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New Member- Need Advice
Posted by Geocappy
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New Member- Need Advice March 28, 2022 10:24AM |
Registered: 2 years ago Posts: 111 |
Hello
I was diagnosed with asymptomatic afib 3 years ago and cardiologist put me on Xarelto and said heart looked fine and since no symptoms and blood flow good we would just monitor. Said EPs wouldn’t do anything until on blood thinners for a year. Fast forward three years and referred to EP finally. Heart appears not to have changed much. He told me strategy has changed and they now favor early intervention regardless of symptoms or heart condition. Said longer you wait lower odds and if condition of heart gets worse might be very difficult to help. EP did cardioversion which worked immediately. He doubled myinitial pre- cardioversion dosage of Fecanaide to 100mgx2/day plus Metoprolol 50mg x1/day.
1 week fu still in rythm. 3week fu back in afib and unusual high Blood pressure. I did have about 40 ounces of caffeine during morning prior to appt. Upped dosage to 150mg x 2 and 75mg Met. Said if I wanted a shot to get off the meds I should consider ablation. Put on 30 day monitor and did my own kardia mobile for another 30 days. Normal sinus rythm. No apparent symptoms.
On verge of moving forward with ablation. My EP is a Fellow of the Heart Rhythm Society and at Orlando Heart Center. I believe he is suppose to be good in the central Florida area(Castle Connolly best doctors 2016, 2017, 2018)
Does anyone have any advice or suggestions on whether I should consider another top doctor? Is there a Dr Natale- like doctor in Florida. Thanks
Edited 1 time(s). Last edit at 03/28/2022 10:31AM by Geocappy.
I was diagnosed with asymptomatic afib 3 years ago and cardiologist put me on Xarelto and said heart looked fine and since no symptoms and blood flow good we would just monitor. Said EPs wouldn’t do anything until on blood thinners for a year. Fast forward three years and referred to EP finally. Heart appears not to have changed much. He told me strategy has changed and they now favor early intervention regardless of symptoms or heart condition. Said longer you wait lower odds and if condition of heart gets worse might be very difficult to help. EP did cardioversion which worked immediately. He doubled myinitial pre- cardioversion dosage of Fecanaide to 100mgx2/day plus Metoprolol 50mg x1/day.
1 week fu still in rythm. 3week fu back in afib and unusual high Blood pressure. I did have about 40 ounces of caffeine during morning prior to appt. Upped dosage to 150mg x 2 and 75mg Met. Said if I wanted a shot to get off the meds I should consider ablation. Put on 30 day monitor and did my own kardia mobile for another 30 days. Normal sinus rythm. No apparent symptoms.
On verge of moving forward with ablation. My EP is a Fellow of the Heart Rhythm Society and at Orlando Heart Center. I believe he is suppose to be good in the central Florida area(Castle Connolly best doctors 2016, 2017, 2018)
Does anyone have any advice or suggestions on whether I should consider another top doctor? Is there a Dr Natale- like doctor in Florida. Thanks
Edited 1 time(s). Last edit at 03/28/2022 10:31AM by Geocappy.
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Re: New Member- Need Advice March 28, 2022 03:25PM |
Registered: 10 years ago Posts: 2,519 |
Perhaps cut down or eliminate your caffeine as an experiment to see if coffee triggers your afib. Not everyone can tolerate coffee…some do, some don’t.
Many will reply to get an appointment with Dr Natale. I’m grateful I did. Good luck with your decision.
BTW, the max flecainide dosage is 300mg in a 24 hour period if you weigh more than 154 pounds. Otherwise it’s 200mg in a 24 hour period if you weigh less.
You increased the dose to 300mg a day —I hope you weigh more than 154 pounds.
Many will reply to get an appointment with Dr Natale. I’m grateful I did. Good luck with your decision.
BTW, the max flecainide dosage is 300mg in a 24 hour period if you weigh more than 154 pounds. Otherwise it’s 200mg in a 24 hour period if you weigh less.
You increased the dose to 300mg a day —I hope you weigh more than 154 pounds.
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Re: New Member- Need Advice March 28, 2022 05:08PM |
Registered: 2 years ago Posts: 111 |
I would love to see Dr Natale based on everyone’s comments. The dive from Orlando would be 18 hrs. I was hoping somebody knew the Dr Natale of Floridaor nearby.
I have cut my coffee down to 8 ounces a day. My Doctor has never mentioned it. I can’t believe I drank over 40 ounces of coffee and pepsi after getting cardioversion on day of followup ekg.
Since I have been in rhythm for 60 days (at higher med dosage) i am wondering if I should have him lower the dosage back down to see if I stay in rhythm at lower caffeine intake.
I am about two hundred pounds and I am hoping the ablation would work and get me off meds. I am tolerating them ok for now but I want off them
I have cut my coffee down to 8 ounces a day. My Doctor has never mentioned it. I can’t believe I drank over 40 ounces of coffee and pepsi after getting cardioversion on day of followup ekg.
Since I have been in rhythm for 60 days (at higher med dosage) i am wondering if I should have him lower the dosage back down to see if I stay in rhythm at lower caffeine intake.
I am about two hundred pounds and I am hoping the ablation would work and get me off meds. I am tolerating them ok for now but I want off them
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Re: New Member- Need Advice March 28, 2022 05:09PM |
Registered: 11 years ago Posts: 4,228 |
Quote
Geocappy
Does anyone have any advice or suggestions on whether I should consider another top doctor? Is there a Dr Natale- like doctor in Florida.
A Florida Natle protege' is Sergio Pinski at Cleveland Clinic, Weston. [my.clevelandclinic.org]
I sent my cousin and his wife there for ablations around 2009 with good success.
I live in Colorado and I'd fly to see Natale in Austin, if it were me. I've sent a number of friends there: [tcainstitute.com]
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Re: New Member- Need Advice March 28, 2022 07:21PM |
Registered: 2 years ago Posts: 111 |
That is interesting. I thought you are not suppose to fly for 4 weeks after an ablation. Btw, can you drive 5-6 hours the next day after surgery? I live 5-6 hours from Weston, Fl. It is a difficult call as I am so far along with the EP I have been seeing. I mean two 30 day monitors and a cardioversion. As I stated my guy (Dr Roland Filart) is not a country bumpkin. He is a Fellow of the Heart Rhythm Society and Castle Connors best doctors 2016, 2017, 2018.
How does it work if you see a doctor 500 miles away. Do you go back and forth for followup appointments? Do I drive down for 2nd opinion and see what he has to say. How long do I delay my ablation taking this max dose of Flecainide and Metoprolol with no symptoms
How does it work if you see a doctor 500 miles away. Do you go back and forth for followup appointments? Do I drive down for 2nd opinion and see what he has to say. How long do I delay my ablation taking this max dose of Flecainide and Metoprolol with no symptoms
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Re: New Member- Need Advice March 28, 2022 08:14PM |
Registered: 11 years ago Posts: 4,228 |
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Geocappy
That is interesting. I thought you are not suppose to fly for 4 weeks after an ablation.
There are many people here, including moderators Shannon & Carey who have flown to Austin and flown home on the return a few days later. I have Colorado friends I've suggested go to Natale in Austin & they've done likewise. The restriction is that you can't carry more than 10 pounds for a number of days (someone here will tell you how many). This is because the insertion sites near the groin have to heal. Others here can also answer your question about follow up. I don't know your EP. He may be a fine doctor, but there is one Natale. Afib ablation has an "art" part of it. Natale is a world class artist. If you had a simple arm fracture, I'd tell you to go to a local orthopedist and get it set. For an afib ablation, go to Natale. See Carey's story of going to other, well regarded, EP's here: [www.afibbers.org]
My doc, Steven Gundry, is a very well regarded cardiothoracic surgeon. At 71, he now practices longevity medicine. A friend who is a Gundry patient was considering getting a mini-maze (external ablation) from a doc who's well known for these procedures. He asked Gundry about him and Gundry said he knew him and was a fine doc. Now I respect Gundry a lot, but he's not an expert in the ablation/mini-maze world, even though he is a heart surgeon. I told my friend that a mini-maze was not for him with his problem. I then referred him to moderator Shannon, who knows more than I do. Shannon said that my friend's issue was his atrial flutter, which the mini-maze would not fix. The guy is now going to Natale.
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Re: New Member- Need Advice March 28, 2022 09:14PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 28, 2022 09:32PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Geocappy
How does going to see Natale work? Does she take Medicare?
Dr. Natale is a he, and yes he takes Medicare. (Andrea is a common masculine name in Italy and other parts of Europe.)
They've been accepting patients from out-of-state/out-of-country for many years and have the system down pat. You would have your records sent to them, they would review them and decide if they can help you, then schedule you. You then travel to Austen, go in on day 1 for blood work and possibly a CT scan. On day 2 would be your procedure. You'll stay in the hospital overnight. On day 3 you'll be discharged and you'll go back to your hotel, or out to eat, or whatever you feel like doing. They ask that you stay in Austen for 2 days following the procedure. So during that time you just take it easy at the hotel, go see what Austen has to offer, or whatever you feel up to. There's some very good food to be had in Austen.
Your only restriction will be no lifting anything heaver than 10 pounds for a week. And that includes your luggage, so you have to come prepared to deal with that.
You'll be assigned a nurse practitioner who will be your point of contact. The NP will provide you with prescriptions, advice on any problems that come up -- basically, they're a point of contact between you and Natale. They will continue providing care for however long it takes you to heal, and prescription renewals for life, if necessary. (My Eliquis prescription still comes from Natale and I've had it since 2017.)
If you have a local EP or PCP you want copied on all your interactions, they will do that.
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Re: New Member- Need Advice March 28, 2022 11:53PM |
Registered: 5 years ago Posts: 146 |
Maybe a bit off track maybe not but….I would not place too much credence in any of the Best Doctor/Top Doctor Awards you may see or hear about without doing serious research. The link below is one of many you will find about these “awards.” I linked this one as it specifically mentions Castle Connolly.
[abcnews.go.com]
Edited 1 time(s). Last edit at 03/28/2022 11:54PM by walt.
[abcnews.go.com]
Edited 1 time(s). Last edit at 03/28/2022 11:54PM by walt.
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Re: New Member- Need Advice March 29, 2022 12:10AM |
Admin Registered: 6 years ago Posts: 5,357 |
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walt
I would not place too much credence in any of the Best Doctor/Top Doctor Awards you may see or hear about without doing serious research.
I completely agree. Those things are worthless nonsense. Ditto with doctor rating web sites. Those are just popularity contests where bedside manner wins and actual skills lose.
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Re: New Member- Need Advice March 29, 2022 01:50AM |
Registered: 9 years ago Posts: 1,087 |
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Re: New Member- Need Advice March 29, 2022 07:37AM |
Registered: 2 years ago Posts: 111 |
Exacly. I am so pissed at the cardiologist who gave this initial advice and myself for not doing research to check out what she was telling me. I ended up going 3 years because her test ( nuclear stress and echo) showed my heart as stable and adequate blood flow. Also, since I had no symptoms
I now have persistent afib of over 3 years which I understand reduces my odds of a successful ablation dramatically. My EP lists in his progress report that I have Symptomatic afib but I do not understand why as whenever I am questioned about symptoms I always say I have not felt anything, no shortness of breath, dizziness, etc
Unless he bases it on what he saw on 14 and 30 day monitor sessions
I now have persistent afib of over 3 years which I understand reduces my odds of a successful ablation dramatically. My EP lists in his progress report that I have Symptomatic afib but I do not understand why as whenever I am questioned about symptoms I always say I have not felt anything, no shortness of breath, dizziness, etc
Unless he bases it on what he saw on 14 and 30 day monitor sessions
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Re: New Member- Need Advice March 29, 2022 08:39AM |
Registered: 11 years ago Posts: 4,228 |
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Geocappy
I now have persistent afib of over 3 years which I understand reduces my odds of a successful ablation dramatically.
If you've been persistent for 3 years, you absolutely should go to Natale, your odds of a good outcome will go up dramatically. As Shannon notes here [www.afibbers.org] 75% of his caseload are persistent or longstanding persistent afib cases.
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Re: New Member- Need Advice March 29, 2022 10:58AM |
Admin Registered: 6 years ago Posts: 5,357 |
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Geocappy
Unless he bases it on what he saw on 14 and 30 day monitor sessions
A symptom is defined as something the patient experiences and reports such as pain, nausea, etc. A sign is something the doctor can observe such as bleeding, fever... and those monitor results. So that entry on your record is simply wrong.
And I second George's recommendation on Natale. You're in longstanding persistent afib. Many EPs wouldn't even attempt to ablate you, and if they did you'd be looking at maybe a 40% chance of success. Natale has a success rate with LSPAF at least double that. I wouldn't consider anyone else.
Edited 1 time(s). Last edit at 03/29/2022 05:06PM by Carey.
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Re: New Member- Need Advice March 29, 2022 02:27PM |
Registered: 2 years ago Posts: 111 |
That is what I thought and made it known to my PE’s. P.A. And haven’t heard back yet. Although I like PE I am less than enamored with his staff. I mentioned to PE that my family lived in earshot of Cleveland Clinic and they wanted me t do it there. He was very understanding of me possibly of at least getting a second opinion.
Does anybody know the liklihood Natale would consider taking me on. I am a 68 year old diabetic (A1C was 7.1 last 90 day checkup but should be low 6’ next test as I have cut out carbs -lost 22lbs to 205). Also have sleep apnea, fluctuating blood pressure, border high cholesteral. My progress chart says persistent symptomatic afib but I have never said I had any symptoms except I did have few panic attacks due to going thru some other life issues as well as the learning of the need for ablation.
If he did does anybody know the wait time to get in? Also, if he is successful chances he would take me off heart med (Flecainide, Metoprolol, and Xarelto.
Edited 1 time(s). Last edit at 03/29/2022 02:46PM by Geocappy.
Does anybody know the liklihood Natale would consider taking me on. I am a 68 year old diabetic (A1C was 7.1 last 90 day checkup but should be low 6’ next test as I have cut out carbs -lost 22lbs to 205). Also have sleep apnea, fluctuating blood pressure, border high cholesteral. My progress chart says persistent symptomatic afib but I have never said I had any symptoms except I did have few panic attacks due to going thru some other life issues as well as the learning of the need for ablation.
If he did does anybody know the wait time to get in? Also, if he is successful chances he would take me off heart med (Flecainide, Metoprolol, and Xarelto.
Edited 1 time(s). Last edit at 03/29/2022 02:46PM by Geocappy.
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Re: New Member- Need Advice March 29, 2022 02:50PM |
Registered: 10 years ago Posts: 2,519 |
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Re: New Member- Need Advice March 29, 2022 05:23PM |
Admin Registered: 6 years ago Posts: 5,357 |
Sure, he would take you as a patient. Wait times vary but usually you're looking at a couple of months.
If the ablation is successful then he will definitely stop the flecainide and metoprolol, but Xarelto probably not. He might want to change it to Eliquis, though, because he prefers it. With the diabetes and hypertension you have a CHADS-Vasc-2 score of at least 2, and probably 3, which gives you a 4.6% per year risk of stroke/embolism without it. That gives you over a 1-in-3 chance of suffering a stroke within the next 10 years without an anticoagulant. What he might do, however, is drop you to a half-dose of Eliquis once you're a year beyond the ablation and have remained afib free. If I were you, I wouldn't be in a rush to get off that med.
If the ablation is successful then he will definitely stop the flecainide and metoprolol, but Xarelto probably not. He might want to change it to Eliquis, though, because he prefers it. With the diabetes and hypertension you have a CHADS-Vasc-2 score of at least 2, and probably 3, which gives you a 4.6% per year risk of stroke/embolism without it. That gives you over a 1-in-3 chance of suffering a stroke within the next 10 years without an anticoagulant. What he might do, however, is drop you to a half-dose of Eliquis once you're a year beyond the ablation and have remained afib free. If I were you, I wouldn't be in a rush to get off that med.
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Re: New Member- Need Advice March 29, 2022 05:35PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 29, 2022 06:09PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: New Member- Need Advice March 29, 2022 06:30PM |
Registered: 11 years ago Posts: 449 |
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Re: New Member- Need Advice March 29, 2022 08:11PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 29, 2022 08:23PM |
Registered: 11 years ago Posts: 449 |
I took no. Zero anti arrhythmia meds. I was on eliquis due to my LAA being isolated. Flutter a different animal than afib so this is not apples to apples. You have afib. A much easier fix than left atrial flutter. But i had afib too so both! But since 8/6/21 zippo episodes. Im
Very pro ablation. Imo you shoulda been ablated a while back but its never too late with elite EPs Im
Strong on opinions: mine - get in there and end this ! It will NOT go away. Some after a Natale afib ablation are put on Mutaq. Ive never taken it. Others can chime in
Best to you. You found the correct site. You were led here. Not an accident
Very pro ablation. Imo you shoulda been ablated a while back but its never too late with elite EPs Im
Strong on opinions: mine - get in there and end this ! It will NOT go away. Some after a Natale afib ablation are put on Mutaq. Ive never taken it. Others can chime in
Best to you. You found the correct site. You were led here. Not an accident
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Re: New Member- Need Advice March 29, 2022 08:31PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 29, 2022 08:37PM |
Registered: 11 years ago Posts: 449 |
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Re: New Member- Need Advice March 29, 2022 08:42PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 29, 2022 09:21PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Poppino
The entire goal of an effective ablation is to no longer rely on meds like propafanone or flecanide or multaq etc. maybe theyre taken for a short period ? But after 3-6 months no
Exactly.
There are EPs out there claiming successful ablations whose patients are still taking antiarrhythmics. They can claim partial success if the ablation and antiarrhythmic significantly improved the patient's symptoms, but they cannot legitimately claim full success.
If you're taking an antiarrhythmic to stay in NSR after the blanking period, your ablation was not fully successful, and Natale will aim for fully successful. He often uses an antiarrhythmic for a month or two following ablations to keep your heart quiet while healing, but he won't keep you a day longer than necessary.
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Re: New Member- Need Advice March 29, 2022 10:22PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 30, 2022 07:24AM |
Registered: 2 years ago Posts: 111 |
Could I get some perspective of how you handled thing with your EP when you decided you wanted to use Dr Natale? Was there a conversation with them or their nurse. Did you just request records. I left my EP’s in Florida office the last time telling them I was considering my family’s request to go to the Cleveland Clinic back home.
Do i keep them as a local office after Dr Natale does my ablation. Do I need them or my existing Cardiologist? I believe I already need to replace her as she was the one who said since I wasn’t having symptoms I could wait to see an EP and just go on blood thinner.
Would Dr Natale’s office refer me to a cardiologist/EP in my area if need be?
Do i keep them as a local office after Dr Natale does my ablation. Do I need them or my existing Cardiologist? I believe I already need to replace her as she was the one who said since I wasn’t having symptoms I could wait to see an EP and just go on blood thinner.
Would Dr Natale’s office refer me to a cardiologist/EP in my area if need be?
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Re: New Member- Need Advice March 30, 2022 08:44AM |
Registered: 11 years ago Posts: 449 |
Just speaking for me: after my 3/29/21 failed ablation by late May i Me. I. Decided i wanted to go to Dr Natale as id learned of him many yrs ago on this site. He began at the Cleveland clinic btw. So i advised my EP here who i have a 12 yr relationship with & love him. He was totally supportive. So in May Austin called me with a 7/5/21 date. I went. Natale sent me home lol. Saying he was not 100% sure i needed a new ablation but probably. So i flew home to Charlotte. A week later flutter at 128 and cardioversion. Natale s office got the ekg and gave me a new date 9-13-21. But i was no 1 on the cancel list. They got one. So back i went 8-6-21. Natale ablation one night another in my hotel then home. Since : zero episodes zero meds other than eliquis. Pain zero. Hematoma zero. Pericarditis zero. My EP here does not have such an ego that damaged our relationship. Hes still my EP as i cant be traveling to Austin on a whim. So i have 2 EPs lol. Best of both world s. Texas Arrhythmia Dr Natale is a machine. Well oiled. Great nurses!! Educated. Tremendous EP staff. The care was incredible. I was back there 2-16-22 for the watchman which Dr Natale also did
Bottom line:,you. Yes you!!! Are no 1. Worrying about a Drs feelings is last. Take care of no 1 you
Bottom line:,you. Yes you!!! Are no 1. Worrying about a Drs feelings is last. Take care of no 1 you
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Re: New Member- Need Advice March 30, 2022 09:23AM |
Registered: 11 years ago Posts: 4,228 |
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Geocappy
I was considering my family’s request to go to the Cleveland Clinic back home.
As Tom said, Natale was at CC in Cleveland. In fact he was the head of the cardiac electrophysiology section till around Sept. 2007. In a "cutting off your nose to spite your face moment," the MD CEO of CC at the time refused to renew Natale's contract because Natale was teaching EPs at other institutions on his own time. This would be like not renewing Tom Brady's contract because he was holding clinics for other quarterbacks. This did not hurt Natale as the folks at St. David's in Austin built him an EP center to run.
I joined this forum in 2004. Natale was a star then and has only gotten better.
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Re: New Member- Need Advice March 30, 2022 03:53PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 30, 2022 05:59PM |
Registered: 2 years ago Posts: 111 |
If you would indulge me one more time. I need to run something by all the knowledeable people on here
As I said I was diagnosed with afib at least 3 yrs ago and I seem to be in afib whenever checked. No symptoms, no meds except xarelto for 3 plus years. Referred to EP who immediately does 14 day monitoand then scheduled cardioversion. Prior to cardioversion he put me on 50mg of flrcainide and 25 mg of metoprolol. My heart immediately went into NSR during CV. He doubled my doses of both meds and a followup ekg was done a week later and I was still in NSR. Still no symptoms. Two weeks later is when i saw doctor again and the day I drank 44 ounces of caffeine before 1pm (prior to I always drank 24 ounces of coffee every morning). I was back in Afib and Blood pressure was 148/85.
EP raised Flec to 150 x 2/day and Met to 75mg. Still no symptoms. Told him I was hoping to get off meds. He said let’s discuss ablation. Told him I wanted to research and talk to wife. Put me on 30 day monitor. Monitor showed I was in NSR and I have been an additional 30 days (monitoring with my Kardia mobile. Met in office and ekg showed NSR two months after cardioversion and on max meds.
I am just wondering if all the caffeine could have caused the afib on the day On my visit after the cardioversion.I have cut my caffeine to 8 ounces a day and as stated no Afib at higher meds dose. Does it make any sense to ask EP to lower meds back down to see if maybe the CV worked?
Or just don’t worry about it and set up visit with Dr Natale since I don’t want to be on meds and there is probably no way I would probably stay in NSR anyway w/o meds
Edited 2 time(s). Last edit at 03/30/2022 06:11PM by Geocappy.
As I said I was diagnosed with afib at least 3 yrs ago and I seem to be in afib whenever checked. No symptoms, no meds except xarelto for 3 plus years. Referred to EP who immediately does 14 day monitoand then scheduled cardioversion. Prior to cardioversion he put me on 50mg of flrcainide and 25 mg of metoprolol. My heart immediately went into NSR during CV. He doubled my doses of both meds and a followup ekg was done a week later and I was still in NSR. Still no symptoms. Two weeks later is when i saw doctor again and the day I drank 44 ounces of caffeine before 1pm (prior to I always drank 24 ounces of coffee every morning). I was back in Afib and Blood pressure was 148/85.
EP raised Flec to 150 x 2/day and Met to 75mg. Still no symptoms. Told him I was hoping to get off meds. He said let’s discuss ablation. Told him I wanted to research and talk to wife. Put me on 30 day monitor. Monitor showed I was in NSR and I have been an additional 30 days (monitoring with my Kardia mobile. Met in office and ekg showed NSR two months after cardioversion and on max meds.
I am just wondering if all the caffeine could have caused the afib on the day On my visit after the cardioversion.I have cut my caffeine to 8 ounces a day and as stated no Afib at higher meds dose. Does it make any sense to ask EP to lower meds back down to see if maybe the CV worked?
Or just don’t worry about it and set up visit with Dr Natale since I don’t want to be on meds and there is probably no way I would probably stay in NSR anyway w/o meds
Edited 2 time(s). Last edit at 03/30/2022 06:11PM by Geocappy.
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Re: New Member- Need Advice March 30, 2022 06:16PM |
Registered: 11 years ago Posts: 4,228 |
Quote
Geocappy
I am just wondering if all the caffeine could have caused the afib on the day On my visit after the cardioversion.I have cut my caffeine to 8 ounces a day and as stated no Afib at higher meds dose. Does it make any sense to ask EP to lower meds back down to see if maybe the CV worked?
The data suggest that caffeine doesn't cause afib. However that doesn't mean it isn't an issue for you. Over the years, some folks who thought coffee was an issue found that switching to organic coffee eliminated coffee as a trigger for them, indicating it could have been pesticides or the like that was the issue.
ECV's have no long term effect after the conversion. The issue is always how to keep someone in rhythm after an ECV. In your case, this is likely the flec (I'm interpreting your post that you are currently in NSR). The purpose of the metoprolol, along with the flecainide is to mitigate the risk of the flec throwing you into atrial flutter. Could a lower dose of flec keep you in rhythm? Certainly. Asking your doc to reduce the dose is reasonable. The risk is that you may go back into afib and require another ECV. If so, it would make sense to drop your dose slowly, maybe 50 mg/day at a time.
Edited 1 time(s). Last edit at 03/30/2022 06:18PM by GeorgeN.
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Re: New Member- Need Advice March 30, 2022 08:34PM |
Registered: 10 years ago Posts: 2,519 |
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Re: New Member- Need Advice March 30, 2022 09:04PM |
Registered: 2 years ago Posts: 111 |
Yes I am currently in NSR at max meds. Do you think it is worth the effort to see if EP would lower dosage as I would still be on two meds at 100mg flec and 50mg Met. If I want to get rid of meds I need to do an ablation, correct. Do you think it would make any difference with Dr Natale at what dosage I am on.
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Re: New Member- Need Advice March 30, 2022 09:51PM |
Registered: 11 years ago Posts: 4,228 |
Quote
Geocappy
Do you think it is worth the effort to see if EP would lower dosage as I would still be on two meds at 100mg flec and 50mg Met. If I want to get rid of meds I need to do an ablation, correct. Do you think it would make any difference with Dr Natale at what dosage I am on.
It isn't zero %, but low probability you could get off the flec and remain in NSR. The fact that you are T2 and doing something to put that into remission is very positive. There are studies that show afib benefit when people who have metabolic issues (i.e. T2) do things to help these issues that afib can improve. In your situation, you could first go down the improving your metabolism path a little farther, then see how low you could go with the flec and stay in NSR. From what I've observed, Natale will likely have you go off the flec for some time (days or weeks, I'm not sure how long) before an ablation. So your dosage won't matter.
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Re: New Member- Need Advice March 30, 2022 09:59PM |
Registered: 10 years ago Posts: 2,519 |
Quote
Geocappy
Yes I am currently in NSR at max meds. Do you think it is worth the effort to see if EP would lower dosage as I would still be on two meds at 100mg flec and 50mg Met. If I want to get rid of meds I need to do an ablation, correct. Do you think it would make any difference with Dr Natale at what dosage I am on.
You may need to temporarily wean off your arrhythmia drug before the ablation. It’s up to the EP. I tried to self wean down a successful 100mg twice a day flecainide to a 100mg am and 50mg pm. It put me right back into afib. I then tried 75am and 75 pm with the same afib effects.
You should consider getting a flecainide serum test to test your current flecainide level. You get blood drawn exactly 11 hours after your last dose. Labcorp offers it.
[www.labcorp.com]
“ Flecainide is a Class 1C antiarrhythmic drug approved for the suppression of ventricular arrhythmias. The drug is well absorbed orally. Plasma half-life averages 20 hours (range 12 to 27 hours) in adults, although in children it has been reported to be eight hours. Steady-state levels are achieved in three to five days. Since 10% to 50% of the drug is eliminated in the urine as unchanged drug, impaired renal function will significantly prolong the plasma half-life. Clearance of flecainide can be accelerated by phenobarbital and rifampin. There are no significant metabolites of flecainide. Co-administration with digoxin increases serum digoxin by 20%; co-administration with propranolol increases both by 20% in serum and creates an additive pharmacological effect.”
Edited 1 time(s). Last edit at 03/30/2022 10:02PM by susan.d.
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Re: New Member- Need Advice March 30, 2022 11:06PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 31, 2022 01:11AM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
Geocappy
Sounds like I should just get started with Dr Natale and just forget about where my flecaide and metoprlol dosage is currently. If he is going to lower it down anyway or take me off it then i might as well let him do it?
Yep, I think you've come to the right conclusion. You got some really solid advice from the folks in this thread.
And don't worry, Natale's not going to care much about your flecainide dose until about a week before the procedure. You'll get instructions on what to do about that, so don't worry about it for now.
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Re: New Member- Need Advice March 31, 2022 06:37AM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 31, 2022 08:44AM |
Registered: 11 years ago Posts: 4,228 |
Quote
Geocappy
Has anyone had to deal with a lot of anxiety. Is it a detriment to afib. Is it possible to deal with afib if you are fighting anxiety (non-medicated). I have heard that anxiety and afib are closely related.
I've pinged Tom Poppino to reply. He's described his issues with anxiety previously.
A non-pharma solution to anxiety is through breathing. A place to start his here: [www.thebreathingdiabetic.com] The author is a T1 diabetic who has found breathing has helped his blood sugar control. He's a PhD who is also trained as a breathing instructor.
The urge to breathe is from CO2 levels in the blood. The sensitivity to CO2 can be increased by training. CO2 also relaxes smooth muscles, so increased CO2 is good. It also helps hemoglobin release O2 to cells. CO2 is necessary not just a waste gas.
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Re: New Member- Need Advice March 31, 2022 12:50PM |
Registered: 11 years ago Posts: 4,228 |
Here is a search on anxiety and afib in this forum: [www.afibbers.org]
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Re: New Member- Need Advice March 31, 2022 03:32PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 31, 2022 04:33PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
Geocappy
Hopefully, last question. Has anyone had to deal with a lot of anxiety. Is it a detriment to afib. Is it possible to deal with afib if you are fighting anxiety (non-medicated). I have heard that anxiety and afib are closely related.
I'd say at least 50% of the people Shannon and I counsel here have anxiety issues, some quite severe. The two go hand in hand and tend to form a feedback loop for people who are symptomatic. Anxiety increases adrenaline production, and adrenaline makes you more likely to go into afib. And then when you go into afib, it increases your anxiety, so the loop is complete. But since you're asymptomatic, there's no loop there for you. All there is is anxiety producing extra adrenaline, which tends to trigger afib. But a successful ablation will prevent the afib no matter what your anxiety level.
You shouldn't expect an ablation to have any effect on your baseline level of anxiety. You'll have to deal with that through other means.
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Re: New Member- Need Advice March 31, 2022 04:59PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice March 31, 2022 06:10PM |
Registered: 5 years ago Posts: 196 |
Geocappy, I am one of those anxious people and have spoken or written to Carey and Shannon many times. My medical records were sent for Dr. Natale’s review during one of the peak covid times. My husband and I had a telemed visit with him after he reviewed my records. He told us exactly what he thought he would need to do during my ablation. I will never forget that conversation…..his confidence and reassurance helped us realize we were going to see the best!!
My ablation was scheduled around Thanksgiving. My anxiety because of Covid got the best of me, and I knew I did not want to travel during that time. I had developed a good relationship with one of the nurses who I could talk to about my concerns. That was invaluable. My ablation was rescheduled for February 23. So the first part of my story ends like this. My husband and I drove 1200 miles one way to Austin to see the EP that could give me the best results. We love road trips, but never thought we would be driving 2400 miles round trip to see Dr. Andrea Natale! There will be return trips because I will need a Watchman. The drive was worth every mile and the follow-ups will be also.
Good luck to you.
My ablation was scheduled around Thanksgiving. My anxiety because of Covid got the best of me, and I knew I did not want to travel during that time. I had developed a good relationship with one of the nurses who I could talk to about my concerns. That was invaluable. My ablation was rescheduled for February 23. So the first part of my story ends like this. My husband and I drove 1200 miles one way to Austin to see the EP that could give me the best results. We love road trips, but never thought we would be driving 2400 miles round trip to see Dr. Andrea Natale! There will be return trips because I will need a Watchman. The drive was worth every mile and the follow-ups will be also.
Good luck to you.
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Re: New Member- Need Advice March 31, 2022 06:38PM |
Registered: 2 years ago Posts: 111 |
Thank you Pixie for responding. My concerns were raised because I had heard if you do not address the underlying anxiety the chance of maintaining NSR after duccessful ablation weren’t good. Carey explanation on anxiety was a relief.
I am already looking at plane flights and hotels. Driving for me would also be around 1200 miles. Based on my dislike for driving long distances, I would have to make it a 1 week each war drive.
I too was paranoid of covid with all my co-morbidities. I did end up getting it and I am a littless apprehensive. I will be flying unless my wife would like to see the I-10 non scenic highway in 7 days to and from.
I am already looking at plane flights and hotels. Driving for me would also be around 1200 miles. Based on my dislike for driving long distances, I would have to make it a 1 week each war drive.
I too was paranoid of covid with all my co-morbidities. I did end up getting it and I am a littless apprehensive. I will be flying unless my wife would like to see the I-10 non scenic highway in 7 days to and from.
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Re: New Member- Need Advice April 01, 2022 05:19PM |
Registered: 11 years ago Posts: 449 |
Sorry for the delay. George asked me to chime in. Carey put it well. Im a type A driven perfectionist. Sounds good but isnt. My past 12 months was hell: 2 ablations 2 ct scans 3 trips to Austin 1 Watchman procedure 2 cardioversions 2 TEEs and covid!!! I sought therapy and its helped alot. I agree that anxiety panic adrenaline can absolutely contribute to afib pvc s pac s flutter etc. getting ablated ie fixed might go a long way in eliminating all of that. I at 68 workout stay busy walk cycle work on bird feeders etc etc i have to stay busy Most my past afib occurred at night asleep not during an anxious moment. The two go hand in hand but lets say you had zero anxiety! Youd still have afib episodes. Im a big believer in the mind body connection. Id suggest reading a Dr John Sarno book. Id suggest learing about the autonomic nervous system. Flight or flight. The vagal nerve. The sympathetic and parasympathetic. Very interesting stuff. Wim Hoff breathing ask George! Journaling meditation etc. all helpful but they are not an ablation. An effective procedure might really reduce your anxiety. Dr Natale is held in high esteem here. I now know why. 1 ablation 1 watchman. My ep here in Charlotte called me at home today. He says im rock solid the TEE showed perfect placement and seal
Tom
Tom
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Re: New Member- Need Advice April 01, 2022 06:10PM |
Registered: 10 years ago Posts: 2,519 |
In the beginning biofeedback helped me. I now have a koi pond with two 4400 gallon big waterfalls and if I need to relax, I do breathing exercises (IWatch has that included) and distract myself by watching my koi body slam each other during feeding with the filter sounds of the water in the background.
Or you can buy a CD.
[www.amazon.com]
I like Dick S’s CDs
[www.amazon.com]
Especially his zapper cd. It says not to listen while driving. I tried it out on some sugar-high kids. :-)
[www.amazon.com]
Edited 2 time(s). Last edit at 04/01/2022 06:20PM by susan.d.
Or you can buy a CD.
[www.amazon.com]
I like Dick S’s CDs
[www.amazon.com]
Especially his zapper cd. It says not to listen while driving. I tried it out on some sugar-high kids. :-)
[www.amazon.com]
Edited 2 time(s). Last edit at 04/01/2022 06:20PM by susan.d.
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Re: New Member- Need Advice April 02, 2022 10:10AM |
Registered: 2 years ago Posts: 111 |
I have seen a lot of discussion about the watchman. Does everybody who gets an ablation end up also getting a watchman? I will most likely need atleast two MRIs after my ablation (back and knee). Does the watchman prevent that and exactly how cumbersome is it? Have I mentioned my anxiety and how much my mind wants to solve everything before it happens?
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Re: New Member- Need Advice April 02, 2022 04:27PM |
Registered: 11 years ago Posts: 449 |
A watchman is almost always for people that have an LAA isolation or cannot tolerate anticoagulant meds
Most afib ablations rarely involve the LAA. The appendage is ablated in left flutter or maybe persistent afib. I get what you are experiencing! Been there. My adice again. Make a plan. Slow down. Get a date. Go for some therapy. I did! And feel confident you ll get fixed. Cause you will!
Most afib ablations rarely involve the LAA. The appendage is ablated in left flutter or maybe persistent afib. I get what you are experiencing! Been there. My adice again. Make a plan. Slow down. Get a date. Go for some therapy. I did! And feel confident you ll get fixed. Cause you will!
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Re: New Member- Need Advice April 02, 2022 05:52PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
Geocappy
I have seen a lot of discussion about the watchman. Does everybody who gets an ablation end up also getting a watchman? I will most likely need atleast two MRIs after my ablation (back and knee). Does the watchman prevent that and exactly how cumbersome is it? Have I mentioned my anxiety and how much my mind wants to solve everything before it happens?
No, most people who get an ablation either come off anticoagulants altogether or they remain on an anticoagulant. The Watchman was originally intended only for people who couldn't tolerate anticoagulants, but its use has been broadened to include people at high-risk of atrial clots who must remain on anticoagulants for life. Usually, this means people who had their left atrial appendage (LAA) isolated during the ablation. About 60% of the people who have that done will be at very high risk of clotting and can't miss even a single dose safely -- ever. If you seek an ablation from Natale, there's a distinct possibility this will describe you.
The Watchman is compatible with MRIs. It's listed as conditionally compatible because it could be hazardous to do an MRI in the first few weeks after implantation. But after the 6-week period MRIs are perfectly safe up to 3 Tesla.
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Re: New Member- Need Advice April 03, 2022 07:40PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice April 03, 2022 11:22PM |
Admin Registered: 6 years ago Posts: 5,357 |
I think they're just accounting for unforeseen things. It would be unusual for you to spend more than one night in the hospital. Almost everyone I've known who's gone through this (including me) had an appointment on day 1 for lab work and possibly a CT, the procedure on day 2, spent the night in hospital, and then was released on day 3. Hang out in town for 2 days and you leave on day 5.
Of course follow their instructions but you could ask about this as you get closer when they've firmed up schedules more. Could be they've changed their procedures a bit.
Of course follow their instructions but you could ask about this as you get closer when they've firmed up schedules more. Could be they've changed their procedures a bit.
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Re: New Member- Need Advice April 05, 2022 10:50AM |
Registered: 7 years ago Posts: 117 |
Quote
Geocappy
Could I get some perspective of how you handled thing with your EP when you decided you wanted to use Dr Natale?...
I didn't even know of Dr. Natale when I saw the first, and only EP from a large local H&V practice. When a very attractive young EP walked into the room my wife says I flat out told her I afib longer than shed been a doctor. I subsequently checked her CV and verified that I was diagnosed before she earned her bachelors degree at FL State.
...Do i keep them as a local office after Dr Natale does my ablation. Do I need them or my existing Cardiologist? I believe I already need to replace her as she was the one who said since I wasn’t having symptoms I could wait to see an EP and just go on blood thinner...
I made a switch from the local H&V practice to another cardiologist based on a recommendation from a neighbor friend at the same time I was about to undergo my first ablation with Dr. Natale. I have no local EP and my cardiologist says he's the plumber and Natale's the boss. The 1,200 mile distance between my cardiologist and Dr. Natale has not been a problem. I am fortunate that, if necessary, I can fly to Austin at the drop of a hat. Dr. Natale does have a colleague at Duke University Medical Center that is only a two hour drive if I needed immediate EP assistance and my cardiologist's practice has several EPs, two of whom currently have patients in the latest Watchman FLX trial.
...Would Dr Natale’s office refer me to a cardiologist/EP in my area if need be?
I undoubtedly think his office would do so.
Good luck!
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Re: New Member- Need Advice April 08, 2022 10:39AM |
Admin Registered: 6 years ago Posts: 5,357 |
There are people who report that lying on their left side can trigger afib, but there doesn't seem to be many of them. There's nothing "bad" about it.
The only hotel within easy walking distance of St. David's isn't one I would recommend. It's a Day's Inn and it's only a block away, but I stayed there once and it's rather run down. Austen's a fairly safe town but I would recommend Uber/Lyft for a woman walking alone at night.
The only hotel within easy walking distance of St. David's isn't one I would recommend. It's a Day's Inn and it's only a block away, but I stayed there once and it's rather run down. Austen's a fairly safe town but I would recommend Uber/Lyft for a woman walking alone at night.
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Re: New Member- Need Advice April 12, 2022 01:31PM |
Registered: 6 years ago Posts: 18,881 |
There is an archived Conference Room Session 36 report on Right Side/Left Side Sleeping related to Afib that may contain some relevant info to new members... I Know it helped me.... Just FYI.
Jackie
[www.afibbers.org]
Jackie
[www.afibbers.org]
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Re: New Member- Need Advice April 27, 2022 02:13PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice April 27, 2022 04:21PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: New Member- Need Advice May 01, 2022 07:54PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice May 02, 2022 12:10AM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: New Member- Need Advice May 03, 2022 12:53PM |
Registered: 2 years ago Posts: 111 |
Hopefully I can get some insight from the board on what I should or need to do. I am currently waiting a date for my ablation with Dr Natale.
I no longer want to see my initial cardiologist as I have no confidence in her. She (maybe I should have researched it) told me we would monitor my afib since I had no symptoms. She put me on a blood thinner and said the EPs wouldn’t do anything until I had been on a blood thinner for a while. I had two stress and echos over the following 3 years and she then referred me to EP who did Cardioversion and then recommended ablation. Followup research and discussion with my EP confirmed my success odds are much better for persistent afib ablation if I had addressed it as soon as possible and certainly in less than a year. My EP said I shoildn’t judge her too harshly as it has not always been so clear. I think sh should have discussed the research (if she knew it) and let me decide.
My EP does not do general cardiology and since I am going to Natale for the ablation I am not sure if there should be followup with my EP. Do I need to find a new cardiologist and should I go back to my EP after ablation by Natale? Should I just go with my Natale long distance team with local followup as needed.
I no longer want to see my initial cardiologist as I have no confidence in her. She (maybe I should have researched it) told me we would monitor my afib since I had no symptoms. She put me on a blood thinner and said the EPs wouldn’t do anything until I had been on a blood thinner for a while. I had two stress and echos over the following 3 years and she then referred me to EP who did Cardioversion and then recommended ablation. Followup research and discussion with my EP confirmed my success odds are much better for persistent afib ablation if I had addressed it as soon as possible and certainly in less than a year. My EP said I shoildn’t judge her too harshly as it has not always been so clear. I think sh should have discussed the research (if she knew it) and let me decide.
My EP does not do general cardiology and since I am going to Natale for the ablation I am not sure if there should be followup with my EP. Do I need to find a new cardiologist and should I go back to my EP after ablation by Natale? Should I just go with my Natale long distance team with local followup as needed.
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Re: New Member- Need Advice May 03, 2022 05:45PM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
Geocappy
My EP does not do general cardiology and since I am going to Natale for the ablation I am not sure if there should be followup with my EP. Do I need to find a new cardiologist and should I go back to my EP after ablation by Natale? Should I just go with my Natale long distance team with local followup as needed.
Do you need a general cardiologist? If you don't have cardiac issues beyond the afib, you don't need a general cardiologist. I've never had one at all.
Natale's team can manage you quite well from afar, but having a local EP is a good idea. For example, suppose you need a cardioversion following the ablation. Having a relationship with an EP will make that much easier to deal with. Just don't let the local EP change any orders from Natale and his staff without consulting them first.
Edited 1 time(s). Last edit at 05/03/2022 06:24PM by Carey.
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Re: New Member- Need Advice May 03, 2022 11:27PM |
Registered: 2 years ago Posts: 111 |
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Re: New Member- Need Advice May 04, 2022 01:16AM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: New Member- Need Advice May 04, 2022 07:34AM |
Registered: 2 years ago Posts: 111 |
So the last time I saw my EP We agreed that my best avenue was the ablation but my family wanted me to consider other options, specifically, the Cleveland Clinic as they all live in Ohjo. His office actually called to sww about setting up the procedure and I told them I was still considering my options. So you don’t think there is a need to inform them that I have opted to go to Dr Natale ( i am guessing they are aware records have been requested)?
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Re: New Member- Need Advice May 04, 2022 09:23AM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: New Member- Need Advice May 04, 2022 10:37AM |
Registered: 5 years ago Posts: 196 |
It is unclear to me how long Dr. Natale and his team will manage the patient from afar. I was told frankly by them not to use the local EP I had because of the attitude, etc.
How long is the support from Dr. Natale and team there for us??
I was told by the team to use the cardiologist I have, but the first time I called the local nurse line after hours to look at an EKG reading from my Kardia, she called me the next morning and told me I had to get an EP because she was not trained in that………again it was an EKG reading I was asking about that turned out to be perfectly normal!!
I am looking for a new EP, but there is no one I can find that has the experience with complicated cases!
How long is the support from Dr. Natale and team there for us??
I was told by the team to use the cardiologist I have, but the first time I called the local nurse line after hours to look at an EKG reading from my Kardia, she called me the next morning and told me I had to get an EP because she was not trained in that………again it was an EKG reading I was asking about that turned out to be perfectly normal!!
I am looking for a new EP, but there is no one I can find that has the experience with complicated cases!
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Re: New Member- Need Advice May 04, 2022 11:03AM |
Admin Registered: 6 years ago Posts: 5,357 |
Quote
Pixie
How long is the support from Dr. Natale and team there for us??
In general, as long as it's needed. They're not going to manage other issues unrelated to your ablation, but anything directly related they should be perfectly happy to help you with a year from now. They still automatically renew the Eliquis prescription they wrote for me in 2017.
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Re: New Member- Need Advice May 04, 2022 04:06PM |
Registered: 5 years ago Posts: 196 |
Quote
Carey
How long is the support from Dr. Natale and team there for us??
In general, as long as it's needed. They're not going to manage other issues unrelated to your ablation, but anything directly related they should be perfectly happy to help you with a year from now. They still automatically renew the Eliquis prescription they wrote for me in 2017.
Sorry, this is a duplicate. I was just trying to figure out how to use the quote feature.
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Re: New Member- Need Advice May 04, 2022 04:41PM |
Admin Registered: 6 years ago Posts: 5,357 |
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Re: New Member- Need Advice May 12, 2022 04:47PM |
Registered: 2 years ago Posts: 111 |
Thanks Carey. Justrying to figure out if I need to schedule a followup visit with anybody local after my ablation so I have somebody local if I need them for anything. At this time, my only heart issue is afib so unless I need a local for that I guess I do not need to maintain contact??
Edited 1 time(s). Last edit at 05/12/2022 04:50PM by Geocappy.
Edited 1 time(s). Last edit at 05/12/2022 04:50PM by Geocappy.
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Re: New Member- Need Advice May 13, 2022 12:08AM |
Admin Registered: 6 years ago Posts: 5,357 |
No, you don't need to schedule anything with him at this point. You can do that after the procedure if you feel it's necessary. Natale's staff will take care of you in the following months. They're very experienced at dealing with remote patients. If you run into problems, they will probably tell you when it's time to visit your local EP. That would probably be because you need a cardioversion or something like that. They'll handle everything else.
Definitely don't burn the bridge because you might need them someday. As I said, just have Natale's people copy your local EP on everything so he knows what's going on. But you don't need to explain your decisions to them. Just do what you need to do and keep your local EP informed by having Natale copy info to them. But you don't need to tell them anything in advance or explain your decisions. People worry about hurting their local guy's feelings, but his feelings are irrelevant and if he's a true professional he won't have any feelings other than hoping your procedure goes great and he'll be happy to help you out with any bumps in the road following the procedure. Just always remember not to ever let him overrule anything Natale orders. If he ever gives you conflicting advice, ask him to consult with Natale directly and work it out between them.
Edited 1 time(s). Last edit at 05/13/2022 12:12AM by Carey.
Definitely don't burn the bridge because you might need them someday. As I said, just have Natale's people copy your local EP on everything so he knows what's going on. But you don't need to explain your decisions to them. Just do what you need to do and keep your local EP informed by having Natale copy info to them. But you don't need to tell them anything in advance or explain your decisions. People worry about hurting their local guy's feelings, but his feelings are irrelevant and if he's a true professional he won't have any feelings other than hoping your procedure goes great and he'll be happy to help you out with any bumps in the road following the procedure. Just always remember not to ever let him overrule anything Natale orders. If he ever gives you conflicting advice, ask him to consult with Natale directly and work it out between them.
Edited 1 time(s). Last edit at 05/13/2022 12:12AM by Carey.
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Re: New Member- Need Advice May 26, 2022 02:15PM |
Registered: 2 years ago Posts: 111 |
Hello
As discussed, I have hd persistent AF for at least 3-4 yrs. I have been accepted by Dr Natale for my ablation. Norma said it does not look like my heart has changed too badly. I read on here that my odds for success are not great because I have the most difficult type being lond term persisistent.
Also, I read about everyone’s bout with AF occurrences
And need to go to emergency. In all my 3-4 yrs I have not felt the need to go to hospital. Am I being naive? Would I know if I needed to go or am I being oblivious. I was put on 150mg x 2 of Flecainide and 75mg of Metoprol after a cardioversion two weeks later.
Lastly, how much notice will I be given prior to ablation date? Been approx a month since accepted and not heard anything on proposed dates yet
As discussed, I have hd persistent AF for at least 3-4 yrs. I have been accepted by Dr Natale for my ablation. Norma said it does not look like my heart has changed too badly. I read on here that my odds for success are not great because I have the most difficult type being lond term persisistent.
Also, I read about everyone’s bout with AF occurrences
And need to go to emergency. In all my 3-4 yrs I have not felt the need to go to hospital. Am I being naive? Would I know if I needed to go or am I being oblivious. I was put on 150mg x 2 of Flecainide and 75mg of Metoprol after a cardioversion two weeks later.
Lastly, how much notice will I be given prior to ablation date? Been approx a month since accepted and not heard anything on proposed dates yet
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