that you discuss with your patients?

There are a few things you might consider doing.

Certainly if someone is smoking they shouldn't be smoking,

for a whole host of reasons

including risk of stroke and atrial fibrillation.

But aside from that, if you have hypertension

then modifying the salt in your diet may be somewhat helpful in keeping your blood pressure normal.

If you have sleep apnea, the disorder where you tend to stop breathing at night and that's been diagnosed,

then there are treatments that can help with that,

various kinds of machines that are used at night to help prevent the stopping of the breathing.

So that's one thing you can do

Interestingly, extreme exercise sometimes is related to the development of atrial fibrillation,

and that’s rare but it does happen

and in those cases then maybe backing off a bit can be helpful in preventing it.

But I think what are the most important points to make about this is that

there are many patients who's atrial fibrillation comes and goes,

and it has absolutely nothing to do with lifestyle,

and so the idea that just modifying a lifestyle or sticking to a particular diet or something like

that is going to cure this is probably unrealistic in most people.

I agree.

And I think within the treatment of atrial fibrillation, the most important thing they need to adhere to is

if it's appropriate for them to take the chronic anticoagulation blood thinners, to prevent strokes.

Right, and even if we know that someone's had atrial fibrillation before,

even if they seem to be doing well now,

and they're not having symptomatic recurrences, they need to stay on those blood thinners.

And particularly a point I don’t think we've emphasized enough yet is that

some patients sometimes have symptomatic episodes where they can feel it,

but many of them can be asymptomatic.

And the fact that a patient isn't feeling like they've had any problems with their rhythm

and then falsely thinks they can stop the blood thinners could be a real problem.

So if you’ve been diagnosed as having a risk, you want to make sure you stay on those drugs,

so that way if you have silent episodes of atrial fibrillation

you don't put yourself at risk of having a stroke.