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Assuming they're using a modern CT scanner, the radiation dose is pretty minimal. I wouldn't be concerned with just one scan. A stress-echo would reveal anything major and show if you needed to investigate a possible blockage further, but she might want to see the lungs too since shortness of breath is your chief complaint and it began after a bout of pneumonia. Makes sense to me.by Carey - AFIBBERS FORUM
This is an example of what distinguishes a top EP from an average EP. He didn't just do a PVI and call it a day, which would have left you calling it a failure 2 months from now. He went looking for other sources of afib, found them, and ablated them.by Carey - AFIBBERS FORUM
Thanks for the fundraising boost, George! And please note that PayPal does NOT take a cut from you or us. 100% of your donation goes directly to afibbers.org. We chose them because they offer free payment processing for non-profits and they operate worldwide.by Carey - AFIBBERS FORUM
Isolating the LAA doesn't mean making burns in the LAA itself just as a PVI doesn't mean making burns in the pulmonary veins themselves. It means making burns around those structures, creating a fence that blocks errant signals from coming out of them. So the presence of a Watchman might complicate the procedure, but it doesn't make it impossible, as Susan's second link statesby Carey - AFIBBERS FORUM
Quotejasams My LAA has not been ablated, which is another issue. If I get a watchman now, there would be no way to ablate it in the future That is not true. Where are you getting your information?by Carey - AFIBBERS FORUM
Quoteswhanson You flecainide users....with or without a betablocker/metoprolol etc? Not exactly sure what you're asking but flecainide without a rate control drug such as metoprolol has a potentially dangerous side effect. Almost all EPs will prescribe both of them together for that reason.by Carey - AFIBBERS FORUM
Quotejasams Thanks Carey, So I guess put another way, you feel that a watchman plus OAC is better than either alone. That’s certainly possible. My concern right now is that at age 65, if I’m lucky, I could live another 20-30 years. The watchman is permanent choice and there isn’t any long-term data about how it will perform over time. Why not stay on OAC until I’m older. Perhaps better treatby Carey - AFIBBERS FORUM
Quotejasams While I don’t understand your reasoning for taking eliquis if a watchman puts you at the same risk as someone who never had afib, I respect your decision. My decision to continue low-dose Eliquis had absolutely nothing to do with my Watchman. I consider the Watchman a done deal, water under the bridge that I never need to think about again. I continued low-dose Eliquis for the sby Carey - AFIBBERS FORUM
Yes, I've seen that data and it doesn't concern me. Do the math. Some 10% of Watchman recipients had leaks, and of that group, 68% were 3mm or smaller, which shouldn't be a concern, particularly since 86% had their leak stabilize or shrink in the following weeks. We're down to a very small number of patients who had leaks that would be a concern or that should be closed. (Rougby Carey - AFIBBERS FORUM
We've been over all this. Aspirin for life is not a requirement. It's only a recommendation by the FDA, and many EPs don't agree with it. That's also not the practice in Europe where they generally stop all anticoagulants and anti-platelets after 6 weeks. Here are the protocols from the clinical trial I was in when I received my Watchman. I'm quoting them directly.by Carey - AFIBBERS FORUM
Very glad to hear this, tallguy! Your post is buried on page 5, so don't expect a lot of responses, but I'm glad to hear you've done so well by simply stopping a bunch of meds.by Carey - AFIBBERS FORUM
I don't know the answer to that question and I doubt anyone does, but I would if I were in your situation. COVID has a nasty reputation for increasing coagulation and that may be behind many of its ill effects. I told my wife back in 2020 that she would be starting Eliquis if she became COVID positive, and she has no clotting risk factors at all. The Watchman isn't very relevant becauseby Carey - AFIBBERS FORUM
Yep, those are both good sources. Throw in a kiwi fruit and you've got a potassium bomb.by Carey - AFIBBERS FORUM
I dealt with atrial flutter (AFL) for several years. In my experience, there is no particular time of day when it will start. It starts whenever it wants. The only thing I found that can prevent it is maintaining high potassium levels. Forget over-the-counter supplements because in the US those are limited by law to 99 mg, and that's less potassium than you'll get from a few almonds orby Carey - AFIBBERS FORUM
QuoteCookie24 A person cant just take Eliquis after Watchman procedure instead of aspirin? My question is aspirin required to be taken for a period of time after Watchman procedure? The FDA recommendation is either aspirin or Plavix for 6 weeks following implantation, and then aspirin for life after that. However, some EPs will modify that to use half-dose Eliquis instead of aspirin afterby Carey - AFIBBERS FORUM
QuoteGeocappy Do have a small bullet size hard spot more like a bead in the shape of a bullet. Yeah, that's what I was talking about. It will probably be there a good long while.by Carey - AFIBBERS FORUM
That's a very rare complication, so I'm glad to hear that EP no longer attempts them because they're clearly not in his skill set.by Carey - AFIBBERS FORUM
QuoteGeocappy Do have huge bruise on right groin. Almost foot long. Nothing on left groun You have a hematoma on that side. That means you bled from the insertion site, which is what made that big bruise. Did you break the lifting rule at any point? Gravity will take over and that bruise will keep dropping lower. I had one following my first ablation and at one point it stretched from my gby Carey - AFIBBERS FORUM
Yeah, you'll be fine. Insurance will only balk if you just decide you want one without compelling medical reasons. A poorly functioning LAA is a compelling medical reason.by Carey - AFIBBERS FORUM
LOL! I don't even know what nutsedge is but I'm glad to hear your Watchman is okay and you're not infested with it.by Carey - AFIBBERS FORUM
Quotejasams 2. After endothelialization, no anticoagulant or anti platelet is needed. Allow me to clarify that that's my opinion, and although I think it's based on sound reasoning and medical facts, there is no authoritative source I can provide to support it. So if you go and repeat that to an EP, they may or may not agree since the official FDA position is aspirin for life. But Iby Carey - AFIBBERS FORUM
Quotejasams I haven’t found anything saying that half dose eliquis is safer than low dose aspirin for intracranial bleeding. Certainly eliquis has a better risk-benefit profile than aspirin for afib, since aspirin has very little effect in reducing afib related stroke. The watchman duplicates or betters the ischemic stroke prevention of eliquis, so it’s only the risk of bleeding between eliquisby Carey - AFIBBERS FORUM
I choose to take Eliquis because I'm 66 years old, I have hypertension, and like virtually every westerner over the age of 60, I have mild aortic plaque. (I only know that because the TEE after my Watchman spotted it.) Half dose Eliquis is extremely safe, much safer than low dose aspirin, and the LAA isn't the only source of blood clots in the body. The risk/benefit ratio is very positiby Carey - AFIBBERS FORUM
I have a Watchman FLX, which is the newest model. Will there be a FLX 2 someday? Oh, probably, but that's irrelevant to me because once it's fully endothelialized, which happens within the first few weeks, one model is the same as another. There is no better or worse after that. And I wouldn't expect to see a newer model for years. It took several years just to complete the clinicaby Carey - AFIBBERS FORUM
Quotejasams Carey, I’ve never seen a study saying that a watchman reduces to chance of a stroke to the same as the non-AFIB population, but rather that it’s non-inferior to oral anti coagulation. Is there a study supporting what you wrote. I’m currently scheduled for a watchman in 2 weeks but sort of on the fence about it. Thanks. I've never seen a study that makes that direct comparisoby Carey - AFIBBERS FORUM
GoodRx is legit. I've used it to get a prescription for $15/month that costs $200/mo through insurance. They do what Medicare hasn't been allowed to do: negotiate prices with pharmaceutical companies. Then they market that discount to big chains and take a cut from them for sending the business their way. You might notice that most of the places that take GoodRx and offer the best pby Carey - AFIBBERS FORUM
I don't recall advising you to wait, and I wouldn't. There's no huge rush, so if you have to wait months for a schedule opening that's okay, but I wouldn't just put it off indefinitely. I doubt if anything's going to happen that would make it worse, but it won't get better, and it is true that in general the sooner you ablate, the better. There's an old sayby Carey - AFIBBERS FORUM
I would recommend any EP who has done at least a few hundred of them. It's not the exquisitely difficult art that ablations are.by Carey - AFIBBERS FORUM
Just make sure you get the ECG when you're in one of these episodes. If you're not, it won't be useful.by Carey - AFIBBERS FORUM
QuoteCindy L Carey…..I have been reading your posts for years.You led me to Natale. Any advice on the Watchman, please let me know. Reading for years but you just posted for the first time today. It's surprising how many people do that (I did it myself). When I see the web site stats on how many daily visitors we have, the numbers are in the thousands, but there are only a few dozen peoplby Carey - AFIBBERS FORUM