Introduction and Thanks

Dear All,

I’ve been reading and learning from this forum and informative website for years, and since I am scheduled for an ablation with Dr. Natale at St. Luke’s this coming Monday morning, August 12th, I felt it was time to introduce myself and to express my sincere appreciation to those of you who have been so open in sharing your experiences, your knowledge and your support to others who deal with AF.

My first AF episode (lone paroxysmal AF) was in 1994, and over the years my episodes have, as often happens, increased in frequency and duration. My journey is not unlike many on this list, and I have tried countless modifications in diet, supplements and lifestyle with the hope of resolution. I believe that my efforts toward better nutrition (a moderately low-carb, mostly gluten-free diet, see Paul Jaminet’s Perfect Health Diet), good sleep and exercise (daily walking and strength training once a week for 20 minutes with a trainer) have helped enormously. At present I have no heart disease, and no atrial enlargement. I have had in abundance, though, all the stresses and fears that come with AF.

As with others who have written here, I have held hope that I would find a way to reverse the trend of more frequent and longer episodes. Every shorter episode was a potential sign that I was moving in the right direction. Alas, in the early part of this year I had a three-week episode that started half way through the month I was wearing an event monitor (not a coincidence from my perspective). I self-converted while on a short vacation and life was good again for five days. This was late March, and I then went into AF again and haven’t gotten out. I’ve not taken any medications for rate or rhythm control at any time. My pulse rate is in the low to mid 80s when I’m in AF. After reading about the experiences with ablation on this forum and in many of the references cited here, I made the decision that an ablation would be the next step. I waited longer than I should have to reach this decision, but I have no regrets, since one has to be ready to undergo a procedure like this.

I consulted with Dr. Natale in late May when I learned that he was at St. Luke’s in New York. I had already begun warfarin to prepare for the procedure and because my AF had become persistent. It took me a few weeks to get in range, but I’ll have six weeks of in-range INRs on the day of the ablation.

I look forward to having Monday behind me, but from what many of you have shared, I feel confident that I’m on the right path for myself, even with the inevitable anxiety. Again, thanks to Hans and so many of you who have been so generous with your time, your remarkable knowledge and your experiences.

With best wishes,

Robert

Welcome, Robert. As you've seen confirmed countless times, you are in the very best of care with Dr. Natale.
We'll summon the Angels for You on August 12 for a safe and successful procedure. Please let us know how you are when you are able.

Special blessings and a peaceful heart,
Jackie

Robert:

You said that you have never taken any medications for rate or rhythm control, unfortunately, it appears that people have tried taking minerals and supplements and stay away from taking any meds, in the long run that may not be wise.

My first AF episode was in the late nineties, over the years they got more frequent ( I am vagal ), my EP suggested that I take 150 mg. of Propafenone before bed, my episodes lessened, I take mag. and few other supplements, get potassium from my food (my levels are good) and continue to take the propafenone at night. I still get some episodes of AF anywhere from two to 5 months, which I can handle.

From what I have read on this forum, it seems that a good diet, some supplements aren't enough for most, we need some extra help, the smallest enough of meds might be what is needed.

Good luck to you
Elizabeth

Hi Rob,

I'm a ways away from choosing ablation (first afib episode in early 2011), but I read everyone's reports also and it sure sounds like you are in good hands! Very, very best wishes for an easy time of it. We look forward to hearing from you next week! Louise

Best of luck Robert. Sounds like you have had a long journey. Natale is a good choice for what ails you.

Jim

Wise decision Robert. I'm sure all will be well and you'll be in NSR in no time.

Thank you, Jackie, Elizabeth, Louise and Jim for your good thoughts and your welcome to the forum. I really appreciate your positive energy on Monday, and I will post as soon as I can after my ablation to let you know how it went.

Elizabeth, your question about medications is a good one. I should have been clearer above to say that I haven’t been on any rhythm or rate medications for any significant period of time since I was diagnosed with AF, and the reason is that the drugs I was prescribed left me either feeling worse or they worsened the frequency or intensity of my episodes. I have tried a couple of different beta blockers (metoprolol and bisoprolol). They made me quite light headed, even when I was in NSR, and I was very symptomatic when in AF. They did not reduce the frequency of my episodes.

I was also advised to take digitalis by one doctor I consulted. This made things worse in a number of ways, although I took this longer than anything else because I was told it would be protective for my heart. I learned here long after I stopped taking digitalis that the verdict was in and that it was not a good thing for those of us with AF. More recently I note that McHale has posted some information about beta blockers that suggests that some of them may be harmful as well.

I have been regularly monitored for years by my current cardiologist who has never strongly pushed me to take any drugs as long as my heart rate remained where it is now during AF episodes and there was no evidence of heart disease or enlargement, etc. An EP who I saw a few years back when I was first considering whether an ablation was the next step wanted me to try amiodarone before having an ablation. But after reading about the potential toxicities and the fact that I would have to be admitted to the hospital for monitoring until the dosage was right, I declined.

Now that my AF is persistent, my cardiologist was in agreement with me that an ablation was a next step, and he did insist that anti-coagulation was necessary (no argument from me). The other option was whether other (stronger class) anti-arrhythmic medications might be the immediate solution to getting back into NSR, but with my long history, addressing the problem with the possibility of a more permanent solution seems prudent. Dr. Natale did not suggest that I take any anti-arrhythmic medications prior to the ablation. The well respected EP I consulted with locally would have wanted me on anti-arrhythmic medication prior and after an ablation for a while. And, of course, I may be on such a drug after the ablation during the blanking period.

My personal sense of the issues around nutrition, supplementation and medications for AF is based on the observation that the experience of AF is very different from one person to the next, and what works for one person in a particular instance may make another worse. One of the reasons this forum is so valuable is because the range of experience that is shared makes this kind of information available, and you can see that you are not the only person for whom this particular supplement or medication works or doesn’t work. For me, understanding that there is no single or simple answer to why anyone gets AF has been one of the most vexing issues about living with the condition.

Best wishes,

Robert

Robert:
All will turn out well for you on Monday. It's my birthday. We started counting again in 2009, so I will be 4. And you will have a successful procedure and a quick and happy return to good health in short order. Rest assured that we will all be thinking of you and waiting anxiously to hear how you are doing.

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.

Thank you, afhound, and all so much for writing, and for your support. It really helps. I will post as soon as I can.

Murray, congratulations on your upcoming fourth birthday. I understand completely and I hope to start a new count tomorrow.

Robert

Robert,

My prayers will be with you on Monday, I truly believe that all will go well. As you know Dr. Natale is the best in the business and you will wonder why you waited so long after it is done and you are back in NSR. I can tell you from my experience that the anticipation leading up to the procedure was the worst, the actual procedure is almost a non event, and then the recovery is pretty quick. I wish you well and a wonderful life in NSR.

KenH

Robert,
I remember one Sunday in May having a beer watching the NBA playoffs when I got an Email from Shannon telling me my angel is coming to St Lukes. I meet the "MAN" for the first time right after Memorial Day, May 28 at 12:30pm and the next thing you know we pulled the trigger after a 40 min consultation. There was no hesitation whatsoever, actual elation as he comes back and gives me the thumbs up after he was able to get the anesthesia team to go at the last minute. At that moment I was on the phone with Shannon, so I tell him you have a phone call and hand him my cell phone to his amazement.. They start to prep me and after I get into my hospital gown, I walk past a break area and there is DR NATALE on the phone casually talking away in Italian.
I look at him and a reassuring smile comes across his face, I felt at peace that I had the Best as I walked into the EP Lab.

NSR is Priceless.

Best,
McHale



Edited 1 time(s). Last edit at 08/11/2013 10:37AM by McHale.

Rob, We will all be rooting for you. I'm not in the position to give advise about ablations but I am very happy I chose dr natale and suspect you will be too. Good luck. Dennis

Hi Robert and welcome to this forum , though you've been reading here quite a while it sounds like.
By the time you read this you'll probably be back in your room for bthe over night stay at St Luke's and the ablation will be done already. Congrats on maki g such a wise decision in your choice of EP, that's the single most important thing you have to contribute to your own long term well being and as many here will affirm... You done well

I just left Dr Natale on Friday after he and Dr Burkhardt installed the Lariat for me in Austin and now you are up tomorrow to bat n NYC

Best wishes to you with much success in this most important step in your process of taming the beast. The first ablation lays the foundation and while its all that is needed for a good number of people, its always wise to underscore the 'process' part of the long term equation for the majority that usually require two procedures and occasionally three to really put things to sleep for the long haul.

Enjoy the ride and the increasing experience of NSR in the days, months and years ahead ... Whatever it takes.

Best, Shannon

Robert,

Welcome and best wishes!

It is hard to fathom that the CC refused to renew Dr. N's contract a few years ago. Talk about cutting off your nose to spite your face!!!

George