My “BackToSinus”-Procedure to stop my AFib Episodes (v2.0)

The procedure I will describe next I have named “My BackToSinus-Procedure” and it has the purpose to switch my heart back into sinus rhythm while being in an (paroxysmal) Atrial Fibrillation (AFib, AF) episode.

This method is not a cure, it is more like a heart conversion without medication and/or electric shock.

Based on my personal research I have found a study from 2002, that was related on this topic called “Self-Cardioversion of Paroxysmal Lone Atrial Fibrillation with Exercise”, published in “The New England Journal of Medicine” (Note: To read it, you must register on the journal’s home page, but this is free).

Attention

The procedure is NOT a medically or scientificly proven treatment and when being immitated potentially might contain risks of harming yourself. The author will not held liable for any damage resulting out of trying this procedure by yourself.

Before you decide to do a similiar attemp yourself please first align your decision together with your doctor or professional health care provider.

Please always remind the Disclaimer as a condition for the use of this blog.

This procedure is in an experimental stage and will be improved step by step over time, so please read the whole post first to get a better overview.

My “BackToSinus”-Procedure

When being in an (paroxysmal) AFib episode I use the following procedure to convert my heart back into sinus rhythm.

Here you can find a video about how AFib vs. sinus rhythm (our goal after the procedure) looks like on a pulse oximeter.

My procedure is based on a set of different methods that are usually executed one after the other until sinus rhythm has been established again.

The methods mentioned first are the ones that are most useful when the AFib episode has just started.

To describe the whole procedure more clearly, I have used the representation of a clock which I have called “My personal BackToSinus-Clock”.

The methods mentioned first in the clock are the ones that are most useful when the AFib episode has just started.

1^st Step: Compressed Breathing:
If the episode is still at the very beginning, perhaps only noticeable by a whole series of “misfires”, I use “compressed” continuous breathing to calm the heart again. This is similar to playing a trumpet or humming, with increased tension on the respiratory muscles, especially the diaphragm. This usually leads to the episode subsiding.

2^nd Step: Valsalva Maneuver:
The Valsalva Maneuverin general is a medical measure and should not be used without consulting a doctor. I use the Valsalva Maneuver in a slightly modified form for stopping AFib Episodes:

I…

0. … I sit down, because the Valsalva Maneuver can reduce Blood Pressure significantly, which can lead to dizziness.
1. … close my lips tightly (I can also put my thumb in my mouth, but this is quite conspicuous when I am among people.)
2. … blow maximum air pressure against my closed lips for about 5 seconds, by compressing my diaphragm at the same time.
3. … Wait a few seconds (10 to 15 secs) and feel if my AFib pulse converts back to a sinus rhythm.
4. … If no sinus rhythm is established, I repeat steps 1-3 for about 3-4 times.

Note: The Valsalva Maneuver in my experience (maybe only) works at the beginning of a new AFib Episode, that is maybe also the reason why doctors mostly do not give it a try in the ER, because people who show up at the ER with AFib are generally into an Episode for much more than a few seconds.

3^rd Step: Interval Training
When the upstream techniques have not worked, I start with interval training. Interval training is a very powerful technique to stop atrial fibrillation episodes and should not be done without consulting a doctor. (I know from various feedback from readers of my blog and other social media groups that Interval Training has sometimes even converted long-running episodes back into sinus rhythm. I myself have used it regularly with success).

I usually use an exercise bike to do interval training. A home trainer with an automatic servo-supported load setting is ideal. (Note: These ones can often be bought very cheaply on the internet in second-hand form, as many people buy such a device but then never use it).

Instead of a home trainer, a skipping rope or simple sprinting on the spot can also be used.

Before I explain the Interval Training Procedure in more detail, I would like to describe some of my complementary observations:

As shown in the figure “BackToSinus”-Timeline figure below, I have defined by my own words “Self Conversion Time (SCT)” as the time the heart needs to convert back into sinus rhythm alone without using the procedure, “Procedure Conversion Time (PCT)” as the point in time when the heart could be converted by the result of using this procedure. “Preparation Time (PT)” I have defined as the time my heart needs to prepare before the procedure works.

All points in time are seen from the start of the AFib episode.

The “General Interval Time (GIT)”, in my words, defines the general duration of a single interval and is shown in the following “BackToSinus”-Interval figure. The intensity load for the interval training I have devided into two categories high and low. Actually I can only provide the parameters of my cycling machine here to define it. (However, it seems to me that it is more important to “feel” a significant difference between high and low ingtensity than having a 100% precise definition, because this might also be much influenced by the actual body condition.)

If the “BackToSinus”-Procedure was successful (no matter which one of the techniques described here was used), the picture below down shows the results on a simple 1-channel ECG device . Within picture you can see where the jump back from AFib to sinus rhythm approximately took place. In order to be able to read an ECG to some extent, some basic knowledge of the PQRST complex is necessary. Two key facts of recocnizing AFib within an ECG analysis is that the “P-Wave” does not (really) exist and the QRS-complex appears completely irregular. (Note: The following picture only shows the section of the conversion.)

As follows I will explain the procedure itself in three steps:

Step 1: Safety-Preparation for the “BackToSinus”-Interval Training Procedure.
I always recommend to insure having a second person, doctor or health care professional in reach in case of emergency and that the use of this procedure is aligned with a doctor / therapist.

1. I stop the procedure immediately in case of any alerting health conditions / reactions.
2. Before I start I always make sure being…
   1. … sufficiently hydrated.
   2. … sufficiently mineralized and energized. (Minerals, Vitamins etc..)
      Note: Please click here to see what kind of nutrition in general I have used.
   3. … not being overfilled with meal.

Step 2: Wait for Hearts Preparation time (PT).
When an AFib episode starts, I wait for an individual Preparation time (PT). In this updated version of my “BackToSinus”-Procedure, I use this time for the intake of 2-3 bananas and a fizzy tablet (over the counter stuff) with magnesium/potassium dissolved in water. After the intake I wait in minimum 15 minutes for digestion (Please also see “BackToSinus”-Booster for options and a more detailed nutrition information).

Note: The preparation time (PT) might vary based on the specific body condition, but it seems to be very needed by the heart before it can respond to the “BackToSinus”-Procedure. Without the intake of the bananas and magnesia, it seemed to me that this time increases significantly. The ammount of magnesium and bananas that fits to me I have found out by trial and error, but for your own trials you should discuss that together with your doctor first. I have decided to take magnesium (OCT stuff) from the supermarket but I am still searching for something non artificial that works for me too.

Step 3: Starting interval training (Original version – please see also alternatives below.)
Here you can find an example video showing how the procedure works.
(Down below you can also find the version history of the procedure.)

Based on your cycling machine the settings might vary completely, This must then be translated analogously.

For the procedure described in the video I …:

1. …intake 2-3 bananas and a magnesium /potassium fizzy tablet (over the counter stuff) dissolved in water.
2. … wait 15 minutes* for digestion (*might vary on body condition ≥ 15 min).
3. … sit on my cycling machine.
4. … change to gear 9.
5. … start low cycling intensity for 15 secs. at approx. 20km/h.
6. … start high cycling intensity for 15 secs. at approx. 30km/h.
7. … if sinus is back, I stop after 2 min. of cooldown in gear 9 or lower at 20 km/h.
8. … if no sinus rhythm, I go back to step 3 (max. 7 times / intervals).
9. … after 7 intervals, I wait 30 minutes and go back to step 3.
10. … after 5 complete Trials (1 to 9) without success, I stop and wait for a self conversion of the heart (Note: This is my own safety rule).

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Hints:

1. If Sinus Rhythm always only comes back for a few minutes / seconds after the interval training and then the heart jumps back to AFib, I try to do a static tention figure (like we know from Yoga e.g. the Downward looking dog) for some time / minutes after the interval training instead of performing another interval round. (Sometimes I combine this also with drinking a glass of some high quality multi vegetable juice, to provide some more minerals and vitamins in their natural form to the body. Vegetable juice, in my eyes, is better than fruit juice because it does not contain that much fruit suggar, which probably might also trigger an Episode in some people.)
2. If the heart always flips back to AFib after some minutes after successfully converting to sinus another strategy could be to lay down on the right side and start breathing 4s inhale, 8s exhale, etc. for maybe 5 minutes.

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Options for the “BackToSinus”-Procedure:

In general, for performing the options shown below, it could be helpful to buy a little interval timer, which helps you to measure the time for every interval automaticly.

1. Modifying the Cycling Machine Method
   In the meantime, I have also had also made good experiences with adapting the interval training with the cycling machine as follows:
   
   Every 15 seconds I change the load from low to medium and then to high intensity. This works especially well with a servo-supported device that makes the change automatically, then you only need to keep the speed constant, the device does the rest. I do this for about 3 minutes and then lie down on the floor for another 3 minutes to breathe deeply and relax. I then repeat the interval training until a sinus rhythm is present or I have to take a break (e.g. 30 minutes) due to my condition.
   
   Note: If there is no sinus at all, I have sometimes have to wait a few hours, maybe even a day until starting a new trial.
2. Do a standing sprint
   Doing a little standing sprint is another powerful technique. The procedure is similiar to that one using a cycling machine. I start by a low intensity (~15 seconds), then I switch over to medium level (~15 seconds) and then to a very intensive sprint (~15 seconds), and so on, for around 3 minutes. After three minutes I lie myself on the ground and doing relaxed breathing for 3 minutes before starting over again.
   
   Another sequence for me could be also:
   
   1. 15s low, 2. 15s medium, 3. 15s high, 4. 15s low, 6. 15s medium, 7. 15s high, 8. 30s Pause, Repeat at 1. maybe for 10 times.
   
   or
   
   1. 15s low, 2. 15s medium, 90s moderate high, 60s to 120s Pause, Repeat at 1. for 10 times.
   Note: If I feel that the heart jumped back to sinus while the 90s phase, I mostly stop the interval training and lay down myself on the right side and start a simple breathing excercise 4s inhale, 8s exhale, for approx. 5 minutes.
   
   Note: As always ask your doctor first before doing a self attemp.
3. Do a standing sprint
   Doing a little standing sprint is another powerful technique. The procedure is similiar to that one using a cycling machine. I start by a low intensity (~15 seconds), then I switch over to medium level (~15 seconds) and then to a very intensive sprint (~15 seconds), and so on, for around 3 minutes. After three minutes I lie myself on the ground and doing relaxed breathing for 3 minutes before starting over again.
   
   Another sequence for me could be also: 1. 15s low, 2. 15s medium, 3. 15s high, 4. 15s low, 6. 15s medium, 7. 15s high, 8. 30s Pause, Repeat at 1 maybe for 10 times.
   
   Note: As always ask your doctor first before doing a self attemp.

4. Use a real bike.
   Of course it is also possible to use a real bike instead of a cycling machine. The technique again is quite similiar to that one with the cycling machine. If the bike doesnt’t have enough gears to simulate the intensity level driving uphill can be done instead or in addition.
   
   Note: Dropping from a bike can be an extra risk, please always play it safe if you decide to do this by your own. (As always ask your doctor first before doing a self attemp.)
   
   Alternative: Another possible way is to I lie myself on my back on the floor and start interval cycling with my feet in the air (maybe it might help to be equipped with some extra weights attached to the ankles, to get a higher interval workload). This technique is helpful when feeling a little bit too dizzy or frightend about sitting on a cycling machine (or a real bike). When I tried this by myself it worked well too.
5. Other Procedures
   There are some other techniques that claim to be able to set back an AFib Episode to Sinus Rhythm, like the “Carotis Sinus Massage”, to be honest I have not tried this yet. It might work, but especially this procedure needs to be aligned with a doctor before, because it can create dangerous malfunctions, if, for example, the flow of the carotid artery is obstructed on one side.

Version history of the “BackToSinus”-Procedure:

Version 2.0 – released 25/09/2023: “My personal BackToSinus-Clock” has been added showing some more options and information for converting myself back to sinus.

Version 1.1 – released 11/24/2020: Better converting results, procedure conversion time (PCT) is reduced, Intervaltime was simplified / improved and nutrition intake has been changed. Video.

Version 1.0 – released 04/15/2020: First version of the procedure. Video (This video in addition shows on a pulse oximeter that the procedure works).

Please always remind the Disclaimer as a condition for the use of this blog.

Copyright © 2020 Christian Bruegge, Get rid of AFib, All rights reserved.