QuoteElizabeth I don't understand why when a person is on a blood thinner and stops it for a few days that they should stroke, why? Strokes happen to people who are 100% compliant, too. There are no perfect anticoagulants. All of them reduce risk, but none completely eliminate it. A stroke from missing one or two doses is unlikely for most people, but when your LAA has been isolatedby Carey - AFIBBERS FORUM
Your urologist is dead wrong. That 2% number is about right if your LAA hadn't been isolated, but since it was you're at much higher risk if you stop the Eliquis. As rocket mentioned, the usual procedure is to bridge you with heparin, and you can get Natale's office to provide your surgeon with their protocol for that. But stopping Eliquis for weeks would be really, really dangerouby Carey - AFIBBERS FORUM
He is quite possibly the top electrophysiologist in the world. And that's true as a clinician, as a researcher, as a teacher, and above all, as an ablationist. He's who you go to when you've had 7 failed ablations (some guy from LA) or 5 failed ablations (me). He's also who you go to when other EPs tell you ablating longstanding persistent afib rarely succeeds. He ablates it sby Carey - AFIBBERS FORUM
Yep, that's the way to go. You don't want to get tangled up dealing with an insurance company when TCAI employs people who do this every day and know how the system works.by Carey - AFIBBERS FORUM
That cut on your arm wouldn't have been a big deal. Many people really overestimate how much anticoagulants make you bleed (aspirin is worse). Your risk of stroke during and after an afib episode is elevated. I don't believe anyone has quantified exactly how much, but does it matter? The risk that stroke presents to you is far greater than the risk of bleeding. If I were in your shoeby Carey - AFIBBERS FORUM
Of course they're trying to deny the authorization but that's standard for insurance companies. The mystery is why they're asking you for this information. They should be asking TCAI or whoever treated you previously, not you. Call Natale's office and ask them to submit the proof the insurance company wants.by Carey - AFIBBERS FORUM
QuoteMadeline How strict is this every 8 hr thing? Eight hours is optimal but an hour or two one way or another won't do any harm. It's not a real time sensitive drug.by Carey - AFIBBERS FORUM
In other words, the reversal agent for Eliquis and Xarelto usually works.by Carey - AFIBBERS FORUM
Sounds like a pretty normal TEE to me. Nothing to worry about in it. Almost anybody who's had afib for any length of time is likely to have at least a slightly enlarged left atrium, so nothing to worry about there. Ditto with the dilated left atrial appendage. It's a good report.by Carey - AFIBBERS FORUM
Lopressor is a brand name of metoprolol, which is a cheap, generic drug. So I hope your cardiologist didn't really write the prescription for Lopressor when they could have just written it for dirt cheap metoprolol. If they did, ask the pharmacy to substitute. But yes, you need a rate control drug if you're experiencing rates of 120+. But all metoprolol will do is slow the rate. It wby Carey - AFIBBERS FORUM
Quotekatesshadow He told me to live my life, and come back in a year. Best news ever!by Carey - AFIBBERS FORUM
You haven't gotten more responses because this thread got pushed to page two of the threads, and a lot of people don't ever look beyond page 1. But looking at your last post above, I'm sure I responded to that question before. I remember saying the TEE is more accurate and so the previous results were probably wrong about the severe dilation. So did you ask that question twice or sby Carey - AFIBBERS FORUM
I don't know anything about him, but I looked around a bit. Seems to have a good reputation and all, and he's board certified in EP. But judging by his medicare billing data, he doesn't do a whole lot of ablations, and experience is the number 1, 2 and 3 most important qualities in an EP if you're considering ablation. If I lived in NJ, I'd go see this guy.by Carey - AFIBBERS FORUM
I'm not going to kid you. You're not going to have ready access to Natale for advice, discussion, etc. I think you'll find that's an extremely rare thing these days. In fact, if your EP is readily available to consult with you, that probably means they're not very busy, which isn't a good sign when it comes to ablations. My first EP was like that. I could call or emaby Carey - AFIBBERS FORUM
Wow, 2018 was a hell of a year for you! Congrats on the 90 pounds! If I were you, I would call your nurse contact and double check on the Eliquis. I'm very surprised he would clear you to stop Eliquis with a stroke in your history even if he didn't isolate your LAA. The stroke gives you 2 points on the CHADS-Vasc score, which puts you in "probably should be" on AC, and if yby Carey - AFIBBERS FORUM
QuoteMadeline Question for all: Do you think I should switch back to an EP in this group instead of trusting this cardiologist? Yes, without question you should see an EP instead of a general cardiologist. It's not so much a matter of trust as it is expertise in the field that affects you most. I'm not going to say it's dangerous to be seeing a general cardiologist instead ofby Carey - AFIBBERS FORUM
Are you seeing a cardiologist and/or pulmonologist?by Carey - AFIBBERS FORUM
Maybe, maybe not. Daily is a lot of afib, but there's no set number that says more than X will cause heart enlargement and heart failure. How long do the episodes last? One thing's for sure: it's doing you more harm than a dose of metoprolol as-needed would. Atrial enlargement is very likely eventually, and that promotes persistence and makes ablations less likely to succeed.by Carey - AFIBBERS FORUM
Quotewhitehaven not quite sure if there is such a thing as complete obliteration. I've been in 100% NSR for 18 months without so much as a single ectopic (that I'm aware of, and I'm always aware). I wore a Holter monitor for 8 days in 2018 that confirmed not so much as a single PAC. Close enough to complete obliteration for me, especially since I failed 5 previous ablations overby Carey - AFIBBERS FORUM
Hi Nancy, Doesn't sound like much fun. They probably weren't concerned about the afib because your heart rate wasn't very high and it's not a life threatening emergency. The lung issue is a much bigger deal. I hope you can find better care than an urgent care center. Let us know what the pulmonary doc has to say, okay?by Carey - AFIBBERS FORUM
I have, by Natale. Also multiple prior failed ablations by other EPs.by Carey - AFIBBERS FORUM
Yeah, the FLX is still in trials so the only way to get one is to be in the trial. And currently you'd have to be male since this is a second round ordered by the FDA that only includes men because the first trial was too heavily dominated by women.by Carey - AFIBBERS FORUM
It's extremely unlikely that your atria changed that much in two months. The TEE provides a much more accurate view of your atria, so in all likelihood the first echocardiogram was simply wrong. Echocardiograms can vary from operator to operator, and an external TTE will probably always vary from a TEE. I would believe the TEE.by Carey - AFIBBERS FORUM
I would suggest using bookmarks ("favorites") in your browser. When you find a post you want to be able to refer back to, create a bookmark for it and you'll be able to go directly back to it later.by Carey - AFIBBERS FORUM
Just go to airbnb.com and plug in St. David's address. There are a bunch within walking distance, though I bet they're often booked since it's so close to UT.by Carey - AFIBBERS FORUM
I knew he's from NZ and I'm sure their insurance laws are different, but I don't get why there would be a wait like that. Quotewolfpack Poo-pooing the mag is commonplace in the mainstream whitecoat community. Ignore it. This is true. It's all about how well a doctor keeps up with their continuing medical education. I was actually prescribed magnesium by my EP five yearsby Carey - AFIBBERS FORUM
QuoteZb3 I am on health insurance now and my a fib will be covered in 3 years time so could go for an ablation then rather than waiting for the public healthy system. I don't understand this. Why will it take 3 years for an ablation to be covered?by Carey - AFIBBERS FORUM
Vitamin D production from sunlight depends greatly on where you live, the time of day, time of year, and how dark your skin is. Someone living in Canada probably can't produce enough vitamin D from October to April, and in the mid latitudes of the US it's more like November to March. Having the sun directly overhead also makes a big difference. You're not going to produce much in eby Carey - AFIBBERS FORUM
As if he can't take metoprolol at home? This is outrageous. They're flat out lying. There's no way an echo showed a pathway causing the arrhythmia. That's just nonsense and I can't believe they said it. And so what if he's going against medical advice? Their advice is absolute rubbish. I've never seen or heard of a hospital behaving like this. Is this some smalby Carey - AFIBBERS FORUM
Quoterocketritch Unfortunately he never made it past the TEE. He had a mucus block from his years of smoking and sleep apnea that created complications with the TEE. Not sure of the extent but they did damage to his esophagus/throat as a bleed developed so they had to bring in a second specialist from another hospital to address the bleeding. In the end they got the bleeding controlled and he spby Carey - AFIBBERS FORUM