We are truly witnessing an epidemic in atrial fibrillation (“A-fib”). In fact, one in four adults in the U.S. now will experience at least one episode of A-fib in their lifetime[1]

What is atrial fibrillation? A-fib is the most common heart rhythm abnormality. Typically, the heart beat very rapid and chaotic which can lead to chest discomfort, shortness of breath, fatigue, and dizziness.

Why should we worry about atrial fibrillation? The biggest worry with A-fib is that it increases the risk of stroke five fold, doubles the risk of heart failure, doubles the risk of premature death, and doubles the risk of dementia or Alzheimer’s Disease[2]! The key to preventing these long-term complications is to maintain normal rhythm.

What causes atrial fibrillation? Certainly genetics plays a role but the big three causes of A-fib are age, high blood pressure, and obesity. Most cases of A-fib, just like other forms of heart disease, are completely preventable. Indeed, studies have shown that 80% of heart disease is totally preventable[3]. While we can’t do anything about our age or genetics, we can take control of our lifestyles and make sure our blood pressure is under control and that we maintain an ideal body weight. As two-thirds of all Americans are now overweight is it any wonder why atrial fibrillation has become so commonplace. It should be noted that sleep apnea is also a big cause of A-fib. However, for most patients, sleep apnea is just a consequence of obesity. If we can lose the weight the sleep apnea will likely go away as well.

What should we do if we have atrial fibrillation? The most critical thing to do is to make sure we are protected against having a stroke. Patients with A-fib and multiple risk factors for stroke will need to be treated with a potent blood thinner. For those without multiple additional risk factors for stroke an aspirin may be enough.

Medications, shocking the heart back into rhythm, or even a procedure to potentially cure atrial fibrillation, called a catheter ablation, may be necessary. Recently, we published a large study of thousands and thousands of patients at Intermountain Healthcare where we showed for the first time that an outpatient catheter ablation procedure for atrial fibrillation was not only able to eliminate A-fib in most patients but was also able to eliminate the increased risk of death, strokes, and dementia/Alzheimer’s Disease that comes from A-fib[4]

Certainly, with A-fib, an ounce of prevention is definitely worth a pound of cure!  I have listed below 3 tips to prevent or even reverse atrial fibrillation.  In giving these tips, I am assuming that you are not smoking, as smoking is the number one cause of preventable heart problems.

1. Get Moving!
   According to the American Heart Association, only 1/3 of adults get “enough” physical activity which is defined as 150 minutes each week of at least moderate activity—that is just a mere 21 minutes each day[5] We also have to move throughout the day. 
   
   A recently published study showed that sitting more than 3 hours a day shortens our life by 2 years. Being physically active will significantly lower our blood pressure and is a critical component of weight loss both of which are critical to preventing or reversing A-fib!
   
   Thus, for my patients I now recommend taking 10,000 steps a day and exercising for 30 minutes each day in addition to the 10,000 steps. Even cardiologists need to get moving more as the average cardiologist only takes about 6,000 steps a day[6].  Just taking 10,000 steps per day, as measured by a pedometer, has been shown to result in about a 5-pound weight loss, without dieting, and a 4-point reduction in your blood pressure[7].
   
   At least a moderate level of exercise on most days has been shown to result it a 6-pound weight loss[8], once again without dieting, and a 6-point drop in blood pressure[9].
   
   
2. Avoid Processed Foods!
   You could not pick a better recipe for high blood pressure and obesity than processed foods.  I would define processed foods as any food item that is already prepared whether it comes in a box, bakery container, soda can, soup can, jar, frozen dinner or pizza, salad dressing bottle, or 99% of what you can eat at restaurants or fast food places.
   
   Processed foods are packed with salt, sugar, and unhealthy fats.  You have to read the labels.  I recently looked at a label of “healthy” whole wheat bread.  I could not believe my eyes; two slices of this “healthy” bread had 500 mg of sodium and 12 grams of sugar!  It is a mystery why food manufactures feel that they need to add huge quantities of salt and 3 teaspoons of sugar to two slices of “healthy” whole wheat bread (1 teaspoon equals 4 g of sugar)!
   
   Moreover, these foods have been shown to be highly addictive[10].  The processed food industry knows this and these addictions lead to huge corporate profits.  We need to get back to the basics and only purchase “real food” and then prepare our own food fresh!
   
   
3. Focus on a Plant Based Diet and Fish!
   If we can focus our diets on fresh whole foods like vegetables, fruits, nuts, whole grains, beans, and fish we will dramatically reduce the salt in our diets and our we will definitely lose weight.  Indeed, studies have shown that if we can eat more of these items in our diet our weight will drop an average of 7 pounds without even dieting and our blood pressure will drop 11 points[11]. In addition, this type of a diet has been shown to help prevent heart disease, cancer, dementia, and significantly prolong life[12]!

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[1]  Circulation. 2004;110:1042-1046

[2] Heart Rhythm. 2010 Apr;7(4):433-7

[3] N Engl J Med. 2000;343:16–22

[4] J Cardiovasc Electrophysiol. 2011 Aug;22(8):839-45

[5] Circulation. 2013 Jan 1;127(1):143-152

[6] Clin Cardiol. 2012 Feb;35(2):78-82.

[7] JAMA. 2007;298(19):2296-2304

[8] JAMA. 2010;304:2603–2610

[9] BMC Public Health. 2012 Nov 20;12:1002

[10] Physiol Behav. 2011 Oct 24;104(5):865-72

[11] N Engl J Med 2001;344:3-10.)

[12] European Heart Journal (2011) 32, 1235–1243