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Quoterocketritch When I say eligible I meant that when Dr Natale and I last spoke that my insurance would not cover, I understood that. What often happens when an insurance company declines to cover a procedure is the doctor arranges a conference with a doctor at the insurance company. They discuss the procedure and its pros and cons and arrive at a decision. It sounds like that's what hapby Carey - AFIBBERS FORUM
QuoteMarkL I email my ECG to myself from within the app. I than open the PDF on my wide monitor PC and manually count the blocks in the QT interval width on Lead II. I do this for 3 randon readable intervals and take the avg. Multply that by 40 for the QT interval total. I then use the Bazett formula for QT corrected: QTc = QT/√RR where RR = HR/60 this formula is valid when HR is betwby Carey - AFIBBERS FORUM
Quotesusan.d Enlarged left atrium? Rate control limits that (and BP control also). Also, it's clinically insignificant if you're already in afib and intend to stay that way. Rate control and anticoagulation are the only two things a permanent afibber needs to concern themself with.by Carey - AFIBBERS FORUM
What do you mean what can happen? As long as you keep the rate controlled and continuous anticoagulation, nothing happens. Permanent afib does not decrease lifespan or quality of life. Millions of people live decades with it.by Carey - AFIBBERS FORUM
You're both good. They wouldn't schedule a Watchman if they didn't already have insurance approval.by Carey - AFIBBERS FORUM
Measuring QT can be done on the original Kardia, Apple Watch, or any device that shows an ECG waveform. All you need is a printed copy of the recording and a ruler. I would pick a sample of QRS complexes that aren't in the first few seconds of the recording, measure them, and then average them out.by Carey - AFIBBERS FORUM
If you decided to go ahead with the procedure today, good luck! Let us know how it went.by Carey - AFIBBERS FORUM
Quotetobherd So is my Cardiologist comment, "if you have to stay on blood thinners, there's no point in getting a Watchman" right then? No. Your cardiologist is ignoring the risks and cost of anticoagulants, and in particular the risks of having to stop your anticoagulant for medical/dental procedures or unexpected problems like losing it in a foreign country, forgetting to bringby Carey - AFIBBERS FORUM
Quotetobherd Carey - if I'm a woman over 65, and had high blood pressure (well controlled now on a low dose of Atenolol), that would give me a Chad score of 3. That sounds like they would make me stay on a blood thinner.....is that right?? They probably won't count the point for being female. Beginning in 2019 the ACC modified their guidelines and that point is no longer considered iby Carey - AFIBBERS FORUM
Quotewalt Not quite sure how to ask this but…..Is the stroke prevention benefits of being prescribed Eliquis etc designed to protect during AFib or also during periods when you are not in AFib? If I am not in AFib and off Eliquis am I still at a greater risk than average for a stroke? The answer in general is it's designed to protect you whether you're in afib or not. Studies have shby Carey - AFIBBERS FORUM
Quotetobherd I'm surprised I haven't heard back from the hospital telling me to either stay on, or get off of Eliquis before I come in this Tuesday to get a Watchman. Does anyone have experience with this? Yes, I have. Do not stop it. Have they not sent you pre-op instructions yet? If not, contact Natale's office and ask for them.by Carey - AFIBBERS FORUM
Quotetobherd Just to clarify, she is supportive of the Watchman, but seems to be saying it's only worth getting it if i can get off of Eliquis. I would think once you get a Watchman (because you had a LAA isolation), you have just as much risk of a stroke as any other person in your age group who has no Afib history. Maybe that's what she meant...? Your thinking is correct: once youby Carey - AFIBBERS FORUM
Kardia is the only consumer-grade EKG device with full FDA approval for detecting afib, so that would be the only "gold standard" device available. Apple Watch has limited FDA approval. It won't detect above 120 bpm and Apple won't support its use if you have already been diagnosed with afib. Everything else is hit or miss. There are fairly reliable devices, there'by Carey - AFIBBERS FORUM
Absolutely okay. If you can tolerate exercise then by all means go for it. I took long hikes in steep terrain and bike rides of 20-75 mile rides almost daily for several years while experiencing afib and flutter. I even did a 50-mile bike ride three days after an ablation with the EP's blessing. As for what George mentioned, I went through a two-year period of experiencing multiple epby Carey - AFIBBERS FORUM
I agree with George that if you're asymptomatic it's nothing to worry about. That's why asked about feeling dizzy or lightheaded. If you don't then you're good to go.by Carey - AFIBBERS FORUM
I agree with Ken that that data probably doesn't exist. That's something that would have been a big red flag in the early Watchman clinical trials, so the fact that it isn't mentioned says it probably just doesn't happen. After regulatory approval, patients and EPs would quickly notice such a coincidence and they haven't, so it's not a question that's likely toby Carey - AFIBBERS FORUM
Quotetobherd Wasn't that incorrect advice to tell me that anticoagulation is safer than the Watchman, and that it doesn't keep me safer from having a stroke, Carey? Well, yes it is. Anticoagulation and the Watchman are roughly comparable in stroke protection, and the Watchman doesn't carry a bleed risk like anticoagulants do, so it is in fact safer. But she's right that it wby Carey - AFIBBERS FORUM
Systolic in the 90s is quite low and runs the risk of syncope (fainting). Do you feel any dizziness or lightheadedness at all when you're that low? How about when you rise from a sitting or lying position?by Carey - AFIBBERS FORUM
Do not stop the Eliquis unless they tell you to, and I'm not surprised they haven't. It's standard procedure to continue Eliquis through the procedure. I think you're overanalyzing your cardiologist's answers. She's simply trying to give you accurate answers and you're interpreting it as negative advice when that's not what it is. Sounds like Shannonby Carey - AFIBBERS FORUM
QuoteElizabeth Flutter does happen quite often after an ablation for AF. I don't dispute that, but it doesn't occur in most ablations. I was responding to your post that seemed to imply that you don't have flutter because you've never had an ablation. No, you're just lucky. Most people who've had ablations also don't have flutter. We can only wish afib andby Carey - AFIBBERS FORUM
Flutter after an ablation is by no means to be expected. It doesn't happen in the vast majority of ablations. Naturally occurring flutter can happen to anyone, ablation or not. Some people start with flutter and eventually develop afib, and some people start with afib and eventually develop flutter (without an ablation). And some people develop one of the two but never develop the other.by Carey - AFIBBERS FORUM
Afib and flutter often appear together. Sometimes flutter will appear first, and when it does it's a pretty good bet that afib is in your future. They're both caused by caused by the same underlying process, which goes by the not-well-defined name atrial myopathy. Basically, fibrosis forms in the atria, which creates barriers the same way an ablation does. It's likely related to atby Carey - AFIBBERS FORUM
Here is a good diagram of what ablation lines look like. See how if one of those burns was a little too far from the one next to it there would be a gap?by Carey - AFIBBERS FORUM
Quotesusan.d Then how can atypical flutter be fixed if the gap(s) are encapsulated in scar tissue? By gap I mean a gap in the scar itself. An ablation line should be a row of burns with each burn slightly overlapping its neighbor burns so it forms a solid line of scar tissue. But if two burns are accidentally spaced too far apart, they don't overlap and a gap is created. That gap is livingby Carey - AFIBBERS FORUM
Any ablation can create flutter. Flutter is created when an electrical barrier in the atria has a gap in it. The barrier can be scar tissue from a prior ablation, fibrosis that developed naturally due to atrial myopathy, or scar tissue caused by something else (prior infection, etc). The gap allows a normal signal to go through the barrier, and if that signal goes all the way around the atrium anby Carey - AFIBBERS FORUM
Yes, it can be ablated again. The ablation creates a barrier around the LAA, not in it.by Carey - AFIBBERS FORUM
I've started sotalol 2-3 times and never in the hospital. Most people I know who've been on sotalol did not start it in the hospital. I think that's generally reserved for people with more risk factors for prolonged QT. Women have longer QTs than men, so being female means you're more likely to be required to start it in a hospital.by Carey - AFIBBERS FORUM
QuoteMabmedz So unfortunately it appears the 2nd ablation was unsuccessful, but we’ll have to wait and see how I do on Multaq. As of yesterday I discontinued Amiodarone and started Multaq. I’ve discussed a 3rd ablation with my EP with a risk of requiring a pacemaker, something he is trying to avoid, if possible. Okay, lots of important information that explains your course of treatment. I wasby Carey - AFIBBERS FORUM
Quotesusan.d Does Amio need to be weaned off or can one stop cold turkey? I had to be weaned off Multaq and Jackie had to wean off of Flecainide. For all the antiarrhythmics, including amio, most people can just stop them. I've stopped flecainide, sotalol, Tikosyn, and Multaq without weaning, also metoprolol.by Carey - AFIBBERS FORUM
Quotesusan.d Carey, you are a CHAD 2, what advice for a CHAD 4-5-6? Would a half dose Eliquis be enough and would temporarily stopping Eliquis and avoid bridging (advantage of the watchman) during surgery be safe after a successful watchman when compared to someone with a CHAD2? Well, it's probably going to depend on why the person is a CHADS 4-6 and what other issues they have. For eby Carey - AFIBBERS FORUM