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Re: Patience is overrated - 2 days ago

With almost all doctors and hospitals using electronic health records these days, you don't need to have your cardiologist send records. Usually, all you have to do is sign a release form and Natale's staff will then download it directly. Your cardiologist doesn't need to do anything, and that's probably why they didn't.

by Carey - AFIBBERS FORUM

Re: Noninvasive Heart Mapping System Speeds Arrhythmia Diagnosis - 6 days ago

I'm sorry for your loss, but I'm glad your father was able to leave on his own terms and surrounded by the people who mattered to him.

by Carey - AFIBBERS FORUM

Re: Radiation-Induced Cardiac Toxicity - 10 days ago

Interesting article about the shoe fitting machines. Never heard of them before. I would think the shoe salesmen of the time were the ones who probably suffered. They were exposed daily for hours at a time. A few visits to a shoe store per year by a customer would be a tiny fraction of their doses, and with radiation it's all about dosage.

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 16 days ago

Pradaxa is known for stomach issues. I was on it a few years ago and although I didn't have any stomach issues, I would definitely recommend you ask to be switched to Eliquis. It's a safer drug with fewer side effects.

by Carey - AFIBBERS FORUM

Re: Does a List of the Top EP's for Ablations Exist? If Not, Why Not? - 16 days ago

QuoteEricY I suppose I should try calling the facility in Texas. I just want to know if they would provide an estimate or maybe they can't since ablation can require more time in some cases. I don't think Texas will be able to help you with this. Call Thousand Oaks again (and again) until you get someone who can help. As for cost, if Kaiser covers it then that will be your deductible

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 19 days ago

Eric, this is why I stress so much how important it is to choose the best EP you possibly can. And in the case of ablations, the best means the EP who's done thousands of ablations, the EP who lives, eats and breathes them, attends the important conferences, and stays fully up-to-date with the best practices. You're young and you've got time, so take the meds if you have to, get th

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 19 days ago

QuoteGeorgeN My understanding is that many EP fellowship programs do not include training such as is required for LAA work. That's true, but that's rapidly changing. There's enough benefit to the procedure that EPs have taken notice and are seeking out the training. There's even an annual conference devoted to it (ISLAA) where EPs can sit in on an actual ablation where the L

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 19 days ago

Quotemjamesone But with an 80-90% success rate for an initial PVI, why take on additional up-front risks? Mapping doesn't add additional risk, and nobody's going to be ablating an LAA that doesn't need ablating. But if the LAA is a culprit, wouldn't you rather find that out and deal with it on ablation #1 rather than go through 9 months of waiting to do a second one? I since

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 19 days ago

If an EP prefers you to be in normal rhythm during the procedure, and especially if they have you continue an antiarrhythmic drug, then that's an EP who doesn't map the actual sources of afib. They mostly just do a PVI and posterior wall and call it a day. Pretty much the same as a cryo ablation. Natale spends a lot of time up front identifying sources of afib, so if you're not in

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 20 days ago

If he goes with Natale, Natale will definitely not want him on amiodarone. He likes his patients to be free of antiarrhythmics when they go into the lab, and amio's insane half-life makes that problematic. I've also never heard of him prescribing it for anyone. Pretty sure he doesn't like amio.

by Carey - AFIBBERS FORUM

Re: Anti-arrythmic meds - 21 days ago

Sotalol is a beta blocker just like metoprolol. So don't be surprised if it lowers your heart rate as much as metoprolol did. But there's really no reason to be concerned about your heart rate dipping into the 40s. It won't harm you.

by Carey - AFIBBERS FORUM

Re: Should I get an angiogram? - 23 days ago

Probably yes. It's possible they might have incidentally seen the clot on the fluoroscope while they were doing the angio, but I doubt it. They would be focused on ventricular blood vessels, not what's going on in the atria.

by Carey - AFIBBERS FORUM

Re: Blood clots on my watchman - 23 days ago

As I said, heparin doesn't dissolve clots so you wouldn't be treating anything. You'd just be increasing your bleed risk, especially if you combined Eliquis, ibuprofen, and heparin. That's a combination I wouldn't take without an absolutely compelling reason and a real expert advising it.

by Carey - AFIBBERS FORUM

Re: Should I get an angiogram? - 24 days ago

An angio would not see anything in your atria. An angio only looks at blood vessels.

by Carey - AFIBBERS FORUM

Re: New Pacemaker with 3 wires - 24 days ago

Quoteacantha In '21 - my EF was 55-60% (visual estimate) '24 - 54 % by something called Simpson's method Dec '25 - it's 45-50% (visual estimate) Those numbers aren't really all that bad. 45-50% is only mildly reduced and I wouldn't expect it to cause significant fatigue. And keep in mind that there's a lot of subjectivity between ultrasound techni

by Carey - AFIBBERS FORUM

Re: A Few Questions - 24 days ago

Stopping anticoagulation prior to an ablation is no longer standard practice. Many EPs, particularly the higher echelon ones, now continue anticoagulation through the entire procedure. As for sending you home in hours, that's another variable. Many (most?) EPs want an overnight stay.

by Carey - AFIBBERS FORUM

Re: Blood clots on my watchman - 24 days ago

Anticoagulants like Eliquis, Xeralto, warfarin, heparin, etc. don't dissolve clots. They only stop them from enlarging and stop new ones from forming. It's up to your body to dissolve the clot, which it will, but it takes time. The drugs that will actually dissolve clots would probably be too dangerous for you given your history of GI bleeds and the pericardial effusion.

by Carey - AFIBBERS FORUM

Re: Should I get an angiogram? - 25 days ago

Quotesusan.d They decided on a CT with contrast. Is it as good? Yes.

by Carey - AFIBBERS FORUM

Re: Should I get an angiogram? - 25 days ago

I would want the know why the angina. An angiogram means dye and a small dose of radiation, which are pretty small prices to pay.

by Carey - AFIBBERS FORUM

Re: List of EP’s - 26 days ago

QuotePixie Please ignore this post. I just found the list I was looking for. Actually, could you link to what you found?

by Carey - AFIBBERS FORUM

Re: To go for PF ablation or not - 29 days ago

Quotemjamesone Sometimes reversible. For me, the key takeaway is that this answers the question of whether rate control is just as good as rhythm control, and the answer is that it may not be in some cases. I haven't seen it mentioned that this study looked only at patients with AF and idiopathic cardiomyopathy (EF < 45%). That's a pretty significant comorbidity indicating there i

by Carey - AFIBBERS FORUM

Re: Looking for an oblation Dr. - 29 days ago

As I said before, Natale flies all over the world regularly to train other EPs. That training usually involves doing an actual ablation. This time it was a soccer manager in Rome. But I'm 100% confident he has not moved back to Italy and will be back in Austin soon enough.

by Carey - AFIBBERS FORUM

Re: Had my pvc ablation! - 30 days ago

If it's that painful you've probably got a hematoma pressing against your femoral nerve. That happened to me way back when and it hurt like hell. The pressure thing can't do any harm and I suppose it may prevent a hematoma now and then, but I've just never heard that advice before so I suspect it is a Los Robles thing.

by Carey - AFIBBERS FORUM

Re: Had my pvc ablation! - 30 days ago

I've never had to use manual pressure for any reason, nor have I ever experienced pain from the insertion sites. Neither should be the norm.

by Carey - AFIBBERS FORUM

Re: To go for PF ablation or not - 30 days ago

Yes, they would want you on anticoagulant for 3 weeks prior to a cardioversion. They could skip that requirement by doing a TEE prior to the cardioversion, but then they'd insist on you being on an anticoagulant the day of the procedure and a month afterward.

by Carey - AFIBBERS FORUM

Re: Looking for an oblation Dr. - 30 days ago

Natale travels the entire world all the time training other EPs. I don't know why he's in Italy, and it might be personal reasons, but I guarantee he's not leaving the US permanently.

by Carey - AFIBBERS FORUM

Re: To go for PF ablation or not - 30 days ago

Quotesrecnivlad I know that even at that low heart rate of 60 BPM the heart is under stress when in an Afib mode and can only take so much and for some time. I don't know how you know that. You realize there are millions of people who live into their 80s and 90s who've been in afib for decades, right?

by Carey - AFIBBERS FORUM

Re: To go for PF ablation or not - 4 weeks ago

Quotegloaming But over time the ventricle and atrium can thicken, the ejection fraction will drop, the mitral valve can prolapse, and the last stage is that very unfortunate term, 'heart failure.' Not everyone gets there, but it's a serious consideration. What you're describing is the result of poorly controlled rate. People in persistent afib who consistently keep their

by Carey - AFIBBERS FORUM

Re: Looking for an oblation Dr. - 4 weeks ago

Quotegloaming My EP in Victoria, BC, is excellent, but his reviews, the few I could find, maybe 15 in all, were somewhat negative. He received the Canadian Cardiology Association's prize in 2002 as the top candidate. He is brusque, matter of fact, busy, and pretty darned good. I highlighted the explanation for his poor reviews. (But you knew that.) Doctor review sites are just popu

by Carey - AFIBBERS FORUM

Re: To go for PF ablation or not - 4 weeks ago

You're asking a very good question: If afib causes you no symptoms and your heart rate is normal, why should you undergo an ablation to fix it? The answer is there's no good reason to do anything, as long as your stroke risk is managed. There are millions of people who choose permanent afib, which simply means longstanding persistent afib that you choose to just live with. I know sev

by Carey - AFIBBERS FORUM