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I don't think you're going to have much luck giving a doctor a list of tests you want, especially not in a managed care system. You're going to have to be quite the diplomat to convince them to follow the orders you want instead of the orders their training and the health care system's guidelines tells them you need. But if you're going to give it a shot, here's whatby Carey - AFIBBERS FORUM
Everyone has ectopic beats (PVCs and PACs). What distinguishes normal from abnormal is the number of them. If they're frequent enough for you to notice them and be bothered by them, then that's not "normal." But it's also nowhere near enough to be concerned about. Doctors will tell you there's really nothing to be done about them until you're having upwards of 2by Carey - AFIBBERS FORUM
QuoteNotLyingAboutMyAfib About 100% sure carbs and glycation* led to my AF so if I had been paleo - ancestral - sapien - carnivore - low carb - whatever you want to call it , I wouldn't be here. I doubt that very, very much. Billions of people around the globe eat hundreds of different kinds of diets, so it's certain that many others out there have followed diets similar to yours. Aby Carey - AFIBBERS FORUM
I think it's pretty much locked in. I suppose if you have flutter with a normal rate (<100 bpm), it's possible that exertion could increase it, but it never worked that way for me. I experienced flutter at several rates over the years, one of them being 120, and I actually tried to get my HR over that with exercise because I'd found that exertion could sometimes terminate my fasby Carey - AFIBBERS FORUM
If you have bradycardia then the only drug options would be antiarrhythmics, but those all come with side effects and some are quite expensive. Are you sure these episodes are really just PACs and PVCs rather than AF?by Carey - AFIBBERS FORUM
QuoteNotLyingAboutMyAfib Does Dr. Natale use this technology or similar to help him target where he ablates? (maybe Shan knows) No, not likely. He targets where to ablate based on where the AF is actually originating from, and that's not necessarily going to be areas with more fibrosis.by Carey - AFIBBERS FORUM
Just based on the regularity of the rhythm and the rate hovering around 150, it's probably atrial flutter.by Carey - AFIBBERS FORUM
Fibrotic structural remodeling as the basis for AF has been well accepted for a number of years now. Nothing new in the first two paragraphs of the quote. The last paragraph perhaps adds new low-level details, but it's only hypothesis at this point.by Carey - AFIBBERS FORUM
Quotetmac52 Carey, after your Watchman implant, did you notice any difference in your energy level or endurance? I recall reading somewhere that because closure of LAA results in slightly less blood volume getting pumped to the body by the left atria, that could impact energy level or endurance. If one is considering getting the Watchman (like me), it would be good to know if closure of the LAA mby Carey - AFIBBERS FORUM
drugs.com is your friend in these sorts of situations. QuoteWhat happens if I miss a dose? Take the missed dose on the same day you remember it. Take your next dose at the regular time and stay on your twice-daily schedule. Do not take two doses at one time.by Carey - AFIBBERS FORUM
QuoteKen Could the blanking period last 5 months? No. The blanking period is generally accepted as being 3 months. That's not a magic number and it's actually somewhat arbitrary. It's simply the period of time that the scars from an ablation take to fully form and become permanent barriers to AF. So AF episodes during the 3 months following an ablation aren't considered to iby Carey - AFIBBERS FORUM
QuoteNotLyingAboutMyAfib Aren't you supposed to take met suc or diltiazem to act as channel blocker before taking flec? Maybe that's why it isn't working. Just straight flec? "administration of flecainide (with a beta blocker or nondihydropyridine calcium channel blocker administered at least 30 minutes prior to flecainide)," No, that's not why it didnby Carey - AFIBBERS FORUM
Maybe, but I can't count how many people have said "X is a trigger for me" and when I ask why they think so, they report a single incident in which AF followed X one single time. Or often they've never even experienced it; they've just been told X is a trigger. Caffeine is a great example. Doctors have been telling people with AF to avoid caffeine for decades, but thereby Carey - AFIBBERS FORUM
QuoteMac I've seen AN post on Twitter that BCBSTX won't approve current Watchman. That’s a little troubling for those of us who had our LAAs ablated based on the Watchman being available. Something's screwed up at BCBSTX. Almost all insurance companies follow the policies of Medicare, which are basically that they'll cover LAA occlusion devices but only as a "by Carey - AFIBBERS FORUM
Quotesusan.d You are right Carey but it still can pose some issues to someone. Every drug lists side effects as well but that doesn’t stop those on Eliquis etc. One needs to make an informed decision. I like being transparent and know what risks are possible. Wouldn’t you want to see the list or are you ok with just jumping in to get the procedure? I've got no problem with posting a listby Carey - AFIBBERS FORUM
Quotecolindo Are you taking MSG? That is big no no. It's a definite trigger for Afib. MSG may be a trigger for some people, and I thought I was one of them until I actually tested it. I went to the store and bought a container of "Accent," which is pure MSG. I dissolved a full tablespoon in a glass of water and drank it. Nothing happened. Felt a little flushed maybe, but thatby Carey - AFIBBERS FORUM
Metoprolol and diltiazem aren't antiarrhythmics, so it's no surprise they didn't work as a PIP. They'll keep your heart rate down, but they won't put you back in normal rhythm. And I don't know how much time you allowed between the Multaq and flecainide, but I'd be extremely careful about mixing antiarrhythmics.by Carey - AFIBBERS FORUM
Quotesusan.d Do you want blood flow through your LAA? I guess you do otherwise instead of a watchman they could surgically close off the LAA. No, absolutely not. My LAA is completely sealed off from blood flow now and has been for two years. That's the whole point. That fabric isn't intended as a filter that allows blood to keep flowing through it. It's a barrier to keep clots inby Carey - AFIBBERS FORUM
QuoteGill A while back I asked my EP about FIRM. He said, with a wry smile, "There have been many false dawns". Yeah, been there, done that, and all I got was a 12-hour procedure and some utterly useless extra scars. It was 2014 when FIRM was being touted as the greatest ablation tech ever devised. Now in 2020 it's largely discredited.by Carey - AFIBBERS FORUM
Quotesusan.d Carey- uneducated question-if one gets this implant which acts like a metal sieve to catch blood clots, what eventually happens to the collected blood clots? Do they accumulate in the fine mesh net until the screen mesh is clogged up with clots? I assume the purpose is to get off Eliquis- so one doesn’t have a blood thinner to dissolve the clots. That's close but not quite howby Carey - AFIBBERS FORUM
QuotePompon Isn't atrial fibrillation a problem with the autonomic nervous system ? I don't say a nerve ablation would be a cure, but it seems logical treating the nerves when the problem is vagal tone. It's not known with certainty what the cause is, but the autonomic nervous system isn't the leading candidate. The ANS can certainly be involved in triggering AF, but triggby Carey - AFIBBERS FORUM
Most insurance companies and Medicare aren't approving Watchman devices unless the patient meets strict requirements like having serious bleed risks, can't tolerate anticoagulants, has an emergency need, etc. I don't see the FLX itself changing that on its own. But I do think their thinking will come around in the near future, but that's going to take data that's not avaiby Carey - AFIBBERS FORUM
So it's a nerve ablation rather than an atrial ablation. Quote“Our technology involves using a catheter to deliver short pulses of electrical energy into the clusters of neuronal cells in which the arrhythmia originates. It destroys these cells without damaging the heart muscle and as such will provide a safe, durable and long-term solution for the treatment of AFib. You wouldn'tby Carey - AFIBBERS FORUM
QuoteMac Approved by the FDA yesterday. My understanding is for insurance it requires a CHADS Score of 2, instead of 3 like the old one. I hope that’s true. That's great news about the approval. I had my last telemedicine interview with Rodney Horton, the lead researcher at TCAI a couple of days ago, and he indicated approval was imminent, but I didn't think it would be this soon.by Carey - AFIBBERS FORUM
You're never going to identify flutter with any device that only has lead I, which would be all devices that read from the fingers or wrist. You need to be able to see flutter waves and that requires leads II, III, and/or aVF. Flutter waves are really just extra P waves in between each beat, and P waves are nearly impossible to see on devices that measure from the hand or wrist. Using the Kaby Carey - AFIBBERS FORUM
Water retention is a known side effect of calcium channel blockers (CCB ), which is what Cardizem is. It doesn't happen to everyone, just some. I used to take amlodipine (another CCB ) for hypertension but it caused swollen ankles due to the water retention so I stopped. So it's likely that 7 pounds is all or mostly water. Don't worry, it will gradually go back to normal if you stiby Carey - AFIBBERS FORUM
QuoteJoyWin Hi All, with the greatest respect for your knowledge and helpful comments over the years , I’m also interested in your (Carey’s ) comment about ablation. Has something occurred that has changed the way you feel about the procedure? No, not at all. For most people who have paroxysmal AF that is symptomatic, ablation is currently considered first-line treatment and I wholeheartedly eby Carey - AFIBBERS FORUM
I've been cardioverted 15-20 times. It's been early in the first hour of the episode and as long as 5 days. With the way cardioversions work, it's not going to matter whether you're early or late in the episode. It will either work or it won't. I don't know if 24 hours is going to be your new normal, but progression of AF is the norm, not the exception.by Carey - AFIBBERS FORUM
Quotewalt I do have sleep apnea (mixed) and use a CPAP machine but that was not mentioned in relation to the pacemaker. But, that could be the type of "long pauses" you refer to. No other heart issues. Sound like you and I, particularly pre- afib, share some similarities. Can flecainide reduce heart rate? Sleep apnea doesn't cause pauses, but if your EP didn't mention pauby Carey - AFIBBERS FORUM