That's probably true of the top EPs in the US, but probably not true of the average EPs. PFA is too new for the training and equipment to have filtered down yet. Both take time and money.by Carey - AFIBBERS FORUM
The interpretation of echoes is rather subjective. It's not unusual for one to report something that several others don't. I have an example of that myself. One TEE I did in 2017 showed "mild aortic plaque" but I'd had about 3 TEEs before that and none of them mentioned it, and then one a year later didn't mention it either.by Carey - AFIBBERS FORUM
Impaired left ventricular relaxation is a prime feature of diastolic heart failure aka diastolic dysfunction aka heart failure with preserved ejection fraction (HFpEF). Sounds scary but no one can diagnose that based on one observation from a single echo, especially when a prior echo didn't see it. At most it might prompt some more testing but your cardiologist might choose to disregard thatby Carey - AFIBBERS FORUM
Pay no attention to what the ECG machine says. I assure you doctors ignore it. Because I have my own 12-lead ECG and spent years dealing with flutter, I have hundreds of recordings of flutter. I just looked through them and the vast majority say nothing about flutter even though it's obvious. Afib is usually an obvious diagnosis on an ECG. Most of the time I can see it at a glance. Thatby Carey - AFIBBERS FORUM
Yes and no. I have years of experience with both, and although they're similar in some ways and often go hand in hand, they're caused by totally different mechanisms. They're not the same thing at all. First, let me laugh at your GP for saying flutter never lasts long. Oh, my word, that's so wrong I don't know where to begin. Flutter is actually a very stable rhythm aby Carey - AFIBBERS FORUM
Actually, posting them here would be preferred so anyone reading can benefit from them now and in the future.by Carey - AFIBBERS FORUM
QuoteJakeSI am surprised RN only took pulse for 15 seconds in a patient that is having cardiac issues. I'm not. That's pretty much the standard that all medical providers are trained to. It's unlikely you're going to find anything new by counting longer. It's plenty of time to feel the quality, strength, rhythm and rate, and anything else you need to know is better obtaby Carey - AFIBBERS FORUM
Maybe a bit more information. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02422-9/fulltext My superficial take is this is a failure of following protocol but not something showing ill-intent or fraud or even substantive mistakes producing incorrect data.by Carey - AFIBBERS FORUM
QuoteSearching9 for the moving average to shift to 74 in a two second period, would suggest the during that "new" period rate would have to be near 0. And very well might have been. A 2-second pause wouldn't be unusual in afib, and even a single beat near the end of that 2-second period could produce that much change. Keep in mind the device is probably calculating in millisecondby Carey - AFIBBERS FORUM
It's obviously doing a moving average so only the very first interval after turning it on has a sample period of more than 1 second. That's the only way you could get continuous readings at 1-second intervals. That's the same way the monitors in the hospital work that show a real-time display of heart rate, and exactly how I would expect it to work.by Carey - AFIBBERS FORUM
If I understand correctly, you experience no bothersome symptoms from the afib, you're taking Xarelto for stroke prevention, and metoprolol to keep your heart rate under 100. Is that correct? If it is, here's an alternative you and your doctor apparently haven't considered: Just keep doing what you're doing now and skip both the Tikosyn and the ablation. Persistent afib wiby Carey - AFIBBERS FORUM
There's really no difference. See this.by Carey - AFIBBERS FORUM
A PVI is the standard ablation for afib, so pretty much everyone here who's had an ablation has had a PVI. Ranolazine is a new one to me. It's used to tread angina. Reading up on it, it's not clear to me (or to science) what its mechanism of action is other than inhibiting potassium and sodium channels, which prolongs the QT interval (so you'll have to watch that, especially bby Carey - AFIBBERS FORUM
Still could be from the GI tract. Pain in the torso often gets referred elsewhere, an example being people feeling pain in their arm, back or shoulder during a heart attack. Angina wouldn't have stopped while you were still exerting yourself. The hallmark of angina is it's brought on by exertion and relieved by rest.by Carey - AFIBBERS FORUM
Those are all the leads that Kardia provides. What each of them means would require an ECG course, but you can safely ignore them and pay attention only to I.by Carey - AFIBBERS FORUM
Hard to say. There are a lot of possibilities that don't involve the heart, but that echo probably isn't a bad idea. Maybe even better yet a stress echo.by Carey - AFIBBERS FORUM
Yeah, pretty much, but how significant it is for you is a different question.by Carey - AFIBBERS FORUM
Quotegloaming So, I would like to understand what the authors mean by 'coronary artery disease'. Is it the slightest indication of plaque...somewhere...anywhere...or are we talking about 40% occlusion and up? The only indication of CAD I've ever gotten was a description of "mild aortic plaque" from one TEE (I've had others, but only one TEE ever mentioned it). Thaby Carey - AFIBBERS FORUM
I don't know a lot about the procedure but I am aware of its existence since I've been dealing with degenerative disc disease in my neck for the past year. Basically, the problem is nerves get compressed when the discs between vertebrae degenerate. This leads to pain in whatever part of the body that nerve serves. In my case, it's pain in my right shoulder that radiates down my rigby Carey - GENERAL HEALTH FORUM
The hallmark of afib is an irregular pulse. An irregularly irregular rhythm, to be exact (this leaves out things like bigeminy, which is regularly irregular). So when you experience this racing heart thing, just feel your pulse for 30 seconds. Can you tap your foot to the beats? If you can, it's probably not afib. But if the rhythm is so irregular that you can't predict the next beat, tby Carey - AFIBBERS FORUM
You're an extraordinarily complex patient so I think you need the most experienced, most capable EP and center you can find. I don't know why your current EP would want to focus on PACs when those are probably the least of your problems.by Carey - AFIBBERS FORUM
Since PFA can only do a PVI (much like cryo), it doesn't matter much if you're in afib for the procedure or not. However, a truly skilled EP doesn't do only a PVI. They'll go looking for other sources of afib and will spend considerable time trying to provoke it. And then when/if found, they'll ablate it using RF. So it would be more helpful to enter the procedure alreadyby Carey - AFIBBERS FORUM
Those ectopics you describe are probably PACs happening right after each normal beat. The result is what's known as bigeminy. It's pretty common around here and it's not an indicator of anything serious. It's just annoying as hell.by Carey - AFIBBERS FORUM
I don't know of anyone who has experienced such symptoms, but apparently it is possible according to drugs.com, which I consider to be a reliable source. Here is the report, but I would caution you about over-interpreting it. I think your dehydration almost certainly explains the issue.by Carey - AFIBBERS FORUM
I don't know where you got the 50% number but that's wrong unless you're talking about longstanding persistent afib, which presumably you're not. Overall, success rates for ablations are in the 70% neighborhood, with top EPs like Natale having numbers in the 90% range. As for having an episode when you're 1000 miles away, that's really not much different than havby Carey - AFIBBERS FORUM
A flutter ablation is typically just a line that serves as a block for the impulses, not an ablation of the source itself. You'll often hear it called a flutter line.by Carey - AFIBBERS FORUM
Your question is above my pay grade and I suspect everyone else's pay grade as well. It makes sense to me to go back to full-dose Eliquis now that the clot is gone, but I'm not going to offer that opinion on a question with such big ramifications. I think the hematologist is the only one who should be answering it.by Carey - GENERAL HEALTH FORUM
Great! Let us know how it went and how it goes.by Carey - AFIBBERS FORUM
QuoteDaisy Then why did some of us get flutter before we ever had an ablation? Because not all barriers are ablation lines. Some (most?) may be naturally occurring fibrosis/scar tissue from prior infections/injury, atrial stretch, etc.by Carey - AFIBBERS FORUM
QuoteDini This is very interesting. Excuse me if I am being naive. If the risk of hemorrhagic stroke a greater while on an anticoagulant and the anticoagulant doesn’t prevent a recurring stroke what is the benefit? The statement that the anticoagulant doesn't prevent a recurring stroke is probably wrong. See my first comment in this thread.by Carey - AFIBBERS FORUM