QuoteAmara My symptoms are constant and torturous at times, so waiting even a few months is hard to imagine. I understand. Trust me, I understand all too well in a very personal way. But your local EPs have already proven that they can only prolong your torture and maybe even add to it. Every unsuccessful ablation you undergo makes the next one more difficult. Please deal only with the elite EPby Carey - AFIBBERS FORUM
QuoteAmara Gloaming, To your point, I had 3 ablations in a 12-month period of time all by different EPs. The first 2, completely failed ablations, the EP did not have the expertise for my issue so had nothing else to offer me. The third has not given up and will likely offer me another ablation if I agree, and it will be within the 12-month period. If I decide to stick with him, I would agree toby Carey - AFIBBERS FORUM
I haven't seen any results from that trial, but my understanding is PFA makes better ablation lines than RF because the EP doesn't have to be concerned with over-burning or heating adjacent structures like the esophagus. That's why a lot of less experienced EPs have high failure rates. They're afraid of doing harm, so they don't burn long enough. That's exactly why wby Carey - AFIBBERS FORUM
What George said. Cleveland Clinic is simply wrong. Originally flec was only used for ventricular arrhythmias, but it has been used for afib off-label for decades. They're just parroting what flecainide's official FDA approval says, which dates from 1985. I can virtually guarantee that section was written by a content creator, not a doctor or pharmacist. I've done content creatiby Carey - AFIBBERS FORUM
Outright asking for cardioversion might have worked, but ER docs tend to be reluctant to do them. Lots of possible reasons with not being a cardiologist ranking high on the list. I encountered one ER doc who wouldn't do anything until he got someone from cardiology to come down and hold his hand (that took an hour). Another reason may be the hospital's policy on anesthesia. Most ER docsby Carey - AFIBBERS FORUM
I can sympathize with how you felt during that metoprolol overdose they gave you. I had a similar experience once. Now you know what cardiogenic shock feels like. If I were you, I would go ahead with an ablation, but not necessarily with the cardiologist you're seeing. First off, are they a board certified electrophysiologist (EP)? If not, do not proceed. Second, how many afib ablations hby Carey - AFIBBERS FORUM
QuoteJohnnyk80 Thanks Carey. I'm think I'm just starting my 30 days of fear regarding this upcoming ablation. I am curious however what causes the incidences of flutter post ablation? Are there any signs that an EP Can look for to discern if the patient may run into flutter? If so, would they tell the patient? Flutter is usually caused by a barrier to electrical conduction in the atrby Carey - AFIBBERS FORUM
Cardioversion is exactly what should have happened, and for her to modify your prescription was over the line. The job of an ER is to stabilize you and prevent you from dying. That's it. My advice in the future is just follow your EP's instructions and don't go to the ER. Relax, stay home, and wait it out. Your experience with an ER is always going to be iffy and it's goinby Carey - AFIBBERS FORUM
I'm not sure what results you're referring to but there's nothing about isolating the LAA that makes flutter more likely, nor is it a more dangerous procedure. It's pretty simple, really. If the LAA is a source of afib, you can either ablate it or have a failed ablation. All the PVIs in the world won't stop afib that is coming from somewhere other than the pulmonary veinsby Carey - AFIBBERS FORUM
Quotebneedell thanks..so that means if I am controlling it with diltiazem it also won't show up on an ECG? But apparently you're not if you're having tachy episodes. Also, flutter is notorious for being resistant to rate control drugs, so that just kind of adds to the suspicion. You need a 12-lead ECG during one of these episodes. That's the one and only diagnostic testby Carey - AFIBBERS FORUM
The first three months after ablation can be a rocky road. You're good. Shrug it off.by Carey - AFIBBERS FORUM
If you're not in an episode when they take the ECG then they won't see it. This is the hard thing about paroxysmal episodes. How do you capture the 12-lead they really need when you can't predict when it will happen? Frankly, the easy answer (at least in the US) is an urgent care center. Almost all of them can do an ECG. So if you find yourself in an episode, drive straight to theby Carey - AFIBBERS FORUM
With SOB something is definitely going on. You need a 12-lead during the tachycardia. It could very well be flutter, and that's important to know. Even the device the doc is recommending probably won't be able to distinguish between sinus tach and flutter.by Carey - AFIBBERS FORUM
That study has come under a lot of criticism. I haven't read it myself, but it's not being well received by the science community. That said, I don't consume fake sweeteners at all and never have. If I can't afford the calories of a natural sweetener then I don't need whatever it is. I consider Gatorade, Body Armor and all those other supposed "sports drinks&quby Carey - AFIBBERS FORUM
You can probably forget about disability pay. I doubt you'll even meet the requirements for short-term disability for an ablation. If you have a physical job involving heavy lifting, you'll be off work for one week because you'll be limited to lifting no more than 10 pounds. If you have a job that doesn't involve lifting, you'll be off work for two days (one day fby Carey - AFIBBERS FORUM
Quotesldabrowski How do you find out the success rate in any of these tables? Good question. The only way I know of to obtain success rates is to ask the EP directly. Obviously, that's not useful as a broad screening tool.by Carey - AFIBBERS FORUM
How fast is it and are you sure it's sinus tach and not flutter? Has your EP seen a 12-lead ECG of it?by Carey - AFIBBERS FORUM
Not keen on taking journalists' interpretation of scientific studies, so I went to the study itself. Diet and nutrition are always so back-and-forth, and I'm not sure how reliable this study is, but if I were at heightened risk of stroke, I would take this to say it's time to eliminate erythritol from my diet until this study is answered. Emphasis is mine. MACE stands for maby Carey - GENERAL HEALTH FORUM
That was a large study and those are very impressive results. The risk of death was reduced by almost 50%, and the risk of stroke was reduced by about 35%. That's big. Huge, actually. I didn't read the full paper but the quality of the journal suggests the study was well done. I think that's going to have an effect on the thinking of doctors, insurance companies, and governmentby Carey - AFIBBERS FORUM
I must say I'm surprised that any EP would prescribe digoxin for afib in 2023. It's a dicey drug with a very narrow window between the effective dose and toxic dose. And like you said, it does the same thing the diltiazem does, so what's even the purpose?by Carey - AFIBBERS FORUM
I know the names of most of the top EPs in the US and none of them appear at the top of any searches I ran. What does this tool use as a criteria for ranking doctors?by Carey - AFIBBERS FORUM
Not sure where you read that vagal afib is unlikely to progress, but I don't believe that's true.by Carey - AFIBBERS FORUM
Please allow me to be frank.... Her first doctor was correct and her second doctor hasn't learned anything since med school. Stop the damn digoxin, continue the diltiazem and Eliquis, and go about about her life in comfort knowing she will live as long and as well as someone who doesn't have afib. As long as the diltiazem keeps her rate consistently under 100 bpm, she doesn't haby Carey - AFIBBERS FORUM
Interesting stuff. I have long believed that the cure for afib will come from gene therapy or biologics of some sort. It won't be drugs or surgical. I wouldn't count on anything reaching the human sphere within 3-4 years, but 10-15 might be possible.by Carey - AFIBBERS FORUM
Sometimes SVT can be terminated with a Valsalva maneuver. Here's an explanation of how to do it. You can also try immersing your face in cold water. It doesn't work for everyone, but it works for many. And since it's a 100% safe*, simple, and free way to terminate SVT, it's worth giving it a try. * Don't do it if you have retinopathy or you've recently had cataraby Carey - AFIBBERS FORUM
That's a new one to me and a quick reading about it seems to suggest your doc is running out of options to offer you. It's not particularly dangerous or anything, but it's just not commonly used.by Carey - AFIBBERS FORUM
Linda, Sounds like you've developed what's generally referred to as SVT. There are two forms of it and it's similar to atrial flutter but not quite the same cause. Fortunately, it's usually easier to deal with. I'm sure Dr. Natale can set you straight.by Carey - AFIBBERS FORUM
Hmmm.... Saying it's tachycardia means only that it's over 100 bpm -- nothing more. Tachycardia isn't a distinct diagnosis and can be caused by many things. Is your cardiologist an EP? If not, I would reserve judgement until you hear from an EP who has seen a 12-lead from you.by Carey - AFIBBERS FORUM
Quotejasams One side effect of any DOAC is a brain hemorrhage -- leading to severe disability or death. The longer one stays on a DOAC, the more likely this side effect will happen. Carey, you are convinced that your watchman obviates your need for any anticoagulant, yet you still take one. Of course, that is your choice, but, if as you believe, your watchman results in your risk of stroke beiby Carey - AFIBBERS FORUM
That study seems to assume that the pulmonary veins are the only source of afib. They are not. The ones who failed the redo probably have afib sources outside the pulmonary veins so no amount of repeating PVIs will ever help them.by Carey - AFIBBERS FORUM