Fair enough George, In review of your points above, I agree, the topic does have enough relevance to AFIB to remain on the Afibbers forum. Initially, it looked to me like it was mostly another colonoscopy thread, which while important for sure, would often warrant posting in General Health were it not for the focus on the electrolyte/AFIB question that I initially overlooked. Thanks for the headsby Shannon - AFIBBERS FORUM
Hi Susan, As you may recall, in the week prior to your ablation when you sent me a ZIO patch report you recently had and asked my view of what it showed, I mentioned to you that I would not assume that you actually had VT (Ventricular Tachycardia), based on the very minimal short duration runs of PVCs noted in the report that you sent to me. Specifically, I said that overall, it looks a lot likby Shannon - AFIBBERS FORUM
Thanks Wolfpack, Smackman and Andy! For sharing your experiences, Smackman with the benzo impact you have so admirably dealt with, and Andy for the withdrawal schedule for those who wish to wean off those drugs ... and Wolfpack, for your recounting the overwhelmingly typical experience you had with post ablation increase with benign ectopy, for those Afibbers who even have any or much ectopy aby Shannon - AFIBBERS FORUM
Susan, The advice still stands, regardless if had been a classic addiction or not to a Benzo. And that advice is simply to be very cautious and titrate very slowly when weaning off a Benzo unless the person has only a sporadic and limited history with these meds. The less total time and the lower the average dosage one has been on with these drugs, generally the less time the titration periodby Shannon - AFIBBERS FORUM
Regarding post ablation increase in ectopy that is not uncommon, it is ‘almost’ always self-limiting over a typical period of usually less that 2 to 2.5 years max before they mostly subside, and often much sooner. When post ablation ectopy appears it can be associated with the degree of zapping/stunning of cardiac myocytes (pacing cells) necessary due to the ablation to address the AFIB/Flutby Shannon - AFIBBERS FORUM
Post ablation ectopy is most often discussed as just benign ectopic beats. Sometimes you’ll see descriptions of PVC’s and/or PACs but ectopy is almost always benign unless your having well over 20,000 to 40,000 PVCs a day which can then warrant a stand-alone PVC ablation The other form of unlikely PVC manifestation that can be less than benign are multiple PVCs in a row with not a single interby Shannon - AFIBBERS FORUM
Hi Peter, Yes I agree, it sounds like it could be a more promising tool for more consistent Non-PV trigger detection if all works out over time. And as I noted above I do fully expect the Johns Hopkins team to approach this in a more sophisticated and scholarly manner, and thus why I will follow it’s development with interest. And I certainly trust that their reporting of results will be withby Shannon - AFIBBERS FORUM
Just as a minor FYI, Dr Natale’s last name spelling is ‘Natale’ rather than ‘Natalie’. The later is a common enough variation, but his actual last name is pronounced ‘Na-TA-Lee’ while ‘Natalie’ is usually pronounced ‘Na-TA-Lee-A’. Of interest, the name ‘Natale’ means ‘Christmas’ in Italian, as in ‘Buon Natale’ means ‘Merry Christmas’. Cheers! Shannonby Shannon - AFIBBERS FORUM
It will be interesting to watch this ‘new’ approach as it slowly makes its way through a prolonged real vetting process over the next few years. I trust much larger independent studies will be conducted much sooner than during the FIRM Rotor ablation marketing hype years, as this looks and sounds a bit like another somewhat similar attempt to detect Rotors/non-PV triggers which, so far, have nby Shannon - AFIBBERS FORUM
Hi AntiFib, Keep in mind the Multaq Susan has been prescribed by Dr Natale is only for short term use during the blanking period ... and maybe just a bit longer depending on how active or quiet her blanking period is. It tends to be well tolerated by the vast majority of post-ablation blanking period users and the side effects you note generally only appear much longer term, if at all, as someby Shannon - AFIBBERS FORUM
Susan, are you taking about at Los Roblos Medical Center they gave you lasik and potassium while you are there? Or are you speaking of another time in which some other docs gave you lasik? Post ablation it is typical in the first day or two after an index ablation to get both a couple doses of last and potassium chlorine tablets, , and that is primarily due to the excess saline load from theby Shannon - AFIBBERS FORUM
Susan make sure you ask Kelly for the copy of the ablation report before you leave later today. Glad to hear it went well, will touch base later. Cheers! Shannonby Shannon - AFIBBERS FORUM
Houston Rockets basketball great Akeem Olajuwon and Boston Celtic star Larry Bird both had AFIB end their stellar careers. Wilt ‘the stilt’ Chamberlain had it too, as have numerous other basket-ballers with huge hearts including BIG left atriums. As Carey noted above, the list of star athletes significantly impacted by AFIB is very long! Shannonby Shannon - AFIBBERS FORUM
No sweat Susan, As we discussed the last few days, it’s in the bag ... ‘... row, row, row your boat gently down the steam ... merrily, merrily, merrily life is but a dream ... Best wishes, Shannonby Shannon - AFIBBERS FORUM
Hi Lorraine! It has been just shy of a week since we last spoke and Im happy as a clam that your latest ECV last Thursday was successful! And wow again ... Atul Verma and team aren’t shy at all about zapping folks with a big gun cardioversion ... 360 joules after the 350 joule last week is not messin’ around by any means. The most I ever had during my 16 total ECVs during my gratefully now forby Shannon - AFIBBERS FORUM
Once again PC, many thanks for your latest interesting thought piece above. It's great to hear from you again and, as always, you are more than welcome here on the forum! Cheers and Aloha! Shannonby Shannon - AFIBBERS FORUM
Hi Madeleine, One thing we discussed by phone is that if the temporary period (though sometimes with longish time frame), in which post ablation elevated heart rate tends to occur (especially after index ABL), becomes a nuisance for you then you can discuss with your NP at Austin if you can take a low dose of either a beta blocker or calcium channel blocker that can help slow it down just a bby Shannon - AFIBBERS FORUM
Hi AFAPR14, Sorry for my delay in getting back to you I have been traveling recently plus juggling my usual ten balls lately, but our trusty teamwork with Carey joined by rockekritch addressed your concern quickly and right on the money, as usual. Normally, an EP will try a diltiazem IV drip for any recurrence during the first 24hrs post ABL while trying to slow down the rate (if it was weby Shannon - AFIBBERS FORUM
HBK, I’m just about to take off from Phoenix to Dallas for the Stop-AFIB.org patient conference tho s weekend that my friend, Mellanie True Hill’s invites me to attend again. I’ll answer your question in more detail when I arrive later at the Dallas Hotel regarding AEF (atrial-esophageal fistula) but the short answer is DO NOT fret one moment about that risk, it’s exceedingly rare and especiaby Shannon - AFIBBERS FORUM
Sounds great Rich! Glad to hear it’s smooth sailing in these early days post ABL. Cheers! Shannonby Shannon - AFIBBERS FORUM
There is a caveat to staying in so-called ‘asymptomatic’ persistent AFIB and that is an increased risk for silent cerebral ischemia and possible increased risk of early onset dementia as noted by a growing body of research worldwide on the topic over the last 10 + years. Please refer to issues #131 and #135 for more insights about the origins and potential outcome of Silent Cerebral Ischemia (SCIby Shannon - AFIBBERS FORUM
The question I have Mike, is what if your recurrence is from a focal trigger such as an atypical left flutter ... or even a CTI flutter source within the right atria far away from the PVs?? It would be very hard to tell beforehand just where your recurrence is originating from, but I suppose he could always just switch back to RF in that case since the only PFA catheter, so far, offered by Faby Shannon - AFIBBERS FORUM
Yes Callydex, This preliminary approach to Pulse Field Ablation is limited to only doing a PVI ... so far. No doubt, as the technology matures, the developing companies will expand the catheter designs and overall supportive systems to allow more flexible ablation for more challenging cases of AFIB like so many of us on Afibbers forum have either required, or are waiting to have a more comprehby Shannon - AFIBBERS FORUM
The main benefit of PFA Mike is, indeed, the safety aspect. There is some degree of potential efficacy benefit for PVI. particularly with less experienced ablation EPs ... but not so much of an ‘efficacy’ advantage for highly experienced elite level operators. More this weekend. Shannonby Shannon - AFIBBERS FORUM
Mike and Anti-Fib l, I’ll write more tomorrow, Saturday, regarding PFA and Electroporation ... and yes, Dr Natale is very familiar with it all and has been actively investigating electroporation or some time now, via Medtronics design for PFA, as well as working with BioSense Webster and Abbott on their respective designs for PFA systems. Its a very exciting development long term and yet Iby Shannon - AFIBBERS FORUM
The QDOT Catheter system is under FDA trial now in a growing number of large US centers, most prominently at St Davids Medical Center starting last month. One of several advantages are it’s suitabilty for use with the exciting (and somewhat new over the 4 to 5 years) ablation strategy based on HPSD (High Power-Short Duration ablation), in which the premise achieving greater consistently in transby Shannon - AFIBBERS FORUM
Hi Tracy, I ditto all of the above replies you received to your questions! Please do NOT read too much into the very brief SVT or VT from a ZIO patch report. They tend to report all the utterly inconsequential micro blips of literally second in duration, and often what they report as ‘SVT’ that is often a good deal less than 30 seconds long, is just using a more generic label for ‘Supraventriculby Shannon - AFIBBERS FORUM
Hey, that’s a good omen Rich ... not that you need one at all! Have an enjoyable flight with the extra $1,200 padding your wallet. And you are number two of three to scheduled to see Dr Natale this week from Afibbers.org ... the first this week just had a successful minor touch up yesterday afternoon and was happy as a clam this morning. Cheers! Shannonby Shannon - AFIBBERS FORUM
Keep me posted AB on your TEE this week! Be well, Shannonby Shannon - AFIBBERS FORUM
Ha Pompom, and I inadvertently typed out my reply twice! :-)... When I had just about finished the first draft, I got wrapped up in a long distance call during which I promptly lost the first version ... or so I assumed ... until after recreating my second reply from scratch and then checking back many hours later only to find I had posted both versions of the same theme, unbeknownst to me. Chby Shannon - AFIBBERS FORUM