Where do you live Joe? If you can afford to travel for 5 days there is usually no real limitation to putting your hearts care in the very best hands. Don't worry about a given mapping system, it's the EP using the system(s), as Cary noted above, that makes all the difference. And the EPs skill in knowing where and how to ablate, plus the all important factor of possessing natural taby Shannon - AFIBBERS FORUM
Yes, Gill and Joe, that has been the opinion of the vast majority of EPs I know for years now. I suspect this will mark the end of that system once and for all, and yet better solutions will arise before long. The new energy source for ablations called, Electroporation, is looking very promising indeed! Though it, too, is still quite preliminary, but since it is dealing with a fundamental DC eby Shannon - AFIBBERS FORUM
Another important reminder from HRS 2019 for those of you taking Xarelto! Always remember to take Xarelto with FOOD!! Many Afibbers forget and take the drug on an empty stomach, but doing so can result in a whopping 40% reduction in absorption of the drug! This large of an inadvertent dose reduction can result in an embolic event! Exactly what you are taking Xarelto to prevent from happeniby Shannon - AFIBBERS FORUM
Hi Joe, My advice is to be very skeptical of these mapping system claims by eager vendors so early on. This is a highly profitable industry for the winners in these technology sweepstakes. They ALL sound compelling when the marketeers go to work. Some may well work out for the better and some much worse for Afibbers over time, as we were reminded of yesterday! What this FIRM debacle teacheby Shannon - AFIBBERS FORUM
Many of our readers, especially relative old-timers, may recall my interest in following the course of development of FIRM mapping and ablation technology that initially sparked a burst of excitement as to a possible step forward in the treatment of more advanced cases of AFIB. That is, were the considerable hype from the marketing campaign to actually pan out in the reality of careful vetting anby Shannon - AFIBBERS FORUM
Indeed Carey, Mitral valve regurgitation is literally ubiquitous from at least 30yrs and older ... even most 25 years old will show mild MVR as well. It’s called ‘being human’ and is not actually considered a ‘condition’ of any note at all and certainly is zero to ever worry for one second about until, and unless, it becomes moderate to severe MVR and really only severe MVR typically warrantsby Shannon - AFIBBERS FORUM
Hi Liz, As Carey noted above my stroke was from a very different mechanism 11 months after my LARIAT LAA Ligation procedure, back before Watchman was FDA approved ( and thus I do not have Watchman device) but I did have both a LARIAT procedure, plus I had an Amplatzer Duct Occluder-2 vascular plug installed to plug the central ‘pucker’ very late leak in my LARIAT procedure, even though my thrby Shannon - AFIBBERS FORUM
We plan to evaluate adopting a new up-to-date Forum platform to migrate our entire forum archive too. However, the Forum platform revamp will occur after we have completed the full Afibbers.org website modernization and update, which is making real progress and looking very nice, clean and easy to navigate! It’s looking good at this point for a summer launch with a little good timing. The foruby Shannon - AFIBBERS FORUM
Hi Katesshadow, I’ve used the Jigsaw Health SRT (Sustained Release Tech) with Albion Labs Chelated Magnesium Malate for many years now and like it best overall of the various brands and forms of oral magnesium I’ve tried over the last three decades. I like their smaller 125mg ‘caplet’ shaped tablets that make finer titration easier than with the huge 200mg horse pills on so many traction alby Shannon - AFIBBERS FORUM
Hi Barb, I’m sorry to hear of your brother-in-laws travails. However as noted above Greg’s scenario, age and complications are not at all unusual in patients referred for Watchman since it originally was designed for folks who can’t tolerate blood thinners. Keep in mind too, that his cardiologist is seriously concerned about what he or her said is his very significant stroke risk now by doiby Shannon - AFIBBERS FORUM
An enlarged right atria can impact the odds a bit, but again it typically isn't anything close to a deal breaker as it maybe for the average EP who mostly dabbles in ablation when a case comes along periodically. Being highly discriminating in the choice of an Ablation EP is highly recommended, in our strict guidelines and we advise everyone to set a very high standard for the key choiceby Shannon - AFIBBERS FORUM
Hey Rich. Good talking with you the other day! And for the sake of many newer readers here, I wanted to underscore that you had two prior ablations before your, so far, one 'index' ablation with Dr Natale. In addition, you have had struggles with the beast off and on since your 20s and you are in your early 50s now, all of which indicate a strong likelihood of a genetic influence inby Shannon - AFIBBERS FORUM
In addition to the very good advice that Carey and others have noted above, it’s important to be relaxed physically and sitting calmly with forearms resting on a table or lap for a few minutes ... if you are anxious and breathing heavy or holding your breath then learning to engage in 5 minutes a of gentle rhythmic breathing (i.e. I’m Not talking about doing Atheletic-style yogic pranayama (breaby Shannon - AFIBBERS FORUM
Very interesting story JWB74, However, having experienced documented in the 240bpm range of atypical left flutter, I come from the same planet as Carey in that I find it beyond impossible to even latch onto any discreet atrial beats at anything close to an actually detected 240 range flutter. I’m not suggesting you might be counting something else, but if you are really rocking away in highby Shannon - AFIBBERS FORUM
Hi Rocketrich, First of all while a super enlarged left atria can increase the odds of needing a bit more work in order to seal the deal long term ... and a severely enlarged Left atria tends to start at 52mm across the widest part of the left atria in men ... and 47mm is considered severely enlarged for women The more elite operators rarely find an significantly enlarged left atria ( noted &gby Shannon - AFIBBERS FORUM
Good to hear from you Fravi! Ectopics can happen even more than 2.5 yrs out but from one’s ablation... though more often they tend to subside around to 2.5 to 3 yr mark. Especially when the proximal triggers for said ectopics are tied to the prior ABL as your EP said, unless you have constant runs of PVCs with well over 20,000+ detected daily ( 40,000 a day seems to be the for sure green lightby Shannon - AFIBBERS FORUM
I can’t vouch for Wellnicity’s test kit Kateshadow, but so long as you don’t have such similar conditions as Sarcoidosis, Non-Hodgkin Lymphoma, Hyper-calcemia etc. then it’s typically VERY difficult to overdose on Vitamin D3... you would almost need to be trying to OD to get there if you were not prone to spiking on a 25/OD/D3 serum test. from one o there above or similar conditions that bring wiby Shannon - AFIBBERS FORUM
Katesshadow, FYI, in my experience I’ve taken10K IUs of Vitamin D3 a day since 2003 and run around 75ng/ml of 25/OH/D3 very consistently. Quite a few people need at least 10K IU a day to reach ~70ng/ml of blood 25/OH/D3. That’s why regular testing in the early few years, especially, is important. If your levels are very stable for several years at twice a year testing on whatever dose helps rby Shannon - AFIBBERS FORUM
Welcome Mack and don’t worry one little bit about these transient changes in HRV or resting HR post ablation. If you do a quick advanced search on Afibbers forum for heart rate increase or elevation (which is also a good idea to search for when looking for answers to many other such frequent AFIB or ablation-related questions) you will see legions of reply’s going back to our forums inceptionby Shannon - AFIBBERS FORUM
Dr. Pete Weiss is a very good EP and a great guy! I know Pete and his wife and you will be in very good hands with Dr Weiss! Cheers! Shannon PS give him my best when you next meet with Dr Weiss.by Shannon - AFIBBERS FORUM
Liz, Your suggestion that there is nary a thought given by both the American College of Cardiology & American Heart Association to the bleeding risk of actual Oral Anticoagulants is simply not true! They pay enormous attention to the balance between embolic stroke/TIA risk versus Bleeding risk of these agents ... exactly as they compare the relative potential benefits of a baby aspirin in teby Shannon - AFIBBERS FORUM
Hi Madeline, I agree with Carey, you’re situation will best be served by eliminating AFIB from your life all together! The issues of moderate temporary heart rate elevation post ablation and even less likely but also temporary potential GI issues post ablation are not that common and almost always tend to be self limited as well. And please don’t let an exagerrated fear of such potential ‘tby Shannon - AFIBBERS FORUM
I Ditto what MissSunshine said Ids001! When I lived in Amsterdam for four years I had to fly round trip from my long-term home in Honolulu to AMS and back four times a year (every 3 months) to renew my Dutch visa. In the first two years, I often was still in AFIB during those very long flights (approx 16 hrs in the air). This was before my index ABL with Dr. Natale in Austin ended my highly syby Shannon - AFIBBERS FORUM
Thanks Pompon for the very thorough report on your latest ablatioof 4 total ablations. conscious sedation (CS) is not often used in the US any longer for AF ablations for a variety of reasons including greater assurance of catheter stability under GA as well as undying no sudden big moans, groans or movements which can definitely happen involuntarily during CS and can even cause the catheter to sby Shannon - AFIBBERS FORUM
Hi Karen, Pompon and Carey both gave a good review of typical right atrial CTI Flutter. The SVC (Superior Vena Cava) is part of the CTI Flutter’s typical counterclockwise rotational circuit (that can also manifest as clockwise rotation as well as lower loop reentry) as it loops around from the IVC/TA junction at bottom of the right atria and following the Crista Terminalis to the SVC area atby Shannon - AFIBBERS FORUM
Welcome Zb3, You’ve gotten some very good advice above, yet inspite of having AFIB show up in your life at your young age, don’t just assume you are doomed to a miserable prognosis by age 60! We strongly our specific guidelines incorporating the best of life-style risk reducing methods (RFM) along with partnering with an experienced and respected EP to help you manage the condition in the eby Shannon - AFIBBERS FORUM
A digital rectal exam isn’t high on the list of AFIB conversion to NSR methods Catherine. As a potential vagal maneuver of sorts, it could happen occasionally ... and most likely randomly, if at all, rather than consistently since AFIB is not classically terminated consistently by vagal maneuvers. Nevertheless, you could always try it out in your case, though it might be tough performing that triby Shannon - AFIBBERS FORUM
Touché Carey! Very well said ... sums it up nicely in a nutshell! See you next week in Kansas City for ISLAA Conference 👍 Cheers! Shannonby Shannon - AFIBBERS FORUM
Hey DavrosT thanks for the inquiry and welcome back. It is not uncommon during certain phases of PAF (paroxysmal AFI for a person to have what appears to be regularly spaced or seasonal-seeming triggering. Over the course of one’s long term gradual progression of the disease it will usually go through a number of such phases over time. That phenomenon you describe can also manifest as this;by Shannon - AFIBBERS FORUM
Really good to hear from you again Victoria! What a past year you have had! And congrats on the 90lbs, that’s a great accomplishment that can really help keep the lid on the AFIB kettle too! Especially in top of the expert ablation process and also reduce any further stroke risk. Do contact your NP to clarify the OAC issue though, in light of the stroke you had prior to your ablations Keby Shannon - AFIBBERS FORUM