Atrial Fibrillation Forum

What % of EPs are capable of isolating LAA? (12 replies)

nonthumper — Tue, 07 Apr 2026 02:58:35 +0000

I am 16 days out from my first ever ablation, after being in 100% Afib since July. The Kardia says I am still in NSR.

I am still analyzing the whirlwind experience. I read Dr. Natale's post procedure notes. Of course, I arrived in the lab in Afib. He did treated several parts of my heart, but was not able to get me into NSR until he isolated my LAA.

I read in a previous thread on here that many EPs do not have the skill to isolate the LAA. So it appears likely that if I had gone to a lesser practitioner, I would have left the hospital still in Afib. So I am wondering what the probabilities of that were.

I now know a good question to ask when you meet prospective EPs would be: "Do you ever isolate the LAA?".

I asked one regional EP how many ablations he did in a month, and when he did not give a clear answer, I crossed him of the prospective list.

As far as how Dr. Natale operates, his clinical notes reveal: A total of 2 minutes of radiofrequency energy lesions were delivered. A total of 199 pulsed field ablations were delivered. Flouro time was 15.6 minutes. (I saw a video where an EP was talking about how important it was to keep flouroscopy times down.)

All this seems to have been accomplished in a little over an hour.

Eliquis & cataract surgery (4 replies)

Madeline — Sat, 04 Apr 2026 23:24:35 +0000

Hi,

A simple question that’s probably already been answered for me, but I wanted to make sure about whether or not to stop Eliquis any period of time before my cataract surgery. I did have the LAA ablation and a Watchman placed and I’m pretty sure Dr. Natale had said in the past that if ever one needed to, they could stop for up to seven days, maybe 5. Since I haven’t heard anything from the cataract people and my procedure is in 10 days, I assume it is not necessary. However, I’d like to get my answers from the experts at A-Fibbers because you all know the specific conditions and answers. I trust the information from most people here.

Thank you.

Afib post ablation (4 replies)

Taytantuc — Sat, 04 Apr 2026 20:27:51 +0000

I just had my 5th ablation 16 days ago. This time with Dr Natale. He isolated the LAA and posterior wall of the LA. Been in perfect sinus until today. I was washing my boat and I think I am out. Pulse is very steady but testing is running at 74. Normal HR is 60 when lying down. Really bummed. Hoping it reverts.

When the Time Comes to Stop Oral Anticoagulation: Options and Obstacles (8 replies)

JakeL — Mon, 06 Apr 2026 15:46:09 +0000

We normally think about a CHA2DS2-VASc score or Watchman Left Atrial Appendage (LAA) procedure. But what about life priorities at a certain age? Or, should it be a combination of all 3 parameters?

https://www.tctmd.com/news/when-time-comes-stop-oral-anticoagulation-options-and-obstacles

Margaret Fang, MD (University of California, San Francisco) said a study led by one of her mentees, Sachin Shah, MD (University of California, San Francisco), provides some data to help inform the issue. Published in 2019, the analysis estimates the net clinical benefit of oral anticoagulation beyond age 75 in patients with AF, showing that the benefits become marginal after age 87 for warfarin and after age 92 for apixaban (Eliquis; Bristol-Myers Squibb).

Shake Your Ears for 30 Seconds - The Results Will Shock You! Dr. Mandell (no replies)

Todd — Wed, 01 Apr 2026 12:03:53 +0000

He brings up the vagus nerve, and rapid heartbeat. Just some of it. Takes about a minute to do it.
Search it more. Auriculotherapy This came up in the search also Auriculot

[www.youtube.com]

Did you know that a simple technique like shaking your ears can help stimulate your parasympathetic nervous system? In this video, we dive into how this practice activates the auricular branch of the vagus nerve, located near the ear and jaw. This powerful connection can help your body restore balance and healing, promoting relaxation and calming the nervous system.

Shaking your ears can have a profound effect on several areas of your health, including reducing stress and anxiety, improving sleep quality, aiding digestion, lowering blood pressure, and even offering relief from conditions like tinnitus and vertigo. By stimulating the vagus nerve, this technique enhances the body’s ability to heal itself, bringing a sense of calm and well-being.

New Magnetic Fluid Gel to Plug the LAA? (no replies)

gloaming — Tue, 31 Mar 2026 06:10:37 +0000

[medicalxpress.com]

As Direct Oral Anticoagulants Face Off in VTE Trial, Apixaban Confirmed as a Safer Option (no replies)

sldabrowski — Mon, 30 Mar 2026 13:45:52 +0000

For those of the forum on AC drugs

[www.medscape.com]

Resting heart rate (3 replies)

gbaileytx — Sun, 29 Mar 2026 15:47:11 +0000

My resting rate (when I'm not in afib) is low, 52 to 55. Sometimes it drops into the 40s, I can feel it, and it seems that this is when afib is on the way, usually to last several hours, sometimes all day.
Anyone else have this experience, or similar?

Need a “quick & dirty” answer (5 replies)

SueChef — Fri, 27 Mar 2026 22:31:25 +0000

I got up at 8am to use the bathroom. Went back to bed & was hit with tachycardia—120 bpm. Did my usual interventions (slow breathing, some low sodium V-8, walked slowly around the house, meditated, ice cold towel on my face, cold pacs on my vagal nerve, ‘straining’ etc)—no change. I waited it out until time for my Flecainide at 11:00am. I know Flecainide is a rhythm medication. It’s 11:45am now.
Is my next step Diltiazem, which I use as PIP & has always helped with tachycardia?…or do I cool my jets until 1pm when I usually take Metoprolol Succinate? I also have faster acting Metoprolol Tartrate on hand too.
Usually the tachy has gone back to a normal HR by now but I’m still tachy and of course I want to avoid the ER.
Thanks for any help!

Normal activites (5 replies)

gbaileytx — Sun, 29 Mar 2026 13:47:54 +0000

How much does your afib influence your normal activities, such as yard work, exercise, sex, driving, housework, etc?
At first, I just sat around waiting for it to go away, but now I ignore it. I swam laps this morning in full afib. I do, however, note significant shortness of breath.

Diltiazem 240mg (5 replies)

Hkk — Fri, 27 Mar 2026 22:07:44 +0000

I take this once a day along with Metoprolol 50mg.About three hours later I get a few palpatations.When I wake up in the AM my heart rate is low,around 50.I am going to start taking it in the mornings and see if that changes anything.Just wondered if anyone had this problem?

New Cholesterol level change (2 replies)

hwkmn05 — Tue, 24 Mar 2026 10:46:42 +0000

After my latest physical I was a bit taken back to see that my Chl levels were apparently higher than the acceptable levels. On closer inspection, my levels hadnt changed a whole lot, as they never do and my ratio was higher, but still under at 4.5. The biggest change was LDL level which isnt really Cholesterol, from 150 to 100 and Non-HDL to 100. Did something new happen or were statin sales slow?

CCB Privatklinik Frankfurt for PF ablations (5 replies)

srecnivlad — Sun, 29 Mar 2026 19:55:16 +0000

Hi,
I was wondering if anyone has had a complex PF ablation procedure done at the CCB Privatklinik in Frankfurt Germany for a condition such as persistent Afib. The most experienced EPs there are Dr. Boris Schmidt and Dr. Julian Chun.
Apparently they have performed over 20,000 ablations split between 3 teams, with up to 15 ablations a day.

Any experience anyone?

Mixed feelings about long distance doctoring (6 replies)

nonthumper — Fri, 27 Mar 2026 16:58:06 +0000

Well, folks, I dunno about this travelling across the country to see a doctor. Had my procedure yesterday. They tell me I am in normal sinus rthym. They tell me Dr. Natale did the procedure. I am now discharged from the hospital. I have yet to meet Dr. Natale face-to-face. Ever.

My introductory appointment with him was a phone call, admittedly that was for my convenience. My wife met him post-op when he popped in for 45 seconds. I was Dr. Natale's 5th procedure, out of a total of 6 he did yesterday.

We traveled 1,500 miles to Austin. Now I have to come back in 2 to 3 months to have a Watchman placed. Then in another 2 to 3 months I have to travel back for a TEE.

Interestingly, a man in the waiting room was saying he was at Texas Arrhythmia for his fourth ablation. He does not use Dr. Natale. He said this time the surgeon was going to turn the power up for better results. This sounded very similar to what Carey went through, even though this fellow started at the good clinic.

I met some very nice and helpful staff here. But I must also say the St. David's hospital is just as disorganized as all the other hospitals I have been in. Anyone trying to decide where to go for their treatment is welcome to send me a private message for more details.

Right now I am thinking I should have chosen a different facility from the list that was not quite so far away, yet not too local. But who knows, I might end up being very happy that I traveled to Austin.

Another point is that I was in 100% Afib since at least July. If I had stayed more local, I could have been treated 2 months ago. My understanding is that my atrium has been enlarging due to Afib this whole time. I don't know by how much, but I know they want to get you treated in less than six months.

KardiaMobile (5 replies)

PamelaJean — Sun, 22 Mar 2026 22:37:28 +0000

Can anyone here read the EKGs from the KardiaMobile? I’ve been in some sort of afib/flutter/tachycardia off and on for two days. I don’t have advanced determinations so my KM says possible afib or unclassified or recently tachycardia. I sent a couple strips to my EP but haven’t heard back yet.

Thanks, Pam

Cardiomyopathy-Causing Gene Variants Linked to Risk for Atrial Fibrillation (1 reply)

sldabrowski — Thu, 19 Mar 2026 10:35:47 +0000

Getting closer to early detection using genetics.

[www.medscape.com]

PIPT taking longer as I age. (20 replies)

hwkmn05 — Fri, 27 Mar 2026 17:50:44 +0000

A brief background as many may not know me. 72 yrs old. Afib since 2010. Never ablated. Last cardioversion was 2014. Since that time average of 2 episodes per year, usually Nov and March. Converting to NSR with supplements to start in 2015, but of the belief that the sooner you convert the better, switched to 300mg Flec and 50 mg Metop. First 10 years, conversion was within 1-4 hours. Last few years it has taken 12 plus and now close to 24. Mind you my afib isnt horrible, RHR is 49-55 and an episode usually stays under 100, average 85 HR. Would a switch to another AA and BB be in order, or has something changed in my system?

UCSF Panel Presentation on AF (1 reply)

gloaming — Tue, 17 Mar 2026 11:17:09 +0000

[www.youtube.com]

Stem Cell Treatments For Heart Failure Approved in World First (1 reply)

susan.d — Wed, 11 Mar 2026 14:21:35 +0000

Japan has approved ground-breaking stem-cell treatments for Parkinson's and severe heart failure, one of the manufacturers and media reports said Friday, with the therapies expected to reach patients within months.

Japan's health ministry also gave the go-ahead to ReHeart, heart muscle sheets developed by medical startup Cuorips that can help form new blood vessels and restore heart function, media reports said.

ReHeart helps form new blood vessels and restores heart function. (Sebastian Moldoveanu's Images/Canva)
The treatments could be on the market and rolled out to patients as early as this summer, reports said, citing the health ministry, becoming the world's first commercially available medical products using (iPS) cells.

Japanese scientist Shinya Yamanaka won the Nobel Prize in 2012 for his research into iPS cells, which have the potential to develop into any cell in the body.

"I hope this will bring relief to patients not only in Japan but around the world," health minister Kenichiro Ueno told a press conference.

"We will promptly carry out all necessary procedures to ensure it reaches all patients without fail."

In a statement, Sumitomo Pharma said it had obtained "conditional and time-limited approval" for the manufacture and marketing of Amchepry under a system that is reportedly designed to get these products to patients as quickly as possible.

The approval is a kind of "provisional license", the Asahi newspaper said, after the safety and efficacy of the treatment were judged based on data from fewer patients than in ordinary clinical trials for drugs

Day 3 after ablation and afib is worse than before. Normal blanking or bad sign? (3 replies)

Maria23 — Sun, 08 Mar 2026 20:54:46 +0000

Hello everyone. I’m a long time reader of this forum and come to you for help.

I had an ablation a few days ago and now my Afib is worse. Before the ablation I was having 1-2 episodes/week; now after the ablation I’m having 2 episodes/day. The episodes are now much stronger (~140bpm now vs ~80bpm before) and longer (~2hrs now vs ~1hr before). Very symptomatic and unbearable.

I’m currently on Eliquis 5mg 2x daily, Lasix 40mg 1x daily, Potassium 20meq 1x daily. I was on metoprolol before but was told stop taking after ablation. I’m 76 F.

EP says this is normal and recommends Multaq 400mg 2x daily to reduce episodes during blanking.

Has anyone had a similar ablation experience? Is this normal during blanking or perhaps a bad sign?

Thank you.

Why aren't more afibbers trying potassium? (32 replies)

Anonymous User — Sat, 04 Apr 2026 11:31:35 +0000

[content deleted by moderators]

Association of atrial high-rate episodes daily burden with the risk of cardiovascular death, heart failure hospitalization, and stroke (no replies)

susan.d — Thu, 05 Mar 2026 08:46:29 +0000

[www.heartrhythmjournal.com]

Abstract
The clinical significance of device-detected atrial high-rate episodes (AHREs) is believed to increase with AHRE burden.
Objective

This study evaluated whether a daily burden ≥6 minutes is associated with major cardiovascular outcomes.

Methods
We analyzed 1160 patients with sinus node dysfunction and dual-chamber pacemakers or defibrillators from the B3 randomized trial, followed for 3 years. The primary composite endpoint included cardiovascular death, worsening heart failure hospitalization (WHFH), and stroke or transient ischemic attack (TIA). Secondary endpoints were individual components of the primary endpoint and progression to long-lasting AF. Using competing-risk survival models with AHRE burden as a time-varying covariate, we calculated CHA2DS2-VASc-adjusted hazard ratios (HRs) after the first day with burden ≥6 minutes. AHREs were all adjudicated.

Results
AHRE burden ≥6 minutes occurred in 52.5% of patients, 47.1% of whom had no prior AF. There were 65 primary events (10 cardiovascular deaths, 39 WHFHs, 16 strokes/TIAs). In patients without prior AF, AHRE burden ≥6 minutes was significantly associated with the primary endpoint (HR 4.9; 95% CI, 2.19-10.91; p<0.001), as well as with cardiovascular death (p=0.033), WHFH (p<0.001), and long-lasting AF (p<0.001), but not with stroke/TIA (p=0.34). In contrast, no significant association was found in patients with prior AF (HR 0.83; 95% CI, 0.37-1.87; p=0.65).

Conclusion
In patients without prior AF, a daily AHRE burden ≥6 minutes was linked to a >4-fold increased risk of major cardiovascular events, mainly driven by cardiovascular death, WHFH, and progression to long-lasting AF. No such association was observed in patients with prior AF.

Early recurrence of atrial arrhythmias and its impact on late recurrence after pulmonary vein isolation using pulsed field ablation of paroxysmal atrial fibrillation: a long-term follow up study (1 reply)

susan.d — Wed, 04 Mar 2026 23:02:03 +0000

[www.heartrhythmjournal.com]

Mechanism of AFIB - when a maze is not a maze procedure podcast tomorrow 5 CT 3/3 (3 replies)

sldabrowski — Wed, 04 Mar 2026 13:21:08 +0000

For anyone interested in this topic presented by Dr. Wolf - the Debakey CV

Pumpkin seeds best for Magnesium (2 replies)

Sam — Sun, 01 Mar 2026 20:34:39 +0000

I strongly recommend everyone watches the U Tube video by Dr William Li Stop buying expensive
Magnesium pills! This 2 dollar food works 16 x Better.

That food is Pumpkin Seeds.

His knowledge of the subject really lmpressed me.

I have already bought a kilo of the seeds but would really love to hear your thoughts.

Pumpkin seeds (no replies)

Sam — Sun, 01 Mar 2026 12:50:38 +0000

I’ve recently watched a long video on the benefits of eating 30 grams of pumpkin seeds twice a day to fill our needs for magnesium. I t would be a big change from the large amount of mag powder I currently use but I was very impressed by his knowledge of the subject. l wish I could send you a link but I don’t know how

Pulsar study: Single-Shot Spherical Pulsed Field Ablation System Shows Durable AF Control (2 replies)

sldabrowski — Sun, 01 Mar 2026 20:37:44 +0000

As Reported by Dr. Reddy in NY

[www.medscape.com]

Eliquis or Not? (26 replies)

JackC — Mon, 30 Mar 2026 02:26:54 +0000

Hello -
I am an 79-year old male with a history of proximal atrial fibrillation (1994-2017), but without ANY occurrences over the last nine years.
I had determined what my triggers were and managed accordingly...
My CHA2DS2-VASc score is (2) for being over 75 years of age.
This week my NEW cardiologist/ EP recommended and prescribed a DOAC (Eliquis) 5mg twice daily.
When I asked why, she said it was fundamentally because of my prior afib history and age...
My question is: Would it be indicated that ANY 80-year old man be put on a DOAC (Eliquis) to lower the risk of stroke?
Thank You,
Jack

7 Day Heart Monitor—Dr. Natale (19 replies)

Pixie — Thu, 02 Apr 2026 02:30:43 +0000

I called Dr.Natale’s office to schedule my annual 7 day heart monitor. I had only one option in the past and that was the Vital Connect monitor. There are 3 options now: the Vital Connect, the Bardy Cam and the Zio patch. The Bardy Cam does not require a phone and the patch is placed vertically on the center of the chest, directly over the sternum as
opposed to the Vital Connect patch which is angled on the upper left chest. Only the patch on the Vital Connect states it is medically grade hypoallergenic. The Bardy Cam is
marketed as having optimal p-wave capture. I know Dr. Natale prefers that monitor, but the patient can get the one they want. I am leading toward the Vital Connect because I have skin sensitivity and have been able to tolerate that patch for 7 days. I do not know if I could tolerate the Bardy Cam, especially vertically on the sternum. Has anyone used the Bardy Cam and, if so, how did the patch work for you?

Pulsed Field Ablation for Atrial Fibrillation with a Balloon-in-Basket System under Conscious Sedation: A Retrospective Feasibility and Safety Analysis (1 reply)

susan.d — Sun, 22 Feb 2026 17:58:20 +0000

[www.heartrhythmjournal.com]