That was a pretty good definition Mike! Yes, an index ABL indicates the primary initial ablation that for an AFIB ABL always includes a foundational PVI at least. More advanced operators typically also include an LAPW isolation (Left Atrial Posterior Wall Iso) and often a Superior Vena Cava Idolation (SVC-Iso) as well... such as in Dr Natale’s classic ‘Natale Extended PVAI (Pulmonary Vein Aby Shannon - AFIBBERS FORUM
Nice post Libby, it’s true PHTN is not always a worse case scenario DX. And one of the best ways I know of reducing any enlarged left Atrial size back toward normal range long term is freeing oneself from any AFIB at all, by whatever means one achieves that, which is most often via a successful expert ablation process. Within 6 months after a completely successful ablation results in restoringby Shannon - AFIBBERS FORUM
Lance, Like Jackie said, I've never had any GI issues related to Nattokinase either while taking it over a decade. Regarding Slippery Elm,. some folks appear to get benefit from it for GI Issues, but a smaller but not insignificant number, including yours truly, have an allergic reaction to this herb. The first side effects I got was from taking Slippery Elm lozenges for a sore throat, buby Shannon - AFIBBERS FORUM
Dear Louise, I’m very glad to see your quiry has been answered. And apologies that you didn’t receive a reply for the first go around. We have so many new Afibbers discovering our forum that we’ve had to start rationing in new registrants wanting to post replies or start new threads on the forum, simply because with so many new posters a post like your original thread could cycle through toby Shannon - AFIBBERS FORUM
Hi Whitehaven, As we discussed on the phone this morning, I haven’t had a single solitary beat of AFIB in over 10 years after 16 yrs of AFIB progression from sporadic early stage Paroxysmal AF to eventually aggressive persistent AFIB. Following my index procedure with Dr Natale, just a couple months after he moved from Cleveland Clinic to St David’s in Austin, and confirmed by my dual chamberby Shannon - AFIBBERS FORUM
My pleasure Steve, Will put a call into Dr Tzou this weekend & next week. Also, I’ve removed your contact info from your post above as that is seen by everyone when posted on the forum. Cheers! Shannonby Shannon - AFIBBERS FORUM
Steve, Send me your contact info plus DOB etc and I will call Wendy and let her know you’d like to come see her.. Cheers! Shannonby Shannon - AFIBBERS FORUM
Sorry to hear of your troubles John S, Can you give a few more details on what happened in your aborted ablation in the UK? That might shed some added light. n And from your recent history it would indeed appear you may well be experiencing an increased progression of your underlying atrial arrhythmia! This often happens over time. Your docs decision to want to stop your FLEC, might be dueby Shannon - AFIBBERS FORUM
Steve ... Wendy Tzou will be perfect as the curious and open-minded EP you are looking for! PS we are having mostly intermittent power outages tonight due to large snow storm in Northern AZ, including Sedona. Am not sure if this message is getting sent at the moment? Shannonby Shannon - AFIBBERS FORUM
Great to hear from you again Steve! As for a Boulder EP, I also second George’s suggestion and strongly endorse Dr. Wendy Tzou at Univ. of Colorado Medical Center in Denver, She is very sharp and is a close colleague of Dr Natale’s, and friend of mine as well. Dr. Tzou will give you very sound guidance. Great to hear from you Steve and stay in touch! Be well, Shannonby Shannon - AFIBBERS FORUM
Great Question MadMax, And George gave us his usual excellent answer above! We have, and always we’ll so long as I have a say, will be the primary online AFIB resource that is truly ‘holistic’ in our approach in that we offer an encyclopedic wealth of life-style risk reduction tips and protocols as well the best of integrative/functional medicine of which, it’s safe to say, we host the greateby Shannon - AFIBBERS FORUM
Hi Karen, While you would hope more CTI flutter ablations were as durable as they are typically advertised to be ... Nevertheless, I can tell I’ve seen a bunch of CTI failures! The premise that they should be ‘relatively’ easy is based on the fact that both a CTI Flutter circuit and an AVNRT Supraventricular Tachycardia circuit are well-defined straightforward ‘cookie-cutter’ ablation lesioby Shannon - AFIBBERS FORUM
Excellent suggestion MadMax on using Evernote, as well as several other similar products available, for keeping track of, and organizing, our digital worlds! Also, I think that once our website redesign project, that is underway now, is fully finished and up and running in the coming few months time, we will all find an easier to navigate and find your way around our valuable resource! Cheeby Shannon - AFIBBERS FORUM
Thanks Linda, and yes indeed it was Carey who found and posted the proper and accessible link to the 2019 Focused Update for the official 2014 AFIB Guidelines. But you, too, get credit for once again highlighting that this more targeted interim update of the 2014 guidelines had been published (in Jan ‘19). It was a team effort! Shannonby Shannon - AFIBBERS FORUM
Well said Carey, And good riddance to the added point just for beimg female! And thanks, Ids001, for posting a ‘useable’ version of this 2019 Focused Update for the 2014 AFIB Guidelines. I had tried to post that Update a couple weeks ago but came up with a bogus link! Shannonby Shannon - AFIBBERS FORUM
You won’t have any problem coming off the FLEC over 5 days Karen. Keep in mind you will have a gradually decreasing level in your body these last few days before your ABL and the vast majority don’t have any real recurrence during this period as it is. And in the outside chance that you do, it’s really no big deal at all ... just consider it a ‘friendly’ reminder of why you are going through thisby Shannon - AFIBBERS FORUM
Good point SAFIB, And that is one reason why I wound up running total of 9 EXAtest tests for myself back in the day when AFIB/Flutter was still a big problem for me, to try to see if there were any consistent levels that at least correlated with my symptoms? And I did find that to be the case. Although, with 9 test samples it was obviously limited data to draw any firm conclusions from, nevertheby Shannon - AFIBBERS FORUM
FYI Folks, We experienced a temporary glitch with the forum platform software that seems to have only affected this particular thread on "Magnesium-especially for PACS" that Jackie kindly posed for us. The glitch caused all the replies to Jackies post to disappear, as if they had been 'unapproved messages' ... which was definitely not the case! It should all be working fby Shannon - AFIBBERS FORUM
Hi Barb, Ditto what Carey said ... get that last TEE at Montefiore with your results to-date being still close to the line of being okay regarding your LAA mechanical function after your initial and touch-up LAA isolation procedures. Then, we can help you make the decision for a Watchman, if that seems the best long term move for maximum safety and freedom from having to remember anythingby Shannon - AFIBBERS FORUM
Hey Gordon, Good point and something like that may be possible down the road a bit, but for the next number of months, in addition to my daily many calls with Afibbers from our group who are at that place in their AFIB experience/history that they are seeking guidance for an ablation, my dance card is quite full now not only with my calls, but excitingly starting over the last two weeks, withby Shannon - AFIBBERS FORUM
Where do you live Sam? If not in Europe. then perhaps you can find an outstanding ablation expert EP/center relatively closer to home ( i.e. a distance conducive to driving/train or maybe doable with the help of a strong tranquilizer on a more modest duration flight with perhaps your wife handling on board baggage etc in the air??). Shannonby Shannon - AFIBBERS FORUM
Hi Sam, was this the first time you had taken DGL, or perhaps have you been taking it at higher doses for a while recently? While Deglycyrrhizinated Licorice should be realitively safe, as Catherine suggested it could be that you may have had an adrenaline spike due to either excess black licorice content that (and I’m speculating here) was not properly or fully deglycyrrhized during productioby Shannon - AFIBBERS FORUM
Good News Worntorn! Jason Andrade is my go-to ablation referral in western Canada, he is very smart and a very good guy too! He and Atul Verma at South lake in Ontario are my most confident Canadian ablation referrals... good choice ... or should I say it was good luck of the draw?! :-) Either way you did good! Cheers! Shannonby Shannon - AFIBBERS FORUM
Hey Joseph, Good news all around! Sure you can take a half does of Eliquis, even if St Davids says its okay to stop the blood thinner, just for your own comfort zone for the time being, Consider doing another TEE in another year to confirm the robust LAA functioning once again and then if all is the same as now, you might feel ready to go off the drug. Alternatively, should there be any redby Shannon - AFIBBERS FORUM
Hi Mike, I like what aive heard the last 9 months about PEF and it looks like a very promising new energy source, but it is still early in its gestation. Only my first short paragraph/sentence above referred specifically to PEF, yet I’m far more interested in keeping an eye on PEF developments than I am the basket mapping rotor tech rehash discribed in the rather poorly researched hype piece iby Shannon - AFIBBERS FORUM
The PEF tech is interesting and promising research that needs larger scale testing with various ablation techniques. On the other hand, I’m entirely skeptical of the AcQMAP approach using a modified Basket mapping catheter with ultrasonic crystals to, in essence, create a modified FIRM-like rotor mapping Hail Mary ... you can color me unimpressed and the articles promoting it are mostly hype aby Shannon - AFIBBERS FORUM
Hi Pompon, As your heard above, enlargement of the atria is strongly associated with AFIB/Aflutter, be that in a causal way, or simply as an associated marker of other CV issues (i.e. the ole' chicken or the egg debate). An enlarged-LA volume also can be associated with LV-diastolic dysfunction related to mitral valve stenosis or regurgitation and including (as both George and Carey notedby Shannon - AFIBBERS FORUM
Not much more to be said here Kevin, Other than underscoring the "run dont walk" advice to get thee in line ASAP! Starting one's 'AFIB Ablation Process' with the single most experienced and most highly skilled ablationist on planet earth is the very definition of "a no-brainer" ... all the more so when Dr Natale has already reviewed your case and recommendedby Shannon - AFIBBERS FORUM
Dr John Day is a really good man and physician who I know well. He is well aware of our site and Afibbers forum and enjoys our insights too very much as the oldest AFIB online resource that really pioneered life-style risk reduction/integrative approach to help stack the deck more in one's favor in contrast to the typical SAD (Standard American Diet). Better common sense diet combined wiby Shannon - AFIBBERS FORUM
Hi Mark, I totally agree with Carey that it’s highly unusual to only stop FLEC the day or night before an ablation! And it’s not at all unusual to need a second ablation as noted above, even with a top EP and even if the first ABL was done essentially perfectly. that’s why I tell everyone to expect two procedures to be truly done with this business, regardless of the operator, and be happy asby Shannon - AFIBBERS FORUM