablation. 3. Non-exercisers are also at high risk for AFib. Regular daily moderate levels of exercise are incredibly protective against AFib. Disclaimer The information provided in this blog article on exercising with atrial fibrillation is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Exercising with atrial fibrillation carries inherent risks, and it is essential to consult with your healthcare provider before starting any new exercise program or making significant changes to your current routine. Your healthcare provider can offer personalized guidance based on your specific medical history, current health status, and individual needs. About the Photo Also, if you liked the photo attached to this article, it is a picture I took today running the Pipeline Trail with my 14 year-old daughter. From the Pipeline Trail up Millcreek Canyon, you can get a spectacular view of downtown Salt Lake City, Utah.

The 4 Best Reasons Why Intermittent Fasting May Prevent AFib Fasting has been shown to slow aging and help most chronic medical conditions but can intermittent fasting also prevent atrial fibrillation? In this article, I'll share everything you need to know about intermittent fasting's role in atrial fibrillation prevention. Why Did I Write this Article? My long-term readers know I've always been impressed by the strong data supporting intermittent fasting for longevity and cardiovascular health. Indeed, both of our books, The Longevity Plan and The AFib Cure, had a section on intermittent fasting. The reason why I chose to cover this topic again came from a recent podcast interview I heard with Dr. David Sinclair. For those not familiar with Dr. David Sinclair, he is a Harvard University longevity researcher. And interestingly, the person who helped him write his New York Times best-seller, Lifespan, was the same person who helped me write The Longevity Plan and The AFib Cure. In this podcast, Dr. David Sinclair reported that he doesn't snack and only eats one meal a day. As someone who has always struggled with fasting, my goal is that writing again on the topic of intermittent fasting will help me to redouble my efforts to fast regularly. And to help you redouble your efforts, below are my 4 best reasons why intermittent fasting may prevent AFib. 1. Fasting May Slow Aging Researchers have long known that caloric restriction, or eating the absolute minimum number of calories to keep the body functioning, makes animals of all types live longer. Indeed, if you're a rat you'll live 80% longer with caloric restriction. But while caloric restriction works great for animals in a controlled experiment, it is almost impossible for humans to maintain caloric restriction long-term. The beautiful thing is that humans may not need to calorically restrict themselves to achieve this longevity boost. Indeed, intermittent fasting activates the same genes that caloric restriction does. How does this happen? Studies show that periodic fasting activates an energy-sensing protein called AMP-activated protein kinase (AMPK), which then keeps the energy center of the cell, the mitochondria, in a “youthful” state. With regards to AFib, as age-related fibrosis (or scarring) of the left atrium is a significant driver of AFib, anything that slows the aging process would be expected to also slow the development of AFib. Indeed, based on a study we were involved with at Intermountain Medical Center, shorter telomeres, which is a marker of premature aging, was associated with atrial fibrillation. 2. Fasting May Lower Blood Pressure 10 mmHg When we fast, blood sugar levels are less likely to spike high. The research is pretty clear, the more time we can give our bodies a break from food the better our insulin sensitivity, the slower our body "rusts" with aging, and the lower our blood pressure runs. And when it comes to AFib, lower is usually better. Indeed, studies show that high blood pressure doubles the risk of AFib. So if you suffer from AFib, the goal is to keep your blood pressure always below 130/80 mmHg. But if your goal is to maximize longevity, then the research suggests a blood pressure in the range of 110/70 mmHg, without the help of blood pressure medications, is where you probably need to be. 3. Fasting is Good for a 9 Pound Weight Loss If you're looking for a quick 9-pound weight loss, then the science suggests you may want to try intermittent fasting. For example, I have found that when I skip dinner I eat approximately 500 fewer calories for the day. And these 500 fewer calories are maintained even after accounting for any "make-up" calories I may consume on the following days. While most people practice intermittent fasting by skipping breakfast, medical science argues the opposite. Studies show that if you're going to skip a meal, skipping dinner is best. To optimize health and longevity, you want your calories earlier in the day rather than right before bed. If you eat late your glucose spikes late. Perhaps this is a reason why the Japanese have long known that the best way to fatten up a sumo wrestler is to give them a big meal just before bed. With regards to AFib, the research is pretty clear. The less you weigh the lower your risk of AFib. Even for those who have already undergone an AFib ablation procedure, our research shows that just a 5-pound weight loss will statistically increase your long-term success rate of that procedure.  4. Fasting May Fix Diabetes If you suffer from type 2 diabetes or pre-diabetes, intermittent fasting may be one strategy to reverse this conduction. As discussed above, fasting improves insulin sensitivity, optimizes glucose metabolism, and drops your weight. Indeed, one study in the prestigious British Medical Journal showed that periodic fasting resulted in a 22-pound weight loss and was an alternative to having to take insulin. But before you dive headfirst into fasting to fix your diabetes, my long-time friends at Intermountain Medical Center have argued in the medical literature that you have to be very cautious with fasting as a diabetic. For example, fasting while at the same time taking diabetes medications or insulin could drop your blood sugars so low it could put your life at risk. The bottom line is that if you suffer from diabetes and want to try fasting, you'll need continuous monitoring of blood sugar levels and very close communication with your physician to know what to do with your diabetes medications and insulin while you are fasting. If your goal is to get rid of AFib then anything you can do to get your diabetes under control will help. Indeed, studies show that diabetes increases your AFib risk by 40-60%. And studies also show that the higher your hemoglobin A1C or the longer you have suffered from diabetes the more likely you are to also suffer from AFib. How to Fast? So how should you fast? Should you only eat during a 1-2 hour time frame like Dr. David Sinclair? Or should you fast for 12-14 hours every day like the centenarians we studied in our best-selling book, The Longevity Plan? While you could easily find 100 ways to fast on the Internet, here is how I fast. First, my goal is to fast at least 12-hours every day. So if I stop eating at 6 pm the night before then I wait to have my breakfast the next day until after 6 am. Second, I try to minimize or avoid any snacking during the day. Third, I do my best to follow my faith's monthly 24-hour fast. As diabetes runs in my family, I'm trying my best to keep my weight down and rest my pancreas as much as possible by intermittent fasting and minimizing or avoiding any added sugars and flour. Will Fasting Cure AFib? So the million-dollar question here is will fasting fix AFib? While fixing AFib is never that easy, the only study published on intermittent fasting as a way to treat AFib is the one we published in our best-selling book, The AFib Cure. In our book, we reported on our unpublished data from when we were at Intermountain Medical Center. In the 329 patients who fasted for 24 hours monthly as part of their faith, a 20% non-statistically significant reduction in AFib was seen over a 10-year follow-up. So while fasting may not be the magic bullet to cure AFib, it just may help through the 4 ways we discussed in this article. Of course, if you want to try fasting, please check with your physician first. For those on blood pressure or diabetes medications, fasting could lead to a dramatic reduction in blood pressure and glucose levels which could result in fainting or a worse outcome. Also, if you liked the photo attached to this article, it is a picture I took during one of our regular trips to Lake Powell at sunset along the Utah Arizona border.

The 7 Best Ways to Stop an AFib Attack If you find yourself experiencing a very occasional incident of AFib, you need not panic provided you aren't about to pass out, you're experiencing chest discomfort, or you're short of breath. Of course, if AFib is happening repeatedly then you need to see your cardiac electrophysiologist or "EP" as soon as possible. An EP is a cardiologist who has had two additional years of training in arrhythmias following their cardiology board certification. And the off chance that such an attack might happen in a very inconvenient time—like when you’re on a long international flight, taking a cruise, or in a very remote area of the world—absolutely shouldn’t stop you from living your life. Lots of people travel with a first aid kit. That doesn’t mean they intend to use it—it simply means they are ready in case something happens. No matter how long your AFib has been in remission from massive lifestyle changes or an ablation, I suggest having a plan of response ready to go, especially when you know you’re going to be away from a hospital or doctor for a while. As the Boy Scout motto goes: “Be prepared.” 1. "Pill-in-the-Pocket" First, keep an antiarrhythmic medication, like flecainide, on hand for an emergency. Sometimes, my patients may also have a medication to also slow down their heart and a blood thinner in addition to the flecainide on hand for an emergency. Even though many of our patients haven’t had an AFib episode in years following an ablation, many still keep an antiarrhythmic in their wallet, purse, or car just in case their heart ever starts fibrillating again. If nothing else, it gives them peace of mind and a sense of control should anything ever change. 2. Rehydrate Next, always be ready to rehydrate. As dehydration is a big AFib trigger, many of our patients report that they are able to quickly get back to sinus rhythm simply by rehydrating. Always travel with clean water at arm’s reach. 3. Optimize Your Electrolytes Third, keep your electrolytes up. Low levels of magnesium and potassium are another common AFib trigger. A quick boost through electrolyte-heavy foods, or drinks like tomato juice or low-sodium vegetable juices, is always a good bet. But if you’re going to be away from a place where you can access these foods and drinks, supplements are a good idea, especially in the case of magnesium. 4. Exercise Away Your AFib Attack Fourth, exercise. While it may seem very counterintuitive, many of my patients report that all they need to do is to overtake their AFib heart rate with an elevated exercise heart rate to get back in normal sinus rhythm. When their heart slows after the exercise, their normal sinus rhythm is restored. Of course, if your heart rate runs especially fast with an AFib attack then driving the heart rate up even higher with exercise wouldn't be a good idea. For those whose hearts break speed records with AFib, option number 5 below may be a much better choice. 5. Lie Down Fifth, lie down. If an exercise-induced increased heart rate doesn’t work for you, the opposite might do the trick. Many of my patients report that taking a nap or going to bed early when they are in AFib is the trick to getting back in rhythm. 6. Stimulate Your Vagus Nerve Sixth, stimulate your vagus nerve. Sometimes autonomic nervous system imbalances can trigger AFib. One way to quickly correct this is through vagal maneuvers, like slow deep breathing, bearing down like you are trying to have a bowel movement, tightening your abdominal muscles, inverting your body by raising your legs or standing on your head, coughing, or taking a cold shower. 7. Get a Quick Cardioversion Finally, if all else fails, it’s time to visit an ER during off-hours or your cardiologist/EP's office for a quick cardioversion to restore normal sinus rhythm. For example, our practice provides same-day cardioversions during normal business hours provided you are fasting. While a cardioversion doesn't fix the underlying AFib problem, it can provide temporary relief until your AFib is fixed either through lifestyle changes, including weight loss, or an ablation. Concluding Thoughts Having a plan in place to stop an AFib attack isn’t admitting defeat. Sometimes life just throws us a curveball. Let bad experiences become good data that can help you prevent another such experience. After all, for some this can be a lifetime fight. Even people who have been "cured" from their AFib with an ablation may have that rare one-off AFib attack and then go decades without another AFib attack. Sometimes this once-in-a-blue-moon AFib attack can come from a major life stressor like a death in the family, divorce, etc., or even a massive infection. As long as AFib is a very rare event, the symptoms aren't worrisome, and the proper stroke prevention measures are in place then it shouldn't cause too much concern. If, however, AFib attacks are repeatedly happening then you need a new treatment plan with your EP. Also, if you liked the photo attached to this article, it is a picture I took this week running out of Neff's Canyon just after sunset in the mountains overlooking Salt Lake City.