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IBN Coverage: HeartBeam (NASDAQ: BEAT) Earns FDA Clearance for First Cable-Free ECG System for Arrhythmia Detection
IBN Coverage: HeartBeam (NASDAQ: BEAT) Earns FDA Clearance for First Cable-Free ECG System for Arrhythmia Detection

Associated Press

timea day ago

  • Business
  • Associated Press

IBN Coverage: HeartBeam (NASDAQ: BEAT) Earns FDA Clearance for First Cable-Free ECG System for Arrhythmia Detection

This article was published by IBN, a multifaceted communications organization engaged in connecting public companies to the investment community. LOS ANGELES, CA - June 20, 2025 ( NEWMEDIAWIRE ) - HeartBeam (NASDAQ: BEAT) announced it has received FDA 510(k) clearance for its flagship ECG system, a first-of-its-kind, credit card-sized, cable-free device designed to deliver high-fidelity, three-directional cardiac recordings for arrhythmia evaluation. The clearance marks a major regulatory milestone and accelerates HeartBeam's plans to improve access to timely, remote cardiac care. When symptoms arise, patients use the app-guided system to record a 30-second ECG, which is automatically uploaded to the cloud for physician review in the context of medical history. The company will soon launch an Early Access Program to engage early adopters and providers ahead of broader commercialization. This foundational clearance also sets the stage for future advancements, including 12-lead ECG synthesis, AI-based arrhythmia detection, and remote heart attack risk scoring. HeartBeam's long-term vision is to revolutionize cardiac care by enabling continuous, predictive insights outside traditional clinical settings. To view the full press release, visit About HeartBeam Inc. HeartBeam is a medical technology company dedicated to transforming cardiac care by providing powerful cardiac insights wherever the patient is. The company is creating the first-ever cable-free 12-lead ECG capable of capturing the heart's electrical signals from three dimensions. This platform technology is designed to be used in portable devices that can be used wherever the patient is to deliver actionable heart intelligence. Physicians will be able to identify cardiac health trends and acute conditions and direct patients to the appropriate care - all outside of a medical facility, thus redefining the future of cardiac health management. The company holds 13 U.S. and 4 international-issued patents related to technology enablement. For more information, visit NOTE TO INVESTORS: IBN is a multifaceted financial news, content creation and publishing company utilized by both public and private companies to optimize investor awareness and recognition. For more information, please visit Please see full terms of use and disclaimers on the InvestorBrandNetwork website applicable to all content provided by IBN, wherever published or re-published: The latest news and updates relating to BEAT are available in the company's newsroom at Forward Looking Statements Certain statements in this article are forward-looking, as defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks, uncertainties, and other factors that may cause actual results to differ materially from the information expressed or implied by these forward-looking statements and may not be indicative of future results. These forward-looking statements are subject to a number of risks and uncertainties, including, among others, various factors beyond management's control, including the risks set forth under the heading 'Risk Factors' discussed under the caption 'Item 1A. Risk Factors' in Part I of the Company's most recent Annual Report on Form 10-K or any updates discussed under the caption 'Item 1A. Risk Factors' in Part II of the Company's Quarterly Reports on Form 10-Q and in the Company's other filings with the SEC. Undue reliance should not be placed on the forward-looking statements in this article in making an investment decision, which are based on information available to us on the date hereof. All parties undertake no duty to update this information unless required by law. About IBN IBN is a cutting-edge communications and digital engagement platform providing tailored Platform Solutions for select private and public companies. Over the course of 19+ years, IBN has introduced over 70 investor facing brands to the investment public and amassed a collective audience of millions of social media followers. These distinctive investor brands amplify recognition and reach as well as help fulfill the unique needs of our rapidly growing and diverse base of client-partners. IBN will continue to expand our branded network of influential properties as well as leverage the energy and experience of our team of professionals to best serve our clients. IBN's Platform Solutions provide access to: (1) our Dynamic Brand Portfolio (DBP) through 70+ investor facing brands; (2) article and editorial syndication to 5,000+ news outlets; (3) full-scale distribution to a growing Social Media Network (SMN) ; (4) a network of wire solutions via InvestorWire to effectively reach target markets and demographics; (5) Press Release Enhancement to ensure accuracy and impact; (6) a full array of corporate communications solutions; and (7) total news coverage solutions. For more information, please visit Please see full terms of use and disclaimers on the InvestorBrandNetwork website applicable to all content provided by IBN, wherever published or re-published: Media Contact IBN Los Angeles, California 310.299.1717 Office [email protected]

Heart Arrhythmia After COVID-19 Vaccine: A Very Rare Side Effect
Heart Arrhythmia After COVID-19 Vaccine: A Very Rare Side Effect

Health Line

time5 days ago

  • Health
  • Health Line

Heart Arrhythmia After COVID-19 Vaccine: A Very Rare Side Effect

Arrhythmia is not a known side effect of COVID-19 vaccines. But ongoing monitoring has shown rare instances of heart complications in people who have received the Pfizer-BioNTech or Moderna mRNA vaccines. Arrhythmia affects the rate or rhythm at which the heart beats. Your heart might beat too fast (tachycardia), too slow (bradycardia), too early (premature contraction), or erratically (fibrillation). Arrhythmia can also be a sign of myocarditis, or inflammation of the heart muscle. Myocarditis is a very rare side effect of Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines. You're more likely to experience arrhythmia or myocarditis caused by COVID-19 itself than from the COVID-19 vaccine. At least 2 out of every 10 people hospitalized with COVID-19 experience heart problems, including damage to their heart muscle and arrhythmia. This is what scientists mean when they say the benefits of vaccination outweigh the risks. Keep reading to learn more about heart arrhythmia and myocarditis following COVID-19 vaccination. What the research says Data from the Centers for Disease Control and Prevention (CDC) shows that higher than normal cases of heart inflammation have been reported in the United States after COVID-19 vaccination with the Pfizer-BioNTech or Moderna vaccines. These heart issues occurred mostly in males between ages 12 and 39 after they received the second dose of the vaccine, usually within a few days of receiving the vaccine. This side effect hasn't been observed in people who received the Johnson & Johnson vaccine or the Novavax protein subunit vaccine. The Pfizer-BioNTech and Moderna vaccines are messenger RNA (mRNA) vaccines. These vaccines contain genetically engineered mRNA that teaches your cells how to create antibodies capable of fighting the coronavirus that causes COVID-19. Traditional vaccines, like the Johnson & Johnson COVID-19 vaccine, contain genetic material from the virus, which also helps your body create antibodies. A 2021 analysis of CDC data found that people ages 12 to 39 who received their second COVID-19 mRNA vaccine had about a 13 in 1 million chance of experiencing heart inflammation. In other words, this side effect is exceedingly rare. Another 2021 study involved people ages 16 and up who were vaccinated against COVID-19. It also found slightly increased risks of heart inflammation after participants' first and second doses of COVID-19 vaccines in the first 28 days after vaccination. This research included the Oxford-AstraZeneca vaccine as well as the Pfizer-BioNTech and Moderna vaccines. This risk of myocarditis did appear to be a bit higher after a second dose of the Moderna vaccine — not the other vaccines studied — and was only observed in people younger than 40. Vaccination for people with preexisting heart conditions Even though arrhythmias are sometimes associated with myocarditis, no direct association was found between arrhythmia and COVID-19 vaccination. The American Heart Association recommends that anyone with heart disease get vaccinated against COVID-19 as soon as possible. This is because they're at a much greater risk of heart-related complications from the coronavirus than they are from any COVID-19 vaccine. However, if you or your child has experienced myocarditis after a vaccine before, discuss your options with your doctor before getting vaccinated. What are the symptoms of heart arrhythmia? Arrhythmia doesn't always cause symptoms — that's why you'll sometimes hear it called 'asymptomatic.' But possible symptoms can include: chest pain shortness of breath feeling like the heart is fluttering or pounding (palpitations) rapid heartbeat slow or irregular heartbeat A 2021 study suggests that most people suspected to have myocarditis after COVID-19 experienced chest pain about 2 or 3 days after the second dose of a COVID-19 mRNA vaccine. Arrhythmia during COVID-19 Arrhythmias are more often seen after developing COVID-19 than after vaccination. In small studies conducted in Wuhan, China, during the initial outbreak of COVID-19, arrhythmias occurred at a rate of 16.7% of people hospitalized with COVID-19, with 44.4% of those who were hospitalized being treated in the intensive care unit (ICU). A retrospective 2021 study of 3,970 COVID-19 admissions at Mount Sinai Hospital in New York City found that atrial fibrillation and atrial flutter (AF/AFL) happened in 10% of study participants. AF/AFL was also associated with a 46% higher risk of death — compared with 26% of study participants who had no arrhythmias. Viral infection is the most common cause of inflammation in the heart muscle in children. Children who develop myocarditis after COVID-19 also typically experience a more severe case than if it happens after a COVID-19 vaccination. Heart complications can occur even after you recover from COVID-19. Common vaccine side effects Heart problems are a very rare side effect of COVID-19 vaccines. More common side effects are mild and temporary, including: fever pain and soreness at injection site fatigue headache chills body aches These side effects occur as the vaccine triggers a response from your immune system. In other words, these side effects mean the vaccine is doing its job. Is the COVID-19 vaccine still effective? When first studied in earlier coronavirus variants, COVID-19 vaccines were shown to be roughly: 95% effective at preventing coronavirus infection 94% effective at preventing COVID-19 hospitalizations and deaths among fully vaccinated adults Yet viruses constantly change. Several new variants have emerged since the novel coronavirus first appeared. But even though the first COVID-19 vaccines aren't as effective at preventing infection by the Delta or Omicron variants, they offer significant protection against these variants by reducing your risk of: severe illness hospitalization death Research published in 2022 estimates that COVID-19 vaccines are still up to 90% effective at preventing severe outcomes of COVID-19, including the need for invasive mechanical ventilation or death. People who are fully vaccinated and received a third booster had the highest level of protection against severe disease and hospitalization. Newer boosters have since been developed. Who should get a COVID-19 vaccine? Under the new administration, the CDC recommends that most people ages 18 years and older get an annual COVID-19 vaccine, while those 6 months to 17 years old and pregnant people make a personal decision with their loved ones. However, the American Academy of Pediatrics (AAP) recommends vaccination for every child 6 months or older, and the American College of Obstetricians and Gynecologists (ACOG) recommends vaccination for all pregnant people.

Young Adults Benefit More From Catheter Ablation for AF
Young Adults Benefit More From Catheter Ablation for AF

Medscape

time10-06-2025

  • Health
  • Medscape

Young Adults Benefit More From Catheter Ablation for AF

Young patients (≤ 45 years) with atrial fibrillation (AF) were less likely to experience recurrences of arrhythmia at 12 months after undergoing their first catheter ablation for pulmonary vein isolation than older patients (> 45 years). METHODOLOGY: Researchers conducted a retrospective cohort study comparing the efficacy of first-time catheter ablation between young and older adults with AF who underwent the procedure between 2016 and 2023. The analysis included 225 patients in the young group (mean age, 39 years; 76% men) who were propensity score matched with 225 patients in the older group (mean age, 58 years; 76% men). Ablations were performed using radiofrequency (54%), cryoablation (44%), or pulsed field ablation (2.7%); all antiarrhythmic drugs were discontinued before the procedure, and oral anticoagulants were continued for at least 2 months post-procedure. Arrhythmia recurrence, defined as any documented atrial tachyarrhythmia lasting more than 30 seconds, was captured using 24-hour Holter monitoring or additional electrocardiograms. TAKEAWAY: In a 12-month follow-up period, patients in the older group were more likely to experience arrhythmia recurrences than those in the young group (odds ratio [OR], 1.80; P = .01). = .01). Greater age was associated with increased AF recurrences at 12 months (adjusted OR, 1.02; P = .017). = .017). The type of ablation was not associated with the likelihood of arrythmia recurrence. Youden index analysis found 59 years as the statistically optimal cutoff to predict 12-month AF recurrences after ablation. IN PRACTICE: "Recognizing the potential influence of sampling variability and the uncertainty inherent to data‐driven estimations, a more clinically applicable age range of 55 to 60 years may be proposed by our results as an age range above which the risk of AF recurrence following CA [catheter ablation] increases," the authors wrote. SOURCE: This study was led by Ourania Kariki, Onassis Cardiac Surgery Center, Athens, Greece. It was published online on June 03, 2025, in the Journal of Cardiovascular Electrophysiology . LIMITATIONS: This study was conducted at a single centre, and data were retrieved retrospectively. Excluding unmatched patients through propensity score matching may have limited the generalisability of the findings. The use of 24-hour Holter monitoring for follow-up may have underestimated the recurrence of arrhythmia. DISCLOSURES: This study did not receive any specific funding. The authors declared having no conflicts of interest.

A woman's heart suddenly stopped. Two passing nurses saved her life.
A woman's heart suddenly stopped. Two passing nurses saved her life.

CBS News

time07-06-2025

  • Health
  • CBS News

A woman's heart suddenly stopped. Two passing nurses saved her life.

Merryl Hoffman knew she was taking good care of her heart. The 63-year-old attorney didn't smoke or drink, and she was an avid hiker who used to run marathons and other distance races. In her 40s, she had been diagnosed with a leaky mitral valve and underwent surgery to repair it. Every year since, she has seen a cardiologist to check her heart and its function. The reports always came back clear. When Hoffman left her apartment on Manhattan's Upper East Side on Oct. 23, 2025, her heart was the last thing on her mind. She was saddled with her work bag and purse, hightailing it to the subway station so she could make it to work on time. That's when her memory of the day ends. Shortly into her walk, Hoffman experienced a sudden cardiac arrest. Her heart stopped beating. She collapsed to the ground. Doctors later told her it was a severe arrhythmia that could have been fatal — if not for where Hoffman fell. Hoffman had collapsed outside Memorial Sloan Kettering Cancer Center's Breast and Imaging Center, about two and a half blocks from her subway station. A patient care technician and a passing runner immediately rushed to her aid. Then, Memorial Sloan Kettering nurses Sabrina Castle and Gianna Formisano stumbled upon the scene while walking to work. "We were so shocked. When we were walking up, people were like 'Nurses, nurses!' We didn't know what we were walking into," Formisano said. "People were grabbing our coffee, taking our bags. It was out of a movie, the way that they were like 'Oh, thank God you're here.'" Sabrina Castle and Gianna Formisano outside the Memorial Sloan Kettering Cancer Center. Memorial Sloan Kettering "They absolutely saved my life" Formisano and Castle took over performing CPR, keeping Hoffman's heart manually beating. She didn't have a pulse, and she had hit her head when she collapsed. The nurses also instructed one of the other bystanders to call an ambulance. Early CPR increases survival for patients in cardiac arrest by "at least two or three fold," said Dr. Jessica Hennessey, a cardiologist at NewYork-Presbyterian/Columbia University Irving Medical Center. Early CPR means that blood flow to the brain and heart continues, preserving the health of those organs. Bystanders in a medical emergency should call 911 and immediately start CPR, Hennessey advised. CPR can be done with mouth-to-mouth or with just chest compressions, Hennessey said. After five minutes that "felt like forever," the ambulance arrived, Formisano said. Castle and Formisano helped the EMTs load Hoffman into the ambulance. Then, she was taken to NewYork-Presbyterian's cardiac care unit for further treatment. For the small crowd, the day carried on. Castle and Formisano headed to work. After a few hours, they called NewYork-Presbyterian to see if they could find out more about Hoffman's status. They went to the hospital and spoke to a nurse there. "She was like, 'You got her back. She's intubated, she's alive, you saved her life,'" Castle recalled. Hoffman was still unconscious. She told CBS News that she didn't wake up until five days after the collapse. Her family told her that she had been rushed into surgery. Doctors told her that her heart had stopped for several minutes -- and the actions of Castle, Formisano and other bystanders had saved her. "Without them, I was told, there was no doubt I would have died or been brain dead," Hoffman said. "They absolutely saved my life." Hoffman had an implantable cardioverter-defibrillator placed in her chest to prevent further cardiac arrests. The device shocks the heart if it detects an irregular heartbeat. She also began cardiac rehabilitation. Shortly after, she returned to work. Life began to get back to normal but one question was constantly at the back of her mind: Who had helped save her? A chance reunion While in cardiac rehabilitation, Hoffman found herself telling the story of the strangers who had helped her. A physiologist there overheard her talking about it and thought the story sounded familiar. His girlfriend was friends with two nurses who had helped a woman matching Hoffman's description. After some back and forth, the physiologist connected Hoffman with Castle and Formisano. The trio immediately made plans to get dinner. Hoffman's husband joined them for the meal. There, the nurses were able to fill in the gaps of the October morning when Hoffman collapsed. Sabrina Castle, Merryl Hoffman and Gianna Formisano at the site where Hoffman collapsed. Sabrina Castle and Gianna Formisano "It was very jarring, when they gave my husband and I the blow-by-blow of that morning. There were things we did not know," Hoffman said. "It was pretty incredible." Since that dinner, the women have stayed in touch. Recently, Castle and Formisano even passed Hoffman on the same block where she had collapsed. The three took a photo at the site. "We were like, 'Wow, this is really crazy,'" Formisano said. "'We're running into you on the same spot, on your way to work, on our way to work, but now you're alive and well and in a much different state than when we met you the first time.'"

What You Need to Know About Abnormal Heart Rhythms
What You Need to Know About Abnormal Heart Rhythms

Health Line

time21-05-2025

  • Health
  • Health Line

What You Need to Know About Abnormal Heart Rhythms

An abnormal heart rhythm is when your heart beats too fast, too slow, or irregularly. It's also called an arrhythmia. Your heart contains a complex system of valves, nodes, and chambers. They control how and when blood is pumped throughout your body. If these are disrupted, damaged, or compromised, it can change your heart rate or rhythm. Arrhythmias can cause no symptoms, or you may feel some symptoms. They may include: discomfort fluttering or pounding in your chest pain in your chest shortness of breath lightheadedness fatigue fainting Not all arrhythmias are life threatening or cause health complications. But to be safe, you should report any abnormal heart rhythm to a doctor. The types of abnormal heart rhythms The most common types of abnormal heart rhythms include: Tachycardia Tachycardia means that your heart is beating too fast. For example, a typical heart beats 60 to 100 times per minute in adults. Tachycardia is any resting heart rate over 100 beats per minute (bpm). There are three subtypes of tachycardia: Sinus tachycardia: This is an increased heart rate that can occur in response to exercise, pain, dehydration, excitement, fever, or illness. With sinus tachycardia, your heartbeat returns to its usual rate once you get better or become calm. Supraventricular tachycardia: Supraventricular tachycardia originates in the upper chambers of your heart, known as the atria. Ventricular tachycardia: Ventricular tachycardia is a very fast heart rate that occurs in the lower chambers, known as the ventricles. Atrial fibrillation This disorganized heart rhythm occurs in the upper chambers of your heart. It's the most common arrhythmia. Atrial fibrillation, or AFib, occurs when many unstable electrical impulses misfire, causing your atria to quiver erratically. AFib causes your heart to beat irregularly and can increase your heart rate to 80 to 180 bpm, which is much faster than the typical 60 to 100 bpm. Atrial flutter An atrial flutter typically occurs in the right atrium, one of your heart's two upper chambers. It may occur in the left atrium as well. Atrial flutter is a type of arrhythmia that originates in the atrium and results in rapid atrial rhythm. It's due to an abnormal circuit of electrical activity. In atrial flutter, your heart's overall rhythm can be regular, but your heart rate is often fast. Atrial flutter also increases your risk of stroke. Bradycardia If you have bradycardia, you have a slow heart rate (less than 60 bpm). Bradycardia generally occurs when the electrical signals traveling from the atria to the ventricles become disrupted. Some athletes have slower heart rates because they're in excellent physical condition, which isn't usually due to a heart problem. Bradycardia can result from: medications, including certain blood pressure and antiarrhythmic medications hypothyroidism hypothermia other heart conditions Ventricular fibrillation Ventricular fibrillation is a life threatening arrhythmia in which the ventricles beat rapidly and erratically. This impairs the flow of blood from your heart and leads to cardiac arrest. It's a serious condition that results in death if not immediately treated with defibrillation. Premature contractions A premature contraction is a beat that occurs early. It can occur in the atrium (premature atrial contraction) or in the ventricle (premature ventricular contraction). In either case, when feeling your pulse, it may feel as though your heart pauses or skips a beat. What are the symptoms of abnormal heart rhythms? If you have an abnormal heart rhythm, you may experience some or all of these symptoms: feeling faint, dizzy, or lightheaded shortness of breath irregular pulse or heart palpitations chest pain pale skin sweating fainting fatigue What causes abnormal heart rhythms? Several factors may cause an abnormal heart rhythm. These can include: High blood pressure High blood pressure means too much force is required to push the blood through your blood vessels. It creates more resistance to blood flow and can affect how your heart works. Over time, high blood pressure can lead to heart disease. Coronary heart disease Coronary heart disease is a serious heart problem that occurs when cholesterol and other deposits block your coronary arteries. This plaque prevents oxygen and essential nutrients from reaching your heart. Heart conditions or damage to the heart A heart condition or an injury to your heart can lead you to develop an atypical heart rate. Some of these conditions may have other symptoms as well. They may include: changes in your heart's muscle after illness or injury healing after heart surgery structural abnormalities of your heart heart failure, which happens when your heart can't pump an adequate amount of blood damage to your heart after a heart attack Medications Some medications or substances may cause your heart rate to change. Medications that may cause your heart rate to increase include: caffeine nicotine decongestants, such as phenylephrine or pseudoephedrine amphetamines, which are drugs that stimulate the brain asthma medications, such as an albuterol inhaler other recreational drugs, such as cocaine Medications that can cause your heart rate to decrease may include: beta-blockers, which treat high blood pressure calcium channel blockers certain antiarrhythmic medications, such as digoxin and amiodarone, clonidine, and donepezil Anxiety or emotional distress Anxiety or other emotional distress can increase your heart rate as part of your body's fight-or-flight response. This can cause sinus tachycardia. You may feel heart palpitations. Your accelerated heart rate typically slows once you calm down. Illness or fever Having an illness or fever may temporarily cause sinus tachycardia. This may temporarily raise your heart rate. Once your illness resolves, your heart rate typically returns to its normal rate. Other causes Other factors can also cause alterations in your heart's rhythm. These can include: pain electrolyte imbalances, such as low potassium, calcium, and magnesium sleep apnea blood clots anemia hypothyroidism other health conditions What are the risk factors for abnormal heart rhythms? The risks for arrhythmia can include: smoking previous heart conditions, or a family history of heart conditions diabetes stress being overweight being physically inactive a diet high in fats and cholesterol high blood pressure or other health problems drinking alcohol in excess drug misuse sleep apnea Diagnosing abnormal heart rhythms A doctor typically performs a physical examination, which may include listening to your heart with a stethoscope and examining your heart's electrical impulses with an electrocardiogram (EKG) machine. This can help them determine whether your heart rhythm is abnormal and identify the cause. Other tools that doctors use to diagnose an arrhythmia include: Echocardiogram: This test is also known as a cardiac echo. It uses sound waves to take pictures of your heart. Rhythm monitoring: You'll wear ambulatory rhythm monitoring, such as a Holter monitor or event recorder, for at least 24 hours while doing your daily activities. These monitors allow your doctor to track changes in your heart's rhythm throughout the day. Stress test: For this test, a doctor has you walk or jog on a treadmill to see how exercise affects your heart. The Healthline FindCare tool can provide options in your area if you need help finding a cardiologist. Treating abnormal heart rhythms The treatment for an arrhythmia depends on its cause. You may need to make lifestyle changes, such as increasing your activity level or changing your diet (for example, limiting caffeine intake). If you smoke, a doctor may recommend you consider quitting smoking and provide resources or medication to help. You might also require medication to control your heart rate and any secondary symptoms. This may include rate-controlling medication or antiarrhythmics to control your heart's rate and rhythm. Certain arrhythmias, such as AFib and atrial flutter, can increase your risk of a stroke. A doctor may recommend blood-thinning medications to lower your risk of stroke. For severe abnormalities that don't go away with behavioral changes or medication, a doctor may recommend: pharmacologic cardioversion, which uses medication, or electrical cardioversion, which uses an electrical shock to your heart other heart testing and procedures, such as cardiac catheterization, to diagnose a heart problem catheter ablation to identify and destroy tissue that causes abnormal rhythms implantation of a pacemaker or cardioverter defibrillator surgery to correct an abnormality Outlook: What should I expect in the long term? Although arrhythmias can be quite serious, they can often be managed with treatment. Along with treatment, a doctor may monitor your condition with regular checkups. Prevention Once your arrhythmia is under control, a doctor may discuss ways to keep it from returning. Certain lifestyle choices can go a long way toward helping you control your condition. A doctor will probably recommend that you: eat a heart-healthy diet exercise regularly quit smoking, if you smoke reduce alcohol intake, if you drink alcohol

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