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Quotekong2018 The question is, could the fast heart rate brought up by hard exercising turn into V-fib? In the absence of structural heart disease, no.by Carey - AFIBBERS FORUM
QuotePompon Carey, Wolfpack, I'm sure you're right saying the best EP can ablate any ectopic he wants. But this supposes any ectopic showing up while the patient is in the room. I'm sure the best EP can make them showing up. But I think it's not that simple. My experience makes me think new ectopics may appear in the weeks or months following the ablation. We're all diby Carey - AFIBBERS FORUM
Quotekbog What % of ectopics would you say Carey.....or anyone else.....come from other than the PV? And... the only way to capture information re: the source is through mapping during an EP study or ablation procedure, yes? When asking doctors whether they will search for additional non-PVI sources during an ablation, are there important ways to phrase the question that might distinguish betby Carey - AFIBBERS FORUM
Quotemwcf Interesting assertion. And as I alluded to as a possibility in my post above (para 6). I’ve never seen it written as such previously - I.e. that a PVI doesn’t only seek to prevent ectopics coming down from the PVs into the atria but also plays a significant role in preventing the re-entrant arrhythmia AF itself. A well-done PVI blocks all electrical signals from the PVs, so that preveby Carey - AFIBBERS FORUM
Quotekbog And geez, I can't imagine many people can afford to pay $40,000 out of pocket for a medical procedure (myself included)!!! I'm happy to hear about how Natale operates... I'm sure that kind of care is a big differentiator to people. I didn't pay $40K out of pocket. My insurance covered almost the entire cost since I had already met my deductible for the year. Generby Carey - AFIBBERS FORUM
Pompon, ectopics can be ablated, but it takes a very skilled EP who knows how to find non-PV sources. I had PACs that would come in a bigeminal pattern (meaning every other beat was a PAC) that would go on continuously for weeks. Three EPs were unable to eliminate them but Natale managed to do so along with two separate flutter circuits and a PVI reconnection. If you consider the ectopics just asby Carey - AFIBBERS FORUM
QuoteElizabeth Really, so you are saying that most coming here are stupid? WHAT?! How the heck did you interpret my comments that way? I said no such thing, meant no such thing, and I don't "stroke" anyone.by Carey - AFIBBERS FORUM
QuoteLarryZ Now I get the edema welts ranging in size from a nickel to a silver dollar. As I said, those are hives. They're a certain sign of allergic reaction.by Carey - AFIBBERS FORUM
Not sure what you disagree about, but do you not get it that not everyone has your knowledge and ability to make sense of it all? Distinguishing between nonsense and useful information isn't as obvious to everyone reading this as it may be to you,by Carey - AFIBBERS FORUM
QuoteElizabeth 5 ablations done in teaching hospitals? They didn't take so it didn't matter whether you asked for the top guy. I had the top guy every time. I've read the procedure reports so I know trainees weren't involved, but yes, your point remains. It highlights what's wrong with ablation procedures today. Just because your EP is the "top guy" in a smalby Carey - AFIBBERS FORUM
What you're describing as patches of edema sure sounds like hives, which are signs of allergic reaction. You need to report this to the doctor that prescribed the Eliquis ASAP. He/she will probably stop it immediately and switch you to one of the other anticoagulants. You really don't want to continue taking a medication you're showing an allergic reaction to.by Carey - AFIBBERS FORUM
Quotejpeters Well, just think how long it takes to go through 6 ablations. Seven years in my case. In fact, my fourth ablation happened in 2014, the same year that Ryan predicted stem cells would soon become the definitive treatment for afib. I wish he had been right and I could have at least enrolled in a clinical trial last year instead of doing yet another ablation, but no clinical trialsby Carey - AFIBBERS FORUM
Quotejpeters Still, I would deem your comment about Steve Ryan "Ryan is speculating rather wildly when he predicts that stem cell injections will become standard treatment for afib" as disrespectful, and ill-informed. I am sure he knows what he is doing without your negative commentary. When someone predicts a treatment will become standard practice with an air of authority and certby Carey - AFIBBERS FORUM
Quotewolfpack I'm curious, in the context of teaching hospitals how does one know if students are or are not on the catheters? That has always been a concern of mine, as my ablation was also done at a teaching hospital although I know for a fact that the EP was the only operator in my case. I wonder if it is in all cases. You ask in advance and get agreement from the EP. All but my last pby Carey - AFIBBERS FORUM
Quotejpeters Let's not get paranoid about reporting research into techniques other then ablation.. Nobody believes that Stem Cell research is currently "ready", but having to remove any mention of it is simply ridiculous. Who are you trying to protect? Seriously? This forum is wall-to-wall research about techniques other than ablation. He didn't say he was going to remove iby Carey - AFIBBERS FORUM
Quotejpeters Not in my experience. I had four TEE's spaced several weeks apart while on Eliquis, and it did almost nothing to remove the clot. Switched to warfarin, and it was gone. One patient's anecdotal experience doesn't outweigh thousands of patients in randomly controlled trials. It's very hard to argue with the data.by Carey - AFIBBERS FORUM
It's important to keep the research in perspective. Repairing heart tissue damaged by ischemia may or may not translate to treating afib. After all, the exact cause of ischemic heart disease is known, but the exact cause of afib is not. Ryan is speculating rather wildly when he predicts that stem cell injections will become standard treatment for afib. That said, I do believe the ultimatby Carey - AFIBBERS FORUM
Quotejpeters The new anticoagulants still lack the research for effective comparison. Effective comparison with what? Do you mean comparisons between them? Although that's true, they're all at least as effective as warfarin and have lower bleed risks than warfarin, so whatever differences might exist between them are probably minimal. The one major difference between them I'm awby Carey - AFIBBERS FORUM
gmperf makes a good point. There are alternatives that might not have the same side effects. There is Pradaxa, Xarelto, and Savaysa, and of course warfarin as a last resort. (Because it's a pain to deal with and it has a higher bleed risk.)by Carey - AFIBBERS FORUM
Yeah, I believe there are several more conditions where warfarin is preferred, but aside from people in those categories I'd be surprised to see an EP prescribe warfarin these days, especially since the DOACs have been shown to have a lower bleeding risk.by Carey - AFIBBERS FORUM
I doubt it's the Eliquis. Are you taking other drugs? A beta blocker or antiarrhythmic perhaps? Those are much more likely to cause fatigue.by Carey - AFIBBERS FORUM
Pradaxa doesn't cause bleeding, but once bleeding begins it can prolong it. In other words, the bleeding isn't because you're taking Pradaxa but the Pradaxa might be making it more of an issue than it would be otherwise.by Carey - AFIBBERS FORUM
Quotejpeters His next option was to send me for Convergent Ablation where they were getting much better results then he was. Natale and other EPs of his stature get much better results than he does and does it without cutting you open. Maze isn't trivial surgery. It requires being put on bypass, and although it tends to be very effective, atrial flutter is a common side effect. I considereby Carey - AFIBBERS FORUM
Quoteggheld Is Warfarin still the "Gold Standard"? That's a good question. I'd say it still is for research purposes but it's being rapidly replaced by the direct-acting oral anticoagulants (DOACs) in routine use for afib. Any study comparing the effectiveness of stroke prevention of a drug or treatment will always use warfarin as the standard because it's so wellby Carey - AFIBBERS FORUM
Pompon, you need to go read Shannon's post again, in particular his last paragraph. An EP who couldn't do an ablation at all because he couldn't induce afib isn't who you should be seeing.by Carey - AFIBBERS FORUM
Quotetraceyf45 I’m sure I am not alone in the feeling that my life has been turned upside down. Oh, trust me, Tracey, you're not alone in that. Here's the reality you're facing now in a very quick summation: Welcome to afib. It sucks. No, you're not going to die. It may feel that way, but if you find a competent electrophysiologist and follow their advice, afib wiby Carey - AFIBBERS FORUM
Quotetsco Carey I'm so glad you are free of any burden ectopics, afib, etc. you are very very lucky and a very rare case. Not my first rodeo and for most of us it's not so cut n dry. Very rare? Well, sort of. You're apparently unaware of my history. Trust me, I know all about failed ablations and partially successful ablations and drugs vs. ablations. We're talking about myby Carey - AFIBBERS FORUM
Quotejpeters Jpeters, he pretty much said that's part of my make-up now. Kind of ignored it. Trust me I am very sensitive to them. I don't think EP's quite know what to do about them, and perhaps don't want to acknowledge ablation had anything to do with the problem. Natale apparently knew what to do about mine. Completely eliminated.by Carey - AFIBBERS FORUM
QuoteThumper This is a big deal; I’ve been planning this vacation with our children and grandchildren for almost a year and really just want to be able to enjoy it without worrying about side effects of new medou's. It’s pretty tempting to just put off making any med changes until after the trip. My biggest concern, however, is my wet macular degeneration. Hi Thumper, welcome to theby Carey - AFIBBERS FORUM
QuotePompon Some afibbers taking a rhythm drug stay in SR for weeks or months between two (possible long) afib episodes. On the opposite, other afibbers have very frequent (and likely short) afib episodes despite taking a rhythm drug. Should they follow the same rule before a procedure? Yes, because the reason for stopping is to prevent the drug from masking afib during the procedure. EPs geneby Carey - AFIBBERS FORUM