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Your brother in-law is exactly the sort of patient the Watchman was originally designed for; that is, the patient who can't tolerate anticoagulants but who is at high risk of stroke. I think you're getting good advice. Although he may have issues with anesthesia, a Watchman implant procedure is very short. Mine took 20 minutes. I think I would go with his doc's advice. As fby Carey - AFIBBERS FORUM
If you're in remote areas, sure, exceptions might apply, but for the vast majority of people in urban, suburban, and non-remote rural areas driving yourself or being driven is generally a bad idea.by Carey - AFIBBERS FORUM
There really aren't any major restrictions. The Watchman is safe in MRIs up to 3 tesla, which is the strongest MRI you're going to encounter. And that's immediately after implant. I would imagine that once it's been fully endothelialized MRIs are probably fairly irrelevant. The metal in a Watchman is nitinol, which is a nickle-titanium alloy and isn't magnetic. A Watcby Carey - AFIBBERS FORUM
QuoteGeorgeN Somehow they did not have to go through all the admin stuff. It all worked well and he has no perceptible residual damage. Foolish thing for a guy who should know better to do. Maybe being a ski patroller he was known to them or he knew the right things to say, but it's safe to say that's not how it's going to work for regular folks. If he'd called 911 it'by Carey - AFIBBERS FORUM
It's been available in the US for a while and has FDA approval. Not sure what the exact timeline was but I see clinical trials dating back to the early 2000s. It's main limitation at this time seems to be vessel size, meaning it's only useful for large vessel obstructions. Those are the most devastating, often leading to death or a vegetative state, so it's a big advance. Fby Carey - AFIBBERS FORUM
I don't think it's accurate to say it reduces concern. It's more accurate to say that it doesn't increase concern for a highly experienced EP.by Carey - AFIBBERS FORUM
Quotewolfpack Therefore Xarelto has a longer serum half-life. This is something that has long puzzled me about Xarelto. It actually has a shorter half-life than Eliquis so I've never understood how it can be a single dose drug while Eliquis is twice daily. Xarelto's half-life is 5-9 hours in younger patients and 12 hours in the elderly, whereas Eliquis is 12 hours (after repeated dosby Carey - AFIBBERS FORUM
Quotekatesshadow My EP said the Eliquis takes effect 2 hours after taking it. Is that your understanding? It starts taking effect within about 30 minutes. Two hours is when it reaches full effect.by Carey - AFIBBERS FORUM
Just go back to your usual schedule and take the next dose at 9pm tonight.by Carey - AFIBBERS FORUM
I wouldn't go through two 24-hr episodes per month without an anticoagulant. Even with a CHADS 1 that's pushing the risks. However, what I might do if I were in your shoes is take the Eliquis only as needed. I would take it immediately when an episode begins and continue taking it every 12 hours for at least a few days after it stops. I doubt your EP will endorse such a plan, but itby Carey - AFIBBERS FORUM
How often are you in afib and how long do the episodes last? There aren't any significant health problems associated with long-term use of anticoagulants. The only downside is an increased risk of bleeding, but whether that risk outweighs your risk of stroke from the afib depends on several things, most notably how much afib you experience and your CHADS-Vasc score. Don't count the pby Carey - AFIBBERS FORUM
QuoteTeddy Before settling on my final and current career, I was a Paramedic. I was trained using the standard ET tube which requires you to visualize and place it between the vocal cords. This can be a problem and the LMA solves this issue because it is placed above the cords but still protects the airway. Welcome, Teddy.by Carey - AFIBBERS FORUM
Yeah, the bicycle thing was just an experiment. The movement produced too much noise for the readings to be useable. In general you can't get a good reading from any ECG device while you're moving unless you happen to have an exercise stress test ECG.by Carey - AFIBBERS FORUM
Quotewolfpack I, for one, can't hear a thing when I'm using it. The ultrasonic link is susceptible to background noise. I can't get a good reading anywhere but a quiet room. Wind, which is white noise, and bird chirps, which are akin to a wideband frequency modulation, will drive mine nuts. I don't know that you blame the Kardia for that or the iPhone that I use. Could be eithby Carey - AFIBBERS FORUM
Swarup has a very good reputation. I know of several people who've had successful ablations by him. Mayo has an excellent reputation in general, of course, but I don't know of anyone who's been treated at their Scottsdale facility. I would rely on the individual EP's reputation more than the facility's.by Carey - AFIBBERS FORUM
QuotePompon @ Madeline... I'm living in Belgium, Oops! Well, I was close.by Carey - AFIBBERS FORUM
They don't usually go any lower than 100J. There's no benefit to going lower since all that would do is increase the odds of needing additional shocks at higher power, and there's no harm to using a higher setting. The risk of creating a skin burn goes up, but that's caused by a poorly applied pad, not higher power settings. I've had many, many cardioversions. They alwby Carey - AFIBBERS FORUM
I believe Pompon is in France, so probably not Natale. You know you have ectopics because you feel them. An ectopic beat is just a beat that's out of place. They feel like a skipped beat, or a particular strong one, or quite often both. They'll feel like a skipped beat followed by a strong one.by Carey - AFIBBERS FORUM
Well, sotalol was effective for me. I didn't like it much because all beta blockers leave me feeling extremely fatigued, but it did the job. I don't think online polls of groups with a built-in selection bias and trivially small sample sizes are meaningful.by Carey - AFIBBERS FORUM
Sure, that's possible. I'm still astonished at being able to feel atrial beats, but a 5:1 conduction rate is a bit unusual but certainly possible.by Carey - AFIBBERS FORUM
I know what flutter is and I know how to read an ECG.by Carey - AFIBBERS FORUM
We're not arguing and you didn't get off on the wrong foot. We're discussing, not arguing! You're good, we're all good. The thing I can't understand is how you could have an atrial rate of 240 (or whatever) that doesn't transmit to a rapid ventricular rate but at the same time have a normally functioning AV node. Either your AV node transmits atrial beats orby Carey - AFIBBERS FORUM
I very much doubt that Natale would use an inexperienced anesthesiologist. Sometimes sh*t just happens.by Carey - AFIBBERS FORUM
Many of the antiarrhythmic drugs used for afib were originally licensed for use as antiarrhythmics for ventricular arrhythmias. If you look them up and read their formal statements of approval by the FDA (and other countries' agencies), you'll see nothing about afib. That's not a problem. They've been found to be useful for atrial arrhythmias also and so they've been usedby Carey - AFIBBERS FORUM
Well, I guess your tactile senses must be a lot better than mine. Being an EMT for many years I've felt thousands of pulses, and it's not uncommon to be unable to palpate a pulse at the wrist even when there is a normal heartbeat. And that's a ventricular beat, so being able to feel an atrial beat is a pretty astonishing ability. I'm going to go with your 3-5 beats/sec estby Carey - AFIBBERS FORUM
Quotejwb74 This is how it happens: upon my first semi-cognitive moment, I arch up my back, yawning and stretching for 3-4 seconds. When I do this, a brief (less than 1 minute) atrial flutter episode occurs at a rate of about 240 bpm, but NONE of the atrial beats translate to ventricular beats..... You sure about what you're feeling? I've never heard of someone being able to feel aby Carey - AFIBBERS FORUM
QuoteMadMax Thank you - I did realize that it changes, but I didn't know how fast it changes. Did you figure out your range of normal for you, or a way to get your potassium stores where they needed to be? Yes, my normal tends toward the low end of the range, which was unfortunate because the one thing I found that prevented my flutter was keeping myself at the high end of the range. I diby Carey - AFIBBERS FORUM
QuoteMadMax Yes, it's low, it was 3.5 in the hospital when I'm normally 4.5- 5.0. I spent two years measuring my own potassium levels multiple times per day. The thing I learned from that is how fast potassium levels can change. I've seen my potassium levels go from, say, 4.9 to 3.9 in just an hour or two. So having seen how rapidly and wildly it can fluctuate, I sort of chuckleby Carey - AFIBBERS FORUM
Occasionally, yes. NSAIDs are okay for short-term use according to two EPs I've asked about it. Just avoid taking it for more than a few days at a time.by Carey - AFIBBERS FORUM
@wolfpack - Fascinating info I didn't know. Regarding the Kardia, I think requiring a monthly subscription to save more than one recording was a huge mistake for Kardia. It's the device's biggest flaw. The app stores data on your device, not their servers, so it costs them nothing whatsoever to save as many as you want. The few people who will sign up for that service won'tby Carey - AFIBBERS FORUM