3rd time not a charm

Only a couple previous posts....73 yrs young, 165 lbs....sleep apnea....50 mg Flecainide 2x....5 mg Eliquis 2x.....

Diagnosed about 3 yrs ago with 3 day stint in hospital trying to chemically revert but finally requiring cardiovert. Now, on my third subsequent episode of afib confirmed with recent visit to EP's nurse practitioner and EKG. Am in a slow rate afib with heart rate in the mid 60's to 70's. BP well within normal range and/or better. Only had one reading in the 80's and think that was just a bad reading. 1st episode (since original diagnosis) spontaneously reverted after about a day or so with rate in the 90's/low 100's. 2nd episode lasted a littlle longer (90ish) and required an additional flecainide or two. Third and current episode going on about two weeks. Pretty much asymptomatic with the exception of some lightheadedness when standing up. During recent visit the nurse practitioner said he could set me up with a cardio version that same week. I balked because of the virus and the hospital being in a somewhat larger metro county with 178 deaths. Not a lot I know but still. Hospital will be opening up May 1st. Ugh, don't know. Anyway, after some discussion, the plan was for me to take an additional flecainide for 5 days in a row and to do a telemedicine conference in 1 month to reevaluate. We talked about the flecainide and the NP thought he would not like to give up on it just yet but we'd talk some more. NP also said that their office is happy to look at Kardia readings (which I currently do not own but will shortly) and that if I could send a reading to him prior to our conference that that would be very helpful. I have been reading up on the Kardia on the forum.

So, I'm still sorting thru getting used to getting into and being on afib, and regularly read this forum and know it to be a great resource and place to find out what's what with respect to afib. So, thanks to you all. Ok, so my question is simply does this plan seem to be reasonable and are there questions I should think about asking in the telemedicine call. Are there things I could/should be doing now. I read the thread "Would you risk COVID-19 and having an ablation at this time" which seems somewhat applicable to my (our) situation as well as the link to a "chart' indicating what afib related procedures which would be considered necessary but elective as this time. My situation would seem very elective. Anyway sorry for the long post but any suggestions or thoughts would be appreciated. Again, thanks for all who make this forum a reality.

Since your rate is well controlled there's no rush. I would wait until things settle down. Basically, when the hospital is willing to do non-urgent procedures again, I would take that to mean it's safe enough.

Try some low sodium V8 and take magnesium. You can order on Amazon. It could possibly self convert your AF.

Regarding the thread on an ablation during the corona, I postponed my ablation for this week with Dr. Natale in Thousand Oaks, CA. I got a call last week saying he is still flying in. He bought the test kit for himself and frequently tests for corona. TO is a semi rural area where the corona numbers are lower than at a major city. I’m told every patient entering gets a 45 minute rapid test. I like the hospital- private rooms.

It’s now 41 days and counting I have been isolated in my home-advise from my EP. So I don’t see myself leaving for an ablation at this time. I’m suffering with the PVCs (started and increased Tenormin for rate control and pvc comfort) but like Carey mentions, if your arrhythmia is under control you may want to wait it out like me. My concern Is any situation (cut needing stitches/broken bones etc) that may require an ER visit. Most people don’t think of it but you never know. My 6yo granddaughter sliced her knee Friday and needed stitches. She is little and an adult mask won’t fit her face. I made her an Olsen Mask and inserted a blue surgical mask to the inner pocket.

[www.unitypoint.org]

I hope Natale stays healthy with his airline traveling and exposure. He is such a generous and caring individual to risk his health for us. He is still doing ablations in Texas as well. He doesn’t have a full load of ablations Wednesday-Friday if anyone is interested for this week.

I would get the ablation if I were you. You'll be fine.

Quote
NotLyingAboutMyAfib
I would get the ablation if I were you. You'll be fine.

Thanks for the good wishes. I am happy that your AF ablation went smoothly and you didn’t catch the virus.

Unfortunately I have to wait. You don’t live in CA, a hotspot, nor (best of my knowledge) recovering from cancer and have respiratory issues, and you don’t share age/health history/complications and you have local family support (I don’t) to help with recovery from the future pvc/Af/other areas needing ablating for tachy. It’s extra chambers to burn. Left Ventricular ablation is its own league. Natale is a qualified expert-but my local EP said he himself has never ablated the left ventricle nor will ever do it.

I am at a risk with challenging factors in play. I am lucky right now just to have food. It’s been 41 days I’ve been in isolation (dr orders) so I can’t physically shop. I shopped 41 days ago and I was even criticized by the store manager for not staying home. But I’m fortunate to had inherited two extra fridge/freezers so we are bunkered in for a while if we ration. It’s lemonade to the situation just to have survival food.

“ I would get the ablation if I were you ”. So yeah...I want it done but perhaps my situation is different than yours.

Sorry-I don’t know why it posted twice

Susan - no worries but I didn't get mine yet either. On the batter circle but trying to see if I can fix it before I take the deep dive. But Dr. N is the choice.

Will give the V8/Magnesium a try. Also, best of luck to those of you in more needy circumstances than mine and are in a bit of a waiting game. Stay safe everyone.

Walt,

You stated you have OSA. Are you using a CPAP ? Do you have one of these (see below) to check and alert you should your spO2 level drop too low? Have you had a series of hsCRP labs to see if you're making progress?


[www.amazon.com]

No, I do not have one of those but at least one other person on an apnea website forum suggest looking into an oximeter of one type or another. So, I should look into.
that. Have upcoming conference with sleep doc and will explore that with him also.


Did try the V8/Magnesium but still in slow rate afib--few symptoms except for occasional dizziness. Had telemedicine conference this PM with the NP at my EP's office. His thoughts: He would still not like to give up on flecainide just yet. Recommends an ECV as he feels that afib can beget afib and would like to get me into NSR. If I slip back out of NSR than he would try other medications or I could consider an ablation. He did state that their office was in flux as my ECV (who has been there 30 years) is leaving to take a job in Jacksonville, Fl. Can't remember where but sort of a dream job type of situation. Replacement seems to be a fellow with Harvard training but as yet not one who has ablation volume. I mentioned Natale to the NP and he has some knowledge about him. We talked about the CoVid situation, traveling to CA (for me flying), and an immuno compromised person at home. All that kind of stuff. He mentioned several other people in neighboring states (drivable) that perhaps I could consider as well as going to Jacksonville to have my current EP do the procedure there with follow up back here in this office. There is a person at Vanderbilt (Nashville), Christopher Ellis, who he thinks highly of and who apparently almost does ablations to the exclusion of every thing else. Don't know if anyone has heard of him or anyone else in the Knoxville/Nashville vicinity that they have heard of as being excellent with respect to doing ablations. Anyway, I'm thinking Natale may be a reach at this time or maybe not. I am thinking of doing telemedicine consultations with some of the other possibilities. I just need to try to reread threads with respect to questions to ask and that kind of thing. Also, need to reread the ins and outs of seeking out Natale logistics of going to CA etc. I also remember reading (somewhat recently I think) that Natale uses a particular technique (?) for his ablations but can't remember exactly what that was or the thread that I read it in. If anyone can link me to threads which might be good souces for some of my questions that would be appreciated. I will "search" also. Sorry for the long post.