A-Fib: The Most Common Serious Arrhythmia

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

Atrial fibrillation, or “a-fib,” is a common and often life-threatening form of arrhythmia—the medical term for irregular heart rhythm. Roughly 2.7 million Americans are living with a-fib.

A-fib can best be described as a miscommunication in the signals that control how the heart beats. Normally, the atria (the two top chambers of the heart) squeeze first, followed by the ventricles (the two bottom chambers). When timed properly, these contractions effectively move blood throughout your body.

However, with atrial fibrillation, the upper and lower chambers of the heart do not work together or communicate properly. The electrical signals that control the process somehow misfire and instead of working together, the atria “do their own thing.” They fibrillate, or start rapidly vibrating, which can cause heart rate to increase up to 250 beats per minute. As a result, the lower chambers do not fill completely or pump enough blood to the lungs and rest of the body. This is problematic for a variety of reasons, which I’ll get into below.

Afib Symptoms and Complications

Afib symptoms can vary from person to person. Some people may feel nothing at all and not even know they have Afib until a doctor discovers it. Other people may feel the fibrillation as quivering or palpitations in the heart. Other Afib symptoms include dizziness, fainting, shortness of breath, weakness or difficulty exercising, fatigue, and chest pain.

When to Worry About Heart Palpitations

Most people can tolerate Afib symptoms for short periods of time. However, episodes that last for several hours or longer place considerable strain on the heart, which can lead to a heart attack or congestive heart failure. But that’s not all…untreated Afib can lead to other dangerous and even life-threatening complications:

  • Blood clots. Because the heart isn’t about to pump blood properly with Afib, it can cause blood to pool and form clots. If a clot breaks off, it can travel to the heart (leading to a heart attack), lungs, spleen, kidneys, intestine, brain, etc. Venous thromboembolism—a blood clot that forms in a vein—is also a possibility.
  • Stroke. If a clot lodges in an artery that leads to the brain, a stroke can result. Up to 20 percent of people who have a stroke also have Afib. In fact, many don’t even know they have Afib until they suffer a stroke.
  • Cognitive impairment. Blockages in the blood vessels leading to the brain can impair cognitive function and even lead to Alzheimer’s disease or vascular dementia.
  • Sudden cardiac arrest. People with Afib have an increased risk of their heart suddenly and unexpectedly stopping—which leads to death.

A-fib Causes

Anyone can develop atrial fibrillation at any age, even those in otherwise excellent health. However, people who have one or more of the following risk factors are more likely to get it:

  • Advanced age (those over 60 are highest risk)
  • Obesity
  • High blood pressure
  • Underlying heart issues, including heart disease, structural (valve) or congenital defects, pericardial inflammation, prior heart attacks, and cardiomyopathy
  • Prior heart surgery (A-fib is the most common complication after heart surgery)
  • Frequent binge drinking
  • Family history
  • Sleep apnea
  • Other chronic conditions, including thyroid disease (particularly hyperthyroidism), diabetes, asthma, and other chronic lung problems

It’s worth mentioning that overexposure to certain man-made electromagnetic frequencies may also cause arrhythmias like atrial fibrillation. I know of two colleagues who developed a-fib after sleeping in close proximity to a cordless phone, and at least one study has linked cordless phone radiation to irregular heartbeats.  If you or a loved one develops an arrhythmia like a-fib, try limiting exposure to cell phones, cordless phones, cell towers and WiFi routers. Keep phones off your body, and in a separate room while you sleep, and sleep grounded to help get your body back in harmony with the earth’s natural rhythms (more on grounding here).

Understanding the Invisible Threat: 5G Health Risks

A-fib Treatment

Sometimes Afib goes away on its own. In this case, it’s called paroxysmal atrial fibrillation. Symptoms come and go, lasting for a few minutes or hours—and eventually they subside.

For some people, though, atrial fibrillation is an ongoing problem. Over time, it happens more often and episodes last longer. These cases are labeled “persistent Afib,” or the more serious “permanent Afib.” Both require treatment.

Treatment restores normal heart rhythms, helps control symptoms, and prevents complications like blood clots. A-fib treatments range from lifestyle changes to pharmaceutical drugs and medical procedures.

Lifestyle Changes

With all cases of A-fib—occasional, persistent, and permanent—lifestyle changes should be the cornerstone of treatment. Sometimes, addressing underlying causes and risk factors is all that needs to be done to eliminate these arrhythmias.

In fact, research confirms that making lifestyle changes and eliminating risk factors can be extraordinarily powerful. In a study of nearly 15,000 participants, researchers determined that, overall, 56.5 percent of A-fib cases could be attributed to having the following risk factors—high blood pressure, diabetes, obesity, smoking, and prior cardiac disease, with high blood pressure being the most important to eliminate. The researchers concluded that “as with other forms of cardiovascular disease, more than half of the A-fib burden is potentially avoidable through the optimization of cardiovascular risk factor levels.”1

In addition to a heart-healthy diet (such as the Pan-Asian Modified Mediterranean, or PAMM, diet), moderate exercise and stress reduction help with weight loss. Additionally, these lifestyle changes decrease stress on the heart and restore its structure and function.

And it should go without saying: Weight loss should be a priority as well. In a study conducted with 1,415 patients,  those who lost 10 percent of their body weight were six times more likely to be free of Afib after four years, compared to those who did not lose weight. The researchers wrote that “long-term sustained weight loss is associated with significant reduction of Afib burden…”2

At least half of patients with Afib have sleep apnea, which can easily be addressed (and sometimes through weight loss alone). Other conditions—thyroid, asthma, diabetes—may require more care and direction from a doctor, but they, too, can be controlled.

Targeted heart supplements may not cure Afib, but they can definitely help improve overall heart health. Top of list is CoQ10. In one study of 102 patients with Afib and heart failure, those taking CoQ10 had significant reductions in malondialdehyde (a marker of oxidation) compared to controls. After 12 months of treatment, just three patients in the CoQ10 group (compared to 12 in the control group) had Afib episodes.3

Other heart-supportive nutrients include L-carnitine, magnesium, vitamins D and E, and D-ribose.

Medications and Procedures

When lifestyle changes and supplements aren’t enough, pharmaceuticals and other procedures may be warranted.

For patients who are especially high risk or who have long-term persistent or permanent A-fib, blood thinners like Coumadin can be lifesavers. They prevent the clotting that so commonly occurs with A-fib, and therefore reduce risk of heart attack and stroke. Blood thinners come with their own set of risks, and it’s important to be carefully monitored while taking them. Despite this, I usually recommend blood thinners for people with recurring A-fib (more than one or two episodes) and who show signs of arterial disease – for these people, the benefits outweigh the risks of not taking blood thinners.

Beta-blockers and calcium channel blockers may also be prescribed to slow heart rate, and antiarrhythmic drugs like amiodarone may be given to control heart rhythm.

Antiarrhythmics are serious drugs with even more serious side effects, ranging from dizziness and nausea to pulmonary toxicity and sudden death. In fact, one study showed that up to 70 percent of patients taking amiodarone experienced side effects severe and bothersome enough to discontinue the drug.4 Therefore, antiarrhythmics should be used judiciously, as a last resort, and under the care of a knowledgeable cardiologist.

Procedures like cardioversion and ablation are also options. Cardioversion normalizes rhythm by sending a jolt of electricity into the atria. It provides relief—usually temporary—for most people. So it’s not a cure, but it’s a decent treatment that’s far safer than long-term use of antiarrhythmics.

With ablation, a catheter is inserted through a vein that leads into the atrium. The areas that trigger abnormal signals are zapped into regularity. Ablation can fully eliminate the need for drugs—but it’s only successful in 20 to 40 percent of patients who get it done. Some patients may need to have the ablation done a second time for it to work.

Bottom line, A-fib is a condition that can’t be ignored. Make sure you find a cardiologist you can trust and who engages in open, honest dialogue with you and your treatment options. While A-fib needs to be monitored and treated, you can absolutely still live a productive and happy life with it.


1.Huxley RR, et al. Absolute and Attributable Risks of Atrial Fibrillation in Relation to Optimal and Borderline Risk Factors: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2011 Apr 12;123(14):1501-8. Last accessed Aug. 15, 2019.

2. Pathak RK, et al. Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY). J Am Coll Cardiol. 2015 May 26;65(20):2159-69. doi: 10.1016/j.jacc.2015.03.002. Last accessed Aug. 15, 2019.

3. Zhao Q, et al. Effect of Coenzyme Q10 on the Incidence of Atrial Fibrillation in Patients with Heart Failure. J Investig Med. 2015 Jun;63(5):735-9. Last accessed Aug. 15, 2019.

4. Park HS and Kim YN. Adverse Effects of Long-Term Amiodarone Therapy. Korean J Intern Med. 2014 Sep;29(5):571-3. Last accessed Aug. 15, 2019.

© Stephen Sinatra, M.D. All rights reserved.

Leave a Reply


  1. Michael G

    on October 3, 2019 at 1:41 pm

    I have had afib for a long time. 8yrs ago I had my aurortic valve replaced. I often get cramps in my chest, upper back, back of neck, blurred vision and vertigo. The doctors do not seem to know what causes these symptoms. They don’t even say if the afib could be the cause. I would like to find something or someone to help me because so far the doctors have not helped.

  2. Robert S

    on October 3, 2019 at 4:16 pm

    A-Fib is a serious condition but its not as life-threatening as this article makes it seem. In fact when treated correctly proven data shows that A-Fib actually DOES NOT shorten life-span. So whatever God’s plan is for you, that will remain in spite of A-Fib. Where the problem lies is that there are people (believe it or not) that ignore the symptoms of paroxysmal A-Fib or take medication only when they experience A-Fib symptoms. This type of ignorance can in fact weaken your heart and lead to other problems. Permanent A-Fib obviously needs blood thinner treatment. FYI – Eliquis is much safer than Coumadin. Advancement in A-Fib treatment has advanced tremendously over the past few years so more options are available than ever before. If you experience A-Fib immediately contact your doctor and cardiologist BUT more importantly research and find an experienced Heart Arrhythmia Specialist – that is the person you need to talk to. Remember this – a Cardiologist is the plumber and a Heart Arrhythmia Specialist is the electrician and A-Fib is a result of misfiring of heart electrical symptoms. When I experienced my episode of paroxysmal A-Fib the Cardiologist immediately put me on a med called Multac. My A-fib actually got worse because of the Multac. It slowed me down and I got dizzy when I worked out. I couldn’t take it any more and contacted an Arrhythmia Specialist who disagreed with Multac and put me on Flecinade. Within 12 hours my A-Fib was permanently gone and I enjoyed a full work-out with no dizziness. But my Arrhythmia Specialist didn’t stop there he encouraged me to have a new procedure done called Cryo-Ablation. I had my procedure in Feb of 2019 and have been med free since May of 2019. I fired my cardiologist and with the advice of my Arrhythmia Specialist found a new Cardiologist. I do take Dr Sinatra’s CoQ10 supplement daily – not sure if it helps but another symptom of A-Fib is the psychological worry of it returning so Dr Sinatra’s supplements definitely help with that. Unfortunately it is beneficial to be your own medical proponent. If you feel uncomfortable with what your doctor advises – do research and meet with someone else. Good Luck and God Bless

  3. Virginia M

    on October 4, 2019 at 5:43 pm

    My husband was recently put on xarelto after one episode of A-fib (a minute and a half long).
    He has a pacemaker for bradycardia since 2016.
    He was given Eliquis after another operation because of a DVT. He had a severe allergic response…skin rash and extreme tiredness.
    In any event, he started bleeding urine about a month ago. He was checked by the urologist and it was caused by the blood thinner.
    Today, he passed a small clot in his urine.
    I am very concerned about xarelto and blood thinners in general.
    I wish there were a natural substance that could be used.

  4. Sharon K

    on October 7, 2019 at 2:44 pm

    To Virginia,
    My husband was diagnosed with A Fib and told to take Eliquis. We declined and after researching found something natural called Neprinol AFD by Arthur Andrew Medical. If I remember correctly was discovered by Dr. Sumi in Japan. My husband has been taking it for over a year and doing great. You will have to find a holistic physician to help or you can call the company and they can give some direction.

  5. Virginia M

    on October 10, 2019 at 11:23 am

    To Sharon,
    Thank you so much for the information. We will look into this right away.
    Blessings to you as well!

  6. Peter G

    on November 3, 2019 at 11:38 am

    Having suffered A F. And had ablation I am now suffering severely from flutter of the heart.
    Does anyone have any advice regards medication treatment etc.

  7. Norma R

    on November 7, 2019 at 11:52 am

    I have Atrial Fibrillation since 2005 to 2016 my Cardiologist put me on Eliquis and Amiodarone,
    Since then, I don’t have AFIB anymore, also, I am taking all the Supplements Doctor Sinatra
    said to take. C-Q 10, Omega 3 Fish Oil,, L-Taurine- Acetyl L Carnitine. and Healthy Foods
    and Walk. Walk is the best for the Heart and Cancer.

  8. Martha

    on January 22, 2020 at 2:16 pm

    Peter G

    Sorry to hear. Did you have flutter before Ablation?
    Did you have a second ablation?

    My heart goes out to you as I am sufferin terribly on this AFIB rollercoaster since 2013 and 6 cardioversions. Just went into AFib AGAIN yesterday after 3mos normal beats Im reluctant to see my cardio doc even though I do him alot because he said “next time we need to talk about an ablation. “
    Im on Sotalol 80 mgs 2x and Eliquis. Ugh.

  9. Martha

    on January 22, 2020 at 2:24 pm


    There’s an EPIDEMIC of AFIB in AMERICA and yet the cardiologists have not a CLUE what’s causing it and are loading us down with poisonous drugs and invasive procedures.

    ANXIETY drives AFIB. I have it – lifelong. And severe PTSD.

    Please… is there anyone in this country today who is addressing ROOT CAUSE and reversing AFIB?

    I am very sick, my stamina and body are in a torn down state. GP is useless. Chiro can only do so much. Im in such agony and yet NO ONE HAS ANSWERS AND NO ONE IS HELPING OR CURING.

    I need help. THE RIGHT KIND OF HELP


    “CARE of the patient means, caring for the patient.”

    Thanks, Peace to all you hearts out there.


  10. Martha

    on January 22, 2020 at 2:29 pm

    Hi Sharon,

    Yes, but is NEPRINOL AFD an ANTICOAGULANT? That is different from a blood thinner as it does not allow the blood to clot. Can you please clarify?
    I would LOVE to not be on ELIQUIS as I started getting weird blood spots under the skin on my forearms.

  11. Susie

    on March 2, 2020 at 11:32 am

    My husband had atrial flutter and had the ablation six weeks ago. He has not had an episode since but is still on Eliquis for another month, then will not have to take it. The ablation procedure was very well tolerated by him and he is 85 years old. I have heard that a chiropractor who is knowledgeable about the spine and heart rhythms can do adjustments in the cervical region and correct heart and voice problems. We did not have enough time to check this out since his cardiologist said he needed the ablation immediately. He tolerates the Eliquis well and it is probably better for him than other blood thinners as he doesn’t bruise as easily with it.


    on March 2, 2020 at 12:05 pm




  13. Jayne

    on March 4, 2020 at 6:45 am

    Hi Martha.
    You are absolutely right on with your comment;
    “AMERICA and yet the cardiologists have not a CLUE what’s causing it and are loading us down with poisonous drugs and invasive procedures.”
    And in my opinion, the increase is due to the fact we are bombarded with high EMF’s ( Electro Magnetic Fields of Radiation) due to all the electronic devices we all live with. These devices cause high levels of inflammation in our bodies, which is a precurser for all disease, including heart issues!
    Since ther is no way getting away from our world of electronics and the EMF’s they cause, ‘GROUNDING’ is what we can do to reduce these high levels of damaging inflammation from our bodies. Dr. Sinatra has discussed the benefits if grounding. In case thus us new to you, search his site and learn or google it.
    Sadly most traditional are clueless.
    Best wishes….

  14. Brij S.

    on May 5, 2020 at 5:06 pm

    Hi all,
    Recently, a close one had what appeared to be A-Fib. A visit to the specialist got a stock answer within 1 minute of discussion: pacemaker + blood thinners. That sounded awful, especially because there was zero discussion of ANY other options – no exploration of causes, no interest in knowing if this was an isolated episode, no interest in consigning the patient to blood thinners.
    So – I decided to dig deeper. (I’ve been researching and using preventive medicine/techniques for decades )

    So the two core issues with AFib are electrical problems with the heart, and possible clots forming in prolonged Afib cases. Neither problem is necessarily permanent. And neither problem is necessarily solved ONLY by pacemakers and blood thinners. Could they be ultimately life-savers in particular cases? Absolutely. But jumping to them as the default seems rote behavior. And needlessly dangerous for many people.
    So I dug around and came up with TWO extremely encouraging findings:
    #1. Most people are deficient in Magnesium. Dr. Carolyn Dean has written a great book about it (Magnesium miracle). The list of problems caused by this deficiency is stunning. AND – the benefits people get, including reversal of Afib and more, is stunning too. So – check it out – Amazon or whatever. Yes she sells Magnesium but there are a few quality sources out there.
    Magnesium deficiency can lead to muscle spasms, cholesterol problems, and electrical problems – and a long list in addition to this. This is according to researchers in science labs, not made up stuff.
    #2. Someone in a previous post mentioned “Sumi” and Leprinol. I do not know Leprinol but Hiroyuki Sumi is the Japanese man who isolated Nattokinase. This is a miraculous substance that is a potent anti-clot-formation and a potent clot dissolver among many other things. There is some material on Nattokinase here and there, but to me, it is super-potent and has NO known side-effects. It enhances the body’s own systems that dissolve clots, and supports many other aspects of endothelial(single cell layer inside blood vessels that touches the blood) health. It also drops cholesterol and blood pressure, but the amounts one needs to take for that may be higher.
    In any case, here’s one paper: search for https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372539/
    Yes this is technical, but scroll to the bottom – towards the end is a section called “Conclusions”. That is reasonable reading.
    Of course, pharmaceuticals have no interest in this – no way to patent it and make money.
    Worse, every cardiologist I speak needs me to spell out N a t t …!##[email protected]%^ Poor guys seem limited to the basic standards.
    To my way of thinking, Nattokinase is my most potent one-stop fighter to prevent, likely reverse many cardiovascular and stroke related problems. Many people use 2000FU capsules once or twice a day. Some use it in combination with 2000mg of good quality fish oil. Research studies show no toxic problems at much higher doses.

    So – both Magnesium and Nattokinase are life savers as fas as I’m concerned. I’ve added them to my daily regimen.
    Best wishes and best of luck,

  15. henry rudd

    on May 18, 2020 at 2:30 pm

    Dr. Steve Sinatra. Do you believe in Nattokinase to prevent blood cloths ? Also what is your OPINON on EDTA chelation therapy ? WE all know about the big veins in our body but we have 10,000 miles of micro ones that have collected plaque and debris and we cannot by-pass those. (I am a white male 84yrs old and had my first confrontation with USA main stream medicine last year. Needless to say I am a advocate of alternative medicine. CON GRAULATION ON YOUR LINE OF PRODUCTS AND CONGRATULATIONS TO YOUR SON BECOMING AN N,D, I AM VERY FAMILAR WITH BASTYR UNIVERSITY. ( i live 4 miles from it) Thank you for your time and consideration.
    Respectfully yours,

  16. Sandi B.

    on May 21, 2020 at 1:57 pm

    Greetings to you there near Bastyr… a lovely area! And thank you for your congrats… my son met his wife at Bastyr and they are both certified in acupuncture as well. You live in a great area for alternative medicine practitioners.
    I do take natto myself for prevention. If you Google my name with the topic you’re are interested in, it is likely you can find my take on the subject—and in greater detail than I can cover here. Here are a few links for more about my opinion on natto:

  17. Belinda L.

    on August 1, 2020 at 3:23 pm

    Where does one purchase a good quality nattokinase capsule? You don’t always know what you are getting. I’ve ordered supplements from Swanson’s Vitamins through the years and they’ve been around forever. Is anyone familiar with Swanson’s Vitamins and use their nattokinase? I’d like to know if there’s a reputable company that sells it.

  18. Kim Upton

    on August 25, 2020 at 12:50 pm

    Edited version:
    I have just undergone surgery for mitral valve replacement and tricuspid valve repair. Due to the extended wait for the operation because of the pandemic, my condition deteriorated to the point where i couldn’t sleep or move with difficulty. I went into a fib for the last few weeks before the operation which worsened my condition. I came across the article below and using Lugol’s iodine trans-dermally, I was able to get back into sinus rhythm for long periods leading up the operation. I use iodine every day now and have remained in sinus rhythm since the operation.

  19. Heather

    on November 2, 2020 at 8:33 am

    I also read the DIM is good for the heart. Any suggestions/recommendations?

  20. Blanche Williamson

    on November 2, 2020 at 7:57 pm

    I take Dr. Sinatra’s. supplements. I also have been taking Nattokinase 100 mg. (non GMO soy derived, 2000 FUs from NOW family owned since 1968. Dr. David Williams and Dr. Mercola have had info about Natto. I am 91 yrs old and have high blood pressure for years and prescription blood p. drugs make me swell and don’t reduce the pressure enough. Trying Natto for a yr. now and hope it will prevent a clot, etc. Hope it helps. I also take Pycnogenol 100 mg. with it

  21. Linda Evans

    on November 28, 2020 at 3:01 pm

    I am trying to use the supplements that Dr.. Sinatra suggested to help with afib…he included d ribose but I read on National institute of health that d ribose causes anxiety and memory loss. I am taking coq10, acetyl l carnitine and magnesium but am afraid to take d ribose now…

  22. vivian m.

    on February 19, 2021 at 9:54 am

    I have Afib, have pacemaker also have COPD. I am taking Cumadin and was wondering if the medication you are offering on Facebook can be taken with the cumadin. Have medications for the COPD but my breathing is getting worse. I’m on oxygen 24/7 and even with that I still get out of breath walking or even doing little chores. With this virus I can’t gio get any testing done cause I can’t breathe with the mask on over my oxygen tube.

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