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Why would you pay for brand name Cardizem and where did they get that $40K figure? The highest dosage of brand name Cardizem can be had for about $14K per year paying out of pocket. Generics can be had for about $360 per year, usually paid mostly or entirely by insurance.by Carey - AFIBBERS FORUM
It's also playing with fire if your CHADS-Vasc score is high. Xarelto has a half-life of only 5-9 hours, so after 24 hours you could be below 6% effectiveness. And yeah, anyone who's had their LAA isolated and didn't get passing grades from a subsequent TEE should never skip a dose, not even one. Surgeons are the worst about refusing to be educated about the LAA, insisting oby Carey - AFIBBERS FORUM
It wouldn't be approved if it's not a standard dosage and twice daily isn't. The only dosages approved for afib are once daily. And you have a rather magical Plan D if a 30-day supply costs the same as a 90-day supply and it allows you to switch dosages from the dosage the prescription calls for.by Carey - AFIBBERS FORUM
The left posterior wall is another important source of afib and is often included in a standard ablation procedure by more experienced EPs. It's more dangerous territory because the posterior wall lies directly against the esophagus, so less experienced EPs are often reluctant to ablate it or proceed so timidly that they don't make durable lesions (that's the cause of my multiple aby Carey - AFIBBERS FORUM
QuoteKwilk What is the history of PVI? My impression is that in the early days, the ablation was done inside PV. The downside was that it could cause stenosis, restricting blood flow. The lesion site was moved proximal, which reduced stenosis. Now the lesion is essentially on the atrial wall. Is that correct? Any details or correct terminology? That is correct.by Carey - AFIBBERS FORUM
I can only believe that shape was chosen specifically to thwart splitting. Pill identifier tools like this one don't even have a choice for that shape. They can't claim it was to make the pill identifiable because that could be done with a simple imprint, so why else make it an unusual shape like that?by Carey - AFIBBERS FORUM
You can also crush it and then split it. Pretty easy to eyeball half of a small pile of powder, or you can get a lab scale if you really want precision.by Carey - AFIBBERS FORUM
Yes, afib can occur at almost any age, but it's true that it predominantly occurs after 50 and becomes increasingly common with advancing age, so the literature isn't wrong by saying most afib is in the older population. A lot of the younger onset afib is among athletes, particularly endurance athletes and professionals. In other words, people who spend years subjecting their hearts toby Carey - AFIBBERS FORUM
The database doesn't exist and I don't foresee it existing any time soon, so I echo Ken's comment. I don't understand your point. Sure, if we're going to imagine a non-existent database then we can also imagine that it tracks all the things we could possibly want to know like complications, PAC/PVC burdens, heart function parameters, heart disease, dementia, strokes, qualby Carey - AFIBBERS FORUM
I live in a small town, but it's on the outskirts of a medium-large city, and I included the entire state in my search, which means it included a large chunk of the NYC metro area. You don't get bigger than that in the US. I looked up Blink pharmacies. They sell online and through all the big chains like Walmart, Kroger, etc. They're no mom and pop operation at all. I remain unby Carey - AFIBBERS FORUM
It probably varies somewhat from place to place. I used Google Maps, which I find to be extremely accurate and up to date with things like this. I would know if there was one as close as 15 miles, and there just isn't. Until I did my search I wasn't sure I would find any at all. They just don't exist here anymore.by Carey - AFIBBERS FORUM
I haven't seen a non-chain pharmacy where I live in years. In fact, I just did a web search and there are a grand total of 4 non-chain pharmacies in the entire state, the closest of which is a 1 hour drive away.by Carey - AFIBBERS FORUM
QuoteIn several studies, patients who develop these sustained forms of AF (persistent/permanent) also have higher rates of cardiovascular disease (CVD) morbidity, including cardiovascular hospitalizations and 7 heart failure 11, 12; recent studies suggest that thromboembolism rates may be higher as well. 7, 13 There are data from recent prospective studies suggesting that patients who develop susby Carey - AFIBBERS FORUM
When I needed to replace our furnace, I went online to do my homework on furnaces, and I learned something very interesting about reviews. The first thing I noticed was that almost all the reviews I found were negative. I figure people tend to expect a furnace to "just work" so they're not motivated to post a review when it does what they expect, but they're sure motivated toby Carey - AFIBBERS FORUM
QuoteKen If on a rate control med and blood thinner, how long is too long to stay in afib? People spend decades in afib without harm. My sister spent 25 years in persistent afib and was otherwise perfectly healthy until her death due to unrelated causes. As long as you're anticoagulated and your resting heart rate remains under 100, life expectancy is the same as someone who's neverby Carey - AFIBBERS FORUM
Maybe contact the company and ask them?by Carey - AFIBBERS FORUM
QuoteKen How do we make a list? This forum, and Shannon and I, have wrestled with that question for a long time. I don't believe doctor rating sites have any validity -- they're just popularity contests and doctor bashing sites -- so that approach is out. So if it's not going to be by patient ratings, then what? Do we do the difficult work of contacting possible candidates anby Carey - AFIBBERS FORUM
LOL.... Ask any EMT, paramedic, or ER nurse and they'll all tell you that the biggest sissies when it comes to medical care are the biggest, toughest guys. I'm not kidding. I've had many frail little old ladies just smile and apologize to me for waking me up late at night when inserting an IV, and even more big, tough guys cry like babies at the sight of a needle. It's predictby Carey - AFIBBERS FORUM
Why would you expect that flecainide would make your usually identifiable episodes suddenly stealthy? It doesn't do that. If you were symptomatic before flecainide, you'll be symptomatic after flecainide. I'd say the flec works for you, be grateful for it, and leave it at that.by Carey - AFIBBERS FORUM
I don't think there's any connection whatsoever. Sciatica is all about the sciatic nerve running from your lower spine down to your feet. When something pinches it or irritates it, sciatica is what you get.by Carey - AFIBBERS FORUM
"Touch-up ablation" isn't a medically defined term. It's used a lot, but all it means is a second ablation close in time to the first to deal with "smaller" problems the first procedure didn't resolve. Typical examples would be the afib is gone but flutter has appeared, or afib is reduced but not completely eliminated. It's not a second procedure to deal wiby Carey - AFIBBERS FORUM
Nobody attacked you, and as I said, you don't get to dictate how people respond to you. This is a discussion forum, not a courtroom. I made a few comments pointing out how difficult your request actually is, but you seem to have dismissed that. The idea of making a list of top EPs isn't a new one here and it's more difficult than you think or it would already exist. Yet here you arby Carey - AFIBBERS FORUM
Is the patronizing tone really necessary? You don't get to dictate how people reply to your posts, and chastising them isn't a good way to encourage more answers. I gave you one suggestion, which you ignored. Daisy asked a simple question, which you also ignored. I have some other suggestions in mind but frankly I'm not encouraged to contribute to this thread.by Carey - AFIBBERS FORUM
Really, I'm not trying to be argumentative, but I don't think you realize how influential he is in the field and how much training he's done over the years. Anyone considered a top EP is probably using many/most of the techniques he pioneered. If they learned those techniques indirectly from someone else, do you still consider them a mentee? If so, the list is probably blank. Doby Carey - AFIBBERS FORUM
QuoteKwilk I'll put this in bold so the casual reader at 3am doesn't miss it. I'm particularly interested in learning of notable EPs in the US outside of Natale's circle. That's actually a bit difficult since the EP world is relatively small, and all the top tier EPs know each other, train together, hobnob together at the conferences, and collaborate in research. If yoby Carey - AFIBBERS FORUM
I second Cookie's nomination of Santangeli. I have a few more in mind that I'll add to this thread when I get time.by Carey - AFIBBERS FORUM
Sorry, but it means they're not accepting new patients. If something happens that changes their needs for new patients then they'll change the status and notify participating centers.by Carey - AFIBBERS FORUM
You're mixing some things up that don't go together. An isoproterenol challenge is done at the end of every ablation by well trained EPs. The purpose is to provoke afib if it's lurking somewhere and didn't reveal itself during the procedure. It has nothing to do with the LAA. As I said before, the LAA is isolated only if it shows itself to be a source of afib. It'sby Carey - AFIBBERS FORUM
You don't need to taper off flecainide or diltiazem. You can just stop them cold turkey without harm. But they really should have given you a bit more instructions. There does need to be a gap between the flecainide and sotalol, perhaps a day or two. So I would continue what you're doing now until you can speak with them and get an actual plan in place. Just telling you they're goiby Carey - AFIBBERS FORUM