new to forum - looking for recommendations

First of all, thank you for this forum, I've only recently found it. I'm frustrated with my current care from my cardiologist and have been trying to do my own research. Below is a very consolidated history, any suggestions and/or recommendations would be greatly appreciated.

I was diagnosed with afib approximately 2.5y ago, probably have had it longer, was diagnosed one evening when my heart rate went to 180 or so and wouldn't come down, went to ER and they cardioverted me. 53yr old male, 6' 1" tall heavy most my life (260-270lb) but active, now at 215lb, moderate blood pressure (80-90/130-140), down a bit now since weight loss and exercise routine (70-80/110-12). Still on diet (low calorie, nothing weird) and walk/jog almost daily for 30-60 minutes.

I'll be good for a few weeks with little to no episodes, then I'll have a few weeks where I'm in afib most of the evening. I believe it's vagal because it has all the typical vagal symptoms, get very bloated in the stomach and the afib will start, can't lay on left side, occurs typically in the evening, can usually get out via moderate exercise for 10-20 minutes, etc.

Been on sotalol since the beginning, tried a couple of other meds (don't recall what) but they gave me all types of weird palpitations. Currently take 80mg sotalol twice daily along with a baby aspirin twice daily (no other blood thinners). Also take 400mg magnesium (recently), 500mg niacin twice daily, glucosamine/chondroitin, and some fish oil.

My cardiologist just doesn't really seem to "get it". He doesn't do anything but put me on a ekg when I come in and then tells me to come back in 6 months, I have had a stress echo and it was OK but he has never holter monitored me or any other type of monitoring, never has even seen afib on any of my ekg's during an office visit. (Dr George Wesley, OC Heart Institute in Orange, CA). He referred me for an ablation evaluation to another doc in his practice (see my other thread) however I really wasn't comfortable with some of what he said, hence I'm trying to get an appointment with Dr. Natalie at Scripps based on recommendations from this forum.

Some of my questions are:

Is it safe to not be on any other blood thinners based on bouncing in and out afib throughout the evening sometimes?

Is it safe to do moderate exercise while in afib (it typically will get me out). My heart rate when in afib is typically 110-120 but will go to 140-160 with moderate exercise. Is that safe?

Should I change cardiologists and/or try some other "fixes" or just move forward with an ablation with Dr Natalie? (assuming I can get an appointment with him). Any recommendations in the Orange County CA area? Should I change cardiologists first before proceeding with ablation with Dr. Natalie?

Any suggestions or recommendations would be greatly appreciated.

Thank you,

jim

Natale is definitely your best bet for a well done procedure. My GP belongs to the Mission internal group and Aseem Desai has a good rep according to my GP which is a long time tennis buddy of mine. I know of a couple of people that got ablated by his group and both reports were good. However, those were simple right sided procedures. He is the main man at Mission for doing AF and other more complex procedures he does a heavy volume since he has the best rep in OC. You can check him out since you are in the area already. I would stay away from St Joseph's in Orange and St Jude in Fullerton. Hoag is a mini-maze shop and that''s not what you will want. UCI doesn't have anything (I think they did start a group but it is very new). I would like to hear your feedback if you do check out Desai.

Hi Jim,
I'm from Orange county, but currently live in L.A county. I recently had ablation done by Dr. Natale almost 2 months ago at Scripps, La Jolla.
You may have read my previous post. I just want to give you my opinion that if you can, go straight to ablation by Dr. Natale. As I have mentioned before in my previous post that I believe ablation done by a good EP is the best way to deal with the beast. I think you will be glad that you decide to go through with it. So far, I'm doing quite well. I wish you good luck. If you have more questions, ask away. Members in this forum are super knowledgeable, helpful, kind and sincere. Let us know how your journey goes.

Duke

Hi Jim,

'My cardiologist just doesn't really seem to "get it".'

One of the first stories I read on this site, over 10 years ago, described afib as “the hemorrhoid of cardiology.”
<[www.afibbers.org] A lot of cardios don't treat it seriously.

If it is possible for you to see Natale in SD, I'd choose that option...

George

It is safe to exercise while in AFIB, only issue is your high heart rate. I suggest you try to get your rate down by re-thinking your rate control drug regimen. Sounds like you need a new Doctor, get an EP who doesn't do Ablations, who will spend time with you, (it has been my experience and observation that non-ablation EP's will try harder to help you through the situation naturally.) You can still follow up with an Ablation Doctor also. What is the point of going to the Cardiologist, if he doesn't seem interested in helping you.

The question about the blood thinners is a debate, I suggest you research the past threads on this site. Posters on here don't recommend Aspirin anymore. Sounds like the risk is not sufficient to warrant Blood Thinners, but that is just an opinion based on the limited info you provided.

Jim:

I get episodes of AF once maybe every 2 months, I cannot take Coumadin (blood thinner) so my EP says to take a baby aspirin. Blood thinners can be as problematic as aspirin, read and listen but in the end you need to evaluate your own situation.

Liz