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Re: When the Time Comes to Stop Oral Anticoagulation: Options and Obstacles - 3 months ago

If there ever is a real published study that anticoagulants become marginally effective after age 87 for warfarin or age 92 for Eliquis, then it might be a real benefit to already have a Watchman in place (assuming it is still effective) to make up for the anticoagulant loss. I have parents that lived into their 90's.

by JakeL - AFIBBERS FORUM

Re: When the Time Comes to Stop Oral Anticoagulation: Options and Obstacles - 3 months ago

For example, when balancing life's priorities, should someone need to take irritating blood thinners when they were in hospice. The article was looking for a balance.

by JakeL - AFIBBERS FORUM

When the Time Comes to Stop Oral Anticoagulation: Options and Obstacles - 3 months ago

We normally think about a CHA2DS2-VASc score or Watchman Left Atrial Appendage (LAA) procedure. But what about life priorities at a certain age? Or, should it be a combination of all 3 parameters? https://www.tctmd.com/news/when-time-comes-stop-oral-anticoagulation-options-and-obstacles Margaret Fang, MD (University of California, San Francisco) said a study led by one of her mentees, Sachi

by JakeL - AFIBBERS FORUM

Re: Update on Stopping Blood Thinner - 5 months ago

Google AI Overview (rivaroxaban is Xarelto) Evidence from the OCEAN trial (presented in late 2025) and supporting studies (such as ALONE-AF) indicates that for patients who maintain sinus rhythm for at least 12 months after a successful AF ablation, the stroke rate is very low, making the discontinuation of oral anticoagulation (OAC) a reasonable option. Evidence from the OCEAN Trial

by JakeL - AFIBBERS FORUM

Re: Potential 2025 Year End Eliquis Savings - 6 months ago

I was thinking the same thing. So, just now I checked my insurance prescription claims online and this is what I see: Claims overview from Past 18 months: Total claims: 7, Total cost: $8080.64, Your total costs: $716.00 And then for my "purchase" today: Service date: 12/29/2025, Total cost: $1559.50, Your cost: $0.00 Was there some recent law passed that gave expensive drugs l

by JakeL - AFIBBERS FORUM

Potential 2025 Year End Eliquis Savings - 6 months ago

I wanted to purchase my last batch of Eliquis pills at the end of 2025 so that I could delay paying the large drug deductible in 2026. So, I purchased my last 90 pills of Eliquis today and was surprised to see they were free, $ 0.00. If you are on Eliquis you might want to check your insurance to see if you can do the same, only 2 days remaining in 2025. See my attached receipt.

by JakeL - AFIBBERS FORUM

AARP: 10 Over-the-Counter Medications That Can Become Risky After 50 - 1 year ago

I received an email from AARP (am a member) listing 10 medications I should be cautious about. There is only one that stood out, the laxative, Magnesium Citrate: 10 Over-the-Counter Medications That Can Become Risky After 50 8. Magnesium citrate, milk of magnesia Gershman recommends older adults be careful with the over-the-counter laxative magnesium citrate. It can cause changes in elect

by JakeL - AFIBBERS FORUM

Re: Dr. Natale’s Watchman Protocols - 1 year ago

QuoteJakeL The question that needs to be answered is -- Which option below reduces the risk of stroke the most: 1. Full dose of Eliquis per day 2. Watchman procedure and 1/2 dose of Eliquis per day 3. Watchman procedure and full dose of Eliquis per day 4. Watchman procedure alone Thanks Carey, you brought up some points that I did not consider. I did not know that patient complian

by JakeL - AFIBBERS FORUM

Re: Dr. Natale’s Watchman Protocols - 1 year ago

The question that needs to be answered is -- Which option below reduces the risk of stroke the most: 1. Full dose of Eliquis per day 2. Watchman procedure and 1/2 dose of Eliquis per day 3. Watchman procedure and full dose of Eliquis per day 4. Watchman procedure alone There is a NIH study underway that will determine if the Watchman is a reasonable alternative to NOACs (Eliqus). It

by JakeL - AFIBBERS FORUM

Re: Significance of a Single Late Afib Occurrence after Ablation. - 2 years ago

We should know by December 2027 if the Watchman is a reasonable alternative to NOACs or a possible supplement to NOACs. CHAMPION-AF trial

by JakeL - AFIBBERS FORUM

Re: Best method of LAA Closure - 2 years ago

We should know by December 2027 if the Watchman is a reasonable alternative to NOACs. Prior Discussion Link

by JakeL - AFIBBERS FORUM

Re: Magnesium intake according to a pharmacist - 2 years ago

One of the USP certified brands he recommended was Nature Made Magnesium Citrate. I checked around and found it Walgreens. The bottle contains 120 softgels and a daily "serving" is 2 softgels, so a bottle lasts 60 days. Cost was high at $30 but until 8/26/23 you can purchase 2 bottles for the price of one ($30). You also get a $3 off with a coupon - net price for 2 bottles: $27.

by JakeL - AFIBBERS FORUM

Re: Honest CHA₂DS₂-VASc scores and need for a DOAC - 3 years ago

See my post about the CHAMPION-AF trial that will compare effectiveness of Watchman and DOACs There is a NIH study underway that will determine if the Watchman is a reasonable alternative to NOACs. It is scheduled to be completed in December 2027. CHAMPION-AF Clinical Trial - NIH US National Library of Medicine Study Description, Brief Summary: The primary objective of this study is t

by JakeL - AFIBBERS FORUM

Re: Electrophysiologist Needed in Florida - 3 years ago

See my post for Medicare Advantage in NY paying for Natale ablation There are some Medicare Advantage plans that do cover out of state care. I have UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO), live in NY, and had it cover 2 Natale ablations in Austin and just paid a copay each time. From their description: This PPO plan gives you freedom to see any provider nationwide

by JakeL - AFIBBERS FORUM

Re: LAA, by Dr. Natale, then Watchman - did YOU stop taking Eliquis? - 3 years ago

At this point I don't think we know if the Watchman or NOACs like Eliquis are most effective against strokes. Therefore I would think that afibbers that take a NOAC and have a Watchman, like Carey, reduce their risk of a stroke vs only taking a NOAC or having a Watchman alone. Patients hear from their EP that if they have a Watchman they may not need to take a NOAC. How do EPs know this

by JakeL - AFIBBERS FORUM

Re: To watchman or not - 3 years ago

Quotejasams I don’t think you can suspend all anticoagulants permanently or the company would be pushing for approval of that instead of merely switching the initial 6 weeks from warfarin and aspirin to a dual antiplatelet. You could infer that Boston Scientific believes that "you can suspend all anticoagulants permanently" with the Watchman since the Champion AF Clinical Trial will

by JakeL - AFIBBERS FORUM

Re: Ablation: Just Got Back to Room - 3 years ago

There is a NIH study underway that will determine if the Watchman is a reasonable alternative to NOACs. It is scheduled to be completed in December 2027. CHAMPION-AF Clinical Trial - NIH US National Library of Medicine Study Description, Brief Summary: The primary objective of this study is to determine if left atrial appendage closure (LAAC) with the WATCHMAN FLX device is a reasonable

by JakeL - AFIBBERS FORUM

The market’s biggest winners and losers in the Inflation Reduction Act - 3 years ago

It looks like seniors on Medicare, possibly including those with Afib, may get a reduction in their drug costs from this new legislation that may soon be signed into law: Winners and Losers in the Inflation Reduction Act The law will only let Medicare negotiate over a few drugs in the early years of its implementation. Medicare will only be able to haggle over 10 drugs in fiscal 2026. On

by JakeL - AFIBBERS FORUM

Re: Getting off of baby aspirin - 3 years ago

If I had a Watchman implanted now I would follow Carey's advice. Taking Eliquis together with a Watchman is likely to reduce the risk of a stroke. I would continue with Eliquis until the CHAMPION-AF clinical trial is completed to find out if/when the Watchman is better or the same than a blood thinner for reducing the risk of a stroke. Don't know when that will happen. Cardiac

by JakeL - AFIBBERS FORUM

Re: Any need for ANY blood thinners after Watchman implant? - 3 years ago

If the CHADS-Vasc score isn't really applicable following a Watchman implant then you think they would state that before you started the calculator; or there would be a question in the calculator asking if you had the Watchman implanted. I did some research to see if the Watchman was as good as Eliquis, or similar drugs, and could not find any answers. However, I did find that there is a

by JakeL - AFIBBERS FORUM

Re: Any need for ANY blood thinners after Watchman implant? - 3 years ago

You can go to the Boston Scientific Watchman FLX website where they offer a CHA2DS2-VASc calculator that will recommend if you should be on a blood thinner, or not. Watchman CHA2DS2-VASc Calculator If you are a male over the age of 75 and no other issues you get a score of 2 with the following recommendation - which I believe means a blood thinner: - For a CHA2DS2-VASc score of 2 and hig

by JakeL - AFIBBERS FORUM

Re: Unequal prescription of anticoagulants among females and males with atrial fibrillation and similar stroke risk: Should we omit sex category from the CHA2DS2-VASc score? - 4 years ago

Thanks to Carey and Susan for that explanation. I have had afib for many years, am over 75 years old, had 2 successful Natale ablations, and been in NSR for over 2 years. That means, according to CHA2DS2-VASc, that I will be on an anticoagulant for the rest of my life. Even though I am in NSR now, afib and a stroke could return at any time. But if I were to get a Watchman, I could go on a h

by JakeL - AFIBBERS FORUM

Re: Unequal prescription of anticoagulants among females and males with atrial fibrillation and similar stroke risk: Should we omit sex category from the CHA2DS2-VASc score? - 4 years ago

We know the CHA2DS2-VASc score is used for people who have Afib. So anyone over 75 years old with Afib should be taking an anticoagulant. So what is the definition of someone who has Afib? If they have an irregular heart beat then they are in Afib. But what if they have had one or more ablations and are in NSR for a year or more (5?) do you still have Afib and have to worry about a stroke

by JakeL - AFIBBERS FORUM

Re: Unequal prescription of anticoagulants among females and males with atrial fibrillation and similar stroke risk: Should we omit sex category from the CHA2DS2-VASc score? - 4 years ago

Related to this question: Does everyone in the world over 75 years old (male or female) with no other heart issues and no afib or diabetes be recommended to take an anticoagulant? The chart below would imply "yes". Or, if you did have afib, but have had one or more ablations and are in NSR for a year or more, do you still have a vascular disease? And if not, would an anticoagula

by JakeL - AFIBBERS FORUM

Re: My cardiologist doesn't seem to fully understand LAA isolation - 4 years ago

Carey, thanks for the detailed answers to my 7 questions. I will use this information when I discuss options with my doctor next month. I gather from your answers that it is most important to get a TEE after an ablation so that you can decide what to do next. If your TEE blood flow is high in the LAA then you to come off anticoagulants entirely if your CHADS score is less than or equal

by JakeL - AFIBBERS FORUM

Re: My cardiologist doesn't seem to fully understand LAA isolation - 4 years ago

A couple of questions about LAA isolation and Watchman: 1. Is a LAA isolation the same as a LAA ablation? 2. Do you need to, or should you, have a Watchman implanted if your LAA has been isolated? 3. I read that you need a successful TEE before a Watchman is implanted. Is this correct? 4. So if you fail the TEE after the LAA is isolated, you cannot have a Watchman implanted. Is this

by JakeL - AFIBBERS FORUM

Re: Ablation or not - 4 years ago

A starter list: Choosing the Right Doctor: 10 Questions You’ve Got to Ask (And What the Answers Mean) https://a-fib.com/questions-for-doctors-and-what-the-answers-mean/

by JakeL - AFIBBERS FORUM

Re: Touch up ablations - 4 years ago

frankangelo , I had my first ablation with Dr Natale over 2 years ago and a touch-up ablation with him over a year ago. I have been in NSR since. In both cases I had the UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) insurance. I reside in NY. The insurance costs $16/month and it paid for all my medical bills in Austin and I am keeping it until I am gone . See if United He

by JakeL - AFIBBERS FORUM

Re: Dr. Natale's EP proteges - 4 years ago

Actually DHANUNJAYA LAKKIREDDY MD, if this is the correct one, does pretty well, except for CODE: 93657-F: 0. Medicare payments in 2015 from the Wall Street Journal database, check my numbers to make sure: https://graphics.wsj.com/medicare-billing/#/1023067881 CODE: 93656-F: 64, Top 20% nationally CODE: 93655-F: 47, Top 20% nationally CODE: 93613-F: 84, Top 20% nationally CODE: 93657-F:

by JakeL - AFIBBERS FORUM

Re: Persistent afib - 4 years ago

There is an article (Finding the Right Doctor for You and Your A-Fib) on another website (https://a-fib.com/finding-right-doctor-for-you-and-your-afib-treatment-goals/) that can help get you started to find a doctor. Once you find a doctor you can compare him/her against what Dr Natale does to see how experience he/she is. It has been said by many here that the more experience the doctor has

by JakeL - AFIBBERS FORUM