Quotemjamesone I'm very happy that your ablation went well, but I think it's a terrible idea to go snowboarding the day after. Your heart needs time to heal and rest from the insult of the ablation on your heart. So with all the time and hard work you put into this ablation, it would be a shame to ruin it by doing too much too soon. A whole lot of people like to say that, and it seemby Carey - AFIBBERS FORUM
Quotemjamesone Thanks. Good to know. Curious why you're still taking Diltiazem as your last ablation was a success? From what I've read -- and personal experience -- it's one of the weaker calcium blockers for bp control only, say versus Amlodipine, which I take. What dose are you on and what is your bp on and off of it, assuming that's why you're taking it. For BP conby Carey - AFIBBERS FORUM
I've taken flecainide and I'm taking diltiazem now. Never had any issues with coffee or alcohol.by Carey - AFIBBERS FORUM
Quotecornerbax What are your thoughts on this? I am thinking My EP who is a specialist and said 80% likelihood In my case NSR would be restored would Be more credible. My thoughts are don't listen to doctors' opinions on ablations if they're not EPs. Seriously, just don't because few of them know what they're talking about but they're not shy about sharing theiby Carey - AFIBBERS FORUM
No, it doesn't prevent NSR from being restored, but it can make it more difficult. An enlarged atrium tends to form fibrosis (scar tissue) and fibrosis promotes afib. So if you undergo an ablation and restore NSR to a heart with enlarged atria, the chances of new sources of afib appearing later are higher. An enlarged atrium can reduce in size somewhat once the things causing the enlargeby Carey - AFIBBERS FORUM
Quotecirenepurzalot Also, I started doing a nebulizer with a few drops of eucalyptus. Why? Inhaling aerosolized oils is usually a bad thing.by Carey - AFIBBERS FORUM
QuoteBrian Also, with regards to persistent Afib, I had heard elsewhere that being in Afib after "24 hours" will cause the ablation to be that much less effective, being after that time, it already caused enough structural/substrate change to the heart. That's not true. Remodeling happens over weeks and months, not hours. One 24-hour episode of afib won't change your chancesby Carey - AFIBBERS FORUM
The majority of people who get an ablation use whatever EP they happen to find or whatever EP the country's health service assigns, they undergo a single PVI-only procedure, and that's it. They're done and afib-free. I don't know how to describe such patients other than "simple cases." These are the people who make cryo look good. Granted, you can't know in advaby Carey - AFIBBERS FORUM
I don't think paying for Natale is cost effective. Verma has a lot of experience and you're a simple case, so paying $45K in "insurance" is a bit over the top. Very unlikely he'll make anything worse. If the Verma ablation doesn't prove successful THEN go see Natale. Pierre Jais probably is the best in Bordeaux, but I don't think he's better than Nataleby Carey - AFIBBERS FORUM
Some thoughts on these choices.... Now that PFA has been approved in the US by the FDA, I would expect Natale to use PFA where appropriate since he's highly experienced with it. Not sure about the others, but I don't believe it's approved in Canada yet. I don't believe your numbers for Natale's annual number of ablations can be right since he does more in Texas thaby Carey - AFIBBERS FORUM
QuoteJoe However, if Care thinks this link is inappropriate then simply delete it. Nope, not a problem. He's asking for evidence-based medicine to support boosters. I'll never have a problem with rational, evidence-based discussions no matter which way they lean.by Carey - AFIBBERS FORUM
I have no experience with COVID, but from what I know of it if I were in your shoes I would continue taking the Eliquis. And I don't know who told you that you can't do activities like hiking while taking Eliquis, but they are just plain wrong. I've been taking Eliquis and other anticoagulants since 2010, and I've been hiking and cycling the entire time. There's no reby Carey - AFIBBERS FORUM
I have an unpublished paper written in 2017 by Natale et al. at Texas Cardiac Arrhythmia Center. In that paper they describe a study they did on patients who had come to them after failing two or more ablations elsewhere. (Anecdotally, the prize winner was a guy who had had 7 ablations, all at UCLA, and all 7 had failed.) There were 305 patients, so it was a reasonably good sample size. They achiby Carey - AFIBBERS FORUM
I believe it's around 40% but that's just verbal information from Natale based on his experience. I've never seen any published studies on the question.by Carey - AFIBBERS FORUM
Quotemjamesone 1. Do you have any idea how often mapping shows the LAA to be the source? Is it most of the time? 50-50? Infrequent? 2. Sort of the same question regarding the closure device? After isolation, about how often does the TEE suggest a closure device is needed? 3. In your case, where "you didn't make the grade" could you have just remained on full dose thinners verby Carey - AFIBBERS FORUM
Although I'm sure they've skipped GA due to necessity or patient preference, both the EPs I named use GA as a general rule. There are reasons beyond patient preference for using GA. It gives them total control over your breathing, for example, which they sometimes need to stop or slow briefly, and it eliminates the risks of things like coughing, sneezing or unexpected movements at inoppby Carey - AFIBBERS FORUM
Quotemjamesone Since you've used him, what is the story with the LAA isolation? Is this something he routinely does for touch up ablations? I ask because my understanding is that it would then require an LAA closure device like Watchman, something not sure I want now. No, he doesn't do it routinely, only when mapping shows the LAA as a source. He doesn't do much of anything blinby Carey - AFIBBERS FORUM
Have you checked your BP when you're feeling the pounding?by Carey - AFIBBERS FORUM
Insurance will depend on what you have. If you're on a plan with a network such as an HMO or Medicare Advantage plan, then it will depend on whether Natale is in network or not. But if you're on traditional Medicare or a private plan that Natale accepts, there won't be any issues. When I did my ablation with him and later my Watchman I had employer-provided insurance so I had to paby Carey - AFIBBERS FORUM
Not me, but I've known a few who have, including a guy who had that and he was in serious pain for a couple of months.by Carey - AFIBBERS FORUM
I've never heard anyone complain of those particular side effects. Most of the DOACs are very similar drugs so if two of them bother you the others might also. But Pradaxa is a totally different drug and might work for you. Ask your EP about it.by Carey - AFIBBERS FORUM
I think you have to reside in the US to buy insurance policies on the exchange, so you would need travel insurance purchased in Canada. The trouble is, most travel insurance is aimed at accidents and emergencies and often excludes preexisting conditions or puts a waiting time on it. For example, have a look at this page. The "Diplomat America" plan is probably the best choice for you, aby Carey - AFIBBERS FORUM
Quoterunner114 Nitro does nothing. Motrin def does. I also had covid each time about a week before my two episodes. But it feels like a constant inflammatory dull ache. Like a sore muscle. Less noticable with activity, much more so laying down. I think you have an answer there. COVID is known to cause myocarditis, and this has apparently been particularly prominent in young, healthy athletby Carey - AFIBBERS FORUM
I don't know since I think everyone doing them during clinical trials were probably all more experienced operators at bigger centers, but I guess we'll find out over the next year or two.by Carey - AFIBBERS FORUM
Have you had a full cardiac workup including a stress test and echocardiogram? Perhaps even a CTA? I know doctors tend to wave off cardiac problems among people in their 20s, but they shouldn't. If you haven't done a full workup, find a cardiologist who will do one. Experiencing discomfort for that long following some minor tachycardia just isn't normal.by Carey - AFIBBERS FORUM
QuoteMeganMN It is literally like clockwork every single night, a switch flips on and I zoom into Atrial Tachycardia and every morning it flips off. No matter what I do, don't do, if I sleep or don't, etc... That's very strange, but it suggests cortisol could be involved. Your cortisol levels drop from morning to evening and then begin rising again at night until they reach a peby Carey - AFIBBERS FORUM
QuoteMeganMN I could certainly look into it. But have to figure out how any other doctor would have better luck inducing? As George suggested, arrange a virtual consult and just ask them. Did the docs who did your EP study administer any drugs during the procedure to try to provoke the AT? I know that Natale uses isoproterenol routinely at the end of an afib ablation when he thinks he'by Carey - AFIBBERS FORUM
QuoteShiny Sleeves "Low sodium" isn't low enough for me. I need no sodium. I add spare pinches to my food but I have to be very very careful or else I get warning beats. It contains no added salt.by Carey - AFIBBERS FORUM
https://news.medtronic.com/2023-12-13-Medtronic-creates-history-with-FDA-approval-of-its-novel-PulseSelect-TM-Pulsed-Field-Ablation-System-to-treat-atrial-fibrillationby Carey - AFIBBERS FORUM
QuoteMeganMN It sounds like my future options are to wait it out, see if it improves on its own, or gets worse. You have more options than that. Go see Natale in Austin or Pasquale Santangeli at Cleveland Clinic.by Carey - AFIBBERS FORUM