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I concur with Carey, but also what about flec either on demand or at a low dose? In my case, in addition to magnesium to bowel tolerance, at the beginning of the day, I put 2 tsps of potassium citrate and 1/2 tsp sodium salt (NaCl table salt) in a liter of water and drink it over the day. It is my version of "time release." The 2 tsps of potassium citrate is about 1 g potassium andby GeorgeN - AFIBBERS FORUM
I would trust Dr. N to do it, and I'd do what I could to get it done in Austin, if possible, if it were me.by GeorgeN - AFIBBERS FORUM
Are you going to have Dr. N do it? Found this paper.by GeorgeN - AFIBBERS FORUM
As Quote the mean (SD) age was 69 (11.8) years, the applicability to younger people may also be limited.by GeorgeN - AFIBBERS FORUM
Full Paper QuoteLimitations Our analysis had several limitations. Information on the exact reasons for undergoing arrhythmia monitoring and for not receiving anticoagulation was unavailable. Given the number of events, we had limited power to determine thromboembolic risk at more granular cutoffs of atrial fibrillation burden, but our data suggested a threshold of approximately 11% as meaniby GeorgeN - AFIBBERS FORUM
In my case, as I've previously noted, consuming excess (for me) calcium "changed the odds for the worse." Things that were not triggers before, or after the 15 or so months when I was consuming excess calcium, became triggers during that time. I could also change the odds for the better. A consistent trigger for me is excessive endurance exercise (excessive being my subjectiveby GeorgeN - AFIBBERS FORUM
QuoteElizabeth How can this guys heart function be normal, his treatment is only a blood thinner (is that a treatment), wonder why he didn't get an ablation. Turns out he's on a beta blocker (and also a statin), which would act as rate control. Rate control & blood thinner is a pretty common treatment for afib. Same article mentioned George W Bush developed afib during his preby GeorgeN - AFIBBERS FORUM
Liz, wonder what the local guy's office would say if you asked for an appointment with him for a second opinion on ablation & med options. If they said yes, then you could then make choices who you could see after you met. When you meet, you could ask directly why he doesn't want you to see others. Second opinions are common on big decisions. I concur with everyone else, I don&by GeorgeN - AFIBBERS FORUM
Quotecirenepurzalot Did you always have no p wave or is this a result of the ablation? I’m thinking about getting my first pv isolation. Will I to ask having to get an LAA isolation? Not sure how that works. Thanks. I'm pretty sure Carey & Smackman's lack of "p" wave is due to LAA isolation. A PVAI (Pulmonary Vein Isolation Ablation) should not have this issue. There aby GeorgeN - AFIBBERS FORUM
QuoteGill I am certain that Hans used to say that. George - can you help here? I’ve tried searching but had no success. The first two chapters of Hans' book are available for free to read if you pull up the Kindle version and "Look Inside." Here is the last paragraph of Hans' summary at the end of Chapter 2, again, I suggest reading the whole book or at least the freeby GeorgeN - AFIBBERS FORUM
QuoteGill I am certain that Hans used to say that. George - can you help here? I’ve tried searching but had no success. After a brief review of Hans' (399 page) comprehensive book Thrombosis and Stroke Prevention 3rd. Edition: The Afibber's Guide to Stroke Prevention, I would say it is much more complicated. For example LAA velocity declines with age, even without afib. It also dby GeorgeN - AFIBBERS FORUM
QuoteGill I am certain that Hans used to say that. George - can you help here? I’ve tried searching but had no success. Gill Hi Gill, don't have time to look it up. I do have Hans' 3rd edition of his stroke book & will take a look when I have time. Here is my understanding. While in afib, the velocity through the LAA can materially drop. This provides an opportunity forby GeorgeN - AFIBBERS FORUM
An example, I've recommended EP's in Australia from this list provided to Shannon by Prof Jais from Bordeaux. I've also recommended Sabine Ernst in the UK.by GeorgeN - AFIBBERS FORUM
QuotePomponif your EP is someone else somewhere else, you're screwed. I don't think this is true. It really depends on your situation. The simple cases that are handled with a PVAI generally don't show up here. There may not be a surefire way to determine this going in, but there are some indicators. I recall a fellow from the US, about 8 years ago who posted here. His situaby GeorgeN - AFIBBERS FORUM
QuoteCarola Have any of you tried CoQ10 ? Should I take 30 mg.? I've taken 100-200 mg of Ubiquinol/day (a reduced form of CoQ10) for years. I've never observed any impact on my afib, positive or negative.by GeorgeN - AFIBBERS FORUM
Quotecaliforniagal 3: Does anyone have experience taking the European herb Strohanthus? I understand it keeps the heart in a steady rhythm and does this by activating the parasympathetic nervous system. In my opinion, if someone had a vagal trigger, this would likely not be helpful. Perhaps for an adrenergic trigger.by GeorgeN - AFIBBERS FORUM
Barb, As an FYI, Medicare Advantage plans typically work like an HMO, hence you are usually restricted to providers in the network. These plans are also usually the lowest cost. Plain Medicare is the most flexible, allowing you to go to whoever accepts Medicare. Your cost issue will depend upon what Medicare supplement insurance you carry, if any. Georgeby GeorgeN - AFIBBERS FORUM
QuoteElizabeth George: What is the difference between persistent afib and permanent Afib? Perhaps I have misspoke I have been told I am in AF about 80%. Are you saying that you have gone in and out of AF during your 2.5 months? Liz I was out of rhythm the entire time. Here are the definitions from the Heart Rhythm Society: < "Paroxysmal AF - AFib that occurs sometimes andby GeorgeN - AFIBBERS FORUM
Hi Barb, I have a cousin who is a quadriplegic. He also has afib. He gets his care at Stanford. I know he and Shannon have talked about the care there. I do not know the details. You might PM Shannon and see if you can set up a time to chat internationally on Skype or some other app. When you PM him, let him know what time zone you are in and what your schedule looks like. To do a PM, gby GeorgeN - AFIBBERS FORUM
QuoteElizabeth Also, you say that my AF is too far advanced, I went into permanent AF about 3 months ago, George N was in permanent AF for about 2 /2 months and he got back into NSR with his protocol. You may be right but I will keep trying. Terminology, I'd say I was in persistent afib for 2.5 months, permanent won't convert period. Also, I converted out of that episode with 300 mby GeorgeN - AFIBBERS FORUM
QuoteDavrosT PS. as a side-note, I know what pacemakers are used for, but just out of interest, are they of any use to regulating heart-rate in terms of irregular heartbeat? Just something I was chatting about this afternoon. Mostly a pacemaker will set a floor on heart rate, like 60 BPM. The pacer times the time since the last beat. If it exceeds a set level of milliseconds, it will send a siby GeorgeN - AFIBBERS FORUM
Published this in 2018. "Clinical Outcome of Electrophysiologically Guided Ablation for Nonparoxysmal Atrial Fibrillation Using a Novel Real-Time 3-Dimensional Mapping Technique . Results From a Prospective Randomized Trial."by GeorgeN - AFIBBERS FORUM
I'd contact Natale's office and ask about the bridging protocol they suggest.by GeorgeN - AFIBBERS FORUM
Not sure where the question comes from. There is an old, very out of favor procedure, for afib where they ablate the AV node and install a pacemaker. Your atria will still fibrulate, so this does not solve the stroke risk. However the signal from the atria to the ventricles will be blocked and the signal for the ventricles to beat will be provided by the pacemaker. If the pacemaker fails, thby GeorgeN - AFIBBERS FORUM
QuoteCarey I doubt a nitric oxide (NO) supplement will be a problem with Eliquis because NO is produced by almost every cell in your body. It also has an extremely short half-life measured in seconds, which is why I don't think NO supplements can possibly do anything for you. One of my friends took this beet root powder. She said, "Dr. told me to take 1/2 tsp (scoop inside) dailyby GeorgeN - AFIBBERS FORUM
QuoteJackie There was also a post Hiatal Hernia and Vagus Nerve Impingement...by Steve Rochlitz, PhD. that offers the potential for an irritated Vagus from hiatal hernia. I bought a number of Steve Rochlitz's books from reading a post by Jackie. I was interested specifically in the vagus nerve info. Because my afib is very well controlled & I have a lot of higher priorities inby GeorgeN - AFIBBERS FORUM
QuoteCarey What's so frustrating about this is there's already data available showing that a Watchman becomes cheaper than NOACs after about 5 years. Plus there are no compliance issues. You can't exactly forget to take your Watchman. So Medicare and the insurance companies should be jumping all over it because it will reduce their costs in the long run. Probably substantially whenby GeorgeN - AFIBBERS FORUM
QuoteGeorgeN Thanks George. I appreciate the advice. I just hope I can afford the trip out to see Dr Natale. Shannon has posted the Medicare data before. Something like 80% of the Medicare ablations were done by EP's who do ~25 or fewer ablations a year. You clearly don't want to be with those guys. Mostly you'd like a high volume center with a high volume EP who actually hby GeorgeN - AFIBBERS FORUM
Quotecirenepurzalot Thanks George. I appreciate the advice. I just hope I can afford the trip out to see Dr Natale. Shannon has posted the Medicare data before. Something like 80% of the Medicare ablations were done by EP's who do ~25 or fewer ablations a year. You clearly don't want to be with those guys. Mostly you'd like a high volume center with a high volume EP who actuaby GeorgeN - AFIBBERS FORUM
Quotecirenepurzalot Could I tell from my 6 lead Kardia ECG if I'll need LAA work done? Or is that impossible to tell with these devices? No, usually don’t know if extensive LAA work is required till after the index ablation. From a conservative point of view, extensive LAA work is typically not done initially. Your afib history could help predict. If you’ve had long standing persistenby GeorgeN - AFIBBERS FORUM