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QuoteThe Anti-Fib I am not saying Natale is doing anything wrong, but my take on Natale was that he is aggressive. That his scheme of handling things was aggressive compared to other Ablationists. I am not an expert on Ablationists, but I can see why others might draw that conclusion, and I don't think it's just because of Jealousy. Calling him "aggressive" is meaningless.by Carey - AFIBBERS FORUM
A rate of 160 that looks rather normal could easily be flutter. Any regular rhythm somewhere in the vicinity of 150 is immediately a suspect of being 2:1 flutter. I would wait and see how it goes. If I were in your shoes and the episodes remained short like 15 minutes, I wouldn't do anything about it. If they become longer or more frequent, that's when you do something.by Carey - AFIBBERS FORUM
Been there, done that. You can take ibuprofen; just don't take it long term. A few days, maybe a week at most was the advice I've gotten from multiple docs. It will go away eventually but it will probably take weeks. I found that walking speeds the process, the more the better.by Carey - AFIBBERS FORUM
Because Eliquis is a better drug. It's more effective at preventing strokes and has a much lower bleed risk. That middle line is risk of all-cause mortality. Not sure why it shows up blank like that. The percentages are how each drug compares to warfarin. So, for example, Eliquis reduces stroke risk 21% more than warfarin. I would imagine he might be amenable to switching back toby Carey - AFIBBERS FORUM
Your insurance company is jacking you around. How is it you don't meet this criterion? QuoteSymptomatic paroxysmal atrial fibrillation, and rhythm control is desired (i.e., in addition to rate control)by Carey - AFIBBERS FORUM
You have a documented diagnosis of afib, right? In 2019 that's all that should be required to make an ablation medically justified. Ablation is now considered a first line treatment. Who actually submitted the request to your insurance company? Was it TCAI? If so, talk to them and see about resubmitting the request. If Natale agreed to do your ablation then it is medically justified.by Carey - AFIBBERS FORUM
QuoteJackie Back then, it was warfarin... and I was not told to go back on it... probably because I had resumed the NK. .....but when, years later, the AFib revved up again as flutter, I wasn't on any Rx anticoag and had numerous ECV's... but was never told to resume taking an anticoagulant and I just continued on with my daily NK routine. The Eliquis Rx began as I prepared for ablby Carey - AFIBBERS FORUM
What reason was given for the denial? Is it because it's out of state or are they saying it's not necessary? Whenever I hear an EP label Natale as "aggressive" I write that EP off. It's nothing but jealousy. When I informed my local EP that I was going to have an ablation with Natale, he immediately said I'd made an excellent decision. And he's no slouch himsby Carey - AFIBBERS FORUM
QuoteJackie Liz - Carey - At the time when I reported my news here, Hans thought that more likely, it was the effect of the electrocardioversion that promoted the clot formation. Possibly. Cardioversions have a stunning effect on the heart that can reduce blood flow in the LAA. That's why the standard advice is to continue anticoagulants for a month following a cardioversion.by Carey - AFIBBERS FORUM
QuoteElizabeth The anticoagulants.stop new clots from forming, but doesn't your own body dissolve a clot once it is formed? I will have to say that Shannon had a stroke after his Watchman and he said he was on a natural anticoagulant, I think he said it was Nattonkinase. Of course as Jackie says you need to have the necessary tests of your blood to know how clots can affect you. Yes, antby Carey - AFIBBERS FORUM
QuoteJackie While I received a good report on the CT scan, when I received a copy of the results for my files about 6 weeks later, I saw there was a notation about a clot formation in the LAA. I called the EP nurse to verify and learned that - yes... at that time there was a clot in the LAA.... but apparently going back on the nattokinase dosing that I had done for years prior to the ablationby Carey - AFIBBERS FORUM
Well, maybe Medicare has changed their policy, and I believe the way it works is BC/BS would have to follow the same policies.by Carey - AFIBBERS FORUM
Louise, I'm curious what changed at BC/BS and Medicare that they approved your Watchman. As I said, in the past their policy was to approve the device only for people who couldn't tolerate anticoagulants. Did your EP intervene on your behalf in some way, for example by making a case that anticoagulants were inappropriate for you somehow? Were you at higher risk of stroke because youby Carey - AFIBBERS FORUM
QuoteLouise Carey, it wasn’t Medicare that paid for my Watchman. I realized you didn’t see the “supplemental insurance.” For me that was Blue Shield. I'm still surprised they paid for it. That's a welcome change. Every insurance company I've heard of up until now has taken the position that they'll only pay for Watchman-type devices if the patient can't tolerate anticby Carey - AFIBBERS FORUM
QuoteLouise I have rarely heard of anyone having “one and done” and since I’ll be 70 in June it would be a bad time to have a “first” one. Do you realize that most ablations are one and done? You don't hear about them because the people who have them don't come to forums like this. They just forget about afib, get on with their lives, and never come here. And there's nothing tooby Carey - AFIBBERS FORUM
QuoteLouise I do remember him saying I wasn’t a good candidate for an ablation based on how long I have been in permanent AFIB. A more experienced EP would give you a different answer. Afib can be persistent, but it's never permanent unless you choose to let it be. If you could quiz your husband more about the process of getting his Watchman approved by Medicare, I'd be really inteby Carey - AFIBBERS FORUM
Actually, you should do the opposite. You should eat a bunch of salmon, as much as you can. I don't believe it for one second. It's just food.by Carey - AFIBBERS FORUM
QuoteLouise It was totally covered by Medicare supplemental insurance. That's very interesting. Last time I checked Medicare was only covering LAA occlusion devices for people who couldn't tolerate anticoagulants. Did you have to go through any special approval requirements?by Carey - AFIBBERS FORUM
It never affected me, but I've seen several people on another forum say they're triggered by cold drinks so apparently it's not that unusual.by Carey - AFIBBERS FORUM
I can see why you might think they were connected but I doubt they were. Just be grateful your episodes only happen once per year and keep taking the magnesium. Maybe it will help prevent it from becoming more frequent.by Carey - AFIBBERS FORUM
Magnesium helps but it won't prevent afib. If it did, it would be miracle drug.by Carey - AFIBBERS FORUM
QuoteElizabeth Brian, when I coughed up blood clots a couple of weeks after stopping Coumadin I was not in AF, in fact I had very few episodes of AF during that time which was about 15 years ago. Coughing up blood isn't going to be relate to afib. More likely a respiratory infection.by Carey - AFIBBERS FORUM
Quotekatesshadow From the link provided: "Conclusions: Stroke that occurred after stopping oral anticoagulants, especially NOAC, and was more severe at presentation and associated with poorer outcomes." Not saying I agree with it, but that was the wording used. I did not draw that conclusion myself. In fact, I guess I wasn't clear in my post, but I was actually questioningby Carey - AFIBBERS FORUM
Quotekatesshadow I don't see how this study concludes that Eliquis produces a state of hypercoagulation? Edited to add: Read further and see that study concludes the strokes suffered by those withdrawing from NOAC was more severe. It doesn't conclude that, and the association with stroke severity is weak. Nothing can be concluded from this study. There is no cause and effect shown,by Carey - AFIBBERS FORUM
Quotelizzie My question is, does taking magnesium interfere with these drugs. Nope. Many of us here take combinations of those drugs without problem. A drug interaction checker agrees it's not a problem.by Carey - AFIBBERS FORUM
Don't underestimate the knowledge level of nurse practitioners and PAs. In most cases I'd say you're better off getting followup care from a NP or PA than a doctor. Although they may lack the skill set of the doctor when it comes to the procedure itself, their skill set at followup care is usually superior. Don't expect that you'll get better, more knowledgeable, or diffeby Carey - AFIBBERS FORUM
Quoteanneh this is my biggest fear ncbi.nlm.nih.gov/pubmed/306... The link you posted has been truncated. Can you please post the full link?by Carey - AFIBBERS FORUM
A TEE won't assess the probability of a heart attack, and it's unlikely to detect that you've had one. It might be possible to see evidence of heart damage from a previous heart attack due to abnormal wall motion, but it's not the tool they would use for that purpose. More useful would be a stress test with external echocardiogram, a nuclear stress test, or an angiogram. Basedby Carey - AFIBBERS FORUM
Quotetobherd thanks Carey. We are beginning to wonder if this all makes sense for him though..given his age, poor health overall, and limited if any real progress in rehab. It's a tough decision to make....it would be a big undertaking for everyone, especially Craig - to get him hoisted out of bed, taken to the hospital for testing, then the procedure...and then he has to go on Coumadin orby Carey - AFIBBERS FORUM