FYI, I mentioned above that I was hoping to attend the bi-annual EP-Live 2020 Conference sponsored by Texas Cardiac Arrhythmia Institute at St Davids Medical Center, and originally scheduled for April 2rd-3rd. My wife Magdalena and I, were hoping to spend an extra day or two at St Davids as well. Alas, EP-Live 2020 conference has just now joined the ranks of many such conferences, such as tby Shannon - AFIBBERS FORUM
Yes, as Carey noted above, Dr Natale is right by the patients side during the vast majority of each of his ablations and, for sure, during the entire time the mapping and actual ablation lesions are being created, that is all solely done by Dr Natale ...100% .. and standing right next to the patient and in control of all catheters! The only, exception is during the roughly 20 minute's neby Shannon - AFIBBERS FORUM
Hi Susan, An 'Index ablation' is the commonly used term by Cardios and EPs for a 'first ablation' (as in 'index' = 'first') ... or it can be used as a first ablation for a given patient by a given EP as well. Plus, an 'index ablation' usually represents the main or most comprehensive ablation, but not in all cases. Shannonby Shannon - AFIBBERS FORUM
Hi kbog, An atypical left atrial flutter can, indeed, appear at this stage after your index ablation. It happens less often at the1.5 year mark and later, assuming there were no to very few breakthrough episodes during that first year or so after an index ablation. What we have learned over the last two decades is that after an advanced expert index ablation by a top operator, such as Dr. Nby Shannon - AFIBBERS FORUM
Hi Gary, Great to hear that you are doing so well, as expected! For those who may not be familiar with the term pericarditis, it simply means inflammation in or around the pericardium which is a protective outer sack or membrane around the actual heart. Keep in mind that pericarditis has a wide range of manifestation, from the far more typical mild-to-moderate pericarditis that most experiby Shannon - AFIBBERS FORUM
Hi Susan, Wishing you all the best with your PVC ablation with Dr Natale ... as usual you couldn't be in better hands. FYI, I confirmed with Dr. Natale yesterday that they have still never had a death from VT or PVC ablation originating in either the left ventricle or epicardium at his centers ... not to mention the RVOT (right ventricular outflow tract). As is typical with Dr Natale,by Shannon - AFIBBERS FORUM
Hi Barry, There is a lot of detailed info on Steve Carr's experiment, that some of our readers are exploring now too, on the General Health Forum for anyone to follow so take a look there to get more info and to keep up with Steve's project. Cheers! Shannonby Shannon - AFIBBERS FORUM
Please do not include any patient or Doctor information listed on any EKG. Thank you, Shannonby Shannon - AFIBBERS FORUM
It's very rarely the case that an EP cannot quickly trigger AFIB in a person prone to AFIB who appears in the EP-Lab in ablation morning in NSR. That is very common especially with PAF patients (paroxysmal AFI who often are in NSR when they check in for an ablation. Keep in mind that you typically will not find a persons coming for an ablation who has been in long term NSR with little to noby Shannon - AFIBBERS FORUM
Good the hear George that your son-in-law did so well with his first PIP Flec dose of only 100mg! Was very nice speaking with him (and you too, of course) on the phone last month and it is good to hear that he's getting the support he needs from his Military EP. Please give him my best wishes, Cheers! Shannonby Shannon - AFIBBERS FORUM
Great news Ken!! So glad you got your very long term follow up done expeditiously and wishing you and your wife all the best for an even longer time frame in NSR than last time. Perhaps you'll get double your original 13 years :-) !! Could well be the case and I'm in favor of thinking BIG! Cheers! Shannonby Shannon - AFIBBERS FORUM
(This is part two of the discussion above on the original thread topic regarding waking with a pounding heart at 3AM) (continued) .... One 'bandaid' response to such a nocturnal 'cortisol mini-crash' can be to swallow something sweet and sugary upon being startled awake, often with a pounding heart plus sweating, and that can lead to AFIB in those so prone. Taking a sugar bby Shannon - AFIBBERS FORUM
(The following post is split into two windows to hopefully result in easier reading of a more in-depth discussion on this frequently asked issue) One common cause of waking up around 3am with a pounding heart and often accompanied by a sudden waking up startled reflex ... can even feel like a panic feeling for some folks is connected to a sudden drop in both blood sugar and can also include aby Shannon - AFIBBERS FORUM
Carey is absolutely right, look for the most experienced and well-vetted ablation doc you can find that has a decent backlog of cases and at least a regional, if not national, reputation for excellence in AFIB ablation. Meaning, you won't be able to get the procedure done quickly in the next couple of weeks (outside of exceptions where one might get lucky by getting a slot vacated suddenly dby Shannon - AFIBBERS FORUM
In the mountain west, it is common to see a lot of excess calcium ... as well as other electrolytes/minerals in local water supplies. Excess Calcium has long been known as a potential offender, not only relative to many cardiovascular issues in general, but also for cardiac arrhythmia in particular! It is certainly true of Sedona AZ where we live. In certain parts of Sedona, excess calcium inby Shannon - GENERAL HEALTH FORUM
Agree with Wolfpack and Carey, don't pay any more attention to ectopics than necessary ... as it's usually not necessary to fret over them at all. Though, for sure, frequent runs of mixed ectopy, especially primarily PVCs, will demand a certain level of attention just cause they can be a big annoyance to say the least. This can be so, even through they are essentially benign in vast majby Shannon - AFIBBERS FORUM
Yes indeed as Carey and George noted above, AFIB should still be clearly detectable on a 12 lead EKG. Keep in mind though, that with a KARDIA or other similar single lead EKGs, it is more likely for a moderately experienced EKG reader to not reach a clear determination or distinction between say ... AFIB and AFlutter ... especially when there is a mix of the two going on. On rare occasions, eby Shannon - AFIBBERS FORUM
There can be changes in post ablation EKGs for some Afibbers that can get misread by some docs and (even some EPs), and especially by ER docs, as indicating the post ablation patient has some 'ST elevation' when that is only a benign artifact and not at all related to actual ST elevation nor is it, in any way, related to a prior myocardial infarction finding. Hence the need for an experby Shannon - AFIBBERS FORUM
Hi Ken, Im very sorry to hear of your recurrence especially after 10/11 years of such great success. But this is not uncommon. Dr Wheelen did a super job for you with a PVI back in the 2007/2008 time frame. However, please keep in mind not to expect this next ablation to be just a 'touch up' of previous lesions Dr Wheelen did long ago, as it is extremely doubtful that those lesions thatby Shannon - AFIBBERS FORUM
Hi Carola, As George and Carey noted above, it is not that your trusty ablation failed, once ablation lesion lines hold up with zero recurrence for at least a full year and a half, it's highly unlikely for those scar lines to ever fail, and thus allow AFIB/aflutter to trigger again from the same previously ablated spots that were solid so long. The old adage that AFIB can't cross a dby Shannon - AFIBBERS FORUM
Quotedartisskis That is all interesting since my velocity was 34cm/sec but Natale said i was OK because it was "contracting". I am not even sure in this case how to understand "must be > 45cm/sec" Hi dartisskis, What is interesting is that the long term line of demarcation consider the borderline of ‘safe’ LAA emptying velocity has been in the past set at 25cm/second.by Shannon - AFIBBERS FORUM
Ha! Carey, That’s a good suggestion for budding EPs ... Obviously, though, I suspect there will not be many EPs taking you up on that advice! One of the other still often overlooked issues that could very well be relevant in this equation, is the increased risk of early onset dementia (meaning onset dementia/Alzheimers before age 70) from poorly addressed long-term AFIB. While we areby Shannon - AFIBBERS FORUM
Great to hear as usual Ken! I always look forward to your reports each year. Dr Wheelan did an excellent job for you ... and you did an excellent job for him too ... as well as for yourself, by your dedication to a robust but not overly aggressive fitness program as well as paying attention to those steps you found important in your experience. A perfect example of our Afibbers.org creed ... cby Shannon - AFIBBERS FORUM
Hi Barb, To be sure, for a straight up Watchman-only procedure there are a good many more well trained EPs at doing Watchman’s to make ones job easier to pick a high volume experienced Watchman installer that can do a good job. Typically, such an experienced Watchman installer would be found around a larger metropolitan area, with some exceptions, that can also do a solid reliable job. Hoby Shannon - AFIBBERS FORUM
Hi Pamela, good to hear from you! I what to strongly second Carey’s excellent summary above! Your no doubt well-meaning cardio is unfortunately misinformed. As Carey emphasized above, he simply doesn’t understand the risks, or the options. Did he define your added bleeding risk? Also, a good solution, even if you do have an actual elevated risk for bleeding, is a Watchman FLX, which you could easby Shannon - AFIBBERS FORUM
It may well seem like it can long time for cardiac myocyte tissue to heal in some folks after an an RF ablation, but the typical reality is that the vast majority of tissue healing is largely over be the end of the blanking period. Some degree of subtle cellular healing can still continue up to a max of around 6 months post ablation, but by and large this final late stage cellular healing is largby Shannon - AFIBBERS FORUM
Hi Buckywood, Welcome to the forum! While your question is very valid, please be aware that this issue of post ablation HR elevation is truly one of the most common repeat questions we get on the forum and thus there are no doubt legions of very complete answers to your inquiry already handy for you simply by using our forums advanced search feature with something like ‘post ablation elevateby Shannon - AFIBBERS FORUM
Barb, As Carey noted above, the temporary ‘requirement’ for Watchman recipients to stay on an aspirin a day will not last indefinitely. As Carey also noted, aspirin is not used long term, post Watchman, in most other parts of the world and as more of the larger scale RCTs in the AuS, Europe and Asia are published over the coming few years, the consensus thinking among those EPs and Cardiologisby Shannon - AFIBBERS FORUM
Do not take Melatonin or high dose GABA (at night/early morning hours), except in very small doses. This recommendation is only IF your are getting such an early-morning 'startle' reaction the makes you wake up rapidly with a startled sense of urgency and often with a rapid HR too, plus possibly a clammy or even panic feeling. This is a sign of a potential very low cortisol crash oftby Shannon - GENERAL HEALTH FORUM
Great to hear Kbog, I’m so pleased, but not in the slightest surprised, by your very typical and yet exceptionally thorough report! And I say ‘Ditto’ to Carey’s answer on the ubiquitous moderate increase in resting heart rate which is actually a good sign that you’ve had a thorough and effective ablation! I was an outlier after my very long index ablation with Dr Natale for aggressive pby Shannon - AFIBBERS FORUM