Atrial Fibrillation Forum A forum for sharing experiences and treatment options regarding atrial fibrillation and other atrial tachy-arrhythmias. https://www.afibbers.org/forum/index.php Sun, 24 May 2026 20:36:18 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,201356,201466#msg-201466 Re: Post ablation questions https://www.afibbers.org/forum/read.php?9,201356,201466#msg-201466 Carey AFIBBERS FORUM Sun, 24 May 2026 19:52:58 +0000 https://www.afibbers.org/forum/read.php?9,201356,201465#msg-201465 Re: Post ablation questions https://www.afibbers.org/forum/read.php?9,201356,201465#msg-201465
Quote
GeorgeN

I don't know who Jackie is,


Jackie is a woman who has been an active member here since the early 2000's. She's now around 89 years old. She had an ablation with Dr. Natale around 2003 and then a subsequent one around 2015 (from memory). She last posted 11 months ago & I last chatted with her on the phone likely within the last year as well.

She hasn’t posted in a while, so I hope she is ok. I’ve been on this site since 2004 and Jackie had contributed a wealth of valuable information.]]> susan.d AFIBBERS FORUM Sun, 24 May 2026 16:24:48 +0000 https://www.afibbers.org/forum/read.php?9,201448,201464#msg-201464 Re: New SVT https://www.afibbers.org/forum/read.php?9,201448,201464#msg-201464 gloaming AFIBBERS FORUM Sun, 24 May 2026 15:40:07 +0000 https://www.afibbers.org/forum/read.php?9,201452,201463#msg-201463 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201463#msg-201463
Quote
mjamesone
You can't seen an EP there unless referred by another cardiologist. So the HF is first

That makes a lot of sense and it may work to your advantage.

At Cleveland Clinic, you're already looking at an elite EP group, including as Wazni, Saliba, Santangeli, Hussein and others. But even at that level one EP may be a better match than another, especially with your previous congntal heart surgery history.

So since you're seeing the HF cardiologist first, Id use that visit to ask who they think is the best EP match for your particular case.

Best of luck,

Jim

Good thoughts there. I just wish I didn't have to wait till august to see the HFpEF doc.]]> bettylou4488 AFIBBERS FORUM Sun, 24 May 2026 14:53:16 +0000 https://www.afibbers.org/forum/read.php?9,201452,201462#msg-201462 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201462#msg-201462
Quote
Carey

I should add- I go to the UofMich. they are having a war with BCBS and I may not be able to see them in a few months unless they iron things out. I have made an HFpEF appointment at Cleveland in August. You can't seen an EP there unless referred by another cardiologist. So the HF is first. (Also made appointment with adult congenital folks but not sure how good they are). Any suggestions on an EP there?

By "there" do you mean Cleveland Clinic or UofM? If you mean Cleveland, then yes, I have a recommendation: Pasquale Santangeli. He's the EP director there so it might take some time to get scheduled, but he's a personal friend of Natale and trained with him. I would consider the two of them on par with each other.

Thanks you sorry that wasn't clear. Yes CC. Hopefully HF card will refer me to them (I may even try and make an appointment or have my UM doc call). Thanks for the name]]> bettylou4488 AFIBBERS FORUM Sun, 24 May 2026 14:51:38 +0000 https://www.afibbers.org/forum/read.php?9,201452,201461#msg-201461 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201461#msg-201461
Quote
mjamesone
So does anyone who is NOT overweight take them- or have info on that- wrt afib or HF if you deal with that?

I looked into some time ago. And yes, cardio protective irrespective if you are overweight or not. However, if you are not overweight, there may be an insurance issue.

I finally decided against these drug because I already have gastroparesis, meaning my stomach empties slowly, and GLP-1 drugs can slow gastric emptying even further. That's in part how they help reduce appetite.

But other than that, I definitely would have considered these drugs, especially since I was recently stented for CAD.


Jim

Thanks for responding. I do have some gastro stuff I deal with.... There is a local. urgent care who does an out of pocket program. They would not prescribe for me but I was wondering if they would work with my cardiologist so I could get on their cash program directed by my doc. it's worth a shot]]> bettylou4488 AFIBBERS FORUM Sun, 24 May 2026 14:50:32 +0000 https://www.afibbers.org/forum/read.php?9,201452,201460#msg-201460 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201460#msg-201460
Quote
susan.d
I wanted to reach out and share my experience with a medication called Spironolactone, as it has significantly helped my heart health.

I was prescribed a 12.5mg daily dose (half of a 25mg pill) to be taken first thing in the morning. While I resisted taking it for six months—partly because my pharmacist was concerned about combining it with Lasix for my edema—it has made a notable difference. After starting the medication, my Ejection Fraction (EF) improved from 39 to 50.

It is classified as a potassium-sparing diuretic, so it does increase potassium levels. I get my labs checked every three months, and so far, my levels have remained within the upper limits of normal.

Given how much it has helped improve my heart failure (HF) markers, I thought it might be worth mentioning. Perhaps you could ask your cardiologist about Spironolactone to see if it might be a suitable option for your situation as well.

Thanks so much.. I have HFpEF which is preserved ejection fraction (so myEF is ok.). But I do take aldactone. It is supposed help HFpEF as well.]]> bettylou4488 AFIBBERS FORUM Sun, 24 May 2026 14:48:15 +0000 https://www.afibbers.org/forum/read.php?9,201448,201459#msg-201459 Re: New SVT https://www.afibbers.org/forum/read.php?9,201448,201459#msg-201459
I did the test and reached 26 seconds. Could go longer but the reflex jumps in. I have always focused on deep breathing when swim training, running, mountain climbing (been up maybe 10 fourteeners and one 18,700 (Orizaba in Mexico). Nothing like that in the last 30 years other than skiing in Telluride Co. where we are at 10,000 to 12,000 for 6 days. No breathing issues while skiing. I stop when the legs burn too much. Mostly blue slopes.]]> Ken AFIBBERS FORUM Sun, 24 May 2026 13:50:57 +0000 https://www.afibbers.org/forum/read.php?9,201452,201458#msg-201458 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201458#msg-201458 You can't seen an EP there unless referred by another cardiologist. So the HF is first

That makes a lot of sense and it may work to your advantage.

At Cleveland Clinic, you're already looking at an elite EP group, including as Wazni, Saliba, Santangeli, Hussein and others. But even at that level one EP may be a better match than another, especially with your previous congntal heart surgery history.

So since you're seeing the HF cardiologist first, Id use that visit to ask who they think is the best EP match for your particular case.

Best of luck,

Jim]]> mjamesone AFIBBERS FORUM Sun, 24 May 2026 13:48:35 +0000 https://www.afibbers.org/forum/read.php?9,201352,201457#msg-201457 Re: Pulsed Field Ablation Bests Meds as First-Line Treatment for Persistent AF in Randomized Trial https://www.afibbers.org/forum/read.php?9,201352,201457#msg-201457 hwkmn05 AFIBBERS FORUM Sun, 24 May 2026 12:40:34 +0000 https://www.afibbers.org/forum/read.php?9,201452,201456#msg-201456 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201456#msg-201456
Quote
bettylou4488
I should add- I go to the UofMich. they are having a war with BCBS and I may not be able to see them in a few months unless they iron things out. I have made an HFpEF appointment at Cleveland in August. You can't seen an EP there unless referred by another cardiologist. So the HF is first. (Also made appointment with adult congenital folks but not sure how good they are). Any suggestions on an EP there?

By "there" do you mean Cleveland Clinic or UofM? If you mean Cleveland, then yes, I have a recommendation: Pasquale Santangeli. He's the EP director there so it might take some time to get scheduled, but he's a personal friend of Natale and trained with him. I would consider the two of them on par with each other.]]> Carey AFIBBERS FORUM Sun, 24 May 2026 03:10:20 +0000 https://www.afibbers.org/forum/read.php?9,201452,201455#msg-201455 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201455#msg-201455 So does anyone who is NOT overweight take them- or have info on that- wrt afib or HF if you deal with that?

I looked into some time ago. And yes, cardio protective irrespective if you are overweight or not. However, if you are not overweight, there may be an insurance issue.

I finally decided against these drug because I already have gastroparesis, meaning my stomach empties slowly, and GLP-1 drugs can slow gastric emptying even further. That's in part how they help reduce appetite.

But other than that, I definitely would have considered these drugs, especially since I was recently stented for CAD.


Jim]]> mjamesone AFIBBERS FORUM Sun, 24 May 2026 02:39:12 +0000 https://www.afibbers.org/forum/read.php?9,201452,201454#msg-201454 Re: HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201454#msg-201454
I was prescribed a 12.5mg daily dose (half of a 25mg pill) to be taken first thing in the morning. While I resisted taking it for six months—partly because my pharmacist was concerned about combining it with Lasix for my edema—it has made a notable difference. After starting the medication, my Ejection Fraction (EF) improved from 39 to 50.

It is classified as a potassium-sparing diuretic, so it does increase potassium levels. I get my labs checked every three months, and so far, my levels have remained within the upper limits of normal.

Given how much it has helped improve my heart failure (HF) markers, I thought it might be worth mentioning. Perhaps you could ask your cardiologist about Spironolactone to see if it might be a suitable option for your situation as well.]]> susan.d AFIBBERS FORUM Sun, 24 May 2026 02:15:48 +0000 https://www.afibbers.org/forum/read.php?9,201448,201453#msg-201453 Re: New SVT https://www.afibbers.org/forum/read.php?9,201448,201453#msg-201453
Know you are fit, but even some who are fit (and young) have a lower CO2 tolerance.

In this post [www.afibbers.org] scroll down to CO2 tolerance test and then follow the link and see how you do. This is something that is trainable. A decade younger than you, I have trained this for years. Today, I commonly rock climb with people 30-40 years younger. I'm carrying a 60# climbing pack up steep canyon trails at 7,000' elevation. I'm never out of breath, always nasal breathing. My younger companions may carry a 10# pack, breathing thorugh their mouth and stopping to catch their breath. I'm typically the person leading all the climbs including trad & multi-pitch. Again, I'm never out of breath while the followers who are not leading get winded. Same when I'm alpine skiing at 12-13000'. Let me know if you want more info.]]> GeorgeN AFIBBERS FORUM Sat, 23 May 2026 18:53:47 +0000 https://www.afibbers.org/forum/read.php?9,201452,201452#msg-201452 HF and afib/flutter https://www.afibbers.org/forum/read.php?9,201452,201452#msg-201452
I tell you all that to say that probably was what triggered it.

But I am researching HF and HFpEF (heart failure preserved ejection fraction), along with Afib and I see a lot of stuff.

I take a calcium channel blocker (cardizem). I am reading that isn't optimal.

I am reading a LOT about GLP1s. I think Carey posted here an article I just read.

6 months ago my HF doc said he only did that for overweight people but it looks like it could be very heart protective for both HF and Afib. I see him again this next week.

So does anyone who is NOT overweight take them- or have info on that- wrt afib or HF if you deal with that?

I should add- I go to the UofMich. they are having a war with BCBS and I may not be able to see them in a few months unless they iron things out. I have made an HFpEF appointment at Cleveland in August. You can't seen an EP there unless referred by another cardiologist. So the HF is first. (Also made appointment with adult congenital folks but not sure how good they are). Any suggestions on an EP there? I am loosely scheduled for an ablation in the fall / early winter at UM- but won't be able to do that if the insurance stuff isn't figured out.

I also see my adult congenial doc next week. I am just trying to figure out what questions to ask and specifically the GLP-1 thing.]]> bettylou4488 AFIBBERS FORUM Sat, 23 May 2026 18:49:28 +0000 https://www.afibbers.org/forum/read.php?9,201448,201451#msg-201451 Re: New SVT https://www.afibbers.org/forum/read.php?9,201448,201451#msg-201451 Essentially, I have been through all those tests with no issues found.

If you've had a CT angiogram and it was clear, then obstructive CAD becomes less likely an explanation, but that doesn't mean, of course, that it's the SVT's. The echo will be another data point but SOB can be a very tough differential diagnosis. Good luck.

Jim]]> mjamesone AFIBBERS FORUM Sat, 23 May 2026 16:42:24 +0000 https://www.afibbers.org/forum/read.php?9,201448,201450#msg-201450 Re: New SVT https://www.afibbers.org/forum/read.php?9,201448,201450#msg-201450
Essentially, I have been through all those tests with no issues found. The patch was because of a low heart rate concern since my resting rate was often in the high 40's. Dr. wanted to see what was happening when I slept. Nothing in the low 40's. The whole thing started when I was breathing a bit harder with my normal activities, similar to a previous bi-lateral pulmonary embolism. No embolism this time, so they looked for something else, but little to nothing found except the SVT. My max heart rate only reached 127 during the stress test, which is within normal limits for my age. I feel like my heart doesn't keep up with O2 demand when under physical exertion.]]> Ken AFIBBERS FORUM Sat, 23 May 2026 15:20:28 +0000 https://www.afibbers.org/forum/read.php?9,201448,201449#msg-201449 Re: New SVT https://www.afibbers.org/forum/read.php?9,201448,201449#msg-201449
Of course you will know more with the echo report, but shortness of breath has be taken seriously, and isn't necessarily related to the SVT's.

I would think given your symptons and age that you need a complete cardio pulmonary work up, including PFT's, Chest CT, a stress exercise test, Lp(a) and a Calcium Score or CT Angiogram. And if you have any GI issues, then a GI workup as well.

I had most of the above with my SOB and it pointed to part coronary and part GI. Ended up with six stents, which is not bad considering what might have happened without the tests. Hopefully, in your case something less serious.

Meanwhile, until you get more information, I would cut bck on the activities that really push your heart rate.

Jim]]> mjamesone AFIBBERS FORUM Sat, 23 May 2026 14:31:17 +0000 https://www.afibbers.org/forum/read.php?9,201448,201448#msg-201448 New SVT https://www.afibbers.org/forum/read.php?9,201448,201448#msg-201448
Any comments on what this may mean would be appreciated. To me, it seems that there is little to worry about, but???

Many of you may recall my story. Two successful afib ablations, excellent physical condition, 81 years old,1968 Olympic swimmer. Play golf, windsurf, scuba dive, snow ski and regular workouts.]]> Ken AFIBBERS FORUM Sat, 23 May 2026 12:31:05 +0000 https://www.afibbers.org/forum/read.php?9,201444,201447#msg-201447 Re: EP visit at Dartmouth Hitchcock. https://www.afibbers.org/forum/read.php?9,201444,201447#msg-201447 This is a teaching hospital so I would like some assurances before hand.

You should have the "talk" about who will do what. Some EPs will do all of it, especially if you ask, some will flat out say, I'll be there supervising, but this is a teaching hospital and we teach.

At the end of the day, teaching hopsitals like Cleveland Clinc and Sinai have very high success rates, so it seems to work. And remember, your success gets credited to the EP, so they have a real vested interest. So if you pick the right EP, you will be fine. I would not overthink.

The one caveat is do not schedule I think in August? I may have the date wrong, but I was told never to schedule an ablation the month the new cardiac fellows arrive and rotate, so find out when that is and schedule say 1-2 months after. This was told to me by an EP at a teaching hospital.

Anyway, for a basic PVI, it's pretty much by formula and if they're trained right, the results should be the same. Now, if they were hunting for an elusive tachycardia, then I'd want a solid assurance who will be looking.

Jim]]> mjamesone AFIBBERS FORUM Sat, 23 May 2026 00:17:53 +0000 https://www.afibbers.org/forum/read.php?9,201444,201446#msg-201446 Re: EP visit at Dartmouth Hitchcock. https://www.afibbers.org/forum/read.php?9,201444,201446#msg-201446 hwkmn05 AFIBBERS FORUM Fri, 22 May 2026 22:03:40 +0000 https://www.afibbers.org/forum/read.php?9,201444,201445#msg-201445 Re: EP visit at Dartmouth Hitchcock. https://www.afibbers.org/forum/read.php?9,201444,201445#msg-201445 Of course they only do PVI ...

Don't know your AF history, but if it's your first ablation, especially for paroxysmal AF, a PVI only is not a bad thing. In fact that is probably what you want. It's what I wanted. My EP was highly qualified to do more, but he did a simple PVI because his experience showed that was the right amount of ablation in cases like mine. Going on 3 years AF free.

More burning does not automatically mean better results and can add risk without necessarily improving success. And just because something can be provoked during the procedure, does not mean it will be a problem when you go home.

And there is study data supporting both these points.

Yes, a simple PVI might not work, no guarantees with any ablation, but according to a couple of EPs I spoke to at top cardiac hospitals, if success is defined as a 95% reduction in AF burden, then the odds of a successful ablation can be close to 90%.

And if your're in the unlucky 10%, you can always go back later. But you can't un-ablate tissue that was unecessarily burned the frst time.

Additional burning outside of the pulmonary veins certainly has its place especially in redo cases, very persistent AF, flutter, identifiable left atrial fibrosis, or other documented tachycardias.

But what might be most important in your case is simply to find a high-volume EP you have confidence in, who works at a cardiac center of excellence. And not just assume that the most extensive ablation is automatically the best, especially for a first ablation for paroxysmal.

Jim]]> mjamesone AFIBBERS FORUM Fri, 22 May 2026 19:08:39 +0000 https://www.afibbers.org/forum/read.php?9,201444,201444#msg-201444 EP visit at Dartmouth Hitchcock. https://www.afibbers.org/forum/read.php?9,201444,201444#msg-201444 hwkmn05 AFIBBERS FORUM Fri, 22 May 2026 11:13:22 +0000 https://www.afibbers.org/forum/read.php?9,201424,201443#msg-201443 Re: Heading for my 3rd ablation with Dr. Natale https://www.afibbers.org/forum/read.php?9,201424,201443#msg-201443
I lived 45 minutes from Los Robles hospital. I knew with my >190 flutter, once I wean I would need the ER to drug convert me. However 911 would only take me to a local ER and i didnt want to be stuck and miss my ablation. So a fellow on this board suggested an inexpensive hotel that was close to the hospital to guarantee if I did need the ER, an ambulance would take me to the hospital where the ablation was scheduled.

Actually I was calmer knowing I was close enough to the hospital if my flutter acted up. I never did need an ambulance but it was a good plan B. Especially if you are flying and don’t want an episode on the flight because of your weaning.

I don’t know about AirbNb prices, but perhaps check it out. Get a place with a kitchenette/microwave/fridge to save on eating out.

Good luck with your ablation!]]> susan.d AFIBBERS FORUM Fri, 22 May 2026 01:28:50 +0000 https://www.afibbers.org/forum/read.php?9,201417,201442#msg-201442 Re: Multaq and low dose amitriptyline https://www.afibbers.org/forum/read.php?9,201417,201442#msg-201442 Carey AFIBBERS FORUM Thu, 21 May 2026 02:54:18 +0000 https://www.afibbers.org/forum/read.php?9,201417,201441#msg-201441 Re: Multaq and low dose amitriptyline https://www.afibbers.org/forum/read.php?9,201417,201441#msg-201441 PamelaJean AFIBBERS FORUM Wed, 20 May 2026 23:22:05 +0000 https://www.afibbers.org/forum/read.php?9,201417,201440#msg-201440 Re: Multaq and low dose amitriptyline https://www.afibbers.org/forum/read.php?9,201417,201440#msg-201440
Quote
PamelaJean
No labs or EKG since I started Multaq so wouldn’t that be needed sooner rather than later?

There's no need for that if you're taking Multaq alone. I spent a while on Multaq and my EP never felt the need to monitor that, and he's a stickler for stuff like that.]]> Carey AFIBBERS FORUM Wed, 20 May 2026 22:51:16 +0000 https://www.afibbers.org/forum/read.php?9,201417,201439#msg-201439 Re: Multaq and low dose amitriptyline https://www.afibbers.org/forum/read.php?9,201417,201439#msg-201439
“our pharmacist was messaged 5/18/26 about this when you messaged us to look into the interactions and she said "The pt is on a lower dose of amitriptyline and, at this time, the potassium and Magnesium are normal. We would need to monitor those levels regularly, along with the QT interval and dose of amitriptyline to make sure the risk of TaP does not increase.” Which we already have yearly labs ordered and yearly EKG as well to monitor.”

This is not the first time I find out they were actually having conversations about me but not informing me. How is that helpful? Not even sure if that means amitriptyline would be safe or not. No labs or EKG since I started Multaq so wouldn’t that be needed sooner rather than later? My appointment isn’t until mid-June. Unless my sleep schedule changes drastically I’m not planning on restarting amitriptyline.

Thanks.]]> PamelaJean AFIBBERS FORUM Wed, 20 May 2026 22:34:23 +0000 https://www.afibbers.org/forum/read.php?9,201417,201438#msg-201438 Re: Multaq and low dose amitriptyline https://www.afibbers.org/forum/read.php?9,201417,201438#msg-201438
Quote
PamelaJean

Not so far, but the loop should be closed IMO. If it's the same issuing pharmacy, the team should pick that up, probably on software they rely on to advise of potential conflicts. Since you don't know, yeah, I would at least say something.

“Not so far” So I shouldn’t be concerned? Say something to the pharmacy? The doctor?

I was perhaps too cryptic...sorry. So far, you don't seem to be suffering unduly, and that's all I meant. Which is good....no? As for contacting someone, if your pharmacist hasn't caught it (mine are scrupulous about this and coach us about any potential problems in view of our medical history), then your PCP, at least, should be queried.]]> gloaming AFIBBERS FORUM Wed, 20 May 2026 20:58:31 +0000 https://www.afibbers.org/forum/read.php?9,201417,201437#msg-201437 Re: Multaq and low dose amitriptyline https://www.afibbers.org/forum/read.php?9,201417,201437#msg-201437 PamelaJean AFIBBERS FORUM Wed, 20 May 2026 14:56:38 +0000