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For those who are curious, you can calculate your HAS-BLED score here.by Carey - AFIBBERS FORUM
The Inuit would be highly amused to hear this.by Carey - GENERAL HEALTH FORUM
Ablation is the only realistic long-term treatment for WPWS. Antiarrhythmics can be used just like with afib, but who's going to put an 18-year old girl on amiodarone, flecainide, etc. as a long-term solution? She could potentially live another 80+ years! Does Natale handle WPW cases? I'm sure he does. He's an EP, and treating WPW is in any EP's arena, but I doubt she specificby Carey - AFIBBERS FORUM
What George said. You can eat 25 cups of spinach per week if you want while on Eliquis, and there's no reason to space anything out. Vitamin K just doesn't matter with Eliquis and the other NOACs. Spinach up!by Carey - AFIBBERS FORUM
Chlorella is high in vitamin K, so it can be problematic with warfarin. That's not to say you can't take it with warfarin. You can, but it's like eating spinach salads. You just have to be consistent about it. But it's no problem at all with the Xarelto and the other NOACs.by Carey - AFIBBERS FORUM
QuotePoppino Thanks George. I believe ive heard the Natale Group brings you back after a period to TEE the Watchman for this exact reason. Leaks But 90% is still decent but you’d expect a complete seal and yes staying anticoagulated until no leak is confirmed may be the protocol. Doing a TEE at 9 weeks post-procedure is the standard FDA protocol. The protocol is aspirin plus anticoagulant forby Carey - AFIBBERS FORUM
Just to be clear, AV node ablation is a procedure of last choice. It will definitely prevent all atrial arrhythmias from affecting your heart rate, but the price is you'll be completely dependent on a pacemaker for the rest of your life. And it won't get you off anticoagulants because your atria will remain in afib (or flutter or whatever your particular arrhythmia is). It's just tby Carey - AFIBBERS FORUM
They'll want to do both a monitor to see if you're reliably in NSR and also a TEE to assess your LAA function at six months. If you're reliably in NSR but your LAA isn't pumping adequately, you become a candidate for the Watchman. The TEE can't easily be done in one trip with the Watchman procedure itself simply because results don't come back immediately, so thereby Carey - AFIBBERS FORUM
I'm going to take a guess and say somewhere in the neighborhood of $20K, but I could be way off. I'll see if I can find out. St. David's can usually quote the out-of-pocket cost of procedures because they do a lot of procedures for non-Americans who are paying out-of-pocket.by Carey - AFIBBERS FORUM
QuotePixie Do you put much faith in Healthgrades as a way to rate doctors? Almost none. I base that on having looked up the doctors I have direct experience with and finding their ratings totally off the mark. I'll explain why, but first I think there's a misunderstanding. I took at look at Lakkireddy's rating on healthgrades and he shows very high on the scale of treating suby Carey - AFIBBERS FORUM
Quotesusan.d Invasive open heart/breaking ribs surgical procedure right? No, I think you're thinking of the AtriClip. That can be done during open heart surgery or also by minimally invasive methods (but "minimally invasive" is used loosely here -- it involves opening several holes in your chest). The Lariat is truly a minimally invasive procedure. They insert two catheters:by Carey - AFIBBERS FORUM
The Lariat has been around quite a while (FDA approved in 2006), so this isn't a trial of a new device. This is comparing using the Lariat prior to a standard PVI ablation vs. just doing the PVI alone. I think there's a very good chance the trial will improve success rates of the PVI because isolating the LAA is key to solving persistent afib in many patients. To my knowledge Nataleby Carey - AFIBBERS FORUM
QuotePixie GeorgeN, you mention that many fellowship programs do not train EP's to isolate the LAA. Do you think that is because of what my EP said about differing EP opinions in the community because of the risks? That's part of it, but it's primarily because isolating the LAA is a fairly new procedure that's limited by a relatively few number of EPs qualified to train otby Carey - AFIBBERS FORUM
Those are exactly my reasons for wanting a Watchman. Expecting to live another 20 years without ever needing to stop an anticoagulant for medical reasons is obviously unrealistic. And then there are all the other possibilities such as losing or forgetting your meds when you're somewhere they can't be promptly replaced, being seriously injured, being unable to communicate to doctors whoby Carey - AFIBBERS FORUM
QuotePoppino I think its 40% can get off and 60 cant approx percentages. That is correct.by Carey - AFIBBERS FORUM
QuoteTony in Boston now I am getting 6L Kardia readings of 40-70 BPM while resting. Don't know what to make of that? Normal rhythm is what I would make of it. The 40 is because sotalol is a beta blocker so it will slow your HR. It's not surprising the sotalol didn't convert you because flutter tends to be resistant to conversion by antiarrhythmic drugs. They're much betby Carey - AFIBBERS FORUM
For Pixie's purposes, Lakkreddy would be the only one in the midwest.by Carey - AFIBBERS FORUM
You know, not everyone is clearly vagal or clearly adrenergic. Many (maybe most?) people are mixed, so if you can't decided which you are, that could be why.by Carey - GENERAL HEALTH FORUM
Quotesmackman I worked with them for at least 2 weeks on and off but I was told I would not be approved as long as I could handle a NOAC like Eliquis. How long ago was this? I know of several people who've received a Watchman in the last 12 months who were doing just fine on Eliquis. They had an isolated LAA and inadequate function, and that was sufficient for approval. I believe all wereby Carey - AFIBBERS FORUM
I wouldn't be concerned with being taken off the list because this is something I don't think you want to do now or anytime in the near future. So I would just cancel and do what your EP said: Carry on with the PIP and wait to see if it gets worse. If it does, that's not likely to be anytime soon enough that being on that list will matter.by Carey - AFIBBERS FORUM
I absolutely would not have an ablation if I were you. I would wait until the episodes start becoming more frequent or longer lasting. This pattern you're in could continue for years, or even the rest of your life, so what's the rush? Plus, pulsed field ablation is a new technology that's in clinical trials now and is very promising. It's much safer because it doesn'tby Carey - AFIBBERS FORUM
Quotesusan.d I would think the right side is more difficult because one has to make sure not to overheat the AV otherwise they are on a path to getting a pacemaker. Avoiding the AV node is easy. A right sided ablation is much easier because it doesn't require a septal puncture, there are no pulmonary veins, and it's not up against the trachea.by Carey - AFIBBERS FORUM
QuoteLenlec Because my ep said he thinks it’s the right thing for me I apologize if you've provided this elsewhere, but can you give us a summary of yourself? How old are you? Any other medical conditions? What drugs do you take for the afib? How often and for how long are you in afib? All the time or only some of the time? Do you experience symptoms when you're in afib?by Carey - AFIBBERS FORUM
Sometimes it is possible to tell, but not always. Most likely he was pretty sure, but not 100% sure.by Carey - AFIBBERS FORUM
QuoteLenlec My resting heart rate is 42 to 45 beats per minute at the mo. Run most days gym at night Just don’t want it going to 60 or. 70 Feel great Do I have the ablation? That's not what you should be basing your decision on. A temporary increase in resting heart rate does you no harm so who cares? If you feel great, why are you having an ablation?by Carey - AFIBBERS FORUM
QuotePixie What questions should I be asking about these results? Not much to ask, really. Like Wolfpack said, right-sided is usually easy to ablate, left-sided can be difficult, and the only way to be sure which it is is to get a catheter in there. My local EP was also unsure if my flutter was right- or left-sided because he just couldn't be certain from EKGs despite having dozens of themby Carey - AFIBBERS FORUM
That's what George linked to. Just click his link to go right to the message.by Carey - AFIBBERS FORUM
Nobody had any pull. It was just being at the right place at the right time to be able to get into the last few slots open in the trial, and meeting the criteria for being accepted. It also required paying for multiple trips to Austin, and then undergoing a bunch of followup exams. It's likely you could qualify for a Watchman now. The criteria in 2016 were hard to meet. You had to be unabby Carey - AFIBBERS FORUM
QuoteGeorgeN Is this what you are looking for? Yes, thank you!by Carey - AFIBBERS FORUM
You can type the last name plus a space and then start typing the first name. A list narrowed down to matching what you've entered so far will appear.by Carey - AFIBBERS FORUM