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 Sun, 25 Oct 2026 16:08:50 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,201902,202006#msg-202006 Re: Back on Flecainide? https://www.afibbers.org/forum/read.php?9,201902,202006#msg-202006 hwkmn05 AFIBBERS FORUM Sun, 25 Oct 2026 11:55:38 +0000 https://www.afibbers.org/forum/read.php?9,202001,202005#msg-202005 Re: Finding my next EP https://www.afibbers.org/forum/read.php?9,202001,202005#msg-202005
I have history with only one EP, and I invited him to redo the first failed ablation.. He located a small gap on the third pulmonary vein that had not closed off with scarring by the time I resumed AF. I'm nearly four years good so far, but I do expect I'll return to AF in the years ahead....quite probably. If I were to be asked to see Dr. Novak again, I would want something from him more than 'I'll just redo a PVI.' That horse must have left the barn by this time, Doc. What else ya got?

I don't understand why you were told by the surly person that you can't change EPs. Of course you can. But, it may not be to Santangeli. There are other crackerjack EPs out there. I think Susan published, or re-published, a list of about 15-20 EPs with strong reputations not long ago.]]> gloaming AFIBBERS FORUM Sat, 24 Oct 2026 14:53:20 +0000 https://www.afibbers.org/forum/read.php?9,202001,202003#msg-202003 Re: Finding my next EP https://www.afibbers.org/forum/read.php?9,202001,202003#msg-202003 The EP I referred to with the remarkable credentials is Dr Santangeli. I was quite surprised to hear he had an opening next month. I thought I would have to wait 9 months or more to see him. So I am scheduled to see him, but the person on the phone was surly with me and initially told me I couldn't change from one doctor to another. My only other option was to try to get back in with my original EP, the one who had the terrible accident and is now recovered. But his first appointment wasn't until March.
I can only hope that Dr Santangeli has patience and takes the time to understand what's going on for me and the best approach. Sometimes doctors are a bit suspicious if you show up as a new patient because you didn't like another MD in the same practice. I'm a little concerned about that. I'm really not "doctor shopping." I just can't stand that last EP I saw - the one who never even listened to my heart or took a BP!
I didn't like his recommendation for me which was to put me back on Flecainide after I spent a year off of it at his suggestion. I have a RBBB and a L fasicular block. Flecainide puts my HR into the low 50's if I'm lucky!
I really appreciate your response, and I'm happy to hear you think so highly of Dr Santangeli. I'm hoping for the best outcome. Thank you.]]> Wolfgang AFIBBERS FORUM Fri, 23 Oct 2026 12:59:19 +0000 https://www.afibbers.org/forum/read.php?9,202001,202002#msg-202002 Re: Finding my next EP https://www.afibbers.org/forum/read.php?9,202001,202002#msg-202002
The EP with remarkable credentials you mentioned is Santangeli or someone else? I ask because you said you were told you can't switch to another EP.

If that's not true and you can, then you should have absolutely no hesitation about doing exactly that. Santangeli is one of only two EPs I will recommend without hesitation to anyone. I consider him to probably be the second most capable EP in the world, second only to his mentor, Andrea Natale.]]> Carey AFIBBERS FORUM Thu, 22 Oct 2026 23:42:47 +0000 https://www.afibbers.org/forum/read.php?9,202001,202001#msg-202001 Finding my next EP https://www.afibbers.org/forum/read.php?9,202001,202001#msg-202001 This is my first post so I may do something wrong! I've had PAF for about 15 years treated with 2 ablations, one in 2019 and then again in 2024. All came off Flecainide last year, and all has been well until recent months when the afib has started to show up again; sometimes just for a few minutes and other times for 1.5 hours. I use Flecainide as a PIP 50 mg, and so far the afib has stopped. My treatment has been at The Cleveland Clinic ever since I was diagnosed. Lately, I am only getting about 2 weeks between episodes of afib or whatever as arrhythmia this is. My EP of may years and the one who did both of my ablations was involved in a serious accident last year. In his absence, I saw another EP who I can't stand. I won't use any names but the EP I dislike I just saw in August. They did not weigh me, did not take my BP, and he never listened to my heart. Every concern I had, he dismissed and told me to come back in a year.
Meanwhile my original EP who I do like is back seeing patients now after a long leave of absence. However, he only does cardioversions and sees patients in the office, as he cannot stand to do ablations or pacemakers.I have a chance to see Dr Pasquale Santangeli next month. He knows nothing about me. The person on the phone today said I can't just change from one doctor to the next.
So what would you do? Go back to the MD who is smart, thorough, compassionate, and knows your case well, or just start over with an MD who seems to have remarkable credentials?? Thank you for your thoughts.]]> Wolfgang AFIBBERS FORUM Thu, 22 Oct 2026 23:12:36 +0000 https://www.afibbers.org/forum/read.php?9,201990,202000#msg-202000 Re: Ablation done https://www.afibbers.org/forum/read.php?9,201990,202000#msg-202000 PamelaJean AFIBBERS FORUM Wed, 21 Oct 2026 15:17:26 +0000 https://www.afibbers.org/forum/read.php?9,201975,201999#msg-201999 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201999#msg-201999 Chevy AFIBBERS FORUM Mon, 19 Oct 2026 01:43:36 +0000 https://www.afibbers.org/forum/read.php?9,201902,201998#msg-201998 Re: Back on Flecainide? https://www.afibbers.org/forum/read.php?9,201902,201998#msg-201998
Closing it off, even if your rate is below 100/110, and you feel well, and don't take anything, or do and there's no shift in the rhythm, you would want to be assessed for some kind of treatment as AF shouldn't normally go on forever...not ideally. It invites problems later that most of us wouldn't find desirable.]]> gloaming AFIBBERS FORUM Thu, 15 Oct 2026 16:12:05 +0000 https://www.afibbers.org/forum/read.php?9,201982,201997#msg-201997 Re: Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201997#msg-201997
Quote
gloaming
I ask because some EPs want their patients on an anti-arrhythmic during the blanking period, or to continue taking one they have been taking, and some don't. It would depend on the EP, their experience, and the patient's particulars. Often a patient only needs metoprolol for a while and a DOAC such as rivaroxaban or apixaban. Some go on propafenone. Have you ever tried it? It may be entirely unsuitable, but that is what my EP would have tried had I not been put on amiodarone (I was never on an AAD until just after my first ablation, but it was straight to amiodarone jail when they made the decision, do not pass 'Go'.)

I am just trying to understand the nature of your circumstance...without prying. I don't mean to intrude, just to get a handle on why amiodarone, and why after the ablation. Perhaps you have a particularly cranky heart and the EP knows this is what must be done.

Thanks for the clarification. I do have a lot going on heart wise. I don't know if I went home on meds with previous ones. It was the NP that said they would do this but I will be talking to the md that morning. I checked in with my adult congenital doc (same hospital.. same hallway LOL) and he was Ok with either as long as the amnioderone was a year max. I really like my EP but I rarely get to see him. Thankfully my adult congenital doc always gets back with me and helps to bridge the gap. I think they are going to make a game day decision but I will be giving my preferences (and actually did already send a portal message).]]> bettylou4488 AFIBBERS FORUM Thu, 15 Oct 2026 02:33:11 +0000 https://www.afibbers.org/forum/read.php?9,201975,201996#msg-201996 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201996#msg-201996 anneh AFIBBERS FORUM Wed, 14 Oct 2026 22:37:33 +0000 https://www.afibbers.org/forum/read.php?9,201902,201995#msg-201995 Re: Back on Flecainide? https://www.afibbers.org/forum/read.php?9,201902,201995#msg-201995 hwkmn05 AFIBBERS FORUM Wed, 14 Oct 2026 21:24:27 +0000 https://www.afibbers.org/forum/read.php?9,201990,201994#msg-201994 Re: Ablation done https://www.afibbers.org/forum/read.php?9,201990,201994#msg-201994 PamelaJean AFIBBERS FORUM Wed, 14 Oct 2026 18:01:48 +0000 https://www.afibbers.org/forum/read.php?9,201990,201993#msg-201993 Re: Ablation done https://www.afibbers.org/forum/read.php?9,201990,201993#msg-201993 gloaming AFIBBERS FORUM Wed, 14 Oct 2026 17:51:38 +0000 https://www.afibbers.org/forum/read.php?9,201990,201992#msg-201992 Re: Ablation done https://www.afibbers.org/forum/read.php?9,201990,201992#msg-201992
ABLATION DETAILS:

The presenting rhythm was normal sinus. A 3D electroanatomic voltage map of the left atrium was constructed using the Opal FaraView mapping system and the FaraWave Nav catheter. This was significant for normal PV anatomy, diffusely scarred posterior wall, reconnected RSPV and LSPV.

Ablation was performed according to manufacturer's protocol with 5 impulses delivered per set, 4 sets of lesions per vein, two in basket configuration and two in flower configuration with slight rotation to creatine overlapping lesions in each set.

Posterior wall isolation was achieved by performing a posteriorly directed anchoring lesion of 2 sets in the flower configuration after completion of the lesion sets of each pulmonary vein, and multiple 2-set lesions delivered spanning the length of the posterior wall in a superior and inferior fashion.

After ablation, the FaraWave Nav catheter was then used to complete post-ablation mapping. This demonstrated no signals within each pulmonary vein consistent with entrance block. Pacing within each vein did not result in capture, consistent with exit block. Pacing was also performed in the posterior wall with no demonstrated capture or electrical activation during normal sinus rhythm consistent with posterior wall isolation. The ICE was used for a quick surveillance in the RV for pericardial effusion. No effusion was seen.

The ICE was removed and exchanged for a Biosense Webster DF curve decapolar catheter which was placed into the coronary sinus. Wenckebach cycle length was 320 ms. Atrial burst pacing down to AERP of 220 ms did not induce any sustained flutter, but did reveal a concentric flutter w/ cycle length of 300-320 ms which did not sustain. I decided then to interrogate the previous CTI line that was made in 2014.

The Agilis sheath was then pulled ot the right side. In flower configuration, the FaraWave catheter was used to evaluate transisthmus time, which was found to be 80 ms. The FaraWave catheter was then exchanged for a Boston Scientific StablePoint irrigated ablation catheter that was placed into the Agilis. A rough electroanatomic map of the right atrium was created. The CS was engaged, his points were tagged. AH 71 millisecond, HV 37 millisecond. Then starting from the tricuspid annulus, linear ablation line was drawn all the way down to the IVC with powers of 40 w. Post ablation transmission was time was found to be 160 milliseconds bidirectionally, differential pacing confirmed bidirectional block.

Protamine 50 mg IV was given. Sheaths and catheters were then removed from the patient's body and the right groin was then closed with Perclose x1 and Mynx x1. The patient was extubated in routine fashion and transferred to PACU in stable condition.

RV pacing/recording was not indicated in this procedure.]]> PamelaJean AFIBBERS FORUM Wed, 14 Oct 2026 12:54:45 +0000 https://www.afibbers.org/forum/read.php?9,201990,201991#msg-201991 Re: Ablation done https://www.afibbers.org/forum/read.php?9,201990,201991#msg-201991
Wishing you a smooth recovery and successful outcome:)]]> Yuxi AFIBBERS FORUM Wed, 14 Oct 2026 12:22:32 +0000 https://www.afibbers.org/forum/read.php?9,201990,201990#msg-201990 Ablation done https://www.afibbers.org/forum/read.php?9,201990,201990#msg-201990
CATHETER ABLATION FOR ATRIAL FIBRILLATION

PROCEDURES PERFORMED:

PFA pulmonary vein isolation and posterior wall isolation
RF ablation for typical atrial flutter
HV interval measurement
3D electroanatomic mapping
Intracadiac Echocardiography
Transeptal puncture
Ultrasound guided access
Left atrial and/or coronary sinus pacing/recording

My throat is very sore and I’m coughing, but it should start getting better after 48 hours, which is soon. I’ve had a headache since Monday afternoon that isn’t going away on acetaminophen. Of course my groin punctures are sore and bruised but that’s to be expected. One unexpected discomfort was the nurse getting my wedding band off! After 51 years it was practically embedded on my finger! I’ll have it made larger. 😊

Pam]]> PamelaJean AFIBBERS FORUM Wed, 14 Oct 2026 11:54:24 +0000 https://www.afibbers.org/forum/read.php?9,82100,201989#msg-201989 Re: Fatigue after AF events https://www.afibbers.org/forum/read.php?9,82100,201989#msg-201989 ANS testing machines are designed to support autonomic function testing in clinical settings.]]> Andre43 AFIBBERS FORUM Wed, 14 Oct 2026 09:57:53 +0000 https://www.afibbers.org/forum/read.php?9,188028,201988#msg-201988 Re: Yawning and Afib https://www.afibbers.org/forum/read.php?9,188028,201988#msg-201988 ANS Test.]]> Andre43 AFIBBERS FORUM Mon, 12 Oct 2026 04:44:18 +0000 https://www.afibbers.org/forum/read.php?9,201982,201987#msg-201987 Re: Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201987#msg-201987
I am just trying to understand the nature of your circumstance...without prying. I don't mean to intrude, just to get a handle on why amiodarone, and why after the ablation. Perhaps you have a particularly cranky heart and the EP knows this is what must be done.]]> gloaming AFIBBERS FORUM Sun, 11 Oct 2026 16:11:48 +0000 https://www.afibbers.org/forum/read.php?9,201982,201986#msg-201986 Re: Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201986#msg-201986
Quote
bettylou4488
I am hoping they will let me go the Sotolol route even though that will necessitate a hospital stay to get on it.

Then you need to express that to them. And don't be shy about it. It's your body, not theirs. It should be easy since they can just start it after your ablation and keep you in the hospital for a couple extra days.]]> Carey AFIBBERS FORUM Sun, 11 Oct 2026 02:44:22 +0000 https://www.afibbers.org/forum/read.php?9,201982,201985#msg-201985 Re: Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201985#msg-201985
Quote
gloaming
Why are you being asked to take amiodarone? Are you still experiencing a high burden of ectopy or AF or flutter? Some paroxysmal ectopy or AF is to be expected for ablatees in the first five or six weeks. They 'should' drop off after that. We need more information.

Amiodarone needs to be tapered normally, but if it turns out to be toxic for you, they won't ask you to taper; they'll ask you to stop taking it cold turkey.

I took amiodarone for eight weeks four years ago. I didn't like it, but it did help me to beat my nasty arrhythmia a week after my first ablation. I tapered for two weeks taking 200 mg per day. I was fine after that, and the Holter came about two weeks later.

Amiodarone stays in abundance in the human body for weeks after ceasing it. I am not qualified in medicine, so my opinion is only that...an opinion. I don't see why a person would be asked to take a powerful anti-arrhythmic drug like amiodarone and take it right up to the time of the Holter. It's residue will mask what the heart wants to do.

I"m not exactly sure your questions. They may or may not ask me to take it post ablation during the blanking period. I have not had the ablation yet (scheduled for 23rd). It sounds like you took for same reason. I am hoping they will let me go the Sotolol route even though that will necessitate a hospital stay to get on it. They are not asking me to stay on it (not on it yet) but potentially after....]]> bettylou4488 AFIBBERS FORUM Sun, 11 Oct 2026 02:38:21 +0000 https://www.afibbers.org/forum/read.php?9,201982,201984#msg-201984 Re: Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201984#msg-201984
And definitely no reason for concern about the diltiazem. If you stop it and your heart rate goes much higher, that's not really a big deal unless you've got comorbidities you haven't mentioned. It may not be comfortable to have a heart rate of 120+ but it won't do you any harm for a limited period of time. Same with metoprolol.

Basically, you have to accept that you may be uncomfortable for the few days prior to your ablation, but you'll be safe. Sounds to me like your EP knows what they're doing.]]> Carey AFIBBERS FORUM Fri, 09 Oct 2026 02:23:42 +0000 https://www.afibbers.org/forum/read.php?9,201982,201983#msg-201983 Re: Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201983#msg-201983
Amiodarone needs to be tapered normally, but if it turns out to be toxic for you, they won't ask you to taper; they'll ask you to stop taking it cold turkey.

I took amiodarone for eight weeks four years ago. I didn't like it, but it did help me to beat my nasty arrhythmia a week after my first ablation. I tapered for two weeks taking 200 mg per day. I was fine after that, and the Holter came about two weeks later.

Amiodarone stays in abundance in the human body for weeks after ceasing it. I am not qualified in medicine, so my opinion is only that...an opinion. I don't see why a person would be asked to take a powerful anti-arrhythmic drug like amiodarone and take it right up to the time of the Holter. It's residue will mask what the heart wants to do.]]> gloaming AFIBBERS FORUM Fri, 09 Oct 2026 00:23:21 +0000 https://www.afibbers.org/forum/read.php?9,201982,201982#msg-201982 Amniioderone and ablation questions https://www.afibbers.org/forum/read.php?9,201982,201982#msg-201982
Also I am on rate control drugs. diltiasem. Last weekend I was in flutter so I took (as prescribed) metropolis. when I went back in sinus my HR went to 40 at one point. It recovered pretty quick. So before the ablation they are stopping the rate control drugs. I just feel that I could be in serious trouble. I take the short acting 60 mg every 6 hours. I also have a CT 2 days prior. If I am off then and I have gotten super nervous at these before, I can see it shooting up. Anyone have any thoughts here? questions for me to ask the team?]]> bettylou4488 AFIBBERS FORUM Thu, 08 Oct 2026 22:51:30 +0000 https://www.afibbers.org/forum/read.php?9,201981,201981#msg-201981 Chia seeds https://www.afibbers.org/forum/read.php?9,201981,201981#msg-201981 I met a man from Singapore recently and he told me that he'd had a heart rhythm problem since he was young. He was now retired, so I guess in his early 70's. He said that he hadn't had an ablation and wasn't taking any anti-coagulants. Perhaps it wasn't a very serious rhythm problem. But what I found interesting was that he said that for the past 2 years he'd been soaking chia seeds in water over night and eating them the next day. He said that from taking the chia, his heart rhythm had improved a lot.]]> TomR AFIBBERS FORUM Thu, 08 Oct 2026 20:51:30 +0000 https://www.afibbers.org/forum/read.php?9,201975,201980#msg-201980 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201980#msg-201980
Last week I had the pneumonia vax, and mRNA doses of over 50 flu and covid. 3 days later, my first ocular in about a couple years.]]> AB Page AFIBBERS FORUM Thu, 08 Oct 2026 12:58:04 +0000 https://www.afibbers.org/forum/read.php?9,201975,201979#msg-201979 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201979#msg-201979 BarbB AFIBBERS FORUM Wed, 07 Oct 2026 17:37:16 +0000 https://www.afibbers.org/forum/read.php?9,201975,201978#msg-201978 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201978#msg-201978 BarbB AFIBBERS FORUM Wed, 07 Oct 2026 17:35:56 +0000 https://www.afibbers.org/forum/read.php?9,201975,201977#msg-201977 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201977#msg-201977 JDfiB AFIBBERS FORUM Wed, 07 Oct 2026 03:49:04 +0000 https://www.afibbers.org/forum/read.php?9,201975,201976#msg-201976 Re: Is there any connection between ocular migraines and Afib? https://www.afibbers.org/forum/read.php?9,201975,201976#msg-201976 Carey AFIBBERS FORUM Wed, 07 Oct 2026 02:52:00 +0000