Greetings

Hello Board Members,

My name is Dr. Pirelli. for the past 10 years I have been a regular MD practitioner with no extra footholds on any particular specialty. Just a good old fashion run of the mill family doctor. I am very much oriented to holistic health and try to adhere to the doctrine of alternative medicine in my practice. If I can be of any help to anyone on this board, just ask. I will make my presence known here from time to time.

My thoughts and prayers go out daily to all a-fib sufferers for I am one myself. I would like to share my expertise not only as an MD but also share my own a-fib experiences and how I go about treating this annoying ailment.


My first line of thought would be directed to all Coumadin users. I feel very strongly that this rat poison is not necessary to protect against blood clots,unless of course you are those who go beyond the 32 hour time clock, those who are substantially under this number should rely in confidence on Vitamin E, AGED garlic extract and omega 3 fatty acids.

Let this point be the breaking of the ice. I am waiting for the attacks!! LOL..

Warm Wishes,
Gary Pirelli

Gary,

Now that you have made yourself known. We welcome you and your opinions and expertise and would appreciate any information that you may be able to lend to our united cause.

Joe

Hello and welcome,

Can you tell us a little about yourself, your medical training and how long you have had afib, what kind of afib, etc.?

Thank you for offering your help. It is encouraging to hear from an M.D. who practices alternatively.

Carol

Gary,

What is the 32 hour time clock? I have often heard that 48 hours after the onset of an afib episode stroke becomes a risk, and most doctors won't cardiovert the patient until the patient has been on a blood thinner for a period of time like maybe two weeks. I've never heard of a 32 hour time clock.

Newman

Gary,

Are you considering an ablation? Why or why not? What do you think of ablations? Are you familiar with the Cleveland Clinic Heart Center? What do you think of it? Do you know of Dr. Natale? Any comments on him (I am aware doctors are reluctant to give public opinions about other doctors). Do you have an opinion about which medical centers in the world are the best places to have a successful ablation? Who do you think the best doctors in the world are for this procedure? Are you aware of any impending major advances in the pipeline for ablation procedures and instruments, tools, equipment etc.? What is your opinion of electrophysiologists who perform ablations without doing a pulmonary vein isolation procedure? How harmful do you feel smoking is to the human body? All information would be appreciated.

Newman

Dr. Gary -- A sincere welcome goes out to ya! Thanks for joining us.

On your breaking-the-ice recommendation re: anticoagulation, I'd be love to hear your corresponding suggestion for those of us with persistent LAF.

Gracias!

LarryG
V/55

If taken properly and INR checked regularly.........it shouldn't be too much a risk. The most important thing is keeping the levels checked.

Thanks for your post. If you will review some of the postings here, and have a look at Hans' book, this should give you an idea of the thinking of contributors here. I think that a lot of us believe that alternative approaches are quite likely to be of benefit in many -- probably not all -- cases of LAF, but that current medical knowledge is insufficient.

One example of such insufficiency is raised by your post, where you refer to a time limit of 32 hours, which I assume is a conservative approach to the 48-hour rule of thumb referred to by another poster (the 48 hours is the limit in current guidelines on electrocardioversion without anticoagulation). As far as I know, such time limits are guesswork. Are you aware of solid evidence of stroke risk in connection with AF episodes that last less than 32 or 48 hours? Would stroke risk be reduced in the case of patients without hypertension and who are below 65? As far as I know, there are no good answers to these questions, but if you are aware of one, I am sure readers of this board would be keenly interested. In particular I would be interested in elucidation of how strokes work: suppose that a thrombus is formed as a result of AF. What does blood pressure or age have to do with the likelihood that that thrombus will cause a stroke, and what kind of percentages are we talking about?

Great to have you on board Dr Gary. I always think a Dr who is more inclined towards holistic practice is in the job to make a difference, not just as a career. Welcome

Fran

Dr. Perilli,

It is an honor to welcome you to this site. I, too, would be very interested to know more about your personal situation in regards to AF. My questions would be, what was your diet like before and have you made any changes? Did you exercise, and if so, to any extreme? Have you had any molecular tests done to check amino acids, vitamins, minerals, metabolic markers, etc. or do you even believe this to be relevant? Are you presently on any meds, and if so, which one/s and have you been on previous meds that didn't work? Do you have any known triggers? And last, but not least, do you have any theories about what you think the cause/s might be?

I completely agree with your opinion on coumadin, but do know it is necessary in some cases. I wish we could all welcome you under better circumstances, but the more brain power we have here, the more progress we will make, so I'm excited to have you join us.

Richard

Dr. Pirelli -

How very nice of you to join us - and sorry it has to be under the circumstances of afib, but who better a person than a physician with the condition. It's delightful that you subscribe to alternative methods and I am sure everyone will keep you very busy.

Regarding Coumadin, I feel they same way you do and have avoided taking it while risking the wrath of my traditional medicine MD's as a non-compliant and difficult patient. However, with the recent ablation, I've had to submit and I am truly having a very difficult time.

No doubt because my blood is naturally thin and I've used naturally thinning supplements for years.... but the establishment doesn't consider that adequate.

Your endorsement of the natural products will help everyone who desires to reduce the risk of clotting and stroke without resorting to the rat poison.

It's an honor to have you with us. I doubt if you will have many attacks, more like many welcoming comments, I would guess.

Best regards, Jackie

Newman - I don't know about the 32 hour clock either, but on one of my ER visits last spring - I had gone 48 hours and they would not convert me until I reached the appropriate INR level which took about 3 days while in the hospital and I also was required to have the TEE before conversion.

It seems at least with the CCF, if you are on Coumadin and reach the numbers between 2.0 and 3.0, they will convert you...if not it takes between 3 and 4 days to get your level up. I was once at 1.96 or something like that and they refused to convert until I reach the 2.0...

So I hung around in the hospital room and finally converted naturally after 39 hours....so they lost the fee of conversion.

Rules are rules and it seems that the INR numbers are the governing rule.

My orders were and still are even after ablation - if the afib goes on longer than 24 hours - go to the ER.

Let's hope that never happens again!

Jackie

Jackie,
Can you explain what you mean by "the truly difficult time that you are having?"
Thanks.
Carol