Atrial Fibrillation Forum - AFIBBERS FORUM A forum for sharing experiences regarding atrial fibrillation and other atrial tachy-arrhythmias. https://www.afibbers.org/forum/list.php?9 Mon, 27 Apr 2026 19:33:19 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,201289,201299#msg-201299 Re: Dairy Products https://www.afibbers.org/forum/read.php?9,201289,201299#msg-201299 Ken AFIBBERS FORUM Mon, 27 Apr 2026 19:08:47 +0000 https://www.afibbers.org/forum/read.php?9,201289,201298#msg-201298 Re: Dairy Products https://www.afibbers.org/forum/read.php?9,201289,201298#msg-201298
Quote
GeorgeN
From an autoimmune perspective, dairy from genetically A2 casein cows is better than from A1 casein cows. Fermented A2 casein milk products like yogurt & some cheeses are better. Goat and sheep cheeses are better they are generally rich in A2 casein and medium-chain triglycerides (MCTs), which are easier to digest and less inflammatory than standard cow's milk products, as I understand.

Most standard US cows genetically make A1 casein. There are some A2's in this country, more in Europe.

George,

That is quite interesting and while I hadn't really looked into it, I started buying the 3 carton pack of Whole Organic Milk at Costco back in maybe December. I also have Hashimoto's which also has its own issues with dairy. I made the switch from Unsweetened Almond Vanilla Milk at that time and noticed recently the A2 designation on the carton vs the grocery store without an A2. I haven't had any issues with my switch and basically was going on trust of the Costco Buyers who decide what products to carry. I should read a bit more on the subject when I have some spare time. I only use 1 cup per day with my Orgain Protein smoothie or 1/2 cup with my Kodiak Seeds and Nuts Oatmeal with some blue/black/rasp berry mix.]]> Qwackertoo AFIBBERS FORUM Mon, 27 Apr 2026 15:48:44 +0000 https://www.afibbers.org/forum/read.php?9,201287,201297#msg-201297 Re: Fluoroscopy https://www.afibbers.org/forum/read.php?9,201287,201297#msg-201297
Quote
Carey

What is the difference between a touch up ablation w/Watchman placement vs a Re-Do with Watchman placement? When appointment is made within 3 days after the initial ablation?

A touch-up procedure is finding the spots where afib signals are getting past the previous ablation lines. It's usually one or two burns vs dozens for a full ablation. And the Watchman is no more than another 10-15 minutes. My Watchman procedure was a total of 20 minutes and that included the entire time needed to insert and position the catheters. If a touch-up is being done at the same time, inserting and positioning catheters has already happened.

Thank you for the reply, Carey

Mine was classified as a Re-Do along with the planned Watchman placement 6 weeks after initial ablation which was more extensive than a PVI with 72 PF only no RF. It has been awhile but in re-reading and studying everything in my history, especially last week after my first visit in quite some time with my local Cardiologist caused me to wonder on the terminology. I believe it was 58 PF applications of energy and a little less than 1 minute for the RF plus the Watchman. The LAA was re-isolated and from what I've read it is thicker tissue and does tend to regain connections after initial isolation plus a few other re-connections during second go round.]]> Qwackertoo AFIBBERS FORUM Mon, 27 Apr 2026 15:07:10 +0000 https://www.afibbers.org/forum/read.php?9,201287,201296#msg-201296 Re: Fluoroscopy https://www.afibbers.org/forum/read.php?9,201287,201296#msg-201296 gloaming AFIBBERS FORUM Mon, 27 Apr 2026 03:49:43 +0000 https://www.afibbers.org/forum/read.php?9,201289,201295#msg-201295 Re: Dairy Products https://www.afibbers.org/forum/read.php?9,201289,201295#msg-201295 GeorgeN AFIBBERS FORUM Mon, 27 Apr 2026 01:21:27 +0000 https://www.afibbers.org/forum/read.php?9,201230,201294#msg-201294 Re: Aspirin and Eliquis https://www.afibbers.org/forum/read.php?9,201230,201294#msg-201294 bettylou4488 AFIBBERS FORUM Mon, 27 Apr 2026 00:57:00 +0000 https://www.afibbers.org/forum/read.php?9,201289,201293#msg-201293 Re: Dairy Products https://www.afibbers.org/forum/read.php?9,201289,201293#msg-201293 Kselzer AFIBBERS FORUM Mon, 27 Apr 2026 00:28:00 +0000 https://www.afibbers.org/forum/read.php?9,201287,201292#msg-201292 Re: Fluoroscopy https://www.afibbers.org/forum/read.php?9,201287,201292#msg-201292
Quote
Qwackertoo
What is the difference between a touch up ablation w/Watchman placement vs a Re-Do with Watchman placement? When appointment is made within 3 days after the initial ablation?

A touch-up procedure is finding the spots where afib signals are getting past the previous ablation lines. It's usually one or two burns vs dozens for a full ablation. And the Watchman is no more than another 10-15 minutes. My Watchman procedure was a total of 20 minutes and that included the entire time needed to insert and position the catheters. If a touch-up is being done at the same time, inserting and positioning catheters has already happened.]]> Carey AFIBBERS FORUM Sun, 26 Apr 2026 23:55:17 +0000 https://www.afibbers.org/forum/read.php?9,201289,201291#msg-201291 Re: Dairy Products https://www.afibbers.org/forum/read.php?9,201289,201291#msg-201291
Most standard US cows genetically make A1 casein. There are some A2's in this country, more in Europe.]]> GeorgeN AFIBBERS FORUM Sun, 26 Apr 2026 23:42:31 +0000 https://www.afibbers.org/forum/read.php?9,201287,201290#msg-201290 Re: Fluoroscopy https://www.afibbers.org/forum/read.php?9,201287,201290#msg-201290
Important success or failure difference or insurance terminology or?

How would they know so fast after just the one night in the hospital with no further testing etc.?]]> Qwackertoo AFIBBERS FORUM Sun, 26 Apr 2026 22:46:13 +0000 https://www.afibbers.org/forum/read.php?9,201289,201289#msg-201289 Dairy Products https://www.afibbers.org/forum/read.php?9,201289,201289#msg-201289 Kselzer AFIBBERS FORUM Sun, 26 Apr 2026 22:46:04 +0000 https://www.afibbers.org/forum/read.php?9,201287,201288#msg-201288 Re: Fluoroscopy https://www.afibbers.org/forum/read.php?9,201287,201288#msg-201288 Carey AFIBBERS FORUM Sat, 25 Apr 2026 21:18:25 +0000 https://www.afibbers.org/forum/read.php?9,201287,201287#msg-201287 Fluoroscopy https://www.afibbers.org/forum/read.php?9,201287,201287#msg-201287
As I began to consider an ablation, I found youtube videos by Dr. Kneller. In the end, I decided not to use him for my ablation, but his videos were informative for me, who knew nothing. One of his videos, which I did not watch prior to my procedure, cautioned about the radiation exposure of the fluoroscopy, and cautioned to find a doctor who kept the radiation time to a minimum.

I had Dr. Natale do mine. As I read his clinical notes, I saw he used fluoroscopy on me for 15.6 minutes.

Notes also said:

Radiation dose

Air Kerma(AK): 119mGy
Dose Area Product (DAP): 1421uGy*m^2

That didn't mean anything to me, so I asked my niece who was in nuclear medicine. She said that dose is equivalent to two Ct scans of the head back to back. Previously, when asking her opinions on letting oral surgeons do Ct scans on me, she said one per year of the head would be OK with her.

So in the case of a heart procedure, I can see why I would be expected to tolerate more time. The medical team certainly has incentive to keep the amount of time to a minimum for their own health risk, despite their protective clothing.

I will have to ask how much fluoroscopy time will be required for my ablation touch-up/watchman placement in two months. Just out of curiosity though. I don't know enough to negotiate on that.]]> nonthumper AFIBBERS FORUM Sat, 25 Apr 2026 21:03:17 +0000 https://www.afibbers.org/forum/read.php?9,201200,201286#msg-201286 Re: What % of EPs are capable of isolating LAA? https://www.afibbers.org/forum/read.php?9,201200,201286#msg-201286 There are currently studying the use of an anticoagulant as a pill in a pocke[/i

That would be the REACT-AF trial. I have also adapted a modified version of that protocol in the past as opposed to daily AC, for reasons you mentioned.

My modification was to extend the one-hour, 30-day AC trigger point to 10 hours, based on both prior estimates of clot formation and the fact that trial participants are only required to wear the Apple Watch monitoring device 14-hours a day, which means in theory that an 11-hour AF window while not following the letter of the trial, does follow the spirit. The 10 hour wait gives ample time to convert either naturally or via PIP antiarrythmics, therefore limiting further the exposure to daily ACs.

In addition to the pilot studies that REACT-AF is based on, newer studies are showing that AF frequency may be a more important factor than simply the CHADS risk score. All this makes me rethink the role of irreversible interventions such as Watchman and LAA isolation, when it seems increasingly plausible that many of us may be managed either by PIP AC's in the future, or not even need them at all. Given my very low AF burden, my only hesitancy in embracing these emerging theories is that study data is weighted mostly for CHADS 1-3 and I'm a CHADS 4.

Jim]]> mjamesone AFIBBERS FORUM Fri, 24 Apr 2026 18:27:23 +0000 https://www.afibbers.org/forum/read.php?9,201279,201285#msg-201285 Re: GLP-1 drugs lower AF risk regardless of weight loss https://www.afibbers.org/forum/read.php?9,201279,201285#msg-201285 hwkmn05 AFIBBERS FORUM Fri, 24 Apr 2026 12:03:25 +0000 https://www.afibbers.org/forum/read.php?9,201200,201284#msg-201284 Re: What % of EPs are capable of isolating LAA? https://www.afibbers.org/forum/read.php?9,201200,201284#msg-201284 jasams AFIBBERS FORUM Fri, 24 Apr 2026 10:12:40 +0000 https://www.afibbers.org/forum/read.php?9,200710,201283#msg-201283 Re: How can 4 TEES show my watchman is perfectly sealed and today a new TEE shows it leaking? https://www.afibbers.org/forum/read.php?9,200710,201283#msg-201283 jasams AFIBBERS FORUM Fri, 24 Apr 2026 10:03:51 +0000 https://www.afibbers.org/forum/read.php?9,201279,201282#msg-201282 Re: GLP-1 drugs lower AF risk regardless of weight loss https://www.afibbers.org/forum/read.php?9,201279,201282#msg-201282
Quote
mjamesone
After reading those trials, I was eager to get an Rx for a GLP-1RA after my stenting, even though I did not qualify based on weight. However, one of GLP's mechanisms is delayed gastric emptying, so in patients with underlying motility issues (like myself) they may be contraindicated, or at the very least ,cautioned.

My niece, in her 40's, is using a peptide that duplicates the pharma products, for weight loss. However at a dramatically reduced dose. For her, she gets the food noise reduction, without the other side effects. My understanding of some of the unexpected benefits come from the body getting a higher level of GLP-1 (than normal) and there are GLP-1 receptors all over the body. I think mechanisms are not well understood at this time, in many instances.]]> GeorgeN AFIBBERS FORUM Fri, 24 Apr 2026 02:33:38 +0000 https://www.afibbers.org/forum/read.php?9,201279,201281#msg-201281 Re: GLP-1 drugs lower AF risk regardless of weight loss https://www.afibbers.org/forum/read.php?9,201279,201281#msg-201281 ".... [GLP-1-RAs are widely prescribed to treat type 2 diabetes and obesity and also are known to improve cardiovascular health, in part through weight loss..."

Yes, but kind of understated, in that newer studies have already shown significant cardiac benefits, independent of weight loss. Given that, it's not surprising that some of the weight-independent cardiac mechanisms may also contribute to a reduced Afib risk.

After reading those trials, I was eager to get an Rx for a GLP-1RA after my stenting, even though I did not qualify based on weight. However, one of GLP's mechanisms is delayed gastric emptying, so in patients with underlying motility issues (like myself) they may be contraindicated, or at the very least ,cautioned.

Jim]]> mjamesone AFIBBERS FORUM Fri, 24 Apr 2026 01:06:32 +0000 https://www.afibbers.org/forum/read.php?9,201200,201280#msg-201280 Re: What % of EPs are capable of isolating LAA? https://www.afibbers.org/forum/read.php?9,201200,201280#msg-201280
Quote
jasams
I believe Natale does an electrical isolation of the laa when he does a watchman, since doing one after a watchman is much more complicated and prone to problems.

This is not correct. Natale isolates the LAA only if the LAA is in fact a source of afib or flutter. The LAA can be isolated with a Watchman in place, but you're right that it does make it a little more complicated. But not impossible by any means. It's also not true that the LAA no longer pumps following isolation. Its pumping action may be reduced to the point where a Watchman or lifelong anticoagulation is necessary, but that's only true for about 60% of patients. About 40% don't need to do anything further.]]> Carey AFIBBERS FORUM Thu, 23 Apr 2026 22:16:27 +0000 https://www.afibbers.org/forum/read.php?9,201279,201279#msg-201279 GLP-1 drugs lower AF risk regardless of weight loss https://www.afibbers.org/forum/read.php?9,201279,201279#msg-201279
EMBARGOED UNTIL THURSDAY, APRIL 23 AT 11:00 AM CT / 12:00 PM ET

NEW STUDY LINKS GLP-1 MEDICATIONS TO LOWER RISK OF ATRIAL FIBRILLATION, INDEPENDENT OF WEIGHT LOSS
CHICAGO, IL, APRIL 23, 2026 – A new study analyzing data from more than 13,000 patients found that people using the increasingly popular weight-loss drugs known as GLP-1 receptor agonists (GLP-1-RAs) have a reduced risk of atrial fibrillation (AF), even after accounting for the medications’ effects on weight loss and overall survival. Researchers presented these findings today at Heart Rhythm 2026.

When AF occurs, the heart beats irregularly and the risk of stroke, heart failure, and other cardiovascular complications are all increased. More than 40 million people worldwide live with AF, and in the United States alone, approximately 454,000 hospitalizations each year are associated with the condition.i,ii As new uses and benefits of GLP-1-RAs continue to emerge, researchers increasingly wanted to understand whether these therapies could help prevent AF or treat it. GLP-1-RAs are widely prescribed to treat type 2 diabetes and obesity and also are known to improve cardiovascular health, in part through weight loss. However, it is unclear whether their potential benefits for AF are primarily driven by weight reduction or whether the medications may have additional independent cardiovascular effects.

Researchers conducted a single-center retrospective study of 13,034 patients who initiated GLP-1-RA therapy between January 2020 and May 2024. Researchers identified patients through electronic medical records and used propensity score matching to compare them with similar patients from a cohort of more than 385,000 individuals who had never received GLP-1-RA therapy and had no prior diagnosis of AF.
The study found that patients who took GLP-1-RAs experienced significantly better survival than matched patients in the control group. Researchers also found a significantly lower risk of AF among patients taking GLP-1-RAs. Importantly, the reduction in AF risk remained consistent regardless of weight change. Patients who lost 10% or more of their body weight, those who lost less than 10%, and those who gained weight while taking GLP-1-RAs all experienced a reduced risk of AF compared with matched controls. Among the medications studied, semaglutide showed the strongest association with reduced AF risk compared with liraglutide, dulaglutide, and tirzepatide.

“As atrial fibrillation continues to affect more patients worldwide, clinicians need new strategies to reduce risk and improve long-term outcomes,” said Kenneth Bilchick, MD, professor of cardiovascular medicine at the University of Virginia. “These findings suggest GLP-1-RAs may influence heart rhythm through mechanisms beyond weight loss. Understanding those effects could help guide how we approach prevention and treatment of atrial fibrillation in the future.”

This study adds to a growing body of research examining the cardiovascular effects of GLP-1-RAs beyond diabetes and weight management. As researchers continue to explore these therapies, future studies will need to evaluate their potential role in AF prevention and management across larger and more diverse patient populations.

Session Details:

“Clinical Electrophysiology: Glucagon-Like Peptide-1 Receptor Agonists Reduce Atrial Fibrillation Independently of Effects on Weight Loss and Survival” [Thursday, April 23, 2026, at 2:30 pm CT]
i Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56–e528.
ii Calkins H, Reynolds MR, Spector P, Sondhi M, Xu Y, et al. (2009) Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol 2 (4): 349-361]]> Carey AFIBBERS FORUM Thu, 23 Apr 2026 20:40:26 +0000 https://www.afibbers.org/forum/read.php?9,201268,201278#msg-201278 Re: generic for Xarelto https://www.afibbers.org/forum/read.php?9,201268,201278#msg-201278
Quote
Carey
They are not. Generic 2.5 mg is available in the US but none of the other dosages are yet. Not sure why that is but I would expect it will rectify itself fairly soon.

I read the issue is US patent protection for the other dosages.]]> GeorgeN AFIBBERS FORUM Thu, 23 Apr 2026 15:48:38 +0000 https://www.afibbers.org/forum/read.php?9,200710,201277#msg-201277 Re: How can 4 TEES show my watchman is perfectly sealed and today a new TEE shows it leaking? https://www.afibbers.org/forum/read.php?9,200710,201277#msg-201277
I don't follow. Isolating the LAA is to prevent the emanation of voltage from it which would cause the atrium to contract, but in this case to fibrillate. I would expect an EP to tell me they would first isolate the LAA and then do whatever else they need to do to seal it, which is then why the taking of a DOAC would be obviated.]]> gloaming AFIBBERS FORUM Thu, 23 Apr 2026 15:48:05 +0000 https://www.afibbers.org/forum/read.php?9,201243,201276#msg-201276 Re: Medication https://www.afibbers.org/forum/read.php?9,201243,201276#msg-201276 hwkmn05 AFIBBERS FORUM Thu, 23 Apr 2026 14:51:33 +0000 https://www.afibbers.org/forum/read.php?9,201268,201275#msg-201275 Re: generic for Xarelto https://www.afibbers.org/forum/read.php?9,201268,201275#msg-201275 hwkmn05 AFIBBERS FORUM Thu, 23 Apr 2026 11:39:59 +0000 https://www.afibbers.org/forum/read.php?9,200710,201274#msg-201274 Re: How can 4 TEES show my watchman is perfectly sealed and today a new TEE shows it leaking? https://www.afibbers.org/forum/read.php?9,200710,201274#msg-201274 jasams AFIBBERS FORUM Thu, 23 Apr 2026 06:23:28 +0000 https://www.afibbers.org/forum/read.php?9,201200,201273#msg-201273 Re: What % of EPs are capable of isolating LAA? https://www.afibbers.org/forum/read.php?9,201200,201273#msg-201273
Not wanting to live like this for the rest of my life, I’ve been considering a watchman device to get off eliquis. The problem was I never accepted that leaks under 5mm were clinically acceptable. It was a random number. In Europe they chose 3mm as their random number. By now, many if not most top eps believe no leak is acceptable. That’s why the watchman ng is currently being tested as well as a foam closure. The goal for each is no leaks.

I believe Natale does an electrical isolation of the laa when he does a watchman, since doing one after a watchman is much more complicated and prone to problems. If the laa has been isolated, it no longer pumps and (1) will let blood accumulate and pool in a leak spot, and become a stroke risk, and (2) no longer produce some chemical that is now recognized as important. All this without even knowing if isolating the laa will be beneficial. I believe in burning only as much tissue as is needed to maintain nsr.

There are currently studying the use of an anticoagulant as a pill in a pocket. I don’t qualify for the study because of prior brain bleed, but that should really be irrelevant as my neurologist, one of the best in the USA, has cleared me for eliquis, which I’ve been taking since the bleed 2 years ago. I may still follow this protocol because I don’t see the logic of being on a dangerous anticoagulant 100% of the time when I’m only in afib 0.04% of the time. After a 1 hour or longer event, you take eliquis for 30 days.

Any thoughts appreciated. Anyone who thinks that an anticoagulant is safe, need not say so. I strongly disagree and my goal is to get off it. Cheers.]]> jasams AFIBBERS FORUM Thu, 23 Apr 2026 03:31:10 +0000 https://www.afibbers.org/forum/read.php?9,201268,201272#msg-201272 Re: generic for Xarelto https://www.afibbers.org/forum/read.php?9,201268,201272#msg-201272 Carey AFIBBERS FORUM Thu, 23 Apr 2026 03:23:09 +0000 https://www.afibbers.org/forum/read.php?9,201268,201271#msg-201271 Re: generic for Xarelto https://www.afibbers.org/forum/read.php?9,201268,201271#msg-201271
No, I use 15mg. I don't know if all miligrams are covered in the states.]]> Elizabeth AFIBBERS FORUM Thu, 23 Apr 2026 01:11:00 +0000 https://www.afibbers.org/forum/read.php?9,201268,201270#msg-201270 Re: generic for Xarelto https://www.afibbers.org/forum/read.php?9,201268,201270#msg-201270 GeorgeN AFIBBERS FORUM Thu, 23 Apr 2026 00:57:42 +0000