another cardioversion but some new insight!

hope all of you had a nice Memorial Day, I spent mine being cardioverted......this time at CMC Charlotte the others were at CMC Union and this time an EP did it, there was no anesthesiologist, he did it! no TEE test since I was at 27 hrs (under the 48 window).....and this was conscious sedation....wow the only fun part of the whole thing.

The cardio that did me was great and I really liked him.....he said mulitple cardioversions are not an issue.....still I hate it, the on call cardio this weekend called twice and he also said mulitple cardioversions are not a long term threat........

He asked me if I had discussed ablation with Dr Holshouser (my reg. EP) and I said yes but that he did not want to do it saying I was not a candidate yet. Then he said I should twist his arm, that doing it now might be a less complex ablation rather that waiting til I needed a complex harder to fix ablation....interesting, I did not know that ablations were complex compared to more simple? I know simple is not the right word here....

made me think though....

HE ALSO said that some recommendations coming soon is for afibbers to use digestive meds!

this episode was caused absolutely by what I ate...broccoli and a salad with the plain steak I ate.......took 20 mins and bam

So I was eating what qualifies as Paleo and it sent me into afib!

Back to my drawing board, I have had only 4 episodes in the last year but 3 had to be cardioverted....Oct 09, March 10 and May 31 10....one last June lasted 45 mins....I just don't convert

Afib may be taking a toll on my brain, at 57 I bought a Nissan 370 Z yesterday (trading in my Tundra pickup)!!

TP

Hi Tom,

It is no wonder that us afibbers get confused. It seems that every EP and Cardiologist has a different opinion on treatment and follow-up.

Afib and digestive meds - this is quite interesting as most afibbers thought there was a connection but not many doctors believed them.

I hope you stay in NSR. Enjoy your new Nissan!

Diane
Toronto

Tom - congrats on your new ride! When hearts are in afib continually or often, the tendency for the electrical remodelling and cardiac fibrosis build up increases. Since yours was doing well for so long, your risk of either is significantly lower.

I think the broccoli overload for you is something you need to pay attention to in future meals. Obviously, broccoli bothers you so now you know. Paleo eating and/or modifications thereof still seem to be the way to go for most and you certainly can't discount the success you had until the broccoli overload.

Let's hope this is the last afib event for a long time.

Jackie

Tom,

Did he say what he meant by digestive meds? I'm assuming he meant drugs such as Nexium. I think it would be a big leap for a traditional medicine doctor to recommend probiotics on digestive enjymes.

I'm glad you are back in NSR. I think he made a good point about the ablation. You have to think about quality of life. It's all about measuring the very small risk verses quality of life. If the surgeon is well researched you can reduce the risk factor. Mike had very little discomfort after his procedures and was feeling normal within two or three days. Although he still has lots of etopic runs his quality of life is much better. (Mine is too!)

Debbie

Tom
Congrats on being back in NSR.
I have 2 thoughts. First, anti-arrythmics like flec and propafanone seem ineffective on you since neither will convert you. That was a criteria for moving to ablation for my EP.
Second, don't discount the positional aspect of you going into afib...laying on your stomach. Broccoli may be a no-no for your biology but laying on your stomach certainly didn't help.
Wishing you continued NSR...you certainly are learning much about your triggers...hope it helps keep you in NSR.
Cyndie

thanks to all of you, yeah I too would be surprised for an MD to suggest enzymes or probiotics......but at least they know it's caused by digestive issues......it's amazing this afib stuff, when my stomach is quiet everything is perfect and I can go weeks.....and yes the propafanone and flec have not worked well at all for me! T

Hey Tom,

Sorry to hear it. not the way to spend your holiday.

Was the EP Dr. Mehta? He believes in the digestive link (in some cases, not all). He put me on Nexium for 6 mos and although it didn't stop the episodes, it seemed to make it easier for me to convert with flec PIP.

My low carb diet has pretty much eliminated my gerd symptoms and I am off the nexium (and I still convert quickly which I am attributing to my ablation plus the mag I am taking.)

At least you got a cool new ride-

EB

Tom,

I suppose according to the following definition, you would be put in the category of Persistent AF:

Persistent — episodes that last beyond seven days or require intervention to terminate, such as medication or electrical cardioversion...

Although you don't really know how long the episodes might last because you haven't let them go for very long (<48 hrs?).

It appears that your episodes may be coming closer together. For a discussion of ablation x progression, see "Permanent afibbers should not
wait for an ablation" in the Nov 2009 issue of the AF Report (http://www.afibbers.org/S/afib94ww.pdf)

I agree with Jackie that your total AF burden at this point is probably light, but scarring could be augmented by a life of heavy exercise or other inflammatory factors. I do not know what the cut-off point is. Certainly the EP is usually influenced by factors such as AR medication failure and AF whose symptoms are severe...

And, there certainly are simpler and more complex CAs. It is usually said that those with Persistent/Permanent AF require more work besides a PVI (or PVAI) and that this additional work requires extra skill and experience.


-- Dick

thanks Dick very interesting insight......yes my last 3 episodes (Oct 09, March 1, 10 and May 30, 10 all went to cardioversion (4 days, 3.5 days and 36 hrs).......when they get going there seems to be no end in sight?

but I do go months between episodes?

I meet with my EP soon and will discuss

thanks for the link, will check it out

TP