Quotebolimasa No, I was not the one with kidney issues... thankfully! Other that being overweight and battling my BP I have no issues.. Oh, sorry. Then certainly go ahead with some potassium loading either by diet or supplementation. I'm the one with short-term memory issues. Anyone seen my keys?by wolfpack - AFIBBERS FORUM
One caveat on potatoes is the light pollution that occurs because they sit in grocery store produce departments that are illuminated 24 hours of the day. You'll see that as a greening that occurs underneath the skin when you peel it and it may even be directly visible through the skin if it's really bad. It is a good indication of glycoalkaloid toxicity. Root vegetables are meant to beby wolfpack - AFIBBERS FORUM
What is the mechanism for anti-arrhythmic action in berberine? I understand it functions on the liver to prevent glucose formation much like metformin, but I'm unaware of any cardioselective activity.by wolfpack - AFIBBERS FORUM
Yes, your potassium is #1 on AF's Most Wanted List. I know you said in your previous thread that you have kidney issues. Get the function tested and then discuss supplementation with your doctor. It clearly needs to be done. Don't take no for an answer, unless the kindeys preclude it. Bananas, while good, aren't something you want to eat a whole bunch of. They have a very sedatiby wolfpack - AFIBBERS FORUM
Prior to my ablation, it was mostly the diurnal cycle. I'd go out of rhythm every night about 8 PM. That is textbook vagal AF. It was always, 100% of the time, preceded by PACs in increasing frequency. Post ablation, I've gone out of rhythm twice now without a single warning sign beforehand. Once while running, going to stopped to start very quickly at a traffic crossing. Just two daby wolfpack - AFIBBERS FORUM
Another episode today lasting about 1 minute. Not sure if that counts but I guess it does. All because I swallowed a big chug of water after a bike ride. Self converted with rhythmic breathing. Tough while driving a car! Also figured out my Kardia is dead. Battery leaked inside of it (thank you, China). Guess I’ll just have to buy another one. Argh!by wolfpack - AFIBBERS FORUM
I totally get the hassle of dealing with doctors. I fired my first set, too. GP and cardio. Never fun but you gotta do what you gotta do! You really need to figure out a way to get to Austin if it's at all possible. Good news is you can always keep your local doctors. You'd keep your cardio anyway and EPs can function in a clinical role. Anyone worth his or her salt should be willingby wolfpack - AFIBBERS FORUM
Why on earth would they not have an ultrasound machine in the ER dept? It literally takes 5 minutes to do. At least they did a chest x-ray so I'm guessing they didn't see too much enlargement of the pericardium and thus weren't overly concerned. The concern for pericardial effusion is progression to cardiac tamponade. That needs an echo to diagnose. I think they can get some diaby wolfpack - AFIBBERS FORUM
With so many things going on, I'm left to wonder if the AF is secondary to it all. What caused the hypertrophic cardiomyopathy? Hypertension? Have you had an echo done? Ejection fraction? You would certainly be a case for the top notch EP. I'd probably go the medication route for the time being until things stabilized. I don't know how your HMO works but is it possible to work oby wolfpack - AFIBBERS FORUM
Ok, wow, that’s a lot. What stands out to me is the thiazide and arrhythmia link. HCTZ will crater your patssium levels. Have you tried supplementation? We always say that magnesium and potassium complement each other. I’d try supplementing magnesium to bowel tolerance in the most bioavailable form - bisglycinate chelate - along with potassium either from dietary sources or powdered form. That beby wolfpack - AFIBBERS FORUM
CT scan can also be diagnostic. Echo is cheaper and faster, but CT should be an option as well.by wolfpack - AFIBBERS FORUM
The cardiac axis is the direction in which charge is flowing over the surface of the heart. Normally it's a bit "down and to the left". You need multiple leads to determine it. It can't be done with a Kardia or probably even the Emay. You find the lead (or the spot between two leads) in which the QRS complex is equiphasic, meaning there's just as much "up" spikeby wolfpack - AFIBBERS FORUM
If your AF is vagal, which I’m sure it is given what you describe, then you are probably going into AF at night while asleep and the ANP (atrial natriuretic peptide) that is elevated during AF is making you have to pee. I doubt blood pressure has much to do with it. Low blood pressure is just a side-effect of chronic fitness, as is AF.by wolfpack - AFIBBERS FORUM
The leads are essentially the angle at which you’re looking at the heart’s surface electrical activity. Lead 1 is arm-to-arm, so basically you’re looking at your heart from side-to-side. Lead 2 is looking from top right-to-left bottom, which is in most cases through the long vertical axis of the heart as it is positioned in the left of your chest. Since your right arm is closest to your right atrby wolfpack - AFIBBERS FORUM
QuoteCarey Afib ablations are the most difficult, most complex ablations of all. Atypical (left-sided) flutter is no walk in the park either.by wolfpack - AFIBBERS FORUM
The first trace is clearly AF. The second trace looks like NSR "peppered" with PACs. The third trace is NSR. I'm estimating your HR at around 65 bpm. QT interval is good (some AARs can prolong that, which is bad). As always, don't substitute my opinion for real medical advice.by wolfpack - AFIBBERS FORUM
Quotesmackman Just wandering why you say it should be 5mg two times a day. It doesn't always have to be, but 5 mg BID is the standard dosing for anticoagulation in AF patients with a CHADS2VASC score of 2 or greater. Certainly once one has established a doctor/patient relationship with an EP things can be changed. However, in the original poster's case I don't think anyone wouldby wolfpack - AFIBBERS FORUM
Is the Eliquis dose 2.5mg twice per day or 5mg twice per day? It should be 5mg twice per day. I'd be surprised if it were not, but it bears mentioning that the drug does come in both doses.by wolfpack - AFIBBERS FORUM
Yes, excess fibrosis or a very large left atrium will, like I said, "scare away" some practitioners. They are indicators that a PVI-only ablation probably won't work. Yours looks pretty vanilla to my layperson's eyes. Ask them, though. Your insurance probably paid a pretty penny for it, so get your money's worth!by wolfpack - AFIBBERS FORUM
If the MRI was of the delayed enhancement variety then it may have been done to look for fibrosis which, unfortunately, is used by some centers as an exclusion protocol for AF ablation. If in your case that was done and didn't show anything then I don't suspect you'll hear much about it at all. The MRI also estimates the dimensions of each heart chamber. LA anterior to posterior isby wolfpack - AFIBBERS FORUM
By that definition, then, my PVI index ablation was a success. It lasted from August 2015 to April 2018. No drugs of any kind. And it still is, minus that one episode. Time will tell, I suppose.by wolfpack - AFIBBERS FORUM
Or maybe not. LAA Isolation isn’t something anyone can figure out beforehand. It’s possible that the 4 PVIs weren’t transmural or their are other areas of ectopy which may include the coronary sinus or posterior wall. Failed PVI does not immediately mean LAA isolation. What it does mean is the patient needs to be seen by a more experienced ablationist.by wolfpack - AFIBBERS FORUM
Or worse, the cardioversion won’t do anything at all and you’ll still be in AF. You can try it but it is by no means guaranteed to either work at all or hold very long. You need a new EP, I think.by wolfpack - AFIBBERS FORUM
No, but it’s impossible to derive meaning from a broad statement like that. I’m going to put forth what I think the criteria are for getting to the real answer: 1. The sample set needs to be exclusively left atrial AF ablation 2. The procedure needs to be defined as either PVI only or PVI plus additional left atrial mapping and ablation 3. Success needs to be defined as freedom from AF wiby wolfpack - AFIBBERS FORUM
QuoteCarey One of my big pet peeves is EPs and other alleged experts who like to write articles blaming people for their afib. (A specific, well-known EP comes to mind but I'll forego mentioning his name.) Well known for an internet soapbox moreso than actual outcomes.by wolfpack - AFIBBERS FORUM
Duke University. I’ve always felt like it wasn’t “complete”. I had AF in the blanking period and plenty of ectopics since. There’s probably some little area where the lesion set isn’t complete.by wolfpack - AFIBBERS FORUM
Quotetobherd Wolfpack - why do you write "when" my Afib returns? Why do you think it will? Because it already has. AF Returns I’m just waiting now to see when it becomes more frequent. Hopefully that will be some time.by wolfpack - AFIBBERS FORUM
Quotedartisskis It is even harder to convince your cardiologist to refer you to the best EP. This can be an issue, yes. I don't think it's necessarily because he or she doesn't mean well. You just might be putting them out of their comfort zone. My cardiologist, whom I like very much, won't talk about anyone other than the local EPs. When my AF returns, I won't be goingby wolfpack - AFIBBERS FORUM
QuoteCarey You become hyperkalemic during exercise. That may also explain the frequent need to "find a tree" at about the same time. But when they vanish, man, they're gone for good. Except the one time two months ago when they turned into AF. Which is more evidence that we can influence AF but at some point it's just going to do what it's going to do. Won'tby wolfpack - AFIBBERS FORUM
Statistics are very misleading. 97% of what? All ablations, including simpler, right-atrial flutter procedures? Also, what's the definition of "success"? Is it complete freedom from arrhythmia without continued use of AAR drugs or with their continued use? You have to ask VERY pointed questions to get to the real answers.by wolfpack - AFIBBERS FORUM