The study is of patients who "underwent ablation between June 2004 and June 2006". That sounds almost prehistoric. The authors admit that the "ablation technology used is outdated and may have influenced success rates". In their "limitations" section they say that "technology improvements both for electroanatomic mapping systems and for catheter design, mby David_L - AFIBBERS FORUM
I pay some attention to what Mandrola says. I appreciate that he puts his point of view forward, i.e. he publishes on substack and appears on a weekly podcast. I wish there were more EPs and cardiologists speaking out like this. Its good to hear different opinions. I often find his attitude irritating, and his arguments at times seem premature or lacking a sound foundation, but he can make vby David_L - AFIBBERS FORUM
FWiW: when I had two recent recurrences of a-fib after 3 1/2 years in remission, my cardiologist ordered a nuclear stress test. My primary care physician noticed the result first. She had a nurse call me to say I needed to draw the attention of my cardiologist to the result as she, my primary care doctor, was very worried about it. When the cardiologist saw the result, according to one of hisby David_L - AFIBBERS FORUM
QuoteBob ThortonI was diagnosed with afib on 4/13/21. Cardiologist states alcohol and dehydration caused it. I drank 3 days prior. Maybe I am being hard headed but I don't think I was dehydrated at the time. "Alcohol is a diuretic. It causes your body to remove fluids from your blood through your renal system, which includes the kidneys, ureters, and bladder, at a much quicker rate tby David_L - AFIBBERS FORUM
QuoteLaniB All suggestions you get here are good, I just didn't see anyone mention stress reduction. When I had my first A-fib episodes 3 1/2 years ago I was experiencing a lifetime high level of chronic stress. I didn't do much research into A-fib before I concluded that a high level of stress maintained over a long period of time could prepare the way for my heart to go into A-by David_L - AFIBBERS FORUM
It turned out the local Costco pharmacy had Levothyroxin made for Lannett in stock: Neolpharma appears to be a Mexican company that manufactures these tablets in Puerto Rico. Lannett is the distributor. I wrote Lannett to ask where does the API, the active pharmaceutical ingredient, come from.by David_L - AFIBBERS FORUM
Quotesusan.d I’m married to a retired pharmacist. He taught me never to buy drugs from countries that have lax temperature control storage. India is top of the list. I guess regulations in India regarding the transport of drugs need to be tightened, but the idea that doing that was an adequate response to the issues referred to in the article is laughable. The article mentioned the officby David_L - AFIBBERS FORUM
Quoteadamh here is one video out of many: one more: Regarding the video on that second link: the patient, Eddie Judge, apparently was in constant A-fib for more than six months. You've been in A-fib for a few days in total so far? Because you are taking it so seriously now the odds are that you have an even better chance than Eddie of a very good outcome. The general beliby David_L - AFIBBERS FORUM
I found information on FDA warnings by typing into Google: "manufacturer's name, FDA warning" and looking at the webpages that came up. The easiest to digest information would be news articles. A news article about the impact on a drug manufacturing company of an FDA warning might discuss the history of the company in relation to the FDA, some details not contained in the FDA wby David_L - AFIBBERS FORUM
This podcast is an interview with Dr. John Day entitled "How to Exercise Without Getting Atrial Fibrillation".by David_L - AFIBBERS FORUM
Quoteadamh I had my first known afib recently on Jan 11th and went to the emergency room. My highest Heart rate was 170-180. Pulse was just as high. They finally put me on 25 mg metoprolol tartrate and 5mg apixaban the next day which put me back to sinus rhythm within 6 hours. I was released on Jan 13. The prime risk of a sudden unexpected A-fib episode is for a blood clot to form, get into yby David_L - AFIBBERS FORUM
It seems the European Union is ahead of the US in attempting to deal with low quality imported prescription drugs. See: The European regulatory system for medicines. "Every batch of medicines must be certified as having been manufactured and tested in accordance with GMP and in conformance with the marketing authorization before it can be released onto the market in the EU. If the produby David_L - AFIBBERS FORUM
Since I discovered that the metoprolol succinate that I buy at my local pharmacy is made by Cadila Healthcare in a plant in India that has been warned repeatedly by the FDA to clean up its act I have been wondering what alternate supplier to specify. Dr. Harry Lever is the Medical Director for the Hypertrophic Cardiomyopathy Clinic at the Cleveland Clinic. He published "A Physician’s Pby David_L - AFIBBERS FORUM
QuoteGeorgeN There is an excellent Peter Attia podcast with David Light, the Valisure CEO: Thanks for that link. I think Valisure is going to do well.by David_L - AFIBBERS FORUM
Here's an assessment of what Remdesivir is good for, by Dr. Daniel Griffin. Dr. Griffin is a senior clinician in New York City who has treated or consulted on several thousand Covid patients. He is the senior clinician in a system where there are thousands of doctors. This is an excerpt from a hastily transcribed partial transcript of This Week in Virology podcast 808: COVID-19 clinical uby David_L - AFIBBERS FORUM
There is a US mail order prescription pharmcy that tests every batch of every drug they sell prior to sending orders out to customers. Given that synthetic thyroid hormone drugs such as Levothyroxin are “recognized to have a narrow toxic to therapeutic ratio with significant clinical consequences of excessive or inadequate treatment”, and that one of those significant consequences is atrialby David_L - AFIBBERS FORUM
I’ve been researching prescription drugs these days. My original idea was to come to some sort of understanding as to whether it was a good idea to buy a generic drug that is made in India from a Canadian online pharmacy. Then my doctor called to say my TSH blood test for thyroid stimulating hormone showed something was wrong. She thought either I was taking the pills at the wrong time, orby David_L - AFIBBERS FORUM
I'm not enthusiastic about AADs, and I'm not enthusiastic about ablation, but I'm not enthusiastic about A-fib either. At this point, I would take ablation over any extended use of AADs, but I haven't gotten in line anywhere at an ablation clinic. If I was experiencing an extended episode of A-fib that would not respond to ECV and I could not get an appointment for an ablatiby David_L - AFIBBERS FORUM
Re: toxicity of AADs. I ran into this cheery article published in JAAC, just before signing off the computer for the night: "Torsades de pointes secondary to Sotalol: Predictable, but not always preventable" They start out the article: "Sotalol is an effective antiarrhythmic drug for the maintenance of sinus rhythm in atrial fibrillation. However, its QTc-prolonging effby David_L - AFIBBERS FORUM
I happened to be reading up on Sotalol the last while as my cardiologist says this is what he wants me to take while I wait in line for the ablation he wants me to have. I haven't accepted either recommendation for the time being. He tried to minimize any risk associated with Sotalol. Perhaps the risk is minimal, I don't know. I've noticed that some doctors view the risks aby David_L - AFIBBERS FORUM
Re: getting stuck with having to pay 50% of the retail cost of Multaq: Travis Van Slooten at Living with A-fib posted that he was enthusiastic about the Canadian online pharmacy YouDrugStore.com, but his post is dated 2017, and he doesn't seem to be currently active. In the comments on his post there are suggestions about other online pharmacies that might be OK as well. At that time heby David_L - AFIBBERS FORUM
What strikes me about this study is how significant what the A-fib literature appears to call a "risk factor" can be. I'm trying to find out what my risk factors are. There might be something about losing weight that leads to more successful A-fib treatment outcomes rather than being a certain weight. The average patient in the LEGACY study started with a BMI around 33. Somby David_L - AFIBBERS FORUM
My cardiologist mentioned that a study had found that patients who lost 10% of their body weight as they were treated for A-fib did better. I looked up one of the studies where this 10% weight loss = improved A-fib outlook came from. There is the LEGACY study. All patients in this study had a BMI that classified them as overweight, or obese. The study excluded anyone who did not weby David_L - AFIBBERS FORUM
Shannon was published this year "Things I Learned and is my Pleasure to Share about Dr. Andrea Natale M.D." saying this, about Dr. Natale: "Most importantly, though, he has also earned the trust, admiration and gratitude from many thousands of patients he has successfully treated. Including well over a thousand now who have sought him out from our own forum over the last two dby David_L - AFIBBERS FORUM
regarding your assumption that when you had "a stress echo" approximately 18 months ago it showed that, except for your diagnosis of A-fib, that in "all other ways my heart is healthy, e.g., good fraction, no atherosclerosis (thanks to BP med, statin) . My pulse is always 70-80." Keep in mind: "...no test is 100 percent accurate. A stress test can be wrong for a varieby David_L - AFIBBERS FORUM
The Heart Rhythm Society 2021 conference published a video of a panel discussion entitled “Update from the Experts: Beyond Pulmonary Vein Isolation and the Promise of Pulsed Field Ablation” Actually, as far as I could tell, discussion of PFA didn't start until around minute 36:40 of the video, when Dr. Douglas Gibson proceeded to discuss uses he is excited about. "it is probaby David_L - AFIBBERS FORUM
QuoteCarey ...Compare that to dealing with a failed ablation for months or years. Your quality of life will suffer much, much more from an inexperienced EP than it will from a trip somewhere else. In my case, it dominated 7 years of my life. I'd like to hear more of your story.by David_L - AFIBBERS FORUM
QuoteCarey Then how does he know there are no other sources of afib? Sounds to me like this guy does a straight PVI and nothing else, not unlike a cryo ablation. He said he would just do a straight PVI. With the little I know, I found the statement disappointing. I didn't ask him to clarify and explain. I think at this point I started to believe I wouldn't be getting an ablation iby David_L - AFIBBERS FORUM
The most experienced EP at the local clinic my cardiologist referred me to met with me yesterday. He said he'd done more than 1,000 ablations, less than 2.000. I asked him if he, as opposed to his less experienced colleague, would be doing the procedure if I chose to have it done at his clinic. He would do it, he said. I had read that they are trying to set up what they will call a dby David_L - AFIBBERS FORUM
The impression I've gained from my brief contact with 2 cardiologists and an E.D. doctor twice, recently, is that early rhythm control is regarded as the superior strategy now, compared to my experience with all sorts of types of doctors 3 years ago. The conclusion of this study points out that the data may not be relevant to those of us who were diagnosed with any sort of A-fib more than 4by David_L - AFIBBERS FORUM