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Re: Ablation scheduled - 2 days ago

I don't have the 2019 guidelines handy, but as I recall the female point isn't counted until she reaches 75. Not sure about the 2019 guidelines, but the updated guidelines give one point for 65-74 and an additional point when you re 75 or older. But to the OP's issue, in the US, assuming no other risk factors, as you stated, one point is added for age when the OP reaches 65

by mjamesone - AFIBBERS FORUM

Re: Ablation scheduled - 3 days ago

Carey: The point for being female is a risk modifier, not a risk in and of itself. It counts if you have other risk factors, but it doesn't count on its own. Yes, in the US, but in Europe female sex is no longer treated as a risk factor at all. So a female in the US with no other issues is a 2 at age 65, but a female in Europe with the same profile is a 1. Making a move to Europe the

by mjamesone - AFIBBERS FORUM

Re: Ablation scheduled - 4 days ago

For some reason I was thinking the point for being female was no longer being Sounds like you really a "2", and if so, then stopping anticoagulation if you're AF free one year post ablation, is a lot more reasonable. Jim

by mjamesone - AFIBBERS FORUM

Re: Ablation scheduled - 4 days ago

He even said I may be able to go off Eliquis if I’m afib free after one year. But his notes say CHADS score 3 so I’m not so sure I would want to stop it. Yes, this is now the trend at the leading cardiac hospitals, based in part on the OCEAN and ALONE-AF trials. I'm a 4 and my EP also said I could come off Eliquis based on my successful ablation. But you are also smart to be a littlle

by mjamesone - AFIBBERS FORUM

Re: 2 yrs post ablation and now PVCs and thumps - 5 days ago

Gloaming: So, it seems that about 50% are going to make it out to the five-year mark, give-or-take. Let's just make it simple and stick to the five-year mark, which you initially brought up. Again, According to Winkle et al. 2023 "Very Long-Term...." nearly 68% of PAF patients remained AF free, five years after a single ablation. And the stats are even better in younger pat

by mjamesone - AFIBBERS FORUM

Re: 2 yrs post ablation and now PVCs and thumps - 6 days ago

Gloaming: But, regrettably, all the hundreds of posts by different patients on several fora dealing with AF suggest that you're doing well if you get to five years without a recurrence. That's because health forums are subject to selection bias. People with unsuccessful ablations are more likely to post. Conversely, those with successful ablations tend to move on with their lives. A

by mjamesone - AFIBBERS FORUM

Re: Av-node ablation - 9 days ago

Was AV Node ablation recommended and why? Because it not, it seems like you jumping too far ahead after only one failed AF ablation. It often takes more than one ablation to get it right. Without knowing your EP, hard to comment, but I'm a big fan of second and perhaps even more opinions (I had five) especially in hard to treat cases, which your cardiologist's inferred. And ideally

by mjamesone - AFIBBERS FORUM

Re: EP visit at Dartmouth Hitchcock. - 21 days ago

First and last TEE left me damaged for months. Not happening. I missed that part. In your place I would also not have a TEE. However, if you read the complete study, there were a few other tests/precautions they added to lower stroke risk, you might consider. As to only 1 stroke in the last six years from PFA, I'm skeptical because this trial had SIX. Anyway, you want to baby your es

by mjamesone - AFIBBERS FORUM

Re: EP visit at Dartmouth Hitchcock. - 21 days ago

I am flat out refusing a TEE for sure I am very impressed your center is offering a TEE prior. I would have thought unecessary myself until a recent trial was stopped because 6 of the first 183 patients had a stroke! The trial was continued after a stricter protocol was put in place, and paramount was a TEE 24 hours prior. No strokes after the new protocol was put in place. You can read my

by mjamesone - AFIBBERS FORUM

Re: EP visit at Dartmouth Hitchcock. - 22 days ago

The 2nd time was a 10 day stint with a TEE and a successful cardioversion. So technically you are "persistent" not paroxysmal, as you edged past the seven-day mark. Still, no worry, your chances of a succesful ablation shoud be he same as if you were paroxymal, according to the several EPs I consulted with. The problem is potentially when you start geting nearer long-term persistent

by mjamesone - AFIBBERS FORUM

Re: HF and afib/flutter - 23 days ago

You can't seen an EP there unless referred by another cardiologist. So the HF is first That makes a lot of sense and it may work to your advantage. At Cleveland Clinic, you're already looking at an elite EP group, including as Wazni, Saliba, Santangeli, Hussein and others. But even at that level one EP may be a better match than another, especially with your previous congntal he

by mjamesone - AFIBBERS FORUM

Re: HF and afib/flutter - 23 days ago

So does anyone who is NOT overweight take them- or have info on that- wrt afib or HF if you deal with that? I looked into some time ago. And yes, cardio protective irrespective if you are overweight or not. However, if you are not overweight, there may be an insurance issue. I finally decided against these drug because I already have gastroparesis, meaning my stomach empties slowly, and GLP

by mjamesone - AFIBBERS FORUM

Re: New SVT - 24 days ago

Essentially, I have been through all those tests with no issues found. If you've had a CT angiogram and it was clear, then obstructive CAD becomes less likely an explanation, but that doesn't mean, of course, that it's the SVT's. The echo will be another data point but SOB can be a very tough differential diagnosis. Good luck. Jim

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Re: New SVT - 24 days ago

Hi Ken, Of course you will know more with the echo report, but shortness of breath has be taken seriously, and isn't necessarily related to the SVT's. I would think given your symptons and age that you need a complete cardio pulmonary work up, including PFT's, Chest CT, a stress exercise test, Lp(a) and a Calcium Score or CT Angiogram. And if you have any GI issues, then a

by mjamesone - AFIBBERS FORUM

Re: EP visit at Dartmouth Hitchcock. - 24 days ago

This is a teaching hospital so I would like some assurances before hand. You should have the "talk" about who will do what. Some EPs will do all of it, especially if you ask, some will flat out say, I'll be there supervising, but this is a teaching hospital and we teach. At the end of the day, teaching hopsitals like Cleveland Clinc and Sinai have very high success rates, so

by mjamesone - AFIBBERS FORUM

Re: EP visit at Dartmouth Hitchcock. - 25 days ago

Of course they only do PVI ... Don't know your AF history, but if it's your first ablation, especially for paroxysmal AF, a PVI only is not a bad thing. In fact that is probably what you want. It's what I wanted. My EP was highly qualified to do more, but he did a simple PVI because his experience showed that was the right amount of ablation in cases like mine. Going on 3 years

by mjamesone - AFIBBERS FORUM

Re: Newly diagnosed with Afib - 29 days ago

Yes, your regular cardiologist may lean more heavily on guidelines, which are often more conservative and tend to treat similar groups thesame way. . But an EP, especially at th elite level, will also weigh their clinical experience and probably be more up to date on newer trial data and therefore more inclined to both individualize as well as set their own revised guidelines for their practice a

by mjamesone - AFIBBERS FORUM

Re: Heading for my 3rd ablation with Dr. Natale - 29 days ago

Thing is, I gotta take a 3 hr flight to get there so I cannot even imagine being without any meds in my system and risking an attack mid air. I couldn't imagine it either and I'm sure Natale's team will not have you do it. If they still want you to hold meds, looks like arriving a few days earlier would be the plan with the "bonus" of having a potential episode within

by mjamesone - AFIBBERS FORUM

Re: Heading for my 3rd ablation with Dr. Natale - 29 days ago

Do not assume they will ask you to hold meds, but you did the right thing putting in the call. Give them as much detail as possible, including your current dosages, which dose you missed, when the flutter started, how long it lasted, what the rate was, what you took to stop it, and an ECG if you captured one. That will not only help them decide about holding your meds, but it should also b

by mjamesone - AFIBBERS FORUM

Re: Post ablation questions - 30 days ago

Susan.d: Jackie will definitely disagree. She recommended shaving the flecainide and have a slow tapering. Hi, I don't know who Jackie is, however if you read my first post in this thread, you will see Jackie and I agree, not disagree. And I do recommend tapering and have done it myself. However, the statement stand re "physical withdrawal". There is no physical withdrawal a

by mjamesone - AFIBBERS FORUM

Re: Newly diagnosed with Afib - 4 weeks ago

GeorgeN: Your CHA2DS2-VASc score would be 3, two for your age plus one for hypertension. So they'd want to keep you on the anticoagulant. While that may reflect the general guideline, the real-world guideline, especially at the more elite centers, also takes Afib burden into account as well as other metrics. For.example, I was advised not to take anticoatulation even as a CHADS 4, based

by mjamesone - AFIBBERS FORUM

Re: Newly diagnosed with Afib - 4 weeks ago

Just Joe: Have you noticed any issues once you get off and is it a cold turkey situation? No issues, cold turkey. It just changes your blood clotting time back to normal. Weaning, like for example with beta blockers, is not required for ACs and would generally have no benefit. Jim

by mjamesone - AFIBBERS FORUM

Re: Newly diagnosed with Afib - 4 weeks ago

Yes, many people tolerate anticoagulation very well and some of the experiences stated here are reassuring. But it's still basically a risk/benefit decision. Major bleeding and intracranial hermorrage, while mot common, are real risks, espcially as we get older. And that's why the CHADS scoring and other metrics including AF burden and bleeding risk are considered in the first plac

by mjamesone - AFIBBERS FORUM

Re: Subclinical AF Burden Not Enough for Anticoagulation Decision-Making, Trial Analysis Shows - 4 weeks ago

Understandable misread. These reports are so awkawardly written, probably by committees, that they'd fail a freshman English class. The big worry is that patients aren't the only ones misreading them Jim

by mjamesone - AFIBBERS FORUM

Re: Post ablation questions - 4 weeks ago

This is probably a stupid question but would they say the ablation is successful if I go years without Afib but while still on the meds? I bet the EP could think it was since I had many episodes of Afib pre ablation. It depends on how you define "successful". In trials, success is often defined, for exampl, as no AF episodes over 30 seconds at the six or 12 month mark, excluding 90-

by mjamesone - AFIBBERS FORUM

Re: Subclinical AF Burden Not Enough for Anticoagulation Decision-Making, Trial Analysis Shows - 4 weeks ago

GeogeN: "Just 0.4% of the 1693 patients who had data to calculate AF burden had the arrhythmia," That's 7 people who had afib. Their reporting thiis is meaningless IMO. The 0.4% refers to the monitored AFib burden, not the number of patients. With the conclusion that no benefits for anticoagulation in this low burden population (around 6 minutes a day) even though they had high

by mjamesone - AFIBBERS FORUM

Re: Subclinical AF Burden Not Enough for Anticoagulation Decision-Making, Trial Analysis Shows - 4 weeks ago

I have been PIP for years after my LAA was surgically closed 19 years ago Yes, while there a slew of new papers coming out now giving more credence to AF burden vs risk factors, including PIP anticoagulation. In practice, a select group of US EPs have endorsed this practice for many years. Close to 40 years ago, I was put on anticoagulation for a short time after my first AF episode and then

by mjamesone - AFIBBERS FORUM

Re: Subclinical AF Burden Not Enough for Anticoagulation Decision-Making, Trial Analysis Shows - 4 weeks ago

Gloaming: This article seems to confirm my contention, all along, that even a few minutes in AF is enough to present a serious risk of stroke. I read the article almost the opposite way. It does not say that a few minutes of AF automatically creates a serious stroke risk requiring immediate anticoagulation. It says that in device-detected subclinical AF, AF burden by itself did not predict

by mjamesone - AFIBBERS FORUM

Re: Newly diagnosed with Afib - 4 weeks ago

This week I did an annual physical with my regular doctor and he also did an EKG and my BPM was 105 and he said I have Afib....Is it possible that the one EKG might be a flute so to speak? Not a "fluke," but it's absolutely possible the EKG was read incorrectly by your GP. That's because GPs are not very good at reading EKGs and, in most cases defer to the machine algorith

by mjamesone - AFIBBERS FORUM

Re: Post ablation questions - 4 weeks ago

I have gone several days without Metoprolol before and I remember feeling anxious and my heart felt like it was beating faster and harder. I think you have answered your own question. And given you've been on Metoprolol for over 10 years, I would taper even slower than I originally suggested. Ask yourself, what is the downside to a slow taper? After ten years, what is a month or so more?

by mjamesone - AFIBBERS FORUM