How to convert at home, and Cardio appointment June 23, 2023 11:35PM |
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Re: How to convert at home, and Cardio appointment June 24, 2023 01:28AM |
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Re: How to convert at home, and Cardio appointment June 24, 2023 03:20AM |
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Re: How to convert at home, and Cardio appointment June 24, 2023 11:11AM |
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Re: How to convert at home, and Cardio appointment June 24, 2023 02:36PM |
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Re: How to convert at home, and Cardio appointment June 25, 2023 01:09AM |
Registered: 2 years ago Posts: 122 |
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GeorgeN
In my post to you here, I mentioned vagal, adrenergic and mixed triggers. Exercise most commonly works (IF it works) for those with vagal triggers. Initially, I converted all my episodes with exercise (including running). This lasted for a couple of months, then I had a 2.5 month episode where it didn't work and converted that episode with on-demand flecainide. The length of the 2.5 month episode had me a bit gunshy & I didn't wish to repeat, so converted most of the episodes in the intervening 18+ years with on-demand flec, which I'd take as soon as I knew I was in afib & chew the pills.
I also mentioned in that thread about increased calcium being associated with increased afib frequency as well as many more things that could be triggers. One of those was the time immediately after orgasm. I could feel the ectopy kicking in, and if I immediately sat up or stood up and moved around, I could terminate these episodes instantly. Fortunately, I have an understanding partner! Also fortunately, when I reduced my calcium intake, this trigger went away.
If you think the episode has an adrenergic trigger, vagal maneuvers can terminate in some people. I strongly suggest that you do not try the carotid sinus massage vagal maneuver for safety reasons.
See Jackie's post on avoiding digestive issues, not to terminate but to prevent, if you think digestion could be a trigger.
I did a breathing conversion in March, described here. I'd also taken some flec, but the conversion happened so fast, that in my experience flec never acts that quickly, always takes an hour at minimum.
Another breathhold conversion from a few years ago is described here. This was a bit different than the one above. I started the breathing almost instantly after the episode started and it converted in a few minutes. I happened to be wearing several monitors, so the graphical data are shown in the post.
Before I reduced my on-demand flec dose from 300 mg to 200 mg, I could get some conversions to flutter (which is a very stable rhythm) that I'd then have to convert back to afib (without more meds) to then convert to NSR. On all these I had taken flec and was some hours into the episode. I have tried all manner of things: sitting in a large bathtub of 58 deg F (14.4 C) water for 10 or so minutes (it worked & cold water on face or cold showers can work for some); inverting or standing on my head for many minutes; jumping rope with my breath held out during the exercise; pushups on an exhaled breath hold and so on with other exercises. Sometimes they worked and many times not. I've done Wim Hof breathing( 3 or more rounds of 30-60 hyperventilation breaths followed by long exhaled breath holds followed by an inhaled breath hold of 15 seconds or longer). Interestingly, the conversions, if they happened, were during the inhaled breath hold. It was this realization that had me try the breathing approach in March (above). I commonly wear a recording beat to beat heart rate monitor during my episodes. The displayed heart rate is a moving average, but I can still tell a lot about my rhythm status. For example, I had the chest strap on in the chilly water & watched my afib rate decline and then convert. I have also done meditation or slow breathing and watched my heart rate drop. If I can get it into the 70's, I can usually convert. Almost 100% if I can drop it into the 60's. Some of what I have tried has resulted in heart rates around 225 (like the exercise during exhaled breath holds). I know my afib and my body pretty well, so this does not cause me issues and I can get this rate lower (into say the 130's) without issue. I mention this, as not everything I try may be appropriate for all, so beware! I've also pushed my heart rate to 230 and then had it convert. Again, I'm not saying that any reader should try much of this stuff as there might be negative consequences for other readers. The March breathing approach is tame and was effective that time, which is why I listed it first.
Re: How to convert at home, and Cardio appointment June 25, 2023 01:16AM |
Registered: 2 years ago Posts: 122 |
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FibberMcGee
I started with meds for afib. I finally got an ablation after a couple of years. Looking back, I wish I had just started with the ablation. Get an EP. Just my 2 cents worth.
Re: How to convert at home, and Cardio appointment June 25, 2023 01:31AM |
Registered: 2 years ago Posts: 122 |
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JakeS
For some reason, perhaps understandably with the current science, cardiologists seem to want to 'play along' for at least a while.
Agree 100%. My situation. First afib in 2017. Seen by the cardio in the ED and I stayed w him as my cardio. Did all the tests. Echo, stress, CT calcium scoring. Subsequently I experienced afib only once a year. Thought the ED was the route go and soon learned to avoid the ED if at all possible. Visits to the cardiologists all the same. He came in, sat across the room. Asked how I was doing? Any episodes? Listen to heart. No change in my meds. I had learned on this forum about supplements such as magnesium. He never discussed any of this w me. When I told him I had read about magnesium and was taking it he said to me “I wish I had thought to tell you that.” He no longer is my cardiologist. Funny when I met w the EP he talked to me about magnesium and wanted to make sure I was taking it.
In 2022 had another episode in summer. Again my episodes were once a year. Then end of September through Thanksgiving episodes were occurring more frequently. end of January the episodes kicked up again. Referred to EP. I had to wait over 2 months to see him. Something you may want to ask about if you need an EP. How long will it take to get an appointment.
The last afib episode was beginning of March. But while the afib decreased the PAC’s increased. They were awful. When I met the EP he gave me options but said the best choice was an ablation. I saw him in January. He was booked through November. I asked around and other EP’s could get me in w a 3 – 4 month wait but I really liked him and wanted him to do the ablation. My PCP had patients he had done ablations on and told me they all were successful. Talking to nurse at cardio office etc all knew him and said they would go to him and had sent family to him. I stayed with the EP. I was told the facility would be opening more dates and had to wait until the end of March before I heard anything about a date. I lucked out. There was a cancellation and the EP staff had me on the cancel list and I had the ablation.
I learned while the episodes were infrequent once a year from 2017 – 2022, it all changed pretty quick. Walking usually helped my episodes. There were nights I was up all-night walking around the house. Sometimes I could not walk because it would raise the BPM and would have to sit. I tried the other tricks such as Valsalva, cold, breathing but walking gave me the best results.
Good luck.
I finally got an ablation after a couple of years. Looking back, I wish I had just started with the ablation. Get an EP. Just my 2 cents worth.
I agree also looking back.
Re: How to convert at home, and Cardio appointment June 25, 2023 02:47AM |
Admin Registered: 7 years ago Posts: 5,561 |
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Marco
If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?
Re: How to convert at home, and Cardio appointment June 25, 2023 05:41AM |
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Re: How to convert at home, and Cardio appointment June 25, 2023 12:23PM |
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Marco
If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?
Re: How to convert at home, and Cardio appointment June 25, 2023 03:56PM |
Registered: 3 years ago Posts: 51 |
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GeorgeN
Before I reduced my on-demand flec dose from 300 mg to 200 mg, I could get some conversions to flutter (which is a very stable rhythm) that I'd then have to convert back to afib (without more meds) to then convert to NSR.
Re: How to convert at home, and Cardio appointment June 25, 2023 10:49PM |
Registered: 2 years ago Posts: 122 |
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GeorgeN
If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?
There is a newcomer, pulse field ablation or PFA. Here is a search on our site.
I'd start with moderator Shannon's posts here. Read Shannon's posts in reverse order (earliest to latest). It will give you a good description of the approach.
Basically it is a different energy source and does not appear to have some of the issues of using heat as an energy source. From my understanding, it is very close to full approval, perhaps in the fall. Reports from members here who have been in the trials and had PFA are positive. Cold is limited as it is used only to ablate the pulmonary veins, which are the starting point in every afib ablation, however, many need to have other areas ablated to solve their afib problem.
If you decide ablation is for you at some point, our general advice is to go to a high volume center with an EP who has done many thousands of afib ablations. Many here travel to Austin TX to see Andrea Natale, clearly a leader in the field.
Re: How to convert at home, and Cardio appointment June 25, 2023 11:07PM |
Registered: 2 years ago Posts: 122 |
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Carey
If I'm understanding well. an ablation is basically either burning or freezing the tissue in the heart that causes the arrythmia, does that mean there is an irregularity of the shape of the tissue then?
Not exactly. An ablation is burning or freezing a line of tissue around the source of the afib so it's sort of fenced in. The errant electrical signals from that area can't go anywhere to cause afib. It has nothing to do with the shape of the tissue. There's nothing visually different about atrial tissue causing afib and any other atrial tissue.
Re: How to convert at home, and Cardio appointment June 26, 2023 02:09AM |
Registered: 11 years ago Posts: 4,324 |
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BobsBeat
George are you saying you now only take 200 mg bolus dose flec instead of 300 mg?
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When previously taking the 300mg dose and converting to flutter, how exactly did you convert back from flutter to afib?
Re: How to convert at home, and Cardio appointment June 26, 2023 02:52AM |
Admin Registered: 7 years ago Posts: 5,561 |
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Marco
is the area in the atria that doesn't behave properly and cause Afib the same in everyone? if not how is it detected?
Since some research I have done last year, I assume the cause that makes the atria misbehave, it is very different for everyone, if someone ever understand what is the cause, correct?
Re: How to convert at home, and Cardio appointment June 26, 2023 04:00PM |
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Re: How to convert at home, and Cardio appointment June 26, 2023 04:30PM |
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gloaming
A competent and conscientious EP will not release you from the surgery during an ablation until he/she has either run out of reasonable options and safety for you, or has simply run out of his/her level of experience and expertise.
Re: How to convert at home, and Cardio appointment June 26, 2023 07:56PM |
Registered: 2 years ago Posts: 122 |
Re: How to convert at home, and Cardio appointment June 26, 2023 08:14PM |
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Re: How to convert at home, and Cardio appointment June 27, 2023 03:03AM |
Registered: 2 years ago Posts: 122 |
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Daisy
I have to say, all of this sound pretty scary.
Point us to the scary parts and we will try to do a good job of "unscaring" you!
Re: How to convert at home, and Cardio appointment June 27, 2023 05:33PM |
Registered: 5 years ago Posts: 802 |
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Marco
I will need to get some good sedative IV for sure.
Re: How to convert at home, and Cardio appointment June 28, 2023 03:18AM |
Registered: 2 years ago Posts: 122 |
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Daisy
I will need to get some good sedative IV for sure.
I found that I did want to know all the details—but if you choose a top notch EP to do your ablation you can let go, trust his/her expertise and not even think about the actual process. The important part of that statement is “top notch EP” and there are all too few of them and seeing one often means traveling—but it is so worth it. The complication rate with a top EP working in a top facility is really low and they do ablations all day, every day. What sounds scary and extreme to us is routine for them. And, you are not only given “good sedation,” everything that is even remotely invasive is done after you are under anesthesia. You are positioned on the table with (IV already placed in pre-op) and the anesthesiologist tells you to breath deeply from an oxygen mask, there is a momentary high as they induce anesthesia, then you wake up in recovery with great individual care before being taken to your room. Even the localized prep is done after you are under. The main thing you experience in the EP lab (other than being the center of attention!) is that it is cold but they pile on heated blankets and even run a hose of heated air under them to keep you comfortable.