Hi Dirk, It can happen no doubt, but is less likely with a real expert, nevertheless that is a certain amount of unpredictability in post index ablation flutter or tachycardia occurrence and its not just down to which areas are ablated. There are anatomical and substrate variations person to person, that mean even the most experience EP can't promise you won't have a post ablation taby Shannon - AFIBBERS FORUM
Thanks McHale, I know Lifewatch has a number of new models now and I didn't know if they have one for more or less permanent use by the patient. The AliveCor is a handy little device. Not quite at 24/7 convenience yet, but very useful for sure. Shannonby Shannon - AFIBBERS FORUM
Hi Smackman and Tsco. Thanks for the article posting Smackman. This new wrinkle in using the nContact epicardial ablation tool is a modification of the hybrid approach which has proven successful for difficult cases, especially those who did not have the advantage of a top tier ablationist skilled in doing more extensive endocardial ablation protocol for persistent and long-standing persistentby Shannon - AFIBBERS FORUM
Hi TomC, Great to hear from you and that things are going well. For those needing potassium, its hard to beat a full avocado for a long lasting boost in K as seen on the Cardymeter. A full avocado ranges from around 800 to 900mg of K and really seems to hold up a good deal longer than potassium supplements or drinking coconut water... At least in my super K and Mag wasting body. Not to menby Shannon - AFIBBERS FORUM
You are on the right track Randy, go for either version of Dr Ohhira's formula but you the pro version is strongest which should like it might be up your alley if you test indicated little to no Lactobacilli.. Key Biotic is also good. After getting your Lacto/Bifido-based repletion going, and consider adding in a soil-based probiotic as well for diversity. But let George and Jackie step in aby Shannon - AFIBBERS FORUM
Hi McHale, Just curious, Do you still have a Lifewatch monitor or is that your AliveCor monitor you are using now? Best, Shannonby Shannon - AFIBBERS FORUM
Many thanks Jackie for this excellent detailed overview of Stress and the HPA axis issues which are so fundamental for so many of us. Lets make both of these into an AFIB Resource link as well for the long term, if you agree? Cheers! Shannonby Shannon - AFIBBERS FORUM
Hi Barb, Yes first and last ablation it is .... until otherwise notified which hopefully will be never. :-) And just skipping a BB regardless of dose can trigger a short term spike in HR from the rebound effect. This can be even more pronounced had you been taking a higher daily dose, but some of that HR increase is no doubt from your ablation still. When Dr N has to branch out more around tby Shannon - AFIBBERS FORUM
I concur on the AliveCor, a very handy device indeed! The Alivecor and Cardymeter are nearly essential AFIB tools in my book. Makes managing this thing a lot easier. Shannonby Shannon - AFIBBERS FORUM
Hi Barb, It was because you skipped your BB combined with the somewhat faster baseline HR from a more extensive first ablation. Nothing at all to worry about as it was sinus tachycardia. You probably notice its slowed down some now after taking the missed dose and getting a good night sleep, right? Be sure your electrolytes are good too and you might either be too low on potassium or perhapby Shannon - AFIBBERS FORUM
Hi Liz, While playing Russian Roulette might slightly exaggerate the risk, it is more or less a good analogy as it is possible indeed to get a excess potassium serum level in our efforts to not be too low and without enough intracellular magnesium on board that can make for a real risk for pro-arrhythmia and stimulating AFIB instead of putting a lid on the kettle. A Cardymeter does run arouby Shannon - AFIBBERS FORUM
Hi researcher, Yes I agree, and am fully confident that Dr Sabine addresses persistent cases as well. She is a well-known long time EP with a good track record from all that Ive heard. My reference above was simply to Phil being paroxysmal, and in cases like his, it makes for an even greater likelihood of being 'one and done', and also a better chance for generally having less activiby Shannon - AFIBBERS FORUM
Hi Ralph, Ectopics generally do not require an ablation, though there are exceptions when PVCs can become too frequent and symptomatic. Usually PACs and PVCs can be controlled and minimized as George, Gill and Lance all noted above. Frequent PACs while in and of themselves might be relatively harmless, prior to the starting AFIB, and before an ablation, they can signal a greater likelihoodby Shannon - AFIBBERS FORUM
Wonderful news Phil! All sounds like it going as planned which you should expect from an experienced team for paroxysmal AFIB in particular. All the steps you describe sounded textbook, though Im not entirely sure what the EP who came in to brief you was saying " ..with isolation into and out of the atria" .... the 'acute success' part of the main thing to hear at this poby Shannon - AFIBBERS FORUM
Good to hear Smackman, The anxiety is something you are familiar with at least from before the ablation too and it will lessen some no doubt as well. I wish you good luck on the IC front. I've heard of some good results from a well known clinic doing Stem cell therapy for that condition, and if I can find the link again will forward it too you. I havent yet researched it but they have repby Shannon - AFIBBERS FORUM
Hi Lisa Mac, Thanks for the details, taking Metoprolol for the a fib only as it seems you do not have hypertension worthy of a drug unless you were above 140 over 90 . .really 160/90 .... Anything less, and usually even much higher can often be controlled well by diet, rate right supplements and exercise along with stress reduction. When you were having AFIB so infrequently, it would have mby Shannon - AFIBBERS FORUM
Hi McHale, I still hope that we learn some valuable things from FIRM rotor mapping, and very likely will, even if one of them is not to ditch the PVI too precipitously. But I agree that Id be a little leery of going for a FIRM only approach with the object of just getting the quickest acute intra-ablation termination of AFIB and then calling it all a success for the long term. No doubt therby Shannon - AFIBBERS FORUM
Sorry to hear of the frustration and down feelings which is understandable Lisa, And Ten years is a fairly long duration of AFIB but if its only truly been once a month or less of short duration episodes you still may not have a lot of structural remodeling or scarring. Though that can change fairly quickly if the frequency and duration of episodes starts to increase appreciably. How longby Shannon - AFIBBERS FORUM
Great news Chris, Other than I would have preferred that you not have to go through the LAA issue. We can't control how our hearts manifest this condition. Just be very glad your LAA decided to do a 200bpm 1 to 1 flutter while Dr N was still in there and watching in real time! That was lucky stars indeed, rather than have it first kick in while perhaps midway through a transatlantic fby Shannon - AFIBBERS FORUM
Hi Eric, Congrats on the new member of your family any moment now! There will be much joy along with the inevitable stresses that such a major addition to your life brings. And yes, yu can easily have triggers com what might with a strict definition be divided into Vagal and Adrenergic influences. These are tendencies not hard and fast rules that once one has one or the other 'style'by Shannon - AFIBBERS FORUM
Thanks folks and Im glad you liked the little blurb. At least they didn't throw any tomatoes in Orlando . And Jean, I don't think Dr Wharton was there, its possible he could have been as I've only seen one photo of him previously a longtime ago, but I didn't recall him being there. Too bad that he missed it being in Orlando so close to his stomping ground in South Carolina.by Shannon - AFIBBERS FORUM
Hi All, Im back home from the 2nd Annual International Symposium on the Left Atrial Appendage held in Orlando last week. It was a very interesting and informative conference and very well attended by a broad range representing all of Cardiology. Interventional Cardiologist, Cardiovascular Surgeons as well as many EPs were in attendance and the unique perspective of all the major sub-specialtieby Shannon - AFIBBERS FORUM
That's sounds like a reasonable plan Doreen, if you have a consult with Schweikert set up be sure to go, even though you aren't in line yet for an ablation. It really helps to establish some connection with who might well be your ablationist down the road, if it comes to that, dr Schweikert won't push you at all toward ablation too early, for sure, but its good for you both to getby Shannon - AFIBBERS FORUM
'Tsco and the Flippies' Or maybe 'Arrhythmiacs' 'Shock Junkies' might work tooby Shannon - AFIBBERS FORUM
PS I concur with Liz, why drop Your propafenone Doreen? It was working pretty well at the original dose. Were there side effects you didn't like? Those drugs tend not to last forever anyway, might as well take advantage of the time it does work okay. But its wise too to get aligned with a skilled ablationist so so are in the loop with them for if, and when, the drug stops working so wellby Shannon - AFIBBERS FORUM
Thanks for the details Doreen, Sounds like you have made a diligent effort at conservative management with drugs and nutrients and good diet. That's good. Try not to worry about an ablation making things worse. That is so far from a likelihood when you make the best choice you can from among the EPs you already know that are excellent, its truly a wasted worry. You make the best choicby Shannon - AFIBBERS FORUM
Doreen, How long have you had AFIB and what has your average AFIB burden been? Its fine to wait it out for some time and nearly everyone does. But if you have had AFIB for a long time even if only still occasional paroxysmal, you don't want to wait indefinitely if breakthroughs are still happening a couple times a month or so. That can become the kind of no mans land (or no woman's lby Shannon - AFIBBERS FORUM
Hi Doreen, Short of making the trip to Austin to see Dr Natale himself, you would be hard pressed to do any better than Dr Schweikert. He can definitely handle your paroxysmal case and is one of those I would trust too for a persistent AFIB process. Also, in that top tier is Dr. Dhanujaya (DJ) Lakkiready who is really wonderful too and a ver nice man and very outgoing and intelligent. Dr Lakby Shannon - AFIBBERS FORUM
Very smart move PH, Best wishes on April 11. Check your PM as I just sent you a quick note. Take care, Shannonby Shannon - AFIBBERS FORUM