Hey Lou, That's the point rapid reversal even with Warfarin requires PCC just like Xarelto. The 4-6 hours reversal with Vit K IV might not be true. The rapid offset of Xarelto might be the best option then? Lou why are you still on Warfarin anyway? An intravenous dose of 5 to 10 mg of vitamin K will correct the international normalized ratio (INR; a measure of the anticoagulant effecby McHale - AFIBBERS FORUM
Tom, Thanks I needed that. A buddy of mine NYC firefighter had a heart attack fighting a high rise fire 30 years ago after being burned badly then had a second heart attack during the painful skin grafting. Been on Warfarin ever since with no problems living a very active lifestyle. Same goes for a co-worker with a mechanical valve replacement. I was also concerned with having elective procedby McHale - AFIBBERS FORUM
No specific fast-acting antidote is currently available to reverse the anticoagulant effect of any of the NOACs or warfarin. In the case of warfarin, vitamin K is frequently misunderstood as an antidote while it is actually a supplement, which simply replaces the vitamin K needed for the synthesis of the coagulation factors blocked by warfarin. Reversal of the anticoagulant effect of warfarin isby McHale - AFIBBERS FORUM
Hey Tom, Glad you are doing well now after a rough start. I'm still trying to decide on what EP to pick Dr Reddy or Dr Steinberg. Dr Reddy tells me I can probably come off coagulation after maybe a year....Dr Steinberg tells me it's for life and anybody who tells you differently is giving bad advice. My cardio and some others say the same thing because of my recent TIA. So my spiritsby McHale - AFIBBERS FORUM
As least with Xarelto there is complete reversal according to this article. Maybe that's why every cardio or EP I spoke with tells me there is a reversal agent. But stocking and proper protocols using this in ER's is a problem as Shannon points out. Also they used 20mg twice a day whereas in AFIB it is used once daily so theses patients had double the amount of the drug in their system.by McHale - AFIBBERS FORUM
Hey Tom How's it going so far? You seem to be doing well. Any AFIB since your ablation ?by McHale - AFIBBERS FORUM
Phylis, These are indeed life saving drugs for us and will be needed by many more on here down the road as Chads score increase as you age. Sometimes I don't get the thinking on this forum........by McHale - AFIBBERS FORUM
Diane98683 Wrote: ------------------------------------------------------- > On the other hand, if you chose to go on them, > then you had a hemorragic stroke (they all > significantly increase the risk of it), then you'd > wish you had a second chance to decide against > them. pick your weapon.......by McHale - AFIBBERS FORUM
Diane I don't think its a rebound effect but rather the fact that stopping any coagulant will greatly increase you stroke risk from what I read.???? As for Xarelto that woman from the other forum not only sliced a nice piece of her finger tip off but I believe she got thrown out of the car during the collision no seat belts. As for bleeding risk most die in trama centers anyway and I mightby McHale - AFIBBERS FORUM
Shannon, What do you think about the 2 differing views of anitcoagulation between Reddy and Steinberg after a TIA? In one of Han's monthly afib reports he had a study about if you use both cyro and RF success rates are much improved during a PVI. Maybe he can dig it up. What about rough sex.......... is that okay? Ha!by McHale - AFIBBERS FORUM
Nobody is too eager to go on blood thinners but look at it this way if you have a stroke then you may wish you had a second chance.......by McHale - AFIBBERS FORUM
Shannon, Took you long enough to read this.........just kidding maybe I should have posted it with a less humorous title. I've always wondered about this that the size and shape of LAA would be a big factor in stroke risk.by McHale - AFIBBERS FORUM
Hey Shannon, I wouldn't consider Dr Steinberg up and coming as he has done thousands of ablations and over 2000 afib ablations. He's actually made NY Magazines Best Doctors now at least 6 years running. Hans I believe has also recommended him? But in the same breath I hear what you're saying about Dr Natale or Dr. Haissaguerre and if they were close it would be a done deal by nowby McHale - AFIBBERS FORUM
Shannon, Dr Steinberg St Lukes/Valley Hospital uses both Arctic Front Cyro and RF for paroxysmal ablations like mine with equal success about 80% without drugs. He's done well over 2000 afib ablations by now. Any recommendation for him? He's using FIRM for select patients on a very limited basis still ironing out the equipment and mapping and waiting on further instruction or somethingby McHale - AFIBBERS FORUM
Dr Mansour is a good one out of Mass General.by McHale - AFIBBERS FORUM
Dr Reddy at Mt Sinai told he he rarely touches the LAA doesn't see much of a problem there.............by McHale - AFIBBERS FORUM
I always wondered about the shape of the LAA and strokeby McHale - AFIBBERS FORUM
The only hope we have to get closer to a "cure" right now is the work of Dr Narayan with FIRM ablations who actually targets the 2 or 3 rotors that sustain afib. Everything else has just been a ban-aid till now with some people actually "cured" with current ablation strategy. A Mt Sinai EP and the top Cleveland Clinic EP's also echo the same thing anybody that tells youby McHale - AFIBBERS FORUM
afhound99 Wrote: ------------------------------------------------------- > If they're silent, how do you know if you had one? > Effect many be cumulative > > You don't without an MRIby McHale - AFIBBERS FORUM
Shannon, Without an MRI of the brain there no no way in knowing if you have silent strokes. No top elite ablationist gives an MRI after a procedure so how do we really know? I had 2 tiny ones that were old and I knew nothing about until my recent one which they diagnosed with an MRI. Time to take my Xarelto now.by McHale - AFIBBERS FORUM
Diane98683 Wrote: ------------------------------------------------------- > > Nevertheless, in a society where aFib is growing > in numbers in leaps and bounds it can't hurt. > > Is AFib really growing by leaps and bounds? Is > this due to an aging population, or is it growing > in specific age groups as well? Actually it's probably not growing in leapsby McHale - AFIBBERS FORUM
Shannon, No I did not convince Dr Reddy to perform a FIRM ablation on me. I'm not too sure he's really that involved in it since his main focus right now is principal investigator for the laser ballon which is not approved in the US. He did offer me that procedure but I told him I not sure I'd be interested. So he told me for my paroxysmal afib right now it would be best to do RF.by McHale - AFIBBERS FORUM
Hey Shannon, Watching that first video was eery as I watched the visuals of the Mt Sinai building and the entrance to the EP lab. They wheeled my mom in there last February for her valvoplasty for aortic stenosis after she called me in the morning with breathing problems. She was put on a ventilator gasping for every breath for 24 hours. After she came out of it they decided on the balloon procby McHale - AFIBBERS FORUM
Hi Shannon, There is more news coming from Dr Narayan..........all good I have another consultation with another top Elite EP in New York next month highly rated doing FIRM after a brief pause to assess the patients he's already done. He's moving forward again after seeing excellent results..........It's not just Dr Narayan promoting it any more.by McHale - AFIBBERS FORUM
Tom, Glad you're feeling better! But wow 50lbs.......take it easy for a while! Best Wishes for NSR! BTW any bruising at your insertion sites? You said they knocked you out? What did they use? Propofol the powerful anesthetic? Where you in a twilight during the procedure? This drug is used for colonscopies you can actually watch the procedure but many times go blank to it afterwards and forby McHale - AFIBBERS FORUM
Shannon, What Narayan claims is there are ONLY 2 or 3 critical rotors that sustain any Human AFIB that are being found thru his Topera mapping system and ablated stopping afib in its track so it doesn't matter all where all these other spots the top EP's are ablating. All this is done well before any PVI takes place and his new evidence is pointing toward FIRM with no PVI being just asby McHale - AFIBBERS FORUM
Hans, Yes I read this article subscribe to your newsletter invaluable info have all the PDF's stored on my Ipad. So much to absorb and sort out. I'm sure hoping there's more data to come out soon. FIRM is totally different than what the top EP's are doing.The difference in the Papone or Natale protocol that shuts down AFIB is first they do a PVI and then look for rogue "by McHale - AFIBBERS FORUM
Shannon, Let me throw this at you? What if I found a top EP that is doing FIRM even if he had only done a limited number? A 90 min procedure with only < 10 burns vs > 200 for full blown PVI? I see all gain and not much downside with this. I'm sure you will correct me on this. My intuition tells me the way we do ablations now is overkill I actually have another name I won't use.by McHale - AFIBBERS FORUM
Oh it will be trust me.........by McHale - AFIBBERS FORUM
Researcher, Dr Reddy was one of the first to investigate Cryo and he told me Wednesday he's concerned about phrenic nerve damage with this technique.by McHale - AFIBBERS FORUM