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Seasonal Produce – Fall and Winter

Fall produceThe cookouts, corn on the cob and fresh fruits of summertime may be history for another year, but fresh-food fans need not fret.

The fall harvest season brings a whole new assortment of delicious and heart-healthy fresh fruit and vegetables. Apples, pears, broccoli and Brussels sprouts are fresh in the market – or in your garden.

“Autumn is a time to shift from the seed fruit that we eat in the summer to all the nutrition-rich goodies, like the grapes and persimmons we get in the fall,” said Riska Platt, M.S., R.,D., a nutritionist at Mt. Sinai Hospital’s Cardiac Rehabilitation Program  and a volunteer with the American Heart Association.

These fresh foods are not only tasty, but can help you feel better, get healthier and may protect against heart disease and stroke.

Colors of Fall

Fall brings its own color wheel of seasonal fruits and vegetables. Deep colors like oranges, reds, and purples are especially prominent in the cooler months. However, it’s important to strive for variety with your fall favorites, Platt said.

“Each season presents many different colors, but I really encourage people to try to eat a rainbow of colors,” she said. “Don’t just have a green salad; add all different colors into the salad. More colors usually means there is good nutritional value in your meal.”

Fruits and vegetables with color contain vitamins,  minerals, fiber and phytochemicals that have different disease-fighting elements. These compounds may be important in reducing the risk of many conditions, including cardiovascular disease. The American Heart Association recommends at least 4-5 servings per day of fruits and vegetables based on a 2000 calorie diet as part of a healthy lifestyle that can lower your risk for these diseases.

Fruits, Vegetables and Your Weight

The autumn months bring additional health and nutritional challenges. The shorter, cooler days can make it harder to get physical activity outdoors. And there are the looming (and calorie-packed) temptations of football party snacks, Halloween sweets and Thanksgiving buffets.

However, one good way to avoid those extra seasonal pounds is to keep eating plenty of fresh fruit and vegetables.

“Apples are thought to have a unique source of fiber that is excellent for weight control,” Platt said. “This is great during the fall, because this is when they are harvested and why they’re so crisp and delicious right now.”

Other Fresh-food Benefits

While grocery stores will carry an assortment of fruits and vegetables throughout the year, buying seasonal produce can take some of the strain off your wallet. When foods are in season locally, they are usually more abundant and affordable.

Buying seasonal produce may also add zest and flavor to your meals. Fruits and vegetables that are in season are typically fresher and more flavorful.

However, some canned or frozen fruits and vegetables can be just as healthy and satisfying. Some people think frozen or canned vegetables lack nutritional value, but they are usually processed at the peak of harvest so can  provide nutritional value which is similar to fresh produce, Platt said.

She recommends rinsing canned vegetables to remove excess sodium, though.

“The flavor might be different and texture might be different but they’re absolutely fine to eat,” Platt said.

from the American Heart Association


Surgical Procedures for Atrial Fibrillation

 

 

 

 

 

There are two different types of procedures for the treatment Atrial Fibrillation

Pacemakers

A pacemaker is a small electrical device implanted in the body. It has wires going to the heart to regulate the heartbeat. The pacemaker is implanted under the skin near the collarbone and sends out an electrical signal to keep a steady contracting rhythm in the heart. Some pacemakers sense when the heartbeat is too fast or too slow. When this happens, the pacemaker fires impulses that help the heart return to the proper rhythm and speed. 

Open-heart maze procedure 
Open-Maze heart surgery is a complex procedure in which a surgeon creates small cuts in the upper part of your heart. The cuts are then stitched together. As a result, scar tissue forms. The scars interfere with the transmission of electrical impulses that can cause AFib. Normal heartbeat is then restored. 

 

Article from the American Heart Association

 


Non-surgical Procedures for Atrial Fibrillation (AFib or AF)

Going under the knife, isn’t always needed for treating Atrial Fibrillation. Find out about the non-surgical treatments for aFib below. 

Electrical cardioversion– the rhythm reset

Electrical cardioversion is a procedure in which a patient receives an electrical shock on the outside of the chest (while under mild anesthesia) using either paddles or patches.  Shock can be used to “reset” the heart to a normal rhythm. The procedure is similar to defibrillation, but uses much lower levels of electricity.  

The decision to use electrical cardioversion

Your provider may recommend a transesophageal echocardiography (TEE) as a first step. The TEE procedure involves swallowing a small ultrasound device that allows the healthcare team to view the inside your heart atria for blood clots. 

If you already have clots in the atria, you will need protection from increasing your stroke risk. For this reason, your healthcare provider may recommend that you take a blood thinner before having an electrical cardioversion procedure. Electrical cardioversion often successfully restores regular heart rhythm, but for some patients their atrial fibrillation may return. In many instances, anti-arrhythmia medications are needed indefinitely to keep the heart’s rhythm and rate in the best range.

Radiofrequency ablation or catheter ablation

Ablation is used for cardiac arrhythmias when long-term medications or electrical cardioversion are either not preferred or were not effective. Before ablation surgery, electrical mapping of the heart is performed. An electrically sensitive catheter is used to map the heart muscle and the origins of the “extra” electrical activity throughout the heart. This map tells the physician which areas of the heart are creating problematic electric signals that interfere with the proper rhythm. 

How is an ablation performed?


A catheter (thin, flexible tube) is inserted into the patient’s blood vessels and is gently guided to the heart. The physician carefully destroys malfunctioning tissue using the catheter to deliver energy (such as radiofrequency, laser or cryotherapy) to scar the problematic areas. The scarred areas will no longer send abnormal signals. If successful, the heart will return to a normal rhythm. But in some cases, atrial fibrillation may return. Sometimes the ablation procedure may need to be tried multiple times. This minimally invasive procedure usually has a short recovery period. Patients are generally placed on a short course of anti-arrhythmic drugs while the procedure takes full effect.  
 
Common types of ablation for AF include:
  • Pulmonary vein isolation ablation (PVI ablation or PVA). In some AF patients, fibrillation is triggered by extra electrical currents in the pulmonary veins. During this procedure, the catheter tip is used to destroy the tissue that is sending the extra currents and, in most cases, normal heart rhythm returns. 
  • AV node ablation with pacemakers.  In other AF patients, the trigger for their AF occurs in the AV node (the place where the electrical signals pass from the atria to the ventricles). The catheter is placed near the AV node and a small area of tissue is destroyed. A pacemaker is then implanted to restore and maintain the heart’s normal rhythm.

Article from the American Heart Association


Atrial Fibrillation Medications

Understand medications and why they are helpful. Medications can be a commitment for life and health!

Medications, for most patients, are the most helpful form of treatment. However, many studies show that patients often stop taking medications because of side effects or their own belief that they no longer need it. Discontinuing medications can be very dangerous!

If you have been prescribed heart medications, taking and tracking your medications is one of the best things you can do for your health.

Tell your healthcare provider about all your other drugs and supplements, including over-the-counter medications and vitamins. 

Medications for atrial fibrillation (AF or AFib)


Medications are often prescribed to prevent and treat blood clots which can lead to a stroke. Additional drugs may be prescribed to control heart rate and rhythm in the AFib patient. These medications may also be used in conjunction with other treatments. The heart rhythm can be more difficult to control. The longer you have untreated AFib, the less likely it is that normal rhythm can be reestablished. 

Medication options may include blood thinners, rate controllers, and rhythm controllers. Lists included here are not intended to be comprehensive, and we encourage you to revisit our page often to keep up with the newest in AFib medication options.

Preventing Clots with Medication (antiplatelets and anticoagulants)
Drugs such as blood thinners are given to patients to prevent blood clot formation or to treat an existing blood clot. Examples include:

  • Warfarin
  • Other FDA approved anticoagulants such as dabigitran, rivaroxaban, edoxaban and apixaban (Direct-acting oral anticoagulants or DOACs)
  • Aspirin (in rarer cases)

Overview of Side Effects

Antiplatelets (aspirin) can increase your risk of bleeding. Even though aspirin can be purchased over the counter, it is important that you do not take more than the dose prescribed by your doctor. Report any of the symptoms stated below to your healthcare provider.

Anticoagulants increase risk of bleeding. If you are prescribed warfarin, there is a monthly blood test that is necessary to monitor and achieve optimal dosing. Read our patient’s guide to taking warfarin.

The newer oral anticoagulants — DOACs — (dabigitran, rivaroxaban, edoxaban and apixaban) do not require the monthly blood test, but care must be taken to take them as directed so that you receive the maximum benefit for stroke prevention. Download our sheet: What are Direct-Acting Oral Anticoagulants (DOACs)? 

Important Precautions when taking anti-clotting medications

  • Call your healthcare provider right away if you have any unusual bleeding or bruising
  • If you forget to take your daily anticoagulant dose, don’t take an extra one to catch up! Follow your healthcare provider’s directions about what to do if you miss a dose.

Always talk to your healthcare provider about switching from one anticoagulant to another (including changing to a generic version). Even small variations in the amount of the dose of a medication can cause problems.

  • Always tell you doctor, dentist and pharmacist that you take one of these medicines. This is especially important before you start taking a new medication or have any procedure that can cause bleeding.
  • If you are taking warfarin, discuss any new medications with your healthcare providers. Many drugs change the effects of these agents on the body. Even vitamins (and some foods) could change the effect.

It is also wise to take extra care with contact sports or any other situation that might risk unnecessary trauma. Here are some things to watch for or report to your physician:

  • An accident of any kind
  • Find bruises or blood blisters
  • Feel sick, weak, faint or dizzy
  • Think you are pregnant
  • Notice red, dark brown or black urine or stools
  • Bleed more with periods
  • Bleeding gums
  • Bad headache or stomach ache that won’t go away

Heart Rate Controlling Medications

  • Beta blockers. These are drugs used to slow the heart rate. Most people can function and feel better if their heart rate is controlled. Read more about beta blockers.

             Some examples may include:
                     Atenolol 
                     Bisoprolol
                     Carvedilol
                     Metoprolol
                     Nadolol
                     Propranolol
                     Timolol

  • Calcium channel blockers. These medications have multiple effects on the heart. They are used to slow the heart rate in patients with AFib and to reduce the strength of the muscle cell’s contraction.

             Some examples are:
                    Dilitiazem
                    Verapamil

  • Digoxin. This medication slows the rate at which electrical currents are conducted from the atria to the ventricle. 
     

Heart Rhythm Controlling Medications


Once your heart rate is under control, the next management consideration is usually treating the abnormal heart rhythm with medications to restore the heart rhythm to normal (also known as chemical/pharmacological cardioversion). Significant side effects may occur, and your healthcare provider will most likely want to monitor progress closely.

  • Sodium channel blockers which help the heart’s rhythm by slowing the heart’s ability to conduct electricity.

             Examples may include 
                    Flecainide (Tambocor®), 
                    Propafenone (Rythmol®)
                    Quinidine (Various).

  • Potassium channel blockers help the heart’s rhythm by slowing down the electrical signals that cause AFib.

             Examples may include: 
                    Amiodarone (Cordarone® or Pacerone®)
                    Sotalol (Betapace®)
                    Dofetilide 

 

Article from the American Heart Association 


Treatment and Prevention of Atrial Fibrillation

Know your treatment goals

The treatment goals of atrial fibrillation (AF or AFib) start with a proper diagnosis through an in-depth examination from a physician. The exam usually includes questions about your history and often an EKG or ECG. Some patients may need a thorough electrophysiology study. Read about treatment options for AFib.

Prevention and Risk Reduction

Although no one is able to absolutely guarantee that a stroke or a clot can be preventable, there are ways to reduce risks for developing these problems.  

After a patient is diagnosed with atrial fibrillation, the ideal goals may include:

  • Restoring the heart to a normal rhythm (called rhythm control)
  • Reducing an overly high heart rate (called rate control)
  • Preventing blood clots (called prevention of thromboembolism such as stroke)
  • Managing risk factors for stroke
  • Preventing additional heart rhythm problems
  • Preventing heart failure


Getting Back on Beat

Avoiding atrial fibrillation and subsequently lowering your stroke risk can be as simple as foregoing your morning cup of coffee. In other words, some AFib cases are only as strong as their underlying cause. If hyperthyroidism is the cause of AFib, treating the thyroid condition may be enough to make AFib go away.

Doctors can use a variety of different medications to help control the heart rate during atrial fibrillation.

“These medications, such as beta blockers and calcium channel blockers, work on the AV node,” says Dr. Andrea Russo of University of Pennsylvania Health System. “They slow the heart rate and may help improve symptoms. However, they do not ‘cure’ the rhythm abnormality, and patients still require medication to prevent strokes while remaining in atrial fibrillation.”

 

Article from the American Heart Association 


Who is at Risk for Atrial Fibrillation (AF or AFib)?

 

Are you at risk for atrial fibrillation? (AFib or AF)

Any person, ranging from children to adults, can develop atrial fibrillation. Because the likelihood of AFib increases with age and people are living longer today, medical researchers predict the number of AFib cases will rise dramatically over the next few years. Even though AFib clearly increases the risks of heart-related death and stroke, many patients do not fully recognize the potentially serious consequences.

 

 

 

Who is at higher risk? Typically people who have one or more of the following conditions are at higher risk for AFib:

  • Advanced age  
    The number of adults developing AFib increases markedly with older age.  Atrial fibrillation in children is rare, but it can and does happen.
     
  • High blood pressure  
    Longstanding, uncontrolled high blood pressure can increase your risk for AFib.
     
  • Underlying heart disease  
    Anyone with heart disease, including valve problems, hypertrophic cardiomyopathyacute coronary syndromeWolff-Parkinson-White (WPW) syndrome and history of heart attack. Additionally, atrial fibrillation is the most common complication after heart surgery. 
     
  • Drinking alcohol  
    Binge drinking (having five drinks in two hours for men, or four drinks for women) may put you at higher risk for AFib.
     
  • Family history  
    Having a family member with AFib increases your chances of being diagnosed.
     
  • Sleep apnea  
    Although sleep apnea isn’t proven to cause AFib, studies show a strong link between obstructive sleep apnea and AFib. Often, treating the apnea can improve AFib.
     
  • Athletes  
    AFib is common in athletes and can be triggered by a rapid heart rate called a supraventricular tachycardia (SVT).
     
  • Other chronic conditions  
    Others at risk are people with thyroid problems (specifically hyperthyroidism), diabetes, asthma and other chronic medical problems.

 

Article from the American Heart Association


Atrial Fibrillation (AFib) can happen to anyone.

Many people who have AFib are not getting the treatment they need.

A racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present, like shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. AFib is an irregular heartbeat or a condition in which the heart muscles fail to contract in a strong, rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.

Why is AFib associated with a five-times-greater risk for stroke?

When the heart is in AFib, the blood can become static and can be left pooling inside the heart. When blood pools, a clot can form. When a clot is pumped out of the heart, it can get lodged in the arteries which may cause a stroke. Blocked arteries prevent the tissue on the other side from getting oxygen-rich blood, and without oxygen the tissue dies.

Any person who has AFib needs to evaluate stroke risks and determine with a healthcare provider what must be done to lower the risks. Studies show that many people with AFib who need risk-lowering treatments are not getting them. 

If I don’t have these symptoms, should I be concerned?

There are people who have atrial fibrillation that do not experience any symptoms. These people may be diagnosed at a regular check-up or their AFib may be discovered when a healthcare provider listens to their heart for some other reason.

However, people who have AFib with no symptoms still have a five-times-greater risk of stroke. Everyone needs to receive regular medical check-ups to help keep risks low and live a long and healthy life.

 

Article from the American Heart Association


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