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Hey NY, I can see your perspective clearly enough, but if 1/8 of the amount your pre-ablation meds (where Flecainide is concerned at an average daily dose of 200mg then 1/8 of that puts you at a frankly sub-therapeutic dose of 25mg/day) calms everything down and your AF hasn’t reoccurred then I’d consider that pretty encouraging and positive overall. I certainly wouldn’t count reaching for thaby mwcf - AFIBBERS FORUM
QuotePompon Carey, when you're speaking about the cost of the procedure, I think we can't make a fair comparison between different countries, because health insurance systems are different too. There may exist motivations, other than strictly medical, to make the procedures cheaper or costlier. I clearly remember the agitation in the room before my GA, there were half a dozen peopleby mwcf - AFIBBERS FORUM
Way to go Billyjeans! Great news!by mwcf - AFIBBERS FORUM
Took a look for articles about incidence of PE following AF ablation. Here are the first pertinent two I found. Patients referred for a first radiofrequency AF ablation were studied prospectively. Transthoracic echocardiography was performed before and 24h after the procedure. If PE was present, transthoracic echocardiography was repeated at 1month to evaluate PE evolution. Early arrhythmiby mwcf - AFIBBERS FORUM
At Bordeaux another reason they prefer you awake is so that they can ask you can stop breathing during each burn duration. GA obviously precludes this option and you will still obviously be breathing in and out whilst burns are being applied which for obvious reasons makes the job a bit more difficult. Pros and cons both ways as always. It's still unclear whether recent Bordeaux ablatee Sby mwcf - AFIBBERS FORUM
QuoteCarey Conscious sedation for an ablation makes no sense to me whatsoever. I would never even consider it. The safety reasons alone are enough to rule it out. CS is certainly better than GA from the POV of atrio-esophageal fistula. With sedation the patient can comment when the burning is getting a bit much and also the swallowing action (that stops under GA) keeps the esophagus more mobileby mwcf - AFIBBERS FORUM
Bordeaux always use sedation (midazolam and opiates) rather than GA - although a low dose of propofol will likely be used for any cardioversion required as part of the procedure.by mwcf - AFIBBERS FORUM
Agreed Carey. Can't see much cause and effect between AF in isolation and MI. Or put another way, it's the co-morbidities that so often accompany AF that predispose towards MI.by mwcf - AFIBBERS FORUM
I have noticed that AF is more likely to strike in the night after a day when I have been particularly bad-tempered and angry about something. I don't see why particularly negative mood can't assist in precipitating AF. In this world of quantum non-reality/non-locality ('nothing real exists') everything IS in the mind!by mwcf - AFIBBERS FORUM
Sounds good!!by mwcf - AFIBBERS FORUM
Liz' point is valid. Sugar is the main killer in western society and anything with 'diet' written on it is poison end of IMHO. I was just in Bordeaux for a week and the lack of overweight/obese folks there was gob-smacking compared to here in the UK. The French know about good quality food and drink. Mediterranean diet healthy? You bet. And mainly because it isn't full of garbby mwcf - AFIBBERS FORUM
Never had any side effects - incl. 'hang-overs' - with Flecainide 100mg BID in the 10.5 years I've been taking it. Maybe some tinnitus coming and going but I might have had/have that anyway.by mwcf - AFIBBERS FORUM
The easy conclusion is indeed that they’re just thinking of doing an index PVI for you (as indeed every centre here in the U.K. will do first procedure for PAF - e.g. Sabine Ernst in London told me likewise stop AAR med the night before). But that said, at 50mg Flecainide once per day only, after one half life of 12-27hrs (let’s average that and say 20hrs) you’d only have 25mg in your system anywby mwcf - AFIBBERS FORUM
Sounds like a good plan!by mwcf - AFIBBERS FORUM
Q to those here who’ve had ablations recently - did you get a LOT of ectopics/atrial irritability in the hours and first few days after your ablation and, if so, how long did things take to settle down?? Mike Fby mwcf - AFIBBERS FORUM
Grace, really sorry to learn you found my post offensive in any way. I mentioned my own PhD only to try and give my opinion a little weight in terms of me being someone who knows how to research thoroughly. Genuinely wishing you all the best for the future, Mike Fby mwcf - AFIBBERS FORUM
Grace, I’m a PhD-educated paroxysmal vagal AFr of 20 years standing and I’ve been hanging on this forum (and devouring any and all research) throughout that time under one nickname guise or another. I regret to say I’m pretty much with Wolfpack and Carey on this. Please don’t make the assumption that all doctors, cardiologists or even EPs know what they’re talking about. Do lots of reseaby mwcf - AFIBBERS FORUM
QuoteSocalsteve As a follow up: Just got back from my cardiologist who put me on 100mg of Flecainide twice daily, plus a low dose of metropolol if my heart rate gets too high to be comfortable. He put me on blood thinners ( just in case they want to cardiovert me in the future and also to prepare for another ablation ), set up a zio patch monitor ( so the EP department knows what they are dealingby mwcf - AFIBBERS FORUM
Thanks Carey - I must say I'd wondered about that myself. Intrinsically compromised by it's 'one-size-fits-all' approach when everyone's atrial anatomy (particularly the PVs) is different. Here in the UK on the NHS one invariably gets the cryo-balloon not RF - the reason being the CB is faster (cheaper) and needs less operator experience (more EPs can use it). I looked atby mwcf - AFIBBERS FORUM
Not new news admittedly, but I’m nonetheless wondering whether or not Natale or any other top EPs in the US are taking a hard look at this?? If not, why not?by mwcf - AFIBBERS FORUM
Different folks = different views. Do your own research and - with your EP's input - make your own choice. (FWIW IMO for me as a vagal AFr = no digoxin thanks.) Personally speaking I'm good with info and opinions provided by Hans, Shannon and Carey (and Jackie, George N, wolfpack and some others here). BTW; has anyone here ever had 1:1 AFlutter with Flecainide? I'm aware a few (by mwcf - AFIBBERS FORUM
FWIW I've found all of Carey's posts excellent. And I've been here on this forum for nearly 20 years under one nickname or another. If I recall correctly Carey has 15 years EMS experience behind him. And I am not in the anti-ablation sect or the pro-ablation sect in so far as one might argue such sects exist on this forum these days. I'm right down the middle and open to all iby mwcf - AFIBBERS FORUM
What RR says. I had AF once in my mid-20s, then next at 39 and ever since. Still paroxysmal. My mum started with it in her 30s and went permanent aged 70.by mwcf - AFIBBERS FORUM
What Carey says. I had my longest ever AF episode in 2002 after being given digoxin - 22hrs whilst every episode ever since has lasted no more than 6 hours (pre-Flecainide) and 1 or 2 hours using Flecainide.by mwcf - AFIBBERS FORUM
Fascinating stuff Dean. Also see: What I can't work out is exactly how the Ca ion channels are affected. If genistein significantly reduces Ca being able to able to get into cardiac cells (thus reducing Ca and increasing Mg in cardiac cells) then that is certainly of great interest to me at least as I've always believed that my genetic predisposition to AF is linked to too muby mwcf - AFIBBERS FORUM
Fascinating link - thank you Carey. I've had gout since 2001 totally controlled with Allopurinol since 2010. Mike Fby mwcf - AFIBBERS FORUM
Just to point out to any newcomers here that naturally-derived digoxin is - IMHO (and experience) at least - absolutely a total NO-NO for vagal AF.by mwcf - AFIBBERS FORUM
That's good news. Had my brain MRI'd a few years ago to check too. Quotelibby No worries. In reality I'm not overly concerned. My brain's been scanned. I have no aneurysms or other risk factors for the genetics.by mwcf - AFIBBERS FORUM