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MAJOR added risk factors involved! Just from going on heart lung bypass has real downsides for greater dementia risk, depression and other significant complications. Not to mention the greatly significant body stress, pain and recovery time from cracking it open. Cox was an old school cardiac surgeon so of course he will prefer that more aggressive approach. Mini-maze has its value, no doubt,by Shannon - AFIBBERS FORUM
Sounds great ... Good find Ron! WHen my Cardymeter sensor goes on the blink, I'll likely spring for this new one instead of the replacement sensor for the added convenience. It can be a real juggle trying to calibrate the older unit sometimes, Particularly while at the blood lab when doing a coorelation test with a true serum potassium blood draw. It's nice and small too .. now ifby Shannon - AFIBBERS FORUM
Hi Ken, Be sure and mention to Dr Natale about the chronic Lyme issue too. Though Lyme isn't necessarily an original 'cause' of AFIB, it certainly can contribute to its flare up and can directly cause other cardiac issues for sure, such as the infrahisian left bundle branch block I have. Ask Dr. N to check for that kind of LBBB during the EP-study part of the ablation when he dby Shannon - AFIBBERS FORUM
Hi Jill, I replied to your first post about your then upcoming Natale visit at the bottom of this page, just so you are aware. Again its great news and JUly seems a good date for you. The sooner the better! Am glad too you enjoyed your visit with Dr. N as I was confident you would. Your job is done now, you got yourself into the best hands you possible could and now just let all the anxieby Shannon - AFIBBERS FORUM
Hi McHale, My sense is that those who are recommending and advocating avoiding PVI-isolation as part of a long term successful ablation strategy at this point are WAY too premature based on the rather skimpy evidence Dr. Narayan has presented so far. Not one other truly top ablationist I know of is going out on that limb with Narayan and Topera .. Hugh Calkins not withstanding. Its quite pby Shannon - AFIBBERS FORUM
Hi Dwightsbride, Regarding your question on age and ablation, considering your extensive past cardio history, once again the best source of confirmation for you would be a consult with Dr Natale or one of his colleagues like Drs. Pinski, Schweikart, Burkhardt, Gallinghouse or Hao .. to name a few. Dr Natale and his group have done the most research I am aware of on ablation in people overby Shannon - AFIBBERS FORUM
Hi Ken, By all means get the ECV, and make sure you get a before and after cardioversion 12 lead EKG to bring to Dr Natale in May as well as all the blood labs that include potassium and magnesium drawn prior to cardioversion. The longer you are in persistent AFIB as it sounds like you are now, the more involved the procedure can get. Fortunately, you are going to the right place in May soby Shannon - AFIBBERS FORUM
Hi Jill, I'm just back home after 8 weeks on the road and was great to see your news above that you were able to see Dr. Natale already ... I just knew you would be glad you went to see him! July sounds super .. just get it done at this point and its one step closer to getting these issues further in the rear view mirror for you with all that you have been through already. 400mg of Topby Shannon - AFIBBERS FORUM
Hi Cindy, Sorry this will be very short as am heading to dinner with my wife the second to last night of our Hawaii stay before returning home to Sedona on Saturday after almost 8 weeks of near solid traveling. I look forward to joining back here more regularly again by next week and we can go into all that I know about Lariat. To answer your immediate question, While Dr Natale is doing Abby Shannon - AFIBBERS FORUM
Hi Gay, Jackie did a good job of summerizing the findings of the largest level 1 trauma center in the US that my neice is a cheif attending trauma doc at in their recently completed and sent for publication report on the new gen blood thinners. In the section comparing specifically Pradaxa with Coumadin, aspirin and Plavix, for the same comparative degree of all cause bleedign trauma that cby Shannon - AFIBBERS FORUM
Hi Ron, What researcher said is most important to appreciate. The stats for Dr Natale for example or Drs. Haissaguerre/Jais are very strong just on the numbers alone, but they represent a vast real-world improvement over the kind of 500 to 1000 ablations in 7 years kind of experience level. The majority of cases Dr Natale handles are among the most difficult ablations that are often referreby Shannon - AFIBBERS FORUM
Thanks Jackie, Dr Guarneri is one of the leading Cardio's in the growing field of functional medicine and I too look forward to her book. These are fully trained and skilled MDs and Cardiologists who have expanded their tool kit to include true preventative medicine as well as the traditional tools and methods of the interventional medicine they were originally trained in during medical schby Shannon - AFIBBERS FORUM
The TEE should not be so difficult in the right hands Ellen, this is another reason why its always good to insure that anyone doing even a marginally invasive procedure like a TEE which isn't .. or shouldn't be ... very invasive, has plenty of experience doing it and you are not in the hands of a trainee. For those undergoing a TEE, my advice is to insist on have an anesthesiologiby Shannon - AFIBBERS FORUM
Hi Mike, In my experience the Exatest is the most reliable and useful measure of IC ions. SErum Potassium is a good marker for adjusting your potassium intake, as is the even more handy Cardymeter, but for Magnesium you cant beat the Exatest for more accurately reflecting your IC Mag status. Some people have argued that it wasn't helpful for them because they had been taking oral magneby Shannon - AFIBBERS FORUM
PS Afhound99, When the heart can sustain AFIB for 24 hours or longer that is a strong indication that remodeling has expanded to include more complex triggering most often including not only the PVs which need to be isolated in all accepted current ablation protocols, but also beyond the PVs in the other areas of the left and right atriums mentioned. Shannonby Shannon - AFIBBERS FORUM
Hi afhound99, In my experience, the most skilled ablationists I have seen, for example both Drs Natale and Haissaguerre, each asked what my longest episode was during our first meetings (this was when I first saw them prior to slipping into 24/7 persistent AFIB some 5 months later while I was still procrastinating on when to get an ablation). They both indicated that for the vast majority of lby Shannon - AFIBBERS FORUM
Hi McHale, Technically Persistent AFIB episodes are not amenable to chemical cardioversion and need to have lasted at least a week duration without either a spontaneous conversion back to NSR or a ECV conversion to NSR. Then, with all future triggers back into AFIB it will require another Electrocardioversion to get back to NSR and drugs will only help control the rate, at best, in the vastby Shannon - AFIBBERS FORUM
McHale, is referring to a summary bullet point that Melanic Truehills posted on the Stop-AFIB.org message board to highlight some of her understanding of the main points a few of the speakers were sharing about their fibrosis findings. The fact is the two top researchers had directly opposite findings on the relationship of AFIB and Fibrosis, so the jury is very much still out. While addby Shannon - AFIBBERS FORUM
One point to clarify on the fibrosis issue, is that current research is still not in total agreement. At BAF there were reports saying that AFIB does not cause fibrosis... which is a position held by most ablationists and EPs, and another basic science report at the same BAF that indicated that AFIB can lead to increase in fibrosis. The question seems to revolve around the causal issue behindby Shannon - AFIBBERS FORUM
Dr Davis reveals in this article to be an entirely misinformed and woefully biased man! Sorry, but his diatribe is clearly biased and he took no time out of his life to learn anything at all about Nattokinase and what is, or isn't, yet known about it so far. If he is waiting for a 100,000 person five year double blind randomized clinical trial he will continue waiting .. and likely continuinby Shannon - AFIBBERS FORUM
Hey Tom B, How are you doing these days after the rough early months after the ablation? Been pulling for you to have it all settle down.. sounds like things are on the upswing right? Take it easy, Shannonby Shannon - AFIBBERS FORUM
Hi Rcece, Long distance travel is not the most conducive thing for heart stability, but there are ways to mitigate that issue and some of which has already been noted above in the other helpful posts. I have had a lot of experience in this area having lived in Amsterdam for four years and flying back and forth from my home in Hawaii anywhere from two to three times a year for a two to threeby Shannon - AFIBBERS FORUM
Hi Ron, Theoretically, there is supposed to be no real added consequence to having to take higher doses of warfarin to achieve a therapuetic INR. However, in my personal experience, since I have demonstrated genetic warfarin resistence and have needed anywhere from 15mg/day as during my first period on Warfarin in 2008 for 6 months both pre and post first ablation and now going on 9 months stby Shannon - AFIBBERS FORUM
You are welcome John and best of luck on the journey! Its a good goal to be Pharma free and if you can do so great, but even if you still need one or two, with that goal you will keep the drugs to the very minimum that are in your best interest. Just keep in mind that in some situations, the right pharmaceutical is the best medicine, but that is not always true in many circumstances and whenby Shannon - AFIBBERS FORUM
Good choice John and welcome out from the lurking shadows , Dr Pinski will be fully able to guide you just fine and with the persistent AFIB, I wouldn't choose anyone other than someone of his calibre and experience so you are off to the right start with regard to considering a good ablation. You digested well the two central messages of Afibbers.com. 1. Putting yourself in the hands ofby Shannon - AFIBBERS FORUM
Totally agree Researcher, The head in the sand cardio's that don't appreciate the value in a good ablation, because they do not yet see it as a perfect cure, have no idea what living with this beast is like. Shannonby Shannon - AFIBBERS FORUM
I would not recommend stopping Pradaxa without instructions from your Doc... call and say its an emergency and see if that gets any action. Not sure how it works in Ireland. Pradaxa is definitely a mixed bag. you definitely dont want to have any kind of traumatic bleeding injury nor internal bleed on it as it can be very difficult to stop since there is currently no reversal agent at all thatby Shannon - AFIBBERS FORUM
Hi Stephen, Start with Jackie's The Strategy that Hans listed and the go through the rest of his excellent list and you'll be good to go! The key for Magnesium as Murray suggested above and Jackie discusses in the Strategy is slow titration just up to bowel tolerance and then back down one notch. You must have decent IC mag levels before going strong with potassium supplementation bby Shannon - AFIBBERS FORUM
Hi McHale, Good points about the findings so far on fibrosis as shared at BAF m not long ago.. The main thing I got from the researchers conclusion was that fibrosis and AFIB are often parallel conditions but not necessarily with the one to one for relational causality as often was assumed until recently. However, just because AFIB might not be the main cause of atrial fibrosis ( it does aby Shannon - AFIBBERS FORUM
Hi Stephen, I'm not sure which of Dr Natale's centers you went to in 2010 and which NP made what sounded at the time like a promise for a one and done cure, but I've never heard Dr N make such a promise or implication in the more than 20+ meetings I have had with him and numerous other communications dating back to early 2008. In earlier years there was hope in the EP world tby Shannon - AFIBBERS FORUM