John. The are you sure it is a SVT which as researcher said is a quite easy and straight forward right atrium only ablation? If so, perhaps Dr N is just waiting until the 9 month follow up to see if it disappears on its own and it sometimes can do. If not surely, he would recommend taking care of that in a short ablation that would not require even a transeptal puncture and has a very high curby Shannon - AFIBBERS FORUM
You are referring to your father I presume and not Dr Camm that needs to push for the referral? Tell your father, not to assume St Georges is on the ball about his case inherently. They may have just assigned him in their mind as a medical management case and that's it in which case they wouldn't even be considering referral. You .. or your father ... has to insist that he would lby Shannon - AFIBBERS FORUM
You are welcome Londoner, Dr Camm is a well known heart doc in London but is not am ablationist and is more on the drugs and management side of the equation but he would know of all the best ablationist around. Bordeaux of Dr Schilling might be worth a try though. At least then you will know you have tried the full range of options and heard from the best available docs in your region. Do eby Shannon - AFIBBERS FORUM
Hi Randy, Yes you read me correctly. Taking too much Melatonin can and will hammer a borderline low Cortisol level. Melatonin, not unlike Growth Hormone which is another nocturnal-release -only anabolic hormone has the exact circadian rhythm set up by nature to be at its peak at night when normally our endogenous Cortisol is at a minimum. With health adrenal glands and a reasonably well balancby Shannon - AFIBBERS FORUM
Hi londoner, Welome to the forum and sorry to hear of your father's travails. I take it you are in London from your handle? Amioderone isn't necessarily his only option, though he would need to see a very skilled EP ablationist who is very experienced in persistent AFIB ablations to accurately review your father's realistic options at his age and in his cardiovascular conditiby Shannon - AFIBBERS FORUM
PS PH, You mention that Bordeaux does not use Stereotaxis for AFIB ablation, and for good reason. Neither does the Natale groups use Stereotaxis for AFIB ablation at all, and use it only for some difficult access maneuvers in certain select VT ablation cases. They like some aspects of the Hansen Robotics system, but you won't find Dr N, or most any top ablationist, using either automatby Shannon - AFIBBERS FORUM
Hi PH, One other point in your post above, you were asking Professor Jais about getting LAA isolation and he suggested that if you didn't have any activity there in the LAA then it wouldn't do you any good to just automatically ablate that area, which is absolutely true. But by the way that was worded he may have been under the impression that the LAA isolation was a fixed conclusby Shannon - AFIBBERS FORUM
Hi PH and researcher. There was a lot of discussion at Boston AFIB last weekend in Orlando that I also attended, on non-invasive mapping systems such as Cardio-Insight and EP-solutions to name two. Dr. Jose Jalife also presented more interesting developments in his on-going fundamental animal research (sheep) into the cellular and biochemical origins of AFIB with his insight into rotor deveby Shannon - AFIBBERS FORUM
Sounds like an more enlightened EP Larry! Shannonby Shannon - AFIBBERS FORUM
Good to hear TomB, Melatonin used correctly in a good dose for you is a wonderful and safe hormone with a number of beneficial properties and like with most of our hormonal milieu it tends to significantly decline in function with the aging process. Try to avoid any blue spectrum lights as in typical incandescent or fluorescent lights after going to bed as well as taking your dose of melatoby Shannon - AFIBBERS FORUM
George the head nurse practitioner and leader of the whole AFIB facility at CPMC is Salwa Beheiry and she is really super! Salwa has always been so helpful and courteous and collaborates with Dr N on many of their scientific publications as well. She is very much aware of this site and sent Hans a personal letter of gratitude for creating this site when she learned of his retirement. Shannoby Shannon - AFIBBERS FORUM
I just wanted to express again here how moved I am as well at the outpouring of such well-deserved gratitude toward Hans and Judi as well as for the many kind words of encouragement for me at the beginning of my tenure in carrying the torch for this real treasure of a website. I was also very touched by how many EPs I spoke with at the Boston AF Symposium 2014 just over now in Orlando, had heaby Shannon - AFIBBERS FORUM
Hi Barb, As we discuss on the phone Friday, as long as you are not in AFIB/Flutter I wouldn't worry about the high HR. Although Flex isn't much of a rate control drug it is possible that its influence on autonomic time could make the typical High HR after an ablation more noticeable for a period. Just to share with others here what we discussed, a high HR post ablation is one of tby Shannon - AFIBBERS FORUM
DSENNET, The bad dreams part with Melatonin is often a red flag for the adrenal deficiency response to too much nocturnal cortisol suppression by Melatonin as described in my post above. Shannonby Shannon - AFIBBERS FORUM
Hi Montos, RonB and Jackie, All good reports and Montos that 7+ reading is serious overdose K readings and is certainly an outlier. Do rinse and clear you mouth as RonB so accurately suggests. Also, when I took my older Cardymeter to the serum lab and did my serum test immediately in the same room right after the blood draw it would come back incredibly accurate. Over the ten times I diby Shannon - AFIBBERS FORUM
Hi Nancy, I'm sorry you had to experience an EP like that. His obvious lack of knowledge and even interest in the whole supplement question such that he demanded you throw them ALL out from some ridiculous and completely misinformed notion that Any and All of them just 'might' well trigger a bad side effect like Torsades du Pointe or long QT syndrome in interaction with Sotalolby Shannon - AFIBBERS FORUM
Be VERY careful with Seriphos unless you have documented testing confirming a 'consistently' high nocturnal cortisol level. This may be common in people in their 40s and ecvewn early 50s but the opposite is far more often the case from 55 onward and often starting earlier in people prone to AFIB. Adrenal deficiency is far more a trigger for later years AFIB than is excess cortisolby Shannon - AFIBBERS FORUM
Yep Iatrogenia, that's how melatonin works and once people are able to reduce excess nocturnal cortisol levels with a bit larger dose of sublingual melatonin, they often can and should titrate their nightly dose down to the low end and those with borderline low to fully low cortisol even 0.25mg can be too high. That's where a good compounded sublingual suspension comes in handy for veryby Shannon - AFIBBERS FORUM
Hi Lynn, I'm typing this on a plane winging down to Orlando to attend the Boston AFIB 2014 Conference (mercifully moved this year to Orlando considering this Jan weather in Boston!) and will share some updates on the more interesting new findings at the conference soon. Stopping the potassium probably was t the best decision but be sure you are taking sufficient Magnesium too so that tby Shannon - AFIBBERS FORUM
Took a while, better late than never. Shannonby Shannon - AFIBBERS FORUM
Melatonin is a wonderful hormone that has many beneficial functions beyond helping to stabilize the sleep cycle. Its also the master circadian conductor for most of the endocrine system and having sufficient Melatonin is key for reestablishign the critical timing for release of various hormones. Melatonin is an anabolic hormone as well and it is produced almost exclusively at night when the liby Shannon - AFIBBERS FORUM
Thanks Jackie, Also, to clarify, my reference that the upper midwest "used to be known as the goiter belt" for sure was not meant to imply that suddenly the native soils in that region have become replete with iodine. It was mainly a reference to the relative lack of full blown goiters seen these days. It seems even iodized salt, as poor a form of iodine supplementation as that is, mby Shannon - AFIBBERS FORUM
Hi Gill, Seems so many of us go way way back, don't we?! And it seems like the vast majority of us old timers have made it over the other side of the fence. I recall the good tips you shared with me too about Bordeaux before my visit there to interview with Prof Haissguerre as well when I was living in Amsterdam those years. Great to hear all is well and ticking right along. Haveby Shannon - AFIBBERS FORUM
Glad your wife has your back Smack, ... Hey that rhymes Listen to what George and Denver say as they have both been there and done that too, just like me and a host of others here. Be sure and read the whole thread on Hans' retirement from active management of this website and AFIB Report. It's incredibly moving and reassuring to see how many people's lives have literally beby Shannon - AFIBBERS FORUM
Marian AliveCor has a case for Android phones of various sizes and just like their I-phone 4 & 4S model it does not have the cracking problem due to the type of plastic used on the I-Phone 5 case and the geometry of that case in relation to the two silver electrodes for some reason made it prone to some combination of electro-mechanical stresses that makes it prone to developing small cracksby Shannon - AFIBBERS FORUM
Forget the typical stats with Natale doing the work Smackman, While most persistent Afibbers will need one index ablation by a true expert like Dr N plus one more targeted touch up at some point to really get this behind you for the long term, he and his group have been getting increasingly more 'one and done's' even among persistent cases like yours. Your EP is right, you arby Shannon - AFIBBERS FORUM
Hi George, Iodine is essential and one of the major deficiencies found in many diets. The midwest used to be famous even as the old 'goiter belt' due to low levels in soil of the region, same story with much of Europe. Like anything good its best to maintain a broad optimal range and not over or under do it. David Brownstein has a lot of good long term practical insights on properby Shannon - AFIBBERS FORUM
McHale, I suggest waiting a bit and just keep in touch with their website for when the announce an undated version, or write them and see if they have a date yet for when the new model with a fix for the cracking issue is out. In the meantime you can use it fine as is as it doesn't seem to effect performance at all. Shannonby Shannon - AFIBBERS FORUM
Thank you too Hans and Judi, Not only for the confidence and encouragement you both have so generously offered to me along with handing over the care of your baby which has grown, under your dedicated oversight and management, into the most broad-ranged and informative resource for AFIB patients around the world, but for being there for me and so many others through the years helping us all naby Shannon - AFIBBERS FORUM
TomB,I definitely would not label any ion replacement protocol a 'cure' for AFIB. But when done correctly and consistently, for those of course that can tolerate them and don't have some other underlying issue or reaction to them as you report. I do know from experience with many patients seen at several clinics of progressive functional medicine MDs that commonly when you findby Shannon - AFIBBERS FORUM