No one's disputing that problems can happen and no one's refusing to investigate them. But would you be willing to have a non-functional PM implanted in you as part of a clinical trial? How about an internal cardiac defibrillator? That's what he's demanding as proof that things like PMs and ICDs are effective.by Carey - AFIBBERS FORUM
Typical Mandrola FUD article (FUD = fear, uncertainty and doubt). He's trying to make his name as a writer and he knows that fear sells. Demanding randomized sham trials for ablations, Watchman devices, and everything else has been his schtick for several years now. Would you be willing to have an ablation knowing it might be a sham procedure that just puts you under, pokes some needle hby Carey - AFIBBERS FORUM
I think they're just accounting for unforeseen things. It would be unusual for you to spend more than one night in the hospital. Almost everyone I've known who's gone through this (including me) had an appointment on day 1 for lab work and possibly a CT, the procedure on day 2, spent the night in hospital, and then was released on day 3. Hang out in town for 2 days and you leave onby Carey - AFIBBERS FORUM
QuoteGeocappy I have seen a lot of discussion about the watchman. Does everybody who gets an ablation end up also getting a watchman? I will most likely need atleast two MRIs after my ablation (back and knee). Does the watchman prevent that and exactly how cumbersome is it? Have I mentioned my anxiety and how much my mind wants to solve everything before it happens? No, most people who get an aby Carey - AFIBBERS FORUM
Modern OCR software wouldn't have any trouble whatsoever converting that image to text, but as you said in your last sentence, I think the only audience is going to be you. Your cardiologist isn't likely to be interested in the level of detail you're thinking of providing. They will most likely only care about a single number -- the burden of PACs and PVCs. How many per day do youby Carey - AFIBBERS FORUM
Quoteadamh i missed the part where taking baby aspirin daily was an option? i am doing that now after being on eliquis. It's not a good option for most people who need an anticoagulant. It has a higher bleed risk and is significantly less effective at preventing afib-related clots than all the DOACs.by Carey - AFIBBERS FORUM
QuotewolHe does have the honor of being rebutted in a published medical journal by a non-MD, though. That’s something.[/quote LOL! I sure wish this site had a "like button"by Carey - AFIBBERS FORUM
I don't know but why would it matter? It's an inert part of your anatomy now. It's there but it does nothing and it's completely sealed off from your circulatory system. If there was any concern I'm sure you'd have heard about it.by Carey - AFIBBERS FORUM
Natale doesn't have anywhere near a 10% leak risk. That figure comes from all the EPs doing Watchmans, a good percentage of whom are brand new at it or have done just a handful. I'd be surprised if he has a 1% incidence. And you're not going to get that TEE report until the doc interpreting it writes the report. It'll probably be a day or three.by Carey - AFIBBERS FORUM
QuoteGeocappy Hopefully, last question. Has anyone had to deal with a lot of anxiety. Is it a detriment to afib. Is it possible to deal with afib if you are fighting anxiety (non-medicated). I have heard that anxiety and afib are closely related. I'd say at least 50% of the people Shannon and I counsel here have anxiety issues, some quite severe. The two go hand in hand and tend to form aby Carey - AFIBBERS FORUM
Compliance rates for anticoagulants are actually appallingly bad. I don't have the numbers handy but as I recall nearly 50% of all people on long-term anticoagulants eventually stop taking them.by Carey - AFIBBERS FORUM
I think a leak at 6 months when there wasn't one at 6 weeks would be very unlikely. I think the thing they're more likely looking for is a device related thrombus (DRT).by Carey - AFIBBERS FORUM
QuoteGeocappy Sounds like I should just get started with Dr Natale and just forget about where my flecaide and metoprlol dosage is currently. If he is going to lower it down anyway or take me off it then i might as well let him do it? Yep, I think you've come to the right conclusion. You got some really solid advice from the folks in this thread. And don't worry, Natale's notby Carey - AFIBBERS FORUM
Great meeting and a really useful post! Thank you and I'm so glad you feel more confident now.by Carey - AFIBBERS FORUM
QuotePoppino The entire goal of an effective ablation is to no longer rely on meds like propafanone or flecanide or multaq etc. maybe theyre taken for a short period ? But after 3-6 months no Exactly. There are EPs out there claiming successful ablations whose patients are still taking antiarrhythmics. They can claim partial success if the ablation and antiarrhythmic significantly improvedby Carey - AFIBBERS FORUM
Just call Texas Cardiac Arrhythmia Institute at 512-544-2342 and explain that you want to arrange an ablation with Dr. Natale. They'll put you in touch with his team and they can get you going. If you have any problems shoot me a PM and we can get it worked out for you.by Carey - AFIBBERS FORUM
Sure, he would take you as a patient. Wait times vary but usually you're looking at a couple of months. If the ablation is successful then he will definitely stop the flecainide and metoprolol, but Xarelto probably not. He might want to change it to Eliquis, though, because he prefers it. With the diabetes and hypertension you have a CHADS-Vasc-2 score of at least 2, and probably 3, whicby Carey - AFIBBERS FORUM
QuoteGeocappy Unless he bases it on what he saw on 14 and 30 day monitor sessions A symptom is defined as something the patient experiences and reports such as pain, nausea, etc. A sign is something the doctor can observe such as bleeding, fever... and those monitor results. So that entry on your record is simply wrong. And I second George's recommendation on Natale. You're in longby Carey - AFIBBERS FORUM
Quotewalt I would not place too much credence in any of the Best Doctor/Top Doctor Awards you may see or hear about without doing serious research. I completely agree. Those things are worthless nonsense. Ditto with doctor rating web sites. Those are just popularity contests where bedside manner wins and actual skills lose.by Carey - AFIBBERS FORUM
QuoteGeocappy How does going to see Natale work? Does she take Medicare? Dr. Natale is a he, and yes he takes Medicare. (Andrea is a common masculine name in Italy and other parts of Europe.) They've been accepting patients from out-of-state/out-of-country for many years and have the system down pat. You would have your records sent to them, they would review them and decide if they caby Carey - AFIBBERS FORUM
I don't know what you mean by "uniform dosage."by Carey - AFIBBERS FORUM
Quotetobherd So if I'm following your thinking, Carey, wouldn't that mean that everyone who is over 60 should be on Eliquis? And if that's true, why isn't that recommended? My Cardiologist said she doesn't have anyone who has had the Watchman, still taking any blood thinners. According to her, that was the whole reason for getting it. It doesn't seem that she beby Carey - AFIBBERS FORUM
I've never heard of anyone experiencing constipation after anesthesia. Since you've experienced it twice I'd say next time a lot fiber and a stool softener beforehand would be a good idea. Bet you won't forget again. :-(by Carey - AFIBBERS FORUM
QuoteCaliGuy Only thing I forgot to ask is what happens if something bad happens after Dr. Natale goes back to Texas. I'm always thinking worst-case scenario. Virtually all the "bad things" that can happen with an ablation are evident either during or immediately after the procedure. There really aren't many big, disastrous things that can go wrong after a day or two, andby Carey - AFIBBERS FORUM
You can ignore it for a few days and hope it resolves on its own, but you can't let it go long term. A rate of 120 for weeks or months can do serious harm potentially leading to heart failure. There's a good chance it's atrial flutter, but whatever it is you can't just live with it.by Carey - AFIBBERS FORUM
Okay, then you can't stop taking it. It's a big part of what improved your heart conditions. A HR of 160 and a BP of 70/40 isn't dangerous if you're not in danger of passing out. If you don't feel lightheaded or dizzy then there's no danger and there's nothing meaningful that A&E can do for you. I would save myself the time and hassle and just stay home aby Carey - AFIBBERS FORUM
QuoteIanHolly Thanks for this .... I take Carvedilol so assume I'd take this first... when I go into AF its usually at high rate (up to 160 bpm). That together with a low BP (70/40) sends me off to A&E. Why are you taking carvedilol? Is that for hypertension or the afib? If it's for the afib, I wouldn't take it or I would cut the dose in half. And I wouldn't go to A&amby Carey - AFIBBERS FORUM
Quotesusan.d Maybe you are special and unique. :-) We both know it's the other way around. ;-) Anyway, it's not important. Everyone should just follow the instructions they were given.by Carey - AFIBBERS FORUM
Then why have I never heard it a single time in 7 procedures at 3 institutions, nor have I ever heard of anyone else being given that instruction?by Carey - AFIBBERS FORUM