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The staff may not have been helpful but they were right. Getting a Watchman approved by Medicare or any private insurance company when you can tolerate anticoagulants and don't have bleeding problems is going to be almost impossible. Incidentally, I have a Watchman and yet I still take a half dose of Eliquis by my own choice. I could have stopped the Eliquis entirely but I chose to contiby Carey - AFIBBERS FORUM
I don't think I'd take the word of a Xarelto employee about when a generic Eliquis will be available. The FDA has already approved generic Eliquis, but Pfizer is fighting it in court (of course). So the problem isn't the government -- it's the manufacturer. According to this: QuoteWhen will generic Eliquis be available? It’s not clear. The FDA has approved applicatioby Carey - AFIBBERS FORUM
We need to talk privately because I don't think your situation applies to most people.by Carey - AFIBBERS FORUM
QuoteJDfiB How is the burden percentage number determined? It's simply the time spent in afib divided by the total time. So, for example, if you spent 12 hours in afib during one week, that's 12 hours out of 168 hours. The math look like this: 12 / (7 * 24) = 12 / 168 = .0714 = 7% afib burdenby Carey - AFIBBERS FORUM
Quotesusan.d Natale plan is to see me every 3 months for now (maybe longer window later on) for 5 years. If any concerns come up he has an excellent NP. Okay, but you're an atypical patient with ongoing issues. Most of his patients don't need follow-up visits following their ablation and they shouldn't expect to travel back to Austin if their ablation is successful. Communicationby Carey - AFIBBERS FORUM
I've heard it from a few people so it's not unheard of, but it's by no means common. I'd say sleep however you want and if it happens consistently then you know it's a trigger for you. But if you label things as triggers because they happen a single time, pretty soon everything in your life will be a trigger. Remember, you were doing something before every single afib epiby Carey - AFIBBERS FORUM
Quotezoeysky2004 Ever since the Mini Maze in March 2017 i have stayed out of Afib but keep going into atrial tach or a flutter even after two Natale procedures. Unfortunately, flutter is a common result of Maze procedures. It's so common that they came up with the "convergent" procedure in which a surgeon does an external lesion set and then an EP does an RF ablation, all in theby Carey - AFIBBERS FORUM
QuoteBarry G. I am not frightened of dying of AFIB, I am frightened of living with it. Wow, that's a great line.by Carey - AFIBBERS FORUM
Fear is one big reason. I've seen many people on this and other forums express extreme fear of the procedure as a reason they won't get one. I think that fear is irrational in view of the actual risks, but fears often are irrational and that doesn't make them go away. And, like Daisy, if the drugs work for you and don't cause uncomfortable side effects, living with it is a perby Carey - AFIBBERS FORUM
Quotecirenepurzalot Also, is it possible to be med-free after the ablation? Of course. That's the expected result. If you're not med-free (other than anticoagulants, possibly) then the ablation wasn't successful.by Carey - AFIBBERS FORUM
Those are two opinions with nothing to back them up, and Steve Ryan isn't even a (medical) doctor. I'm no fan of Ryan and his site. The reason you don't find much information about this is because it's not particularly important in the management of afib. Once afib begins, what triggered it is utterly irrelevant. What's important is that keeping your heart rate down willby Carey - AFIBBERS FORUM
It's not that US doctors don't recognize vagal afib; it's just that it's not all that important of a distinction. I know people here like to talk about it as if it's a separate form of afib. It is not. The only difference between vagal afib and adrenergic afib are the things that tend to trigger it, just as you said. But once triggered, the two are IDENTICAL diseases. Theby Carey - AFIBBERS FORUM
I would do as they suggested. Stop the bisoprolol and start the diltiazem. Diltiazem is a really benign drug and there's no reason to be afraid of it.by Carey - AFIBBERS FORUM
You asked about flecainide earlier, but flecainide is completely contraindicated for you. I hope nobody suggested giving it to you, and if they did get a second, third, fourth and fifth opinion before agreeing to it. It sounds like Tikosyn would be a good choice for you. I wouldn't be afraid of trying it. And if you do try it, give it time. When I was put on it people told me it became moby Carey - AFIBBERS FORUM
Quotecirenepurzalot Thanks all for such wonderful responses! How much roughly does a procedure cost? And does he require meds before and after procedure? Are you self paying all of it? If so, I believe you're looking at around $20,000 but you'll have to discuss that with them. That number is what I was told they charge self-pays, but that was a year or two ago. Could be more now. Butby Carey - AFIBBERS FORUM
I've never used the Apple Watch but I've used a Kardia for years and it will label almost anything that isn't pristine NSR as inconclusive. In my experience, inconclusive virtually always means "not afib." That's because they try to err on the side of being ultra-conservative and would much rather give you an inconclusive result than a false negative. False negatby Carey - AFIBBERS FORUM
There are other brands of wireless monitors so I wouldn't limit your search to Zio. I'd be really surprised if the average EP at Mass. General doesn't use some type of wireless monitors, so you could just call a few of their offices and ask. Another option would be to call Zio or some of the other companies and ask them for doctors in the area who use their product. I did thatby Carey - AFIBBERS FORUM
I'd be surprised if any non-cardiologist would prescribe flecainide. It's just not a drug GPs would be familiar with.by Carey - AFIBBERS FORUM
Oh, and you shouldn't need any follow-up visits. You'll be assigned to a nurse practitioner who can answer questions, adjust meds, or take care of any issues. They'll probably want you to send them a Kardia recording once per week, and then at six months they'll send you a monitor to wear for a week. If that recording is free of problems, you're done.by Carey - AFIBBERS FORUM
Yes, he is arguably the best EP in the world. He fixes arrhythmias other EPs can't. If you travel to Austin for an ablation with him, you should only need one trip. Here's the basic procedure: You call and request a consult. Your local EP/cardiologist sends your records to Natale's office. He'll look them over and if he agrees to take the case, they'll call youby Carey - AFIBBERS FORUM
No, that is not standard procedure, or at least it hasn't been for the last 25+ years. It was common when flecainide was first released (1985), but with more experience with the drug and more clinical trials they learned that you don't need to do that. They also learned that you really need to avoid giving flecainide to people with structural heart disease and who have had MIs. I thby Carey - AFIBBERS FORUM
Quotecirenepurzalot Wonder why Natalie doesn’t mix metoprolol with it. My rate usually seems high during afib so maybe that’s why I was told to take them together. Because the whole idea is the ablation and the Multaq will prevent you from going into afib in the first place, so there's no reason to add metoprolol.by Carey - AFIBBERS FORUM
Quotecirenepurzalot Thanks. The only problem is that it’s $700 for 60 pills. 😞 What do you mean by capping of your heart rate? My dr wants me to take this with metoprolol because during afib my heart is usually around 150 bpm. Yeah, price can be a problem depending on your insurance but $700/month sounds like your insurance doesn't cover it at all and you're quoting retail prices.by Carey - AFIBBERS FORUM
I wondered that myself but the little bit of info available about it says that's not an issue.by Carey - AFIBBERS FORUM
I've been on it twice with totally different results. The first time was prior to my Natale ablation when I had severe flutter. Multaq was totally ineffective at preventing that (but then again, so was everything else). The second time was in the month following my ablation. Natale often uses Multaq following ablations because it's kind of a light weight antiarrhythmic with few side effby Carey - AFIBBERS FORUM
Well, there are some similarities but blood doesn't flow through a Watchman after the first few weeks. The Watchman is designed to encourage your endothelial tissue to grow over it and completely seal it closed, whereas the carotid filter is designed to remain open and let blood pass freely. Incidentally, filters like that have existed for many years. The difference is they were used inby Carey - AFIBBERS FORUM
Oh, okay, an ACE inhibitor makes sense for the heart failure, but you're in a tough spot with the BP. You definitely don't want to go lower than 80/60. Tikosyn isn't known for lowering BP. It's an antiarrhythmic and a fairly effective one at that. In order to start it you have to spend 3 days in the hospital being monitored. I wouldn't worry about the BP issue since yby Carey - AFIBBERS FORUM
Quotemerri I take50mg Metoprolol once a day and 1/2 of Metoprolol TAR 25mg for breakthru afib if my bp systolic is greater than 100 and my heart rate is higher than 110bpm. My blood pressure has always been on the low side of normal my entire adult life. With this med it drops. For the last 4 days my heart rate has been between 103 to 118 bpm with blood pressure anywhere from 80/60 with 103bpmby Carey - AFIBBERS FORUM
Major surgery is definitely a different issue than bruises and will have to involve your surgeon and EP working together to agree on a protocol. Eliquis really doesn't prolong bleeding all that long, but when we're talking surgery "all that long" changes scope. Rest assured that your foot hasn't been bleeding since about 10 minutes after the chair fell on your foot.by Carey - AFIBBERS FORUM
No way you're still bleeding almost two weeks later. Deep bruises can take weeks to go away, especially on the lower extremities. I had a hematoma after my first ablation that left a huge bruise that covered almost my entire thigh. That bruise took 2-3 months to vanish. Honestly, Eliquis doesn't prolong bleeding all that much. Aspirin is far worse.by Carey - AFIBBERS FORUM