A question for the board....

I have had LAF episodes since about 1988. On a yearly basis episodes have varied in number between 2 and 11. Episode duration varies from 45 minutes to 6.5 hours. This year I have had 6 episodes with an average duration of about 5 hours each.

Has anyone on this board with problems no greater than mine undergone the PVI procedure and if so what were the results.

Thanking you in advance for all resposes.

Oh, one other thing, I am in an episode right now. Hope I self convert soon since to this point I have not had to have electro-cardioversion.

Jim,
I have similar mild afib to you. I'm 47. After monitoring this website for 9 months I decided to have an EP study and if needed, an ablation, in August of this year. Unfortunately the EP study indicated that I had many focal points for afib so EP decided not to proceed with ablation as my afib was only mild. He would only ablate in the future if afib badly deteriorates.

With mild afib I think EP's are more cautious and will ablate only when they are certain they have the focal point. Don't forget that this is a 2 part proceedure - an EP study AND, IF THEY ARE CONVINCED, an ablation. Some of the posts on this board are a bit alarmist. They make it sound like the EP's can't wait to get into your heart and ablate everything in sight! I agree that some have had really bad experiences but you have to take all this into account when you are deciding about ablation.

The EP study by itself was invaluable as it convinced the EP that my afib was GERD related so even though there was no ablation I regarded the proceedure as successful for the information it provided me and the EP.

Also, from a psychological point, it has made me feel more relaxed about afib. I have now tackled the GERD with drugs and diet changes and my afib has deceases to 1 or 2 year. Tollerable. I keep studying this board for new info and if ablation techniques improve in the years to come I will definately have another go at ablation. I would not hesitate.

Hope this is of help to you.
Good luck.
Dean

Jim,

I'm in broadly the same camp as you - 5 episodes in 4 years (always middle of the night, a few hours long, and self-converting). I do, however, think I get quite frequent episodes of a few seconds duration - one or two per week. I also get quite frequent ectopy.

I'm encouraged by your and Dean's posts. In 15 years of AF, you still are 'only' getting a few episodes per year. And Dean is down to one or two per year by controlling his GERD (a problem I am also blighted with).

So guys, I figure we should deal with our relatively mild AF burden until ablations and mini-mazes are FULLY sorted as regards efficacy and risk.

Best seasonal wishes fellas,

Mike F.

Thanks very much for your thoughts guys. GERD is also a long standing problem of mine. I have been on daily medication for about the last 20 years. Presently take Prevacid which helps but doesn't completely keep me asymptomatic. I had the Stretta procedure done earlier this year to try to overcome the GERD problem. For me, the procedure turned out to be a complete waste of time and money. My condition is not bad enough to go through Nissen Fundoplication so I guess I am stuck with GERD.

Have you guys heard of any other treatments for GERD that might prove to be of benefit?

I guess I will hold off on the PVI until my situation becomes worse than it is now, but I really hate the unknowns that Paroxysmal Atrial fibrillation puts into my life. Your commnets concerning an EP study are enlightening. I may wish to have one at some point.

The damn coumadin issue is always out there nagging at me. At 62 years of age I am nearing the age category in which protcol insists that I be on a blood thinner. However, to this point I haven't been able to make myself get on it and stay on it.

Jim, check back into Richard's old posts. I think he is the one whose GERD was cured by going on the paleo diet.
Peggy

Jim C Rose - You've undoubtedly read my posts before and after PVI ablation - My decision to proceed was mainly based on increasing frequency of events - some were every day or everyother day as well as very long events - some ranging 36 - 37 hours. The whole thing was debilitating....although I had gotten over the anxiety part of it.

With my doctor's help and support, I managed to go without Coumadin by keeping my blood naturally thin - with all the usual supplements discussed here and in Hans book. My Pro Time was always at the max range and I was comfortable knowing that and also comfortable weighing the risks of that versus the risks of Coumadin.

However, with the advent of two ER visits this past spring and afib that seemed out of control regarding breakthrough - the flecanide was not holding at double the dose, I caved in and sought the ablation. I am 67 and decided enough was enough and that I was feeling the effects of the flecanide - extreme fatigue.

If you are tired of the afib and it affects your lifestyle....I'd go for the ablation. If you aren't ready yet; I'd strongly suggest you try using the stepped up dose approach of the magnesium glycinate I have so frequently written about over the past six months. With that, I was able to eliminate any breakthrough afib while still on the flecanide and was able to have two months of no afib before the ablation...this has lasted afterwards as well although I am back on the flecanide.

I never wanted to give in to ablation; but I just felt that as long as I was in good health generally, and I had a risk of insurance coverage changing, it was time to do it; but my intuition still tells me I was on the right path with the extra magnesium and could have probably controlled iafib to the point I could have stopped the flecanide...but that it would probably take another year to get to that place. I just didn't feel waiting was the best choice.
I wish you well with your decision.

Jackie

Jim--

You can read my post on 12/15--my experience with AF is very similar to yours. Although noy nearly as severe as many whou undergo the PVA route, my key reasons for wanting to go forward with PVA are
1. get off all medication--including the NEW addition of coumadin--something I have desperately wanted to avoid. By the way, I think that Coumadin is the great CYA drug of choice for most cardiologists.
2. eliminate the "water torture" effect of AF--when will I have the next episode, and how long will it last--plus, I don't particularly care for the electro-cardioversion routine.
3. eliminate the worry factor for my family--this whole mess has been almost as hard on them as it has been for me. My daughters don't know their father without AF.

Of course, as highlighted in another post, although I am ready to proceed psycologically, there is no guarantee that my EP study will reveal a clear indication that I can follow through with the PVA. I am prepared for either outcome.

Jim,

I had indigestion, and then debillitating GERD for the past 20 or so years. I lived on Tums, much of the time prior to taking Prevacid. I had a Schatzky's ring, from the acid reflux, causing me to have a hard time getting food down, due to the blockage at the sphincter, entering into the stomach. Once I had the S. ring stretched out and was put on Prevacid, I felt good. No more indigestion. BUT, and it's a big but, I believe this med is what ultimately caused my arrhythmia. I did NOT have over aciditiy, I had under acidity, and the Prevacid further worsened an already bad situation, thereby causing me to not break down the foods I was eating, and leading to malabsorbtion.

The first thing I did, was to quit taking Prevacid. The second thing I did was start taking digestive enzymes, such as betaine hydrochloride, amylase, protease, lipase, pepsin, etc. This helped considerably, but there was still a bit of a problem. Jackie, mentioned that I take the lemon juice challenge, to find out if I was over or under acidic. I took a tablespoon of fresh lemon juice and it helped my situation a bit, and did not hurt it, which would have indicated over acidity. All along I had been under acidic, as much of the population is, that have indigestion problems. The next thing I did was to change my diet completely around. On the first day, I only ate organic meats, salads, and vegetables. The second day, I did the same, and I have had no indigestion since the second day. I couldn't believe how much better I felt, as well. Come to find out, more recently, when taking acid inhibitors, it causes the body to not be able to absorb vit. B12, because this vitamin is reliant on acid, and guess what. My tests indicated a severe deficiency of B12, and one must know that the liver can store up to 6 yrs. of this nutrient. I was on Prevacid for approx. 3 yrs, before my arrhythmia happed, so at that point I'm thinking, is when my deficiency presented itself. To understand the whole concept behind B12, pls. visit the conf. room.

So, Jim, you need to try to find out if you are under or over acidic. I'm not sure if doctors could or would check this, but my suggestion would be to stop Prevacid for a day and try the lemon juice, or digestive enzymes, and see what results you get. If they help, then you are under acidic and Prevacid and other such meds are a possibly cause of your problem.

If you need further info, pls. feel free to ask. I typed this quick, so hope there's no mistakes.

Richard

Your comments are most appreciated.

Richard, I have always had a problem with orange juice and tomato based sauces which I assume would pretty well bear out an over acidity problem.

A big question in my mind is why does the Stretta procedure cure some people and do absolutely nothing for others. The human body is indeed a miraculous creation with each of us having our own little problems to deal with.

Jim,

Could you explain to me, what the Stretta procedure is, and why it was done?

I would also like to mention, that I, too, was bothered greatly by oranges and their juices, as well as, tomato based products, but they didn't bother me when on Prevacid. Lemons are actually more acidic, but are extremely medicinal. I had every reason to believe that I was over-acidic. Anything of an acidic nature would bother me, pre-Prevacid. In retrospect, the only reasoning behind why the acidic foods bothered me so much, was because they would sit in my stomach, undigested, because of lack of acid, and/or bile. This could have been caused by drinking milk with my dinner, or eating starchy substances, such as fruit, bread, potatoes, rice, or corn, of which all of these foods are sugary by nature. They could also be neutralizing of the stomach acid, as well. Usually acidic fruits turn to alkaline substances once the digestion process begins, thereby causing the acid to be reduced. I have read that fruits should never be eaten with protein meals, and this could be the reason. Another problem could be bile production. The intestinal tract and the esophagus do not have the mucosa for protection of any acids from the stomach. So then, after the acid digestion process is done, the bicarbonate is sent in, to start reducing the harmful acids, for protection of the intestinal lining. To further help this acid reduction, bile is then excreted from the liver and gall bladder, as the stomach contents enter from the pyloric sphinchter to the intestines. If bile is deficient, then the stomach can't empty its contents. So now you have your stomach contents sitting there, while the body tries to conjure up more bile. In the meantime, the bicarbonate solution, now in the stomach, is building up gases, and those gases have to release somewhere, and that's usually the esophagus. In the meantime you're experiencing bloating, burping, and gastric distress. Minerals, such as calcium and magnesium are neutralizing minerals, that are probably used in this process, but I haven't found too much info. on that, and I lost the link that described this process. It all made sense to me and once I eliminated any sugary/starchy substances from my meals, my problem vanished immediately. Here's an interesting link you may find informative.

[www.rheumatic.org]

Richard

Thanks for the information. The Stretta procedure is a minimally invasive procedure developed by Curon Medical, Inc. Specifically, the physician inserts a patented device down into the esophagus to the sphincter valve at the junction of the stomach and esophagus. Radiofrequency waves are then used to scar the cicumference of the valve thereby eliminating the leakage of acid back up into the esophagus. Sounds alot like PVI doesn't it?
For reasons not entirely clear to me the procedure is only effective for about 80 per cent of the people having it done. Unfortunately, I was in the other 20 per cent.

Jim,

What did the doctor say was causing the sphincter to leak? Was scar tissue formed from acid reflux? I've never heard of this procedure before.

Thank you for explaining.
Richard