January 22, 2018

Can Avoiding Dehydration Prevent Atrial Fibrillation “Holiday Heart Syndrome”?

Avoid dehydration

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The holidays seem to bring on lots of atrial fibrillation, often attributed to a condition called “Holiday Heart Syndrome”, which is supposedly caused by consuming too much alcohol and caffeine during the holidays. This year, can we avoid afib caused by Holiday Heart Syndrome? I think so, by avoiding dehydration. Here are my thoughts about this issue.

Holiday heart probably results from many things added up over the extended holiday season, some of which may include:

  • Overindulging in alcohol due to a concentrated period of holiday celebrations. Alcohol dehydrates us.
  • Consuming more coffee and other caffeinated beverages to keep us going despite a lack of sleep and more to do than we can do during the holidays. Coffee and caffeinated beverages can dehydrate us.
  • Cold weather and indoor heat. Both of those dehydrate us.
  • Flying to see family and friends, or for ski, beach, or other holiday vacations. Flying dehydrates us a whole lot because the humidity level on planes is generally less than 10%.

Add up all this dehydration, along with the stress of the holidays and frequent overindulging in sugars, chocolates, flour (gluten), and fats, all of which are considered triggers by many people in the afib community, and you have a recipe for more holiday afib. So what can we do about it?

Here are a few of my rules of thumb, not just for the holidays but for all of the time:

  • For every alcoholic beverage consumed, have an equal amount of water, or even better, twice as much water.
  • Drink lots of water (or club soda) during flights to avoid dehydration caused by the very low humidity levels on board. For me, that means 6–12 ounces of water for every hour in the air. Yes, that means more trips to the restroom, but that has benefits, too, in that it gets your legs moving and decreases your risk of blood clots in the legs due to deep vein thrombosis (also called “economy class syndrome”).
  • During flights, avoid alcohol, or consume 2X–3X as much water as alcoholic beverage. It’s easy if you pace yourself with one sip of alcoholic beverage followed by several sips of water.
  • In cold weather, especially when ice and snow are on the ground, drink more water than usual. Under normal conditions, 64–80 ounces of water per day is considered enough, but more is needed when weather conditions are dry and dehydrating. This also applies at high altitudes and in the desert.

Just an extra personal anecdote for those traveling long distances by air during the holidays, or any time… I think that jet lag is largely due to dehydration. I believe that a little bit of extra salt on long flights helps with hydration. At least it does for me. Everyone is different, so before trying this, discuss it with your doctor, especially if you have high blood pressure. This is just my opinion, and I know that salt is politically incorrect these days. This is not an everyday practice, but I believe it is warranted in unusual circumstances such as this, especially for those without high blood pressure.

Thus, here are a couple of my personal favorite jet lag “cures”:

  • A margarita, with a little bit of salt, just after a very long international flight. I’m not sure if it’s the lime juice, tequila, or hydration aided by salt and all the extra water I drink with it, but it seems to work well for me in quickly getting over jet lag from long international flights.
  • A couple of large bottles of Gerolsteiner, a mineral water from Germany, when I return home. (I get it at Whole Foods, but it is probably available elsewhere.) While on business in Germany recently, there was Gerolsteiner mineral water everywhere, and I delighted in indulging in it. Interestingly, I had no jet lag when I got home from that trip.

I’ll admit that, having been afib free for over 6 years, maybe I’m just a bit fanatical about staying hydrated, especially since I no longer have my left atrial appendage, which plays a role in thirst regulation. (It is typically removed or closed off in mini maze surgery as it generates 90% of afib clots). But if being fanatical helps keep the afib beast at bay, it’s so worth it. [She stops writing and slugs down more water.]

Another fanatical thing I do to keep the afib beast at bay is to consistently treat my sleep apnea, but that is a whole other story for another day.

On this blog, we wrote earlier about whether alcohol and coffee are really the culprits they are portrayed to be in causing atrial fibrillation? You can read those articles at Does Alcohol Put You at Risk for Atrial Fibrillation? and The Role of Coffee in Atrial Fibrillation.

Could it actually be that it’s not the alcohol and coffee at all, but instead is the dehydration that they can bring on if we don’t have enough water with them? So can we decrease afib by staying fully hydrated? I think it’s worth a try.

Please let me know below what you think, and about any experiences you have with this, especially during the holiday season.

Here’s hoping these simple ideas for staying hydrated during holiday travel and feasting can get you through the holidays with no afib.

Wishing you a happy and afib-free holiday season.

Mellanie True Hills and
The StopAfib.org Team


  1. I strongly believe that dehydration and stress are major triggers for those who have a predisposition to Afib. It runs in my family (father, sister). I have had 5 episodes, all of them with certain elements in common:

    1) stress related to travel
    2) sever dehydration brought upon by other excessive consumption of alcohol without other liquids to replenish or consumption of alcohol plus extreme exercise in a hot climate without sufficient hydration

    I’ve also had a Ca lack for a number of years and am overweight.

    And interestingly, the AFib has started 4 times when I was asleep and once when I was dozing in a chair late at night.

    • Brenna Lara says:

      Hi Paula,

      Thank you for sharing your story and thoughts regarding stress and other factors that might have triggered your afib. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php?act=idxhttp://forum.stopafib.org/index.php?act=idx) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story there, and you may also learn a lot from others who have already shared their experience.

      • Brenda Wilcox says:

        I wonder if you have sleep apnea, as I do. I believe my A-fib is also triggered by sleep apnea.

        • Brenna Lara says:

          Hi Brenda,

          Thank you for sharing your story concerning your afib and your thoughts on the relation between afib and sleep apnea. You may be interested in joining our patient discussion forum (http://forum.stopafib.org/index.php) to connect with other patients who collectively have a great amount of knowledge and experience. You may want to post your story there, and you may also learn a lot from others who have already shared their experience. I hope that you are able to find others to connect with there that can give you advice, suggestions and hope. There are many resources on living with afib that you might find helpful. Best of luck to you! We wish you sinus rhythm.

  2. eccentricMagpies@gmail.com says:

    For myself, I believe it’s the exact cause.

    This past Thursday I went into Afib. Told the doctor I had spent the past 5 days camping and traveling with family. Then, on the following day I decided to use a post hold digger to put in a few posts. Half way through the first hole I knew I had sent my heart into Afib. aaghhh!!!

    After leaving ER with some beta blockers and blood thinners, it dawned on me that 2 years ago (last time I had been in Afib) I had come to the conclusion that it is hydration related.

    So, I went on to flood myself with as much water as I could handle and soon afterwards, my heart came out of Afib. One could argue that I was also taking beta-blockers, but I’m convinced had I been hydrating myself while I was on vacation I would have never went into Afib.

    • Mike Locke says:

      Although there could be any number of triggers I am convinced that in my case dehydration is also a major factor. A few weeks ago I started having AF episodes every other day in-spite of being previously controlled while on flecainide.
      I remembered the references to hydration and started drinking copious amounts of water each day. The episodes stopped and I have now been free for over two weeks.

  3. Todd Williams says:

    I first went into AFIB during surgery for a deviated septum. I stayed on Rythmol for about 6 months and then got cardioversion. That worked for about a year and after about a molnth on vacation where I frequently drank too much and smoked pot, I went into AFIB again. Now I’m going in for cardioversion next week. I’m a vary active 64-year-old (ski, surf, kayak, mountainbike, skateboard,, hike, etc.). So I’ve stopped coffee, no more pot, and 3-5 beers a week. Also I tend not to hydrate and after reading this discussion am determined to drink more water every day! I never knew pot could cause AFIB. But a few recent sudies indicate this. What’s your opinion?

  4. Shelley Dryden-McCann says:

    A water like Gerolsteiner? Which I have personally tried and I have not been in afib since the beginning of March 2015.

  5. Shelley Dryden-McCann says:

    Can drinking water , especially natural water with magnesium content in it , help athletes young and old deter from developing atrial fibrillation when competing on all levels of competition?

    • Shelley, we do not yet know whether a natural water with magnesium will prevent atrial fibrillation for athletes. There have not yet been studies done, and it would be interesting to know. What has your experience been?

  6. Anton Ferreira says:

    My afib went from occasional to frequent to persistent in the course of a year. Not incapacitating, but enough to leave me slightly breathless.

    My dentist commented that my mouth was dry, which made me suspect that I might be chronically dehydrated. I began slavishly sipping my way through ten cups of water a day, and the afib vanished IMMEDIATELY and has not returned. It feels like being reborn.


  7. Dehydration has always been a trigger for me, so before i begin an activity that I know is going to cause heavy sweating, I drink sports drinks in addition to water, and if I drink enough, I am successful in avoiding an episode of afib. Although I always new that alcohol dehydrates, until now I never put the two together, so rather than giving up my holiday cheer completely, maybe I’ll try drinking plenty of water. Thanks for the article, very enlightening.

  8. I was diagnosed with A-Fib in April 2014 aged only 44. I have never smoked, drink infrequently, and have a healthy weight and BP of 110/65. Before the A-Fib my pulse was around 55 at rest.

    The trigger seems to have been an air pollution event, but since then the A-Fib has been persistent. Cardioversion has been tried once so far, but it failed quickly. Another one is scheduled for next Jan. Amiodarone has been suggested, but the side effects put me off.

    I can still walk reasonable distances, but get lots of chest pain, dizziness and other A-Fib symptoms, and need much more sleep than I used to, and occasionally my BP will crash to 80/40 and I won’t feel too good.

    Can anyone suggest a safe alternative to Amiodarone to increase the chance of successful cardioversion.



    • Robert, You may be interested in asking your question on our afib patient discussion forum. Instructions for how to sign up are here. Our active forum is full of others who have been managing their afib, and they may be happy to share with you their experiences with afib.

    • Hi Robert
      I am 38 and have had this for the past 2 and half years. I was in the er many times. I used to take amiodarone but was switched to dronedarone. Amiodarone made me very ill and my life was drastically affected. I am much better with dronedarone you were right to refuse amiodarone.
      I hope this helped

      Best wishes

  9. I first went into A-Fib in 2010 at the age of 52 (FYI I lift run and walk alot) they shocked me back into rhythm and put me on meds. Xarelto 20 mg, Sotalol 240 mg every 12 hours and metoprolol 50 mg. I have been on the meds since. At first when i would go back into a-fib i would go see the doc and he would shock me to put me in rhythm now When I go into a-fib I found that weightlifting upper or lower body for 20 minutes than walk on treadmill at 3.5 setting for 1 min than run at 5.5 for 1 min than walk 1 min than run 2 min walk 1 run 3 walk 1 run 4 walk 1 puts my heart back in rhythm. This has happened at least 10 or more times and I feel great afterwards. So far it has worked every time. I think the trick is not to get over anxious while walking and running just let your heart rate slow down than speed up and its like magic you start breathing easy again.

  10. Hi my name is Mike,I have been suffering from afib since I was 27,16 years now and every time it is brought on my body temp is high and I am drinking something cold,then I get instead of a brain freeze,a heart freeze,followed by afib.i have told my doctors and they just say that’s interesting it happens twice a year.have you ever heard this before.

    • Hi Mike,
      Thanks for sharing. We have heard of people having afib at a young age, and people have shared things that they notice may trigger their afib. You may be interested in sharing this on our patient discussion forum and seeing what other folks have experienced. Here is info on getting started.

    • I’m young, also. Started afib when I was 26. I’m 34 now. A huge trigger for my afib is cold liquid, or swallowing a big bite of food.

      My docs were also perplexed, but when they went in to do my ablation, they found that one of the nodes that was malfunctioning was right up against my esophagus, so every time I swallowed something cold, or a big bite of food, it would irritate that bad node and trigger afib.

      They were unable to ablate that node because it was so close to the esophagus, and so I still have afib in this way, even post ablation.

      So you’re not crazy, and you’re not alone.

    • Dennis Osborne says:

      I ended up here because I swallowed wrong a bit ago and knew the minute I did, I would go into afib because it’s happened before. So I hash-tagged about swallowing wrong and here I am.

  11. Hi,

    My Afib is triggered only by high heart rate sports. Often happens early in the game, so wouldn’t seem to be a hydration issue. Is anyone else experiencing this? Also usually accompanied by gastric issues (gas/burping). Beta blockers and good warm-up seem to help.

    • Hi, Colin. It seems there are many whose afib is affected by sports and physical activity. You may be interested in joining us on our afib discussion forum to ask your question. Go to Forum.StopAfib.org and register to get started. We hope you join us.


    • Colin,

      Im 43 and was diagnosed with AF about 2.5 years ago. I have raced bicycles (think Lance Armstrong, but without the drugs or celebrity girlfriends) since I was 30.

      As a serious racer who trained 20+ hours per week, going into AF and subsequently being put on Diltiazem was a race-killer. I continued to race for another 2 years, but, my performance dropped more and more as I was on the Dilt. I now know that Dilt basically blocks the contraction of muscles, which put me at a huge disadvantage.

      At any rate, last summer the med just stopped working and I went back into AF. My doctors convinced me to have ablation surgery and while it was successful (I’ve been off meds now for 7 months), something more alarming is happening.

      Now my heart “tries” to go into AF but it wont and because I am incredibly symptomatic, and it keeps trying over and over to go into AF, it feels like its going to explode out of my chest.

      To your point, I ONLY experience this now when I try to exercise and get my heart rate up over 140 or 150. Futher, it happens at the beginning of the exercise, but then tends to not happen again afterwards. In my case, now my heart speeds up, like… a lot… For example, if im trying to go uphill at 170 bpm and I have an episode (I can feel it the moment it starts to happen), my HR will jump up from 170 to 177, 183, 190, 195, 205, 212, 216, 222… I’ve seen it all the way up to 230 bpm!

      When I feel this happening, I stop all activity and try to calm myself even though I’m really freaking the hell out. Watching my HR on the monitor go from 170 and climb to over 220 is terrifying…. and trying to calm myself down is really really hard.

      The doc has me on a Zio patch now to try to record an episode of this happening, so, my fingers are crossed that we can get data on it.

      To the OP, I have noticed that alcohol itself plays a role in my AF bouts and as a former athlete, Ive noticed and completely agree that hydration plays a key role… I’d imagine both for the hydration aspect and the electrolytic composition of our bodies.

      To be honest, I’ve been pretty depressed for the last year since Ive not been able to race, or really even train. Besides my wife and baby boy, cycling is my life… I’m just not ready to give it up.

      Any thoughts you all have for me are welcomed and I look forward to some replies. Also going to register on the site mentioned above.



      • Josh, thank you for sharing your story. You may be interested in sharing this on our discussion forum as well. Many folks there may benefit from learning about your experience, and you may also learn from others. Details on how to sign up can be found here.

      • Josh, there is an EP doc that has a great blog and great articles at medscape and other sites like the heart.org

        He’s also an active cyclist and has personally dealt with afib.
        Google Dr. John M blog to find him.

  12. Docia Vagnerini says:

    I have been dealing with irregular heart beat for about 10 years jut off and on episodes.I can go months at a time with nothing and then all of a sudden out of the blue it hits and puts me down until it goes away. Most of the time I feel like a million bucks but when it hits me I feel like an invalid.I noticed that mine started when I started menopause,does anyone else know of a correlation between these things?I know alcohol is a trigger,I only drink 1 cup of coffee everyday in the morning (love it) and I do love my chocolate and sweets,I don’t have any other health issues other than hypothyroidism which also started at about the same time maybe 2-3 years before,correlation there?I know how badly this can make a person feel and the scary stuff sends me into panic attacks almost every time,it becomes quite debilitating. Any responses will be greatly appreciated.

  13. Drank lots of water in the summer.Afib went away.Winter, drank a lot less water,thinking I was not dehydrating.Mistake!Started lots of water.Afib gone.

  14. Roberto Hernandez says:

    Melanie.Gracias por mantenernos al dia sobre la Fibrilacion Auricular,sus comentarios y recomendaciones son muy importantes para los que sufrimos de esta dolencia,Creo que conociendo bien esta enfermedad nos permitira disminuir crisis futuras.Esta es una condicion que se desencadena por muchos factores que intervienen en ella.quiero que sepan que aquellos alimentos que llevan canela puede estimular el ritmo cardiaco y por ende una Fibrilacion auricular.Por mi parte despues de una Ablacion cardiaca con radiofrequencia mejore bastante pero no estoy curado,sin embargo creo que las crisi se han ido espaciando en la medida que he ido decubriendo los factores que puedan desencadenarla,por tanto el tratamiento y la conducta debe de ser individualizada.Gracias por su ayuda la cual nos ha sido muy util.
    Roberto Hernandez

  15. Larry Allen says:

    I believe that afib is directly related to a lack of electrolytes in the body. For me, all of my afib events happened when I was hot, sweaty and dehydrated.

    Our hearts work by receiving electrical impulses that are generated within our body. Much like an old style battery, that electiricity is generated by reactions with an electrolyte. When those old style batteries got low on water (the electrolyte), there was not enough intereaction between the cathode and anode and the battery would lose it’s ability to generate electricity..

    I believe our bodies work in exactly the same way and when our electyrolytes get low, our body fails to generate the right amount of electricity at the right time and causes the heart to beat irregularly.

    My solution has been to drink an energy drink first thing in the morning to counteract the dehydration that we all get from sleeping. For me this has worked and since starting this regemine I have not had an afib event. I also make sure that if I’m working outside and sweating, I drink plenty of water – with electrolytes.

    Hope this line of thinking helps someone else.

  16. I have been to hospital twice for afib. Just back from the last episode.

    Both occurred during nasty gastroenteritis attacks.

    So, the dehydration theory looks good in my case at least.

  17. Came across this website and article today and find it fantastic. I have long suspected dehydration to be the problem with my Afib but am now sure of it. One of the comments by Anthony suggested Roobios Tea. I have been drinking this for several years without realising that it was actually helping my Afib. Also learned from another comment Pradaxa can cause digestion problems which it does with me. However I am willing to put up with this inconvenience rather than go on Warfin. Will definitely make sure I am hydrated in future.

  18. Diane Dicresce says:

    I just was released from the hospital, where I was staying for a kidney infection
    The second evening at the hospital, I went into a fib. Never had a problem before
    Drs. Say the kidney infection maybe the cause , I do drink lots of water, an 2glasses of wine each evening. I am still in afib but on meds an blood thinners. Seeing my cardo dr. This week , my bp is 102/62 heart rate 72, in hospital hr was 119 or 70′ if you have any suggestions please let me know
    God Bless

  19. not sure .as I haven’t read the entire blog-just this article but why would you have undergone a maze surgery if it is keeping hydrated is the answer to keeping afib at bay?
    Sorry if this has been answered elsewhere but also if someone has afib that has ever been triggered by alcohol.I would say just stop drinking totally-

    • Hi Anjie,

      Please note that no two cases of afib are alike, and it’s rarely as simple as staying hydrated or avoiding alcohol. However, knowing what can help provides the opportunity to potentially decrease the “afib burden”.

      Mellanie underwent mini maze to decrease her significant stroke risk–she had had blood clots and a close call with a stroke and was unable to be stable on Coumadin, the only blood thinner option at the time. As a “stroke walking around waiting to happen”, mini maze significantly decreased her stroke risk by also eliminating the left atrial appendage (the source of 90%+ of afib-related blood clots).

  20. SoulHealer says:

    Bea, your post is amazing! Perfectly fit with my episodes of paroxistic supraventricular arrythmia I experienced during last 4 years (twice per year- TPSV, Afib, flutter). Indeed any change of vagal tone is a trigger for extrasystoles and those paroxismal arrythmia. So, because I have also a hiatal hernia of a medium size (slide type) I kindly ask you about remedies indicated you by your GE to control your HH.
    Thank you

  21. I just had my first incidence of self diagnosed AF. It was brought on by exertion due to sawing trees down for 3 hours in 30 degree heat. Plus not drinking any water I suppose. The effects lasted for 8 hours then I was fine. At 75 would this be likely to trigger further episodes?

  22. Should I hydrate before having any alcohol? It doesn’t seem to work for me after. Even one beer seems to set off the afib for me. Vigorous exercise seems to put my heart back in rhythm. Am I the only one who has that experience?

    • Excercise and simply moving around keeps my AF at bay. When I sit down and relax after work will trigger it.

    • I found that doing crossfit exercise puts my heart back in rhythm. This has happened at least 6 times and I feel great afterwards.

  23. I had problems over Thanksgiving brought on by gluten and sugar. It was a joy for me to pinpoint the problem and avoid over the Christmas holiday.

    • Mike Williams says:

      Sugar, especially a good amount on an empty stomach (chocolate chip cookies, maybe a bit of caffeine from the chocolate) has triggered at least 2 episodes in me. But I have had it for at least 25 years. Controlled by medicines for 15 years pretty well , was in sinus rhythm = regular beat, now is in a-fib. Not working with meds. any more to go back into beat, but does stay slower 70 to 90 bpm.

  24. Patricia McCracken says:

    Hi Melanie. I enjoy reading your articles and wondered what is the difference in irregular heart rate and AFib or are they one and the same.

    • Patricia,

      Thanks. There are many different irregular heartbeats, most of which are uncommon. Afib is the most common one–most people who have irregular heartbeats have afib.

      • I recently discovered that I have vagal afib and a low level hiatal hernia recently, after another procedure, ramped my hernia up to a major problem. Having a-fib means about half of the herbs and ALL of the products that have even a hint of nutrasweet (Aspartame) sets off my a-fib in minutes but my new discovery is that anything that triggers my hernia also triggers my a-fib, even something as simple as bending over to pick up something shortly after eating. The more I burp the less likely my a-fib is to continue or grow worse, so the key isn’t the water, it’s keeping the hernia from sliding up, pushing against the vagal nerve adjacent to it and to the atria, all of which trigger the a-fib. My doctor prescribed a compounded series of ingredients which help enormously with the hernia, thus with the a-fib, but if I overeat, pressing the gas and/or food upward against the hernia/vagal nerve, I can count on the a-fib. The first thing you need to learn is what type of a-fib you have. Why doctors have never made this connection is a mystery to me when I did it by typing in “hiatal hernia and vagal a-fib.” You will also find a series of exercises that help a bit, and I have stomach massages as well. If standing on my head helped, I’d try that too.

  25. Thank you for this informative website.

    Each time I’ve landed in the hospital for occasional lone atrial fib that’s failed to convert on its own, I’ve been told I was dehydrated. Some people are slow to learn (smile) but, yes, I now drink loads of water each day, although I do not enjoy it the way some people do.

    I have not had any alcohol for two years — and won’t ever again — have one decaf coffee a day, walk three miles three times a week (it should be more) and avoid people who cause me stress.

    Stress has, for me, been a clear precipitant of AF. (I’m 68).

    I’ve also meditated for many years and teach meditation. It’s really true what so many say: Meditation on a regular basis does wonders for alleviating the sense that daily life is cracking is apart under the stresses most of us face. Sit with eyes closed, hands on knees with palms upraised, breath quietly and steadily for 20 minutes.

    My life is very very happy, and I’m involved with lots of good volunteer work and socializing, all of which helps me.

    Question: I love travel but seldom do it anymore for fear I’ll be stuck somewhere w/o medical help. How do other people cope with this? It’s absurd to cut such a lovely pursuit out of my life!

    • Betsy,
      Thank you for the kind words about our website. Where do you enjoy traveling? I know Mellanie travels very often, and she does so seemlessly. Perhaps there are others who could share with you their tips on travel with afib. The stopafib.org forum may be the best place to ask this question. To get to the StopAfib.org Discussion Forum, go to: http://forum.stopafib.org. To post or ask questions, you’ll need to register. Instructions for registering and getting started are here: http://forum.stopafib.org/index.php?showforum=25

      Kind regards,

  26. Have had Afib since 2010; Cardiologist took me off Coumidin and put me on 325mg of aspirin a day. Said the effects of Coumidin were worse than taking aspirin. I still drink wine every day and lots of water. and I feel good. Still take lasik, potassium, calcium, Vit. D-3 and fish oil, plus eating very healthy.

  27. Melanie,

    What about supplements & herbal remedies such as: CoQ10, scotch broom, tincture of cactus, hawthron, valerian, lily of the valley; mega doses of niacin & folic acid?

    I take a multi-vit, plus, magnesium, potassium, & 81mg aspirin.


    • Hi Kathy,
      We do not specialize in supplements because Hans Larsen covers that area. You may be interested in seeing his Lone Afib forum, and the link is in our blogroll on the side of the blog. Also, many people also try supplements for a while without much change before they go on to get procedures to stop their afib.

      The supplements we do believe are important for those with afib are CoQ10, magnesium, potassium, and fish oil/Omega-3s. It’s also very important to stay hydrated. Additionally, niacin, folic acid, and aspirin should definitely be discussed with the patient’s doctor as there have been studies that point to harm from them, including interference with with medications.

      Melissa @StopAfib.org

  28. CindyMBlack says:

    I drink lots and lots of water every day, so no problem with that.  
    Just want to say:  thanks so much for this website!!!!  It is so user-friendly and informative.  I was dx’ed with AF recently though have had it for years.  I never had it checked out because I have no insurance.  I always thought  it was stress-related and I could reverse it on my own when my stress was resolved by FINALLY finding a job!  (I am 64yo but look 44, and consider myself in my prime!).  
    Now I’m finding out all about AF and must admit I’ve been terrified.  I’m also on Coumadin (yuk!!) and Sotolol, a beta-blocker.  I have a very active life (skiing, hiking, swimming…) and these meds are of course creating many problems for me though I am trying mightily to be good.  I do deep-breathing and am careful to avoid stress reactions.  I’ve also cut WAY down on caffeine and am limiting myself to ONE BEER per day… I dearly hope I can continue having one cup of coffee and one beer per day, as that is so important for not feeling like your life is over and you’re some kind of a freakin invalid…. 
    Anyway, I’ve had 2  recent cardioversions, neither lasting even a week.   I’m hopefully having a catheter ablation in about one month.  I am SO very hopeful re this  ablation!  I’m in the process of qualifying for “charity care” so I can get it.
    I also have MANY mercury amalgams in my mouth, including one huge one where the tooth has broken away and it’s mainly just a huge filling standing there like Stonehenge, with no tooth around it.  THIS, I’m starting to find out, might be strongly tied to the darn AF.  I’ve got to get it out of my mouth, and am working on ways to make that happen too.   
    Otherwise, I’ve always eaten fabulously heart-healthy (& no meat, white stuff or chemicals of any kind), exercised regularly, taken great supplements.  I’m sure I have squeaky-clean arteries and great cholesterol numbers… so there’s that at least.  
    Just meant to write a quick statement, and look at this missive!  Sorry, but just want to say I’ll be scouring this site for every bit of info I can get.  IF (shudder) the ablation doesn’t work, I’m planning to go off the Coumadin to more natural supplements in any case; and I’ll need help with that for sure.  Cheers everyone (and especially MELLANIE)….    Cindy Black, Seattle WA

  29. pattyingrassia says:

    I was just reading your information on dehydration and its relationship to AFib.  I believe my AFib was brought on by taking too many hot saunas over a short period of time and staying in one way too long, thus dehydration.  After the last one, I fainted on the shower for a short time and came to on my own.  I did not bring my water that day.  After I got home, I just laid down for a while and told no one about the incident at that time.   A short time later I began having a rapid beating of my heart.  I believe this was the start of my AFib but didn’t know it.  I discovered something was wrong when the heart monitors on the tread mills at my health club all seemed to not work.  My husband bought me my own heart monitor and when I tried it for the first time my pulse was very erratic.  I went to the doctor the next day and after many test was pronounced with AFib and put on an aspirin.  Later I went to a cardiologist and told him my story of how I believe I got my AFib problem and he pooh-poohed it. He said that I would have had to have been in a desert environment for several days. (What do you think a sauna is?) I asked him how do people get AFib and he said it just happens as people get older.  I was 58 and didn’t believe I was that old.
     I just thought you might like a story about dehydration I believe is related to AFib.
    Patty 🙂

  30. andy mcintosh says:

    does anyone have any info on relationship between “alfacacidol” and a-fib. ie taking too much or too little…thanks..Andy.

  31. jaffray geddes says:

    I am 79 with A/F. Tell me are their any Meds apart from Dioxegen.Betalog.
    and Dialtizen -all spelt wrong sorry- that have some beneficial effect
    as opposed to these Beta Blockers which merely control? I was put on
    Prxada instead of Warferin but the effect of it on my digestion was intolerable
    so I stopped taking it ! and would rather go on massive doses of Garlic
    what do you think? iT IS A TERIBLE AFFLICTION , to have to rely on these drugs
    I am also vastly overweight and breathless, can hardly walk up a hill!
    I believe its is the drugs effecting my metabolic rate increasing my weight
    belly fat, huge, yet I do not drink alcohol/caffeine what can I drink to
    lose weight that is not in opposition to the drugs!


  32. Tim Healy Jr says:

    Great web site for information.
    I had my first bout with AF while volunteering in a hospital ER in 2001. Was put in a bed for about 5 hrs and converted after treatment. Started with a cardiologist the following day and still see him. Nothing like being in the right place. I take flecainide, amlodipine, losartan/hctz and xarelto(which i was just perscribed). I have had additional minor bouts and I know when to go to the ER or when they will convert themselves. I still work in the ER as a Tech so I’m always asking questions. I am 80 yrs old. I trust my cardio Dr. for my treatments. I use no caffeine and drink wine spareingly. Lots of sparkling water.

  33. Valerie Brooke says:

    Susan Nicolini,
    Can you please tell me what the deep breathing technique is that you use, or kindly point me in the direction of where I might get the information.

    Kind regards

  34. John Macker says:

    very informative blog! Had my 1st afib attack early 2009. ICU, converted next morning via drip. Many tests, no structural problems. No medication, then another attack 4 mos later, put on diltizem. Have been able to control w/diltiazem & beta blocker (once.) I believe the hydration issue is important. Also, anyone have any thoughts about the effectiveness of acupuncture? I
    am 56.

    Keep up the great work!

  35. Mellanie, Gary,

    Thank you for the CPAP information. My ResMed Elite II has expiratory pressure relief, but I have never been able to get use to it. I use
    nasal pillows, but would like to try something else.
    The ablation went ok. I thought I would be off work for 1 week, that turned into 2 weeks. I am back at work now and feel so tired. I know it takes a long time to even know if the ablation stopped the afib. If it works I will have an atrial septal defect closure done sometime this year. The doctor did not want to wait a long time to do that.

    I hope everyone is doing well.

    Thanks for all the information.


  36. Dear Fay

    I do not use a mask that fits over my entire nose. I use a configuration that has an orifice that fits into each nostril. Here is some experience with the CPAP air supply compressor that you may find useful. I am able to utilize a variable pressure CPAP. The CPAP compressor that I now use adapts to provide less pressure when you exhale and greater pressure when you inhale. I have found this format to be preferable to the continuous pressure format. I hope this is of some help.

    Yours sincerely,

  37. to Anthony,
    interesting that you would have afib for 10 years and then convert to sinus with Rooibos tea. Were you or are you on any meds at all?

  38. I just found your website and really am glad i did. I will keep hydrated always. I was in hospital 5days for afib 1st time nov 25. I came out of it on my own with the help of a drip 11hours later. I had many test done. Im now seeing a specialist at brigham and womens hosp in boston. Your web site will be visited by me often. Thank you

  39. Nicolas Dzepina says:

    For me …it is the reverse.. Wine at dinner time ..while in Afib …. has reverted my pulse to normal… by speeding up drastically my pulse rate all of a sudden…. ….lasting a few seconds to about a minute .Why?…. because I think wine is releiving the main cause of my afib which is the story of my life (ANXIETY STRESS) ..in the same manner going running while in Afib has reverted it during and/or after my run during the recuperation period 65% of the time I have tried it ….. by bringing down that stress level.. and the blood pressure level

    For having monitored myself meticulously I came to the conclusion that my anxiety stress raising my blood pressure drastically was and is the main trigger…. and what allow the heart rate to revert normal under paroxysmal Afib is the fact that while you are in Afib your blood pressure drops drasically to very low .. releiving the pressure on your heart walls.. and that’s what allow it to return to normal after awhile . The more episodes you have the more it effects the atria walls which gets more and more dilated… and the longer your episodes last . After awhile you fall into persistent then permanent Afib once they get too dilated. For whatever this is worth

  40. I am almost 61 and I have had afib since 2001. I’ve had open heart surgery when i was 15 for a septum defect, have been active but not really athletic all my life. The first time I felt this dysrhymia was when i was in menopause and it was exercise induced. It reverted back to normal sinus after a few months on meds. I’ve been cardioverted twice since and almost made my 3 year mark when I was struck again on New years Eve. I’m wondering if hydrating myself will get me back to normal. I will give it a try. This blog has been really encouraging to me. I also found out during the last episode resulting in cardioversion that my blood was high in heavy metals and i needed chelation therapy. I’m otherwise healthy, but I do consume coffee and have an occasional wine. I’ve resigned myself to the fact that the open heart surgery may have contributed to this and that I will be plagued with episodes for the rest of my life.

    • Audrey,

      I’m sorry. I hope that staying hydrated may help. The surgery could have contributed, but it may not have been the cause. Perhaps one day we will know what causes afib.


  41. Thanks for the information. Got sick last May got Afib, had a doctor that did not know anything new about Afib. Now have another doctor. I am going to have an ablation January 10, 12 and in the future having the ASD fixed that the first doctor did not find in any of the tests he did. I take Multaq & carvedilol 2x daily, and Cumadin.
    I also have sleep apnea. I am interested in the type of mask you use.
    I do not drink alcohol and I really try to keep hydrated. I had never heard of Afib before I got it and it is so discouraging that there is so little to do for it and it will never be cured.

    • Fay,

      I hope the ablation went well and that you will be afib-free.

      For me, the full-face CPAP mask is the only way to go as I sometimes have breathing difficulties (sinus issues certain times of the year). I love my ResMed Mirage Quattro.


  42. Dear Mellanie

    I have had Afib for about a year now (age is 66 and still play hockey a couple of times per week). I have a mild case of sleep apnea.(SA) However, I think that a mild case of SA becomes more severe SA with the effects of alcohol. I use a CPAP every night without fail. I just had my third cardioversion (CV) [in November]and have successfully gone through the past holiday period by reducing my alcohol consumption (2 small tasting glasses of wine 2.0 oz each per day at dinner). After reading your blog, I will increase my H2O consumption.

    It seemed that each previous reversion was caused by a combination of SA and more than a couple of glasses of wine (Afib reverted during my sleep). It seems that you sleep deeper with the increased alcohol.consumption. It would seem to me that increased hydration dilutes the effect of alcohol. If it was only a lack of hydration, my hockey playing would have triggered a reversion previously (you get pretty dehydrated). It would seem to me that the SA effect with increased alcohol consumption is the cause of the reversion. I would like to know what is happening when you are in the deep sleep mode? You stop breathing, eventually gasp but in my case my O2 levels do not fall appreciably. But the heart rate increases – why? [simplistically – the brain seems to be telling the heart to make sure it gets enough O2 – the brain seems to be sensitive enough to detect a reduction or change in something]. Would a heart rate monitor with an alarm function wake up a person before Afib reversion occurs? Your thoughts will be most appreciated.

    Yours sincerely,


    • Gary,

      Your thoughts make sense. A heart rate monitor that alarms when the rate falls might make sense if it wakes you before you can have an apnea event that triggers afib.


  43. I’ve had three bouts of Afib but only officially diagnosed once. The first two only lasted about 40 minutes and the third lasting about 4 hours. The last one I converted on my own while I was at the emergency room. The first and last once were after drinking several glasses of wine. I haven’t had any alcholol since the last episode and just assumed that you shouldn’t consume alcholol if you’ve had an Afib episode. I’ve done lots of reading and it appears that most of the concesus if that moderate drinking (1 glass of wine for women) doesn’t pose any risk of bringing on Afib. Is that your opinion as well?

    • A.C.,

      The research says that one glass of wine for a woman is reasonable, but we’re all different, so some women may not be able to have wine at all. You have to decide what works for your body, not what the research says.


  44. Anthony Murphy says:

    Dear Mellanie

    I have had Afib for over 10 years now and today I am 100% Afib free! A few months ago I started drinking a lot of Rooibos tea (South African herbal tea with two teaspoons of sugar – no milk) It helps hydrate my body without the caffeine and is also refreshingly thirst quenching at a low temperature! (you can get Rooibos at most supermarkets around the world and many hotels now have it available)

    For no apparent reason my heart has kicked back to normal and I can only attribute this to the Rooibos tea??

    I now stay hydrated drinking my Rooibos on long flights and after a night of social drinking. For me I believe hydration is the key to keeping the Afib Monster away!



  45. Andrew Ross says:

    Yes, the dehydration/holiday heart syndrome. My condition started with this diagnosis, back in 2000, in the DC metro area. After a long, long while of unsuccessful drug therapy I underwent a cardioversion. And began 10 years on amiodarone. Fortunately my new CT cardiologist pulled me off amiodarone and we tried Multaq with limited then no positive results. I had a cardiac ablation this past July and have been in sinus since. Keeping lots of seltzer water by my bedside, in my cars for all trips and regular hydration is some of the best advice I can give. I think Melanie hits on a true point here: sometimes ordinary water is too boring to drink, so switch to fuzzy seltzer or soda water, it is more fun to drink!

    • Andrew,

      I’m sorry about your experiences, but am so glad you’re doing well. I think when we’re afib-free, we will do just about anything to stay that way. If it means lots of water, no matter how boring we think it is, then so be it.

      Thanks for the confirmation of my comments. Here at home, we have a water filter built in, so the water is actually quite good. But on planes, I’m more likely to go with club soda, as much for a change of pace as anything.

      But for jet lag, nothing beats Gerolsteiner, at least for me. While home in Birmingham just before Christmas, I cleaned out all the Gerolsteiner that Whole Foods had (2+ cases), and distributed it among family members since afib is so common among the senior-most generation of our extended family there (including lots of relatives that are related by marriage only).


  46. Susan Nicolini says:

    Is it really possible to be A-Fib free? I have had 3 cardiologists so far in dealing with my a-fib. They all have assured me that this will be with me forever.
    The first one always threw me into the hospital, the second one told me not to come back unless I completely give up wine and the 3rd one tried to sell me his services in cardio ablation. So right now I have no cardiologist. I have had a couple of episodes in 2011 and dealt with them through the deep breathing technique. It has put me back into sinus rhythm. I am presently on 400 mg of Multaq 2x daily and Cumadin (I hate being on this stuff). I didn’t have any problems over the holidays and I did consume a lot of wine, but I also consumed a lot of water too. I had no a-fib problems. So maybe Melanie has found a cure for this annoyance. I would love to keep in touch and hear of any recommendations you all have. Thanks for listening.

    • Susan,

      I wasn’t indicating that you’d be cured, or even afib-free for any period of time; the point was just a possible way to decrease the number of afib episodes by paying close attention to hydration, especially under dehydrating circumstances. In other words, here’s something that might avoid afib being triggered.

      Afib generally is forever (one exception is afib resulting from surgery). But you can potentially decrease your afib burden (the amount of afib you have). That’s a good thing, because the more afib you have, the more risk you are at for having even more.

      It sounds like you have a good handle on this already, and that you’re under control. I’m glad you’re getting lots of water and staying hydrated. Perhaps you can keep the afib beast at bay.

      To stay in touch and learn about our recommendations, feel free to sign up for our newsletter at our other site, http://www.stopafib.org (we’re working on getting a signup box here on the blog). The signup box is on the right, below the menu.

      The newsletter today featured a link to our news story about the Top Atrial Fibrillation Videos of 2011 – see http://bit.ly/top10videos2011


  47. It really does make alot of sense. Back in Feb of this year I went to the ER after spending 2 days with the flu, not being able to stay hydrated. This was the first time that I was told that I had a Atrial Fib – when put on the monitor I was in Atrial Fibulation, I converted on my own. Fast forward 9 months later – got dehydrated – ended up with a stroke, caused by atrial fib. Not sure where to turn now, on bood thinners and they are talking about flecainide. I reall enjoy the blog and stopafib.org


    • Peter,

      I’m so sorry that your afib and dehydration led to a stroke. After a stroke, being on blood thinners is really important because your risk is increased by having had a stroke (gives you 2 more points on the CHADS2 score, meaning that blood thinners are pretty much mandatory). If you want to drop me a private message (our Contact link at http://stopafib.org/contact.cfm is probably best) with a little more info, I’ll be glad to share any thoughts.

      Thanks for your kind words.


  48. AL Drelich says:

    I was first diagnosed with AF in Aug 2008. I had 2 subsequent episodes(all converted with IV medication) No episoide since April 2009.I contribute this success to losing weight. My BP now is 115-125 over 60, pulse 55-62. Amiodarone was cut 100 mg 4x a week. Normal routine of daily life. My second secret of success is I got rid of my STRESS with a change of attitude. Everything that maybe negative goes over my head. I ploay bridge at least three times a week which I immensly enjoy and I believe this also contribute to my success. All these invasive procedures in an attempt to cure AF. I laugh at.

    If I can be any help please Email me

    • Al,

      I’m glad that losing weight and managing your stress have helped so much. Will your doctor be weaning you off the amiodarone then?

      Many who have procedures do so because they would much rather do so than be on amiodarone, due to the bad side effects that result from it in some people.



  49. Dr Clive Putman says:

    I am in full agreement with everything that Melanie says. I have just had my second event after the frirst 10 months ago and am writing this in ICU after a successful conversion with Carderone (first time was the paddles!)

    The conditions leading up to the events were identical – successive parties with lots of wine over a three day period followed by a couple of days break! Another evening socialising and then an event starting in the middle of the night. I had got slack with the water over time. I had regularly been drinking water with wine and especially before sleeping. Missed the latter this last time so here I am!

    So now we know- no more than one or two social events a week with lots of water and you can still have fun and avoid afib!

    • Dr. Putman,

      Thank you so much for sharing your experience with this. Good luck, and may you never have to deal with afib again.


      • Hi Mellanie

        Not so easy. Managing afib is a balancing act, I have discovered. After my 3rd afib I adopted a pill-in-the-pocket approach, not wanting to take Amiodorone full time. This has worked for me on every occasion but of course it means that you still have an event! I typically covert in 2 hours. Events seem to be linked to alcohol and so if there is an occasion coming up (such as my recent 60th) I take 200 mg for two days before the event (and no problem with the 60th). I control social events but then there are those spontaneous ones. I’ve had maybe 8~10 events now despite being quite good with hydrating. My GP has me on Pradaxa.

        I am concerned about the long-term stability of my approach and the dangers of Pradaxa (no antidote – what if I’m in an accident?) and so am considering an ablation as I read that this is a mainstream technique now. It’s either that or change my lifestyle completely. The specialist may well advocate the latter!

        What is your opinion?

        Thank you for a wonderful site.

        South Africa

        • Oh incidentally my heart has been thoroughly checked out including an angiogram and is 100%, although a little enlarged but then I cycle a lot.


  50. Larry Allen says:

    I agree with the idea that afib is triggered by dehydration. I can attribute every afib event I’ve had with dehydration.
    I now drink about 30 ounces of water, with electrolytes during the first two hours I’m awake in the morning and I hadn’t had an afib event in 6 months.
    Two days ago I had one and when I walked in the kitchen later I saw the second glass of water and electrolytes I had forgotten to drink.
    I am a believer that it’s not just dehydration but also a lowering of electrolyte levels that result fr it. Like any other electrical device that works off batteries, I believe the heart reacts to lower levels of electrolytes.
    The best analogy I can think of is older style car batteries. When the fluid levels went down, they lost their charge and wouldn’t work properly. Fill them up with water and they began generating electricity.
    It works for me.


  1. […] irregular heart rhythm). Mellanie True Hills suggests that those at risk for atrial fibrillation stay away from caffeine and alcohol to avoid triggering this […]