QuoteElizabeth Is the LARIAT still being performed? It sounds much simpler than the Watchman, it doesn't have anything added in the closure of the LAA like the Watchman does? The LARIAT is a vastly different device, it's considerably more invasive than the Watchman, and not simpler at all. Here's a pretty good explanation of how it works with diagrams. Unlike the Watchman, it reby Carey - AFIBBERS FORUM
Hi Pamela, If Dr. Natale isolated your left atrial appendage (LAA) during your ablation and then told you to continue anticoagulants after seeing your TEE at six months then you should believe him. If he said that, that means the TEE showed that you don't have adequate blood flow within your LAA to prevent blood from pooling and clotting there. The LAA is the source of 90% of all afib strby Carey - AFIBBERS FORUM
QuoteElizabeth Sorry not true, I had to respond. Shannon has posted about his TIA because of a leak. Shannon doesn't have a Watchman. He has a completely different device that works differently.by Carey - AFIBBERS FORUM
The new Watchman you're talking about is the Watchman FLX. I have one and so does Andy (AB Page). We got them the same day in August 2018 as part of the Watchman FLX trial, and they've been perfectly fine and leak free for both of us. The FLX is only an iterative improvement on the original design, not a completely new device. It has more anchor points to prevent it from slipping ouby Carey - AFIBBERS FORUM
QuoteThe Anti-Fib 1) Stay on Multaq and endure, until blanking period over. 2) Withhold Multaq on a trial basis 3) Stop Multaq, and substitute another Anti-Arrythmic on a trial basis. I agree with this. In fact, #2 is exactly what I did following my ablation. I tried stopping the Multaq at 3 weeks but the ectopics increased, so I resumed taking it for another week and then tried again. Afterby Carey - AFIBBERS FORUM
I wouldn't worry about it. Kind of a bummer that no doubt took the wind out of your sails a bit, but I would bet it's just a bump in the road that won't keep repeating. The fact that it converted on its own so quickly is a very good sign. I think it's smart you maintain a relationship with a local EP you know and trust. I do too, and in fact I have my annual followup appoinby Carey - AFIBBERS FORUM
I totally understand that feeling with the bike rides. You'll get back to where you were soon enough now that you've got a heart that works the way it's supposed to.by Carey - AFIBBERS FORUM
QuotestrongHeart sorry, not sure how to do the little square quote box thingo, but: Look at the bottom right of this post. See the three links? ("Reply" , "Quote", "Report") Click "Quote" on this post and see what happens.by Carey - AFIBBERS FORUM
Quotetobherd My left emptying velocity has been all over the map, which is one reason I went for multiple TEE's. It's been 28.8, 41.4, 32, 40, and 58.5. That 58.5 number is the only one that meets the minimum of 45. Not sure what Natale would say about those numbers but he'd probably want to do another TEE and go by that. He'd also want to see the E:A ratio, which it sounby Carey - AFIBBERS FORUM
Quoteron Cary, what is the E:A ratio ? It's a measure of the blood flow from the left atrium to the left ventricle. The E wave is the passive flow of blood from gravity in between each beat, and the A wave is the flow from the atrial contraction. Normal is E > A. But as the number gets larger that means your atrium isn't contracting as forcefully. I don't recall what the numbeby Carey - AFIBBERS FORUM
The measurement they look at is the LAA emptying velocity, but that's not something you'll find on most TEE reports. They have to be specifically looking for it. It needs to be at least 45 cm/sec. (Mine was 30 cm/sec so not even close.) They also look at the E:A ratio and the presence of "smoke" in the left atrium, which are also things you won't likely find in a standardby Carey - AFIBBERS FORUM
PVCs don't require anticoagulants. Just because something is technically called an arrhythmia doesn't mean it creates a stroke risk. Most arrhythmias don't. The atria aren't quivering and pumping ineffectively like they are in afib, so the risk of blood pooling in the left atrium and forming clots isn't present. I've seen several of your ECGs and although they showedby Carey - AFIBBERS FORUM
I haven't searched the literature on this but out of six ablations I was kept on an OAC for at least three months for all except one of them. After the one exception I was only kept on an OAC for one month, but that ablation involved only the right atrium so very low stroke risk. From what I've seen from others, three months is almost universal, at least in the US.by Carey - AFIBBERS FORUM
Singulair is for asthma and allergies. Don't know how well it's going to work against congestion if it's due to a cold. Any of the antihistamines like Zyrtec, Allegra, Claritin, etc. should be fine. Just avoid decongestants. If you see a "D" appended to the name, that probably means it also contains a decongestant so avoid those.by Carey - AFIBBERS FORUM
Quotetobherd Why are some saying that even missing one dose of Eliquis could be catastrophic? I was told that isn't true by my cardiologist. And if it were true, how would anyone on Eliquis ever be able to get off for a medical procedure, such as surgery? That's true only for people who've had their left atrial appendage (LAA) isolated during an ablation and now have inadequateby Carey - AFIBBERS FORUM
Quotecolindo Nattokinase is a fibrinolytic enzyme, which means that it has the ability to break down or "degrade" excessive fibrin that our bodies produce when recovering from injuries or other health issues. I get that and I don't dispute it, but I'm unaware of any research showing that it's effective at preventing strokes in afib and I'm unaware of any research sby Carey - AFIBBERS FORUM
Although that's what the guidelines say, in practice length of time in afib is still often considered. An easy example would be cardioversions. If you walk into an ER with afib and want a cardioversion, the first questions they're going to ask are how long you've been in afib and if you're on anticoagulants. If you say you've been in afib a couple of days and you'reby Carey - AFIBBERS FORUM
Okay, but how does knowing its mechanism of action help?by Carey - AFIBBERS FORUM
What you're describing sounds like PACs. And the beat-skip, beat-skip sensation probably means there's one PAC in between each normal beat. As you suspected, that's bigeminy. Bigeminy isn't a condition or disease; it's just a description of the pattern. There's also trigeminy and quadrageminy. I used to get PACs in a bigeminal pattern that would go on for weeks. Annoby Carey - AFIBBERS FORUM
I'm aware of that but we don't know Lenlec's details. The odds are pretty good he/she is more than a CHADS 1 so don't you think the best advice would be to see a doctor of some sort to get evaluated and get referred to an EP?by Carey - AFIBBERS FORUM
QuoteJoyWin What does such a high level of Troponin mean for me? I've googled and looked at research but can't see anything that high. Also what is AF with RVR? Have I had a heart attack? The troponin level means nothing for you. George explained why. Anti-Fib explained what AF with RVR is. Nope, you haven't had a heart attack. Sorry you had the experience, butby Carey - AFIBBERS FORUM
QuoteJoe Anti-Afib i've been wondering as well - why don't they test the clotting factors/viscosity etc of one's blood prior to prescribing anti-coagulants. Because there are few, if any, studies showing how clotting factors, viscosity, etc. predict strokes, or even if they do at all, so they have no science to guide them and no guidelines to follow. The doctor who decides not tby Carey - AFIBBERS FORUM
I don't understand at all. Tenormin is a beta blocker (atenolol) and you indicated earlier you were taking a beta blocker. Could you email or PM me a list of your current meds to help un-confuse me? If you're concerned about prolonged QRS send a strip along with the meds and I'll have a look. I doubt it's a problem. Ablating the septum had nothing to do with your PVCs, aby Carey - AFIBBERS FORUM
75-100 is a respectable number. It's not in Natale's realm but few EPs are. The success rate of 75% is the average for most EPs with paroxysmal afib (much lower for persistent). I give the EP points for answering with actual numbers. It sounds to me like this guy would probably do a good job. With your age and history I doubt that you're a complex case and as I said before it'by Carey - AFIBBERS FORUM
Why are you taking a beta blocker at all?by Carey - AFIBBERS FORUM
QuoteAB Page His NP claimed he was insistent that I go off the half dose Eliquis I was still on at the one year mark, and switch to low dose aspirin. This seems to conflict with the either/or it's your choice Carey was told. I've never compared the bleed risk between the 2, and I guess there could be other things in my or my family history for him to be insistent on aspirin over ld eliqby Carey - AFIBBERS FORUM
Oh, didn't know about the side effects. That would change things for me too. You can't go wrong with whatever Natale recommends so you'll be good to go. It would be nice if you reported back here later to tell us what he says.by Carey - AFIBBERS FORUM
Quotegmperf I will be doing the second Watchman TEE tomorrow. I have been on 1/2 Eliquis and a baby aspirin since the Watchman placement. Dr Natale did my Watchman. I am hoping tomorrow I can stop the Eliquis. Either way, now stopping blood thinners or aspirin, for tests, surgery, etc, does not carry the high risks it did before the Watchman. Good luck! But I'm sure it will be fine. Iby Carey - AFIBBERS FORUM
There are a lot of cardiologists who think nuclear stress tests are overused and produce far too many false positives. I wouldn't do one either unless they could give me very good justification for it. "Just checking" isn't very good justification. I would ask them to just do a stress-echocardiogram instead. No dyes, no radiation, and it's pretty much the gold standard ofby Carey - AFIBBERS FORUM
I didn't say it was easy to get them to cover it but I've heard from a few who have been approved, and that never would have happened in their circumstances just a year or two ago. I think you'll see them gradually relax the standards in the coming year or two. And I haven't checked the status of this recently but Pradaxa is coming off patent so hopefully there will be a cby Carey - AFIBBERS FORUM