Nikhil Ahluwalia

Understanding Your ECG

This summary gives a very simple overview of how to analyse your own ECGs. If you have ever wondered what the red lines on your ECG mean then read on. Note- this is not a substitute for medical interpretation, especially if you experience new or worsening symptoms. However, the automated

Slow Atrial Fibrillation

Much of what we have explored so far relates to fast Atrial Fibrillation. However, the heart rate during AFib can slow, especially as patients become older, and this can also lead to troubling symptoms. A lot of confusion can occur when slow AF is detected, and it can lead to

The Mind-Atrial Fibrillation Connection

Talking therapy for AFib management I apologise for the brief hiatus in emails- I was under a self-imposed lockdown whilst writing up and completing my PhD in Atrial Fibrillation. The hard work has paid off and Thesis now submitted. After a period of embargo I look forward to sharing the

For Patients

Blood Tests for Atrial Fibrillation

Atrial Fibrillation is diagnosed and monitored using pulse checks and ECGs. However, a series of blood tests 💉are also necessary to help individuals understand and manage their condition effectively. This post summarises the standard blood tests that should be undertaken when AF is diagnosed and those required for ongoing surveillance.

Depression and AFib

As I continue to analyse the symptom scores and reports from the patients in our AFib research studies, I am struck by how much variability there is in the individual experience. Previous studies by Canadian researchers has shown that the change in the amount of AF after catheter ablation correlates

Measuring severity of AFib

“How do you feel?” this ambiguous question is frequently asked of people with Atrial Fibrillation during their hospital consultations or if they become unwell and present to the Emergency Department. But how should this nebulous question be answered? and does it alter the treatment decision a doctor is going to

What should we do with AF in the blanking period?

Early AF recurrences can still cause symptoms which should not be ignored When is the blanking period? The blanking period is the initial phase after an AF ablation procedure. During this time window, arrhythmias like AF may recur, but they can have different implications on the long-term outcome than recurrences

Olive Oil and AFib

The PREDIMAR study results and their impact on AFIB patients It can sometimes feel superficial as a doctor advocating for lifestyle changes in the cardiology clinic. Often done at the end of the consultation as icing dressing on the cake salad. One reason may be that a good diet and

My top three AFib sessions at #HRS2024

A short post today as I am in transit to 'Heart Rhythm Society 2024'. This is the US-based annual conference for Healthcare Professionals working and researching in the field of Arrhythmias including Atrial Fibrillation. Last year we presented our findings from mapping the electrical health of the heart

Should I stop my blood thinner after ablation?

"Even though your AF ablation was successful and we have not seen any AF in the last 12 months you should continue your blood thinner for the rest of your life…" When I started my Electrophysiology training I remember thinking this had to be a defensive medicine/medico-legal

Ear stimulation: A new approach to AFib treatment

We need more treatment options for AF. Despite the effectiveness of anti-arrhythmic drugs and catheter ablation, we still need additional treatment options for patients. A wider choice of treatment strategies would allow us to match the right treatment to the right patient and AF profile.  And so it was refreshing

Atrial Fibrillation and Chest Pain

How can an irregular heart rhythm cause chest pain? And can it lead to a heart attack?  Chest pain is a concerning symptom to a Cardiologist. Guidelines from the NHS in the UK and the American Heart Association advise the same thing- call 999🇬🇧 (or 911🇺🇸) if you are concerned

The 2024 Catheter Ablation for AFib Guidelines- what's new?

I analysed the 2023 Atrial Fibrillation Guidelines only a few months ago, especially how they strengthened their recommendations for invasive treatment of AF in heart failure patients. And hot on its heels, we have another big drop this week, as the 2024 Catheter Ablation for AF Guidelines has just been

Sweetened drinks and Atrial Fibrillation

Studies of the effects of diet on heart disease are challenging to conduct.  Trying to compare health outcomes in vegans versus vegetarians versus meat-eaters is challenging because of all the other associations with these behaviours that you can’t balance. So it isn’t clear if you are measuring the

Atrial Fibrillation and Dementia

Stroke is the sharp end of the ‘complication spear’ when it comes to Atrial Fibrillation. The two are intimately connected with 25% of strokes attributable to AF. A stroke is a sudden cerebrovascular (=brain blood vessel) blockage but cerebrovascular blockage can also happen gradually. This is the underlying pathology in

AFib Ablation from outside the heart

The heart is a three-dimensional structure. The left atrium (the top left chamber of the heart that is targeted during catheter ablation) is only a few millimetres thick. However, in some areas, it can be thicker- up to a centimetre thick. Catheter ablation involves applying energy through heating or cooling

Covid and Atrial Fibrillation

“My AF only started after I got Covid. I was fine before that.” This has not been an uncommon statement from patients with Atrial Fibrillation (AF) when they first present to Clinic. I haven’t dwelled on it too long- partly because it doesn’t change the subsequent approach to

Extra heart beats after ablation

"The ablation worked but I'm still feeling very brief symptoms that are different from my AF." The primary indication for catheter ablation for Atrial Fibrillation is to improve symptoms from the arrhythmia. The most common symptoms of AF are palpitations and shortness of breath and after

Why does my resting heart rate go up after AF ablation?

In the era of wearables and heart rate trackers, this phenomenon is being picked up incidentally by patients in the weeks or months after successful catheter ablation for their Atrial Fibrillation. So before you let anyone convince you that you’re just being paranoid, read on… How high is too

Why do they go through the leg for heart procedures?

A few years ago, in the clinic, I was explaining the details of a Catheter Ablation procedure to a patient. He was troubled by his Atrial Fibrillation and keen to have something done. I explained that the thin catheters are passed up from the groin to the heart and the

The Next-Generation of Blood Thinners: The Newer Oral Anticoagulants on the horizon

Rivaroxaban, Apixaban, Edoxaban or Dabigatran - can we do better?  The problem with the latest generation of blood thinners- the “direct oral anticoagulants” named above is that they’re so good at doing what we want them to (prevent strokes) we can forget that 1 in 10 patients can still

The Atrial Fibrillation trials that will change 2024

It has been 25 years since the seminal work from Michel Haïssaguerre showed where Atrial Fibrillation originates from in the heart. It has been cited by other Scientific papers more than 10,000 times. However, the progress in AF research in 2023 continued at an impressive pace. And importantly the

Does an AFib ablation make you live longer?

Several trials have explored this- but do we have enough evidence to say yes? People with AF have an increased risk of death Atrial Fibrillation is a chronic disease. Patients live with it in the same way patients live with Diabetes or Coronary Disease. But do people who develop AF

The new Atrial Fibrillation Guidelines are out

The 2023 AF guidelines bring a lot of change to patients with AF. None more so than those with Heart Failure. I’ve had to come back and write this post. For the last 2 months I’ve been buried deep under scans, ablation results and statistics analysing the results

Wearables for AF follow-up: Proof of concept

Yes we can! It's a 'yes we can' day. Your Apple Watch can record ECGs and so inferring that it could be used to monitor your Atrial Fibrillation after ablation may seem like a reasonable assumption to make. However, the burden of proof remains- to scientifically