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QuoteKleinkp Does the 12 lead tell them where the PVC's are coming from? No, the only thing that will tell them where they're coming from is an electrophysiology study, which means inserting catheters into your heart to record activity from the inside. No type of external ECG can pinpoint exactly where the PVCs are coming from. And, truth is, it doesn't really matter. If you knewby Carey - AFIBBERS FORUM
No, it's not going to tell them that. It mainly just counts events and doesn't provide any sort of detailed diagnostic information.by Carey - AFIBBERS FORUM
My bet would be the metoprolol. Metoprolol (all beta blockers, actually) completely suck the life right out of me. It does that to many people. It feels like someone tied weights to my arms and legs. Simply walking up a flight of stairs becomes a chore. And the flutter won't help, of course. I would tell you to try skipping a dose to see if that's the cause, but since you're onby Carey - AFIBBERS FORUM
Probably because they had to put him on an anticoagulant and wait for any clots that might have formed to dissolve. That's pretty standard procedure for ECV when the patient hasn't been on an anticoagulant. The alternative is to do a TEE prior to the ECV.by Carey - AFIBBERS FORUM
I don't believe they use a contrast agent for the type of TEE we're talking about.by Carey - AFIBBERS FORUM
You weren't as fuzzy as you think. They generally want the TEE at 6 months. A TEE is (or should be*) a trivial procedure. It's a dose of propofol to knock you out and 10-15 minutes of having a tube down your throat while you're unconscious. Total time is maybe 2 hours with an hour of that being prepped (you know, stupid gown, IV, etc) and being bored waiting for the doc to showby Carey - AFIBBERS FORUM
The TEE they require post-LAA isolation is a difficult one with very specific requirement that they've had poor results from using outside providers, even when those providers thought they understood the requirements. You can definitely use a local provider -- that's entirely your choice -- but do so with the knowledge that it may not be adequate and they'll require a repeat so youby Carey - AFIBBERS FORUM
Quotesusan.d Isn’t lifting your bike from horizontal to upright when it was on the ground “lifting”? Yes, but I don't lay my bike on the ground. If I get off it, it gets leaned against something, put in a bike rack, or whatever. Way too expensive to be lying on the ground.by Carey - AFIBBERS FORUM
But how much of your diminished capacity was loss of atrial kick and how much was due to the irregular, uncoordinated heart beat of being in AF? Without question my cardio capacity was also diminished during AF episodes, but I've been in NSR for three years and I know from two TEEs that my atrial kick is virtually gone now due to extensive ablation work. Nevertheless, I can climb hills at thby Carey - AFIBBERS FORUM
Well, you do lose the "atrial kick" during AF, and I've heard that estimated to be as high as 15% of your cardiac output. But I'm a bit skeptical of that number. I've lost most of my atrial kick and I never really noticed a difference in cardio capacity. I'm pretty sure I would notice such a drop if it were real.by Carey - AFIBBERS FORUM
Quotesusan.d I am happy you posted because I have had a nagging curiosity question. Kind of two. You reiterated a story a few times about how you went biking 50 miles in a very challenging terrain after 3 days post ablation. I used to bike. Going uphill was standing off my seat pumping the pedals. That must have had hurt your plug sites something awful after three days post ablation! Yeah? No,by Carey - AFIBBERS FORUM
I ended up with small pearl-like lumps at each insertion site after all but one ablation. They lasted for months, weren't painful, and eventually disappeared on their own. I also experienced a large hematoma after my first ablation that left me limping and taking pain meds for a month because it was pressing against my femoral nerve. But that happened because of a cardioversion a day orby Carey - AFIBBERS FORUM
QuotePompon Does a lower than usual BP while in AFib shows a weak EF ? No, BP and EF aren't closely related until you get to the extremes. A dangerously low EF will also produce a dangerously low BP, but you can easily have a low EF and hypertension at the same time. BP is usually influenced more by blood volume and vascular resistance than EF. If you want to know your EF, you need an echoby Carey - AFIBBERS FORUM
Of course, that's just common sense. But I don't think I've ever heard of an EP imposing an exercise restriction post procedure unless there are comorbidities or complications. There's really no reason for it in an uncomplicated ablation on an otherwise healthy person. The days of convalescing for days or weeks following medical procedures are long gone because it was found toby Carey - AFIBBERS FORUM
Quotesusan.d Carey- you recommend exercise ( jog up and down stairs or hills) after a week post ablation? If he feels up to it and hasn't been told to do otherwise, then yes. I did a 50-mile bike ride in very challenging terrain 3 days after an ablation, and I did it with the EP's full blessing. The only physical restriction I ever followed was the no-lifting for 5 days rule. None ofby Carey - AFIBBERS FORUM
Yes, there's a cause, but no one knows exactly what that cause is. Fibrosis probably plays a big role, but then you get the question of why there's fibrosis, and that can have multiple causes. So for now the generic term atrial myopathy is used.by Carey - AFIBBERS FORUM
I spent years battling flutter and the only trigger I ever found was dehydration and low potassium levels ("low" meaning the low end of the normal range, not abnormally low). It's a very different beast than AF. Flecainide was effective at preventing it for me, but useless at stopping it. Rate control drugs had absolutely no effect on it either. I didn't even bother with metopby Carey - AFIBBERS FORUM
We removed most instances of the word "lone" from this site a couple of years ago for this reason. You'll still find it here and there, but once the site redesign is complete you won't find it anywhere. The original meaning of the term "lone afib" was afib with no concurrent heart disease, but the consensus now is that the presence of afib is itself a form of heart dby Carey - AFIBBERS FORUM
There aren't many ways to get out of flutter. It's often not responsive to rate control and antiarrhythmic drugs, but cardioversion is almost always successful. It may stop on its own, but if it hasn't by morning definitely give the NP you've been assigned to a call. How fast is the rate? If it's super high an ER will likely be willing to cardiovert you.by Carey - AFIBBERS FORUM
If your heart rate is 110 even with a rate control drug then that's not acceptable and your EP is right that something more needs to be done. If you allow a rate like that to continue it will eventually lead to heart enlargement and heart failure. Multaq and cardioversion are a reasonable first course of action to try. Multaq is one of the "mildest" antiarrhythmic drugs available,by Carey - AFIBBERS FORUM
Quotesusan.d Did anyone get a sore heart afterwards? Not a sharp pain-more just sore plus an elbow pushing down? I’m told it’s common but nobody ever posted it. Yeah, some dull chest pain post procedure is very common. It should diminish within a few days.by Carey - AFIBBERS FORUM
Glad to hear it went well. You seem more positive and upbeat.by Carey - AFIBBERS FORUM
The missing link is http://getinrhythm.com/ Thanks Carey for adding the all important link.:-) 👍 Shannonby Carey - AFIBBERS FORUM
QuoteJoyWin Who knows...5 mins ago just sitting outside in the sunshine, ate a peppermint and went into rapid AF. HR currently 140+. Totally has spoilt my day's plans again! In over 20 years I've just about given up on my triggers, altho eating is definitely one of them, so is walking, sitting, sneezing, lying on my left or right side, laughing, excitement etc etc. In other words,by Carey - AFIBBERS FORUM
It's all over the map with ERs. Some do cardioversions correctly with a knock-out dose of propofol and others do stupid crap with conscious sedation using versed, low doses of propofol (as in this example), or even ketamine. If you're going to undergo a cardioversion, demand that they use sedation that renders you fully unconscious no matter what they're using.by Carey - AFIBBERS FORUM
I'd have to see a recording of what you're describing, but I think the difference between constant ectopics and AF is the difference between VERY LITTLE runs of normal beats and none.by Carey - AFIBBERS FORUM
Nothing serious, I hope.by Carey - AFIBBERS FORUM
If you're not at high risk of stroke (LAA isolated, very high CHADS score, etc), you just stop the anticoagulant for the few days the surgeon recommends. For the average person with AF, stopping the anticoagulant for a few days is a trivial risk.by Carey - AFIBBERS FORUM
Well, sounds like you had a rough go of it for a while, but I'm not seeing the problem now. An elevated resting heart rate is perfectly normal and to be expected for many months following an ablation. Your BP is to be envied, even at what you think are elevated levels. I would not be concerned in the least if I were you.by Carey - AFIBBERS FORUM
Quoteshca67 Just talked to my EP...since my rate is in the 80's/90's and I have having minimal discomfort (first time for this!), plus the fact that I ate a banana and a smoothie at 7:30am, they are recommending I take a 20mg Xarelto this am(left over from 1 year ago), and rest today. If the AFIB persists overnight, they will refer me for an ECV tomorrow morning at a cardiologist to avoby Carey - AFIBBERS FORUM