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You're misinterpreting those emails. That symposium runs every year, like many science symposiums do. Science and medicine don't stand still, and almost all procedures undergo gradual changes and improvements. That's normal and desirable. Since you have a Watchman and you're on 1/2-dose Eliquis, you really don't have anything to worry about.by Carey - AFIBBERS FORUM
Being on Eliquis before and after an ablation is completely routine and expected. Going into the left atrium is also very routine. They get there by using a needle on the end of a catheter to puncture through the septum, the wall of tissue that divides the left and right atria. The Eliquis creates very little risk for you and in this case it actually lowers your risks. Doing an ablation without iby Carey - AFIBBERS FORUM
They're going to need to catch your arrhythmias on a 12-lead to make a definitive diagnosis between SVT and AFL. AFL is a type of SVT, after all, so distinguishing between them with a single-lead device probably won't be possible. Although ablations for the two would be different, the medical management is about the same. What's also different is SVT isn't usually a prelude toby Carey - AFIBBERS FORUM
QuoteKen Avoiding a stroke is a no brainer. Yep. As I like to remind people, death isn't the worst outcome from a stroke. It gets much worse than that. Incidentally, I've got a similar issue to yours. I'm on Eliquis, but a couple of months ago I developed bursitis under my scapula. Hell, I didn't even know we have bursas there, but we do. It's painful as hell and itby Carey - AFIBBERS FORUM
I'm surprised they let you stop the Eliquis after the PE since if the cause is unknown that means the cause might still be present. And now with afib on top of that I think without question you should be on a full dose of Eliquis. You're greatly overestimating the risk of Eliquis and underestimating the risk of the PE and afib. People get this notion in their head that they'll bleeby Carey - AFIBBERS FORUM
I would recommend a second opinion from an interventional cardiologist.by Carey - AFIBBERS FORUM
QuoteKen My CHADS2-VASc score is 2 (my age of 78). With this, should I be on a blood thinner for life? Probably, yes. It's all a matter of risk tolerance. A CHADS-Vasc 2 is considered moderate-high risk with a 2.2% chance of stroke per year (2.9% chance of stroke/TIA/systemic embolism). That may not sound high but remember, you're facing that 2.2% chance every year. When you considerby Carey - AFIBBERS FORUM
Quoteama1952 VAERS (Vaccine Adverse Event Reporting System) is co-sponsored by the CDC + FDA and has been monitoring adverse effects of all vaccines since early 1990's... You should learn what VAERS is before citing it as evidence the vaccine is not safe and effective. The minute you see someone citing VAERS you know they've been listening to the antivaxxers who intentionally misuse Vby Carey - AFIBBERS FORUM
Quotecornerbax What are your thoughts on all of this in my case? Number 1, I think you're overthinking it. Number 2, I think you're forgetting that as those 3, 5, 10 years progress your valve issues will cause more deterioration in other areas of your overall health. Number 3, I think you're ignoring the mortality risks you face on a daily basis just going about living your life.by Carey - AFIBBERS FORUM
I don't believe arterial blockages can be seen on echo. You need an angiogram for that.by Carey - AFIBBERS FORUM
Sure, anything that indicates heart failure. A low EF is the primary measure, but ventricular wall thickness, motion, and filling time are all important too. But heart failure only increases the risk of cardiac arrest. There isn't really a test that points specifically to cardiac arrest. The things in this world that clearly point to a high risk of arrest are well known by cardiologistsby Carey - AFIBBERS FORUM
Quotemjamesone From what I've read on various forums, the majority now require some pre-testing. If you say so. Just telling what I know from personal experience and the hundreds of people we hear from here. I'm not voicing any opinions on what should or shouldn't be done, only relating what I think is common practice, at least in the US.by Carey - AFIBBERS FORUM
Quotemjamesone I'm assuming you qualified for Flecainide both by ekg and some sort of stress test and/or echo? In addition, Flecainide should be closely monitored by ekg, both before and during treatment, especially with any dose increase or with symptoms as you describe. !/quote] That's the by-the-book answer, but it's very common these days for EPs to prescribe it based on notby Carey - AFIBBERS FORUM
Quotecornerbax You're saying the EP would still be there during the Robotic Surgeries? That would only be the case in a hybrid procedure where they do the ablation at the same time as the Maze. There's no reason for an EP to be present for a Maze procedure by itself.by Carey - AFIBBERS FORUM
Quotemjamesone With a score of O or 1, you would generally not need to take a thinner, even without any type of LAA Closure, or am I missing something here? With an isolated LAA you may need to remain on an anticoagulant even if you're a zero. It depends on how well your LAA continues to pump after the isolation. They generally do a TEE at six months to assess LAA function and if you donby Carey - AFIBBERS FORUM
Quoteswhanson Anyone have data on fluoroscopy times/exposures of different EP for ablation procedures? I have that data for my ablations but it's going to be different for every person and every procedure. Large, overweight people need more power than thin ones, and duration time is going to depend on how long the procedure was and what was done. I don't know how you could ever comparby Carey - AFIBBERS FORUM
Quotecornerbax In my case, if my LAA is completely closed with the AtriClip or Suturing, and my ChadsVasc score is either 0 or 1, would it be fine to discontinue Eliquis at some point? I would think with a complete closure of the LAA and a 0 or 1 ChadsVasc score I could? Yes.by Carey - AFIBBERS FORUM
Quotecornerbax With that said, would an AtriClip from the OUTSIDE still restrict that circulation and increase the chance of clots in the LAA as you stated with the Watchman? No, you're not understanding the point that the Watchman and Atriclip both completely seal off the LAA. There won't be blood flowing inside it at all so there's no way for clots to form. No doubt the bloodby Carey - AFIBBERS FORUM
Quotecornerbax Ahhhh,.... Got lt. Let's say an atria clip Was put the first time around would there Ever be a possible benefit down the line To remove the atria clip and replace with A Watchman? No, that would make no sense at all. An Atriclip cuts off the blood supply to your LAA so it just dies and withers away. There's no removing it. Removing a Watchman is possible but itby Carey - AFIBBERS FORUM
The trouble with these kinds of studies is that anticoagulants prevent clots from forming everywhere in the body while a Watchman (and other LAA closure techniques) only prevents them in the LAA. The LAA is the source of 90% of all afib-related clots, but there's still that 10% that form elsewhere in everyone, even those without afib. So doing direct comparisons between LAA closure devices aby Carey - AFIBBERS FORUM
Quotesusan.d Some say… “Apixaban (Eliquis) was the safest, followed by edoxaban (Savaysa), dabigatran (Pradaxa), warfarin (Coumadin) and then rivaroxaban (Xarelto); the Watchman device ranked last. The Watchman device has been advertised heavily, both to the public, in medical journals, and at medical conferences.Jul 4, 2019” › health I can't find whatever article that came from, butby Carey - AFIBBERS FORUM
Quotemjamesone Just so you know, one difference is that with Watchman, low dose aspirin will be required for life to help prevent clots from forming on the Watchman Device itself. Actually, that's controversial. It's what the FDA says, but many EPs disagree and Europe has always disagreed and it's been in use there longer than here. Two EP Watchman experts explained it to me asby Carey - AFIBBERS FORUM
QuoteKen So, if one has an ablation and no more afib, why is there an increase in stroke risk over the normal population? I was highly symptomatic when I was in afib, so I clearly know when I am not. Maybe the increase in strokes for ablated people is because some continue to have afib, but don't know it. No, it's not because of unrecognized afib continuing. No one knows the answerby Carey - AFIBBERS FORUM
Replacing a Watchman would be major open heart surgery. No one's going to be doing that just to upgrade to the latest model. Besides, after a few months, a Watchman gets covered by your own endothelial tissue. (That's what Daisy meant when she said hers would be fully endothelialized by now.) It literally becomes completely encapsulated by your own heart tissue, and once that happens thby Carey - AFIBBERS FORUM
QuoteDini but I also know statins are not good. I don't think that's an accurate statement. When you look at the actual data available today for modern statins, it's quite the opposite. They are good for people who need them. Their bad rep is based mainly on old statins, old data, and a lot of just plain old rumor and unfounded claims. If you actually want to live longer and yourby Carey - AFIBBERS FORUM
I'm very sorry about your friend, Elizabeth.by Carey - AFIBBERS FORUM
I believe Daisy is right. It's just that they haven't run trials for valvular afib and they would have to do so in order to be able to claim it works for those people. Clinical trials are hugely expensive, many millions of dollars and years of work for hundreds of people. So they have to make a business decision weighing those costs against the expected market. The market of people withby Carey - AFIBBERS FORUM
Quotecornerbax Any reason you didn't have a Watchman done originally When you had the LAA Closed off? Putting in a Watchman during the original procedure that isolated the LAA is dicey because of swelling that could occur from the ablation, which could make the Watchman too big at first but then too small later. Best to let everything settle down first.by Carey - AFIBBERS FORUM
I think the the right-sided numbness is pretty much proof you did have a stroke.by Carey - AFIBBERS FORUM
QuoteDaisy So, getting a top EP trumps getting in faster with a less experienced person. This can't be repeated too many times. Any EP who can do an ablation within 2 weeks isn't the EP you want.by Carey - AFIBBERS FORUM