Ablation and the long game September 11, 2022 01:58PM |
Registered: 1 year ago Posts: 137 |
Re: Ablation and the long game September 11, 2022 03:58PM |
Registered: 1 year ago Posts: 137 |
Re: Ablation and the long game September 11, 2022 04:46PM |
Admin Registered: 6 years ago Posts: 5,365 |
Re: Ablation and the long game September 11, 2022 05:15PM |
Registered: 1 year ago Posts: 137 |
Re: Ablation and the long game September 11, 2022 05:54PM |
Registered: 11 years ago Posts: 4,234 |
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Kwilk
I need an excellent-as-possible heart in order to keep up my very active lifestyle, which is essential to my life goals, not to mention mental health. And it means often being no where near healthcare/cell service/roads/etc.
Re: Ablation and the long game September 11, 2022 06:24PM |
Admin Registered: 6 years ago Posts: 5,365 |
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Kwilk
At the moment I'm trying to figure out the NSR remodeling that occurs after CA.
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Kwilk
And also there seems to a standard of ablating the PV. From there, ablating more areas during initial procedure, or during follow up. Scaring only the proximal PV seems to allow remodeling to improve LA structure/function, but ablating more does not.
Re: Ablation and the long game September 11, 2022 06:55PM |
Registered: 1 year ago Posts: 137 |
Re: Ablation and the long game September 11, 2022 07:49PM |
Registered: 1 year ago Posts: 137 |
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Carey
The over simplification is that part about ablating more than the PVs doesn't produce better results.
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Carey
Haissaguerre
Re: Ablation and the long game September 11, 2022 09:06PM |
Registered: 1 year ago Posts: 137 |
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GeorgeN
I worked out what detraining meant for me .
Re: Ablation and the long game September 11, 2022 09:14PM |
Registered: 1 year ago Posts: 137 |
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Atrial Fibrillation in Competitive Athletes
Aug 16, 2019
[www.acc.org]
We direct the reader to the following references that provide an overview in support and against catheter ablation for AF in athletes, respectively.31,32
31. McNamara D, Link M. Ablation of atrial fibrillation in athletes: PRO. [www.acc.org]. Mar 8, 2017. Accessed Nov 16, 2018. [www.acc.org].
32. Madamanchi C, Chung E. Ablation of atrial fibrillation in athletes: CON. [www.acc.org]. Mar 8, 2017. Accessed Nov 16, 2018. [www.acc.org].
Re: Ablation and the long game September 11, 2022 11:00PM |
Admin Registered: 6 years ago Posts: 5,365 |
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Kwilk
For the vast majority of patients, i presume the metric is simply the degree of reduction in afib burden.
Re: Ablation and the long game September 12, 2022 03:49AM |
Registered: 12 years ago Posts: 247 |
Re: Ablation and the long game September 12, 2022 08:46AM |
Registered: 11 years ago Posts: 4,234 |
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Kwilk
you've probably read this, but in case not:
Atrial Fibrillation in Competitive Athletes
Aug 16, 2019
[www.acc.org]
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The position paper from the European Society of Cardiology recommend a total detraining period of up to two months for restoration and maintenance of sinus rhythm. However, this is rarely well received by the athlete and may be unacceptable at the elite level. By contrast, the American Heart Association and American College of Cardiology recommend athletes with well tolerated, self-terminating low-risk AF may participate in all competitive sports without therapy (Class I; Level of Evidence C).
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But for the next 20-30 years want to regularly be able to do, say, 15 miles with 5000 ft elevation gain at 2-3 mph.
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Self correcting asymptomatic afib bouts <12hr every other day or so.
Re: Ablation and the long game September 13, 2022 08:55AM |
Registered: 12 years ago Posts: 501 |
Re: Ablation and the long game September 13, 2022 09:26AM |
Registered: 1 year ago Posts: 797 |
Re: Ablation and the long game September 13, 2022 03:26PM |
Registered: 1 year ago Posts: 137 |
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CareyQuote
Kwilk
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Carey
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Kwilk
And also there seems to a standard of ablating the PV. From there, ablating more areas during initial procedure, or during follow up. Scaring only the proximal PV seems to allow remodeling to improve LA structure/function, but ablating more does not.
The over simplification is that part about ablating more than the PVs doesn't produce better results.
Depends on how outcomes are measured. For the vast majority of patients, i presume the metric is simply the degree of reduction in afib burden.
Whoa! That's a bad presumption and that's not the metric at all. Most paroxysmal afib patients are highly symptomatic. It's literally torture for them, so they would view simply reducing afib burden as a failed ablation, and that's exactly what it would be. An ablation should render you 100% free of all atrial tachyarrhythmias without the use of antiarrhythmic or rate control drugs. If you're coming into this expecting nothing more than a reduction in afib burden but having to remain on maintenance drugs, then you're coming into it with expectations far below current medical standards and what you should expect in 2022. I would recommend less focus on new emerging technologies (they're all just variations on the same basic procedure), and more focus on the disease you actually face. I don't think you've quite grasped it yet.
And I must say that if that's all you aim for and that's all you get, I predict you'll be back in an EP's office a few months or years later because if you don't stop it completely, then it will simply continue to progress and worsen. That's not going to be how you achieve your goals.
Re: Ablation and the long game September 13, 2022 03:59PM |
Registered: 1 year ago Posts: 137 |
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GeorgeN
At least in my part of the world (Colorado) the grade is rarely constant, so this would be material.Quote
Kwilk
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But for the next 20-30 years want to regularly be able to do, say, 15 miles with 5000 ft elevation gain at 2-3 mph.
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GeorgeN
During the first 4 months of afib, 18 years ago, my burden was 57%. During 9.5 months of 2021, a bad time for me, it was 0.56%. During the subsequent 46 weeks, it has been 0.019%. The bad year was 29 times greater than the subsequent 46 weeks, but still relatively modest.
Re: Ablation and the long game September 13, 2022 04:07PM |
Registered: 1 year ago Posts: 137 |
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Ken
As for success from an ablation - I have had two, the first lasted 13 years with NO afib or the need to take any meds. Then it was back, and the second ablation is now over 2 years with NO afib and taking no meds.
Re: Ablation and the long game September 13, 2022 05:06PM |
Registered: 11 years ago Posts: 4,234 |
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Kwilk
I've read a few of your detailed posts in other threads here, but don't remember you mentioning having had an ablation. I'd ask about trends in your atrial cardiomyopathy, but will start a new thread for that.
Re: Ablation and the long game September 13, 2022 05:19PM |
Admin Registered: 6 years ago Posts: 5,365 |
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Kwilk
At least as expressed in the threads I've read on this forum, reduction in afib burden and what it takes to maintain that reduction is largely all that is talked about.
Re: Ablation and the long game September 13, 2022 07:56PM |
Registered: 1 year ago Posts: 137 |
Re: Ablation and the long game September 13, 2022 08:04PM |
Registered: 1 year ago Posts: 137 |
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GeorgeNQuote
kwilk
I'd ask about trends in your atrial cardiomyopathy, but will start a new thread for that.
To my knowledge, no cardiomyopathy.
Re: Ablation and the long game September 13, 2022 08:25PM |
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Re: Ablation and the long game September 13, 2022 08:36PM |
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Carey
The term is atrial myopathy, not atrial cardiomyopathy. The term cardiomyopathy means disease of the entire heart, aka structural heart disease. .
Re: Ablation and the long game September 13, 2022 09:00PM |
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Re: Ablation and the long game September 13, 2022 10:24PM |
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Re: Ablation and the long game September 14, 2022 12:58AM |
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Re: Ablation and the long game September 14, 2022 09:41AM |
Registered: 12 years ago Posts: 501 |
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Kwilk
As for success from an ablation - I have had two, the first lasted 13 years with NO afib or the need to take any meds. Then it was back, and the second ablation is now over 2 years with NO afib and taking no meds.
That's great. Hope my path is similarly successful. So it started in the late 90's for you. Are you, or were you, considered a Lone AF case?
Re: Ablation and the long game September 14, 2022 12:22PM |
Registered: 1 year ago Posts: 137 |
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Ken
Yes, Loan AF. My athletic history as a competitive swimmer culminating in the 1968 Olympics (not exactly endurance training, but not far from it) likely was a factor in my susceptibility to AF. Also, for a couple of decades, my wife and I trained and competed in dozens and dozens of 5K runs, plus a few 5 milers and one, half marathon. I am now 77 and work hard at staying fit, but a hip replacement put an end to the jogging. After a 50+ year vacation from swimming, I am now back to it again for aerobic conditioning,
Re: Ablation and the long game September 14, 2022 03:38PM |
Registered: 1 year ago Posts: 137 |
215,168 myopathy 144,566 cardiomyopathy 220,532 atrial 10,647 atrial cardiomyopathy 935 atrial myopathy 190 "atrial cardiomyopathy" 149 "atrial myopathy"
Re: Ablation and the long game September 14, 2022 07:40PM |
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Re: Ablation and the long game September 15, 2022 01:38AM |
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Re: Ablation and the long game September 15, 2022 09:33AM |
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Re: Ablation and the long game September 15, 2022 10:57AM |
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Re: Ablation and the long game September 15, 2022 01:59PM |
Registered: 4 years ago Posts: 741 |
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susan.d
The downside is one has to be very careful not to bang into things because the pacemaker is just inserted into a pocket under the skin and has no muscle/fat protection.
Re: Ablation and the long game September 15, 2022 02:51PM |
Registered: 11 years ago Posts: 4,234 |
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Daisy
You can have them “buried” in the pectoral muscle. I know that yours is already in place but it is something to keep in mind for the future. Mine is buried in those more protected from bumps.
Re: Ablation and the long game September 15, 2022 03:02PM |
Registered: 10 years ago Posts: 2,520 |