“The US Food and Drug Administration (FDA) is informing healthcare providers of potential differences in procedural outcomes between men and women undergoing transcatheter left atrial appendage occlusion (LAAO).” But they are not withdrawing approval: “Currently, the FDA believes the benefits continue to outweigh the risks for approved LAAO devices when used in accordance with their instrby David_L - AFIBBERS FORUM
QuotePixie Carey, thank you for the thorough explanation. The article was written by John Mandrola and that did put up a red flag for me. Is the rebuttal written by Shannon one of the comments to the article? No, I linked to Shannon's article directly so maybe you didn't notice the link. Here it is again https://www.medscape.com/viewarticle/853571by Carey - AFIBBERS FORUM
Carey, thank you for the thorough explanation. The article was written by John Mandrola and that did put up a red flag for me. Is the rebuttal written by Shannon one of the comments to the article?by Pixie - AFIBBERS FORUM
QuotePixie I am so confused about this. Can the LAA be ablated or is a closure done and no ablation is involved? Is it always necessary to have a watchman implanted if you have an LAA procedure? The LAA can be ablated. Mine was, and there are others in this group who also had theirs ablated. If the LAA is a source of afib or flutter, simply closing it would make you safer from strokes but itby Carey - AFIBBERS FORUM
QuoteRobbiecriss I have read conflicting data on drinking caffeine and afib. Some have said it is a trigger and others say while it may exacerbate pac or pvc activity it is not an afib determinant. Anyone here have any advice or clear guidance. I must admit I do love my one cup of coffee or tea each day. Thanks in advance for your insights. I had an afib ablation three years ago and have not hadby GeorgeN - AFIBBERS FORUM
QuotePomponI didn't know both my parents were afibbers. They even didn't know themselves! In their cases, it'd been diagnosed after a stroke. They were active, but nothing like athletes. My father was one of the least active people I've known. To my knowledge, he never had afib. Both of his brothers did, however. They had obesity and not very active. Onset was later in aby GeorgeN - AFIBBERS FORUM
QuotePompon I know that "too much exercise" can be bad. The fact is we're not equal and "too much" for one may be "nearly negligible" for the other. So, "too much" can obviously damage the heart (as often described) and lead to arrhythmias. OTOH, "too much" can be far from what is usually described as "excessive". In my case,by GeorgeN - AFIBBERS FORUM
QuoteNotLyingAboutMyAfib # 1 - Is this a good book? Too much exercise can kill you. The Haywire Heart is the first book to examine heart conditions in athletes. Intended for anyone who competes in endurance sports like cycling, triathlon, running races of all distances, and cross-country skiing, The Haywire Heart presents the evidence that going too hard or too long can damage your heaby GeorgeN - AFIBBERS FORUM
QuoteGeorgeN One tip I got from a Mandrola article years ago was to be quiet (i.e. inactive) after taking PIP flec to reduced the risk of flutter. I Zinn & I were going to talk in 2015 as I live ~30 minutes from him. He was early in his afib journey. Because of our schedules, it never happened. He did connect with EP John Mandrola to write the book (which I've not read). Mandrola,by susan.d - AFIBBERS FORUM
Zinn & I were going to talk in 2015 as I live ~30 minutes from him. He was early in his afib journey. Because of our schedules, it never happened. He did connect with EP John Mandrola to write the book (which I've not read). Mandrola, also a cyclist, got to experience afib personally. One tip I got from a Mandrola article years ago was to be quiet (i.e. inactive) after taking PIPby GeorgeN - AFIBBERS FORUM
# 1 - Is this a good book? Too much exercise can kill you. The Haywire Heart is the first book to examine heart conditions in athletes. Intended for anyone who competes in endurance sports like cycling, triathlon, running races of all distances, and cross-country skiing, The Haywire Heart presents the evidence that going too hard or too long can damage your heart forever. # 2 - Aby NotLyingAboutMyAfib - AFIBBERS FORUM
In terms of competing or hard exercise during afib, question I ask, "is it optimal?" During my 2 1/2 month episode 16 years ago, I did everything I'd always done. Later, I decided it was likely suboptimal for me long term and took it easy during episodes. I was concerned it would accelerate fibrosis and remodeling. I also never take a beta blocker with PIP flec. At one pointby GeorgeN - AFIBBERS FORUM
Yep, I think dehydration and the electrolyte imbalances it causes is a universal trigger that affects virtually everyone. It's really underappreciated even by EPs. Several years ago when I read about John Mandrola's single AF episode the first thought that came to my mind was that he was seriously dehydrated. A hot humid day, two hours on the bike, he's feeling "hot, sweaty anby Carey - AFIBBERS FORUM
Was the Natale/Mandrola discussion at the AF symposium recorded?by Leo J - AFIBBERS FORUM
As best I can tell, Mandrola has had precisely one afib episode, years ago, and that was during a bike ride when he very well could have been dehydrated and had electrolytes out of whack. As we all know, electrolyte imbalances can cause afib episodes even in people who don't actually have afib.by Carey - AFIBBERS FORUM
Quoteallofus Dr. M should get an ablation with Natale. It would improve their relationship, plus he'd probably feel a lot better, too. hahahaha exactly!by fravi - AFIBBERS FORUM
Dr. M should get an ablation with Natale. It would improve their relationship, plus he'd probably feel a lot better, too.by allofus - AFIBBERS FORUM
QuoteGeorgeN Years ago, I used to read Dr. M's stuff. He was and may still be an avid cyclocross rider. He ended up in afib (2012?) and, as I recall, his wife (an ER MD) gave him flec. Hence he should be well aware of exercise as a trigger for afib. In fact, he coauthored a book about exercise (too much) and afib with Lennard Zinn. I've not read it. I corresponded with Zinn at onby rocketritch - AFIBBERS FORUM
Years ago, I used to read Dr. M's stuff. He was and may still be an avid cyclocross rider. He ended up in afib (2012?) and, as I recall, his wife (an ER MD) gave him flec. Hence he should be well aware of exercise as a trigger for afib. In fact, he coauthored a book about exercise (too much) and afib with Lennard Zinn. I've not read it. I corresponded with Zinn at one point and tby GeorgeN - AFIBBERS FORUM
We're going to have to agree to disagree. I wouldn't have a problem with him if he wrote in medical journals where the audience is going to be other EPs, but he doesn't. He writes on WebMD where the audience is primarily patients and the ability of other EPs to dispute or correct him is very limited. Every time he writes a new article I know I'm going to see scared patientby Carey - AFIBBERS FORUM
QuoteCarey He has repeatedly written articles and made statements on twitter that demonstrate a less than thorough understanding of his subjects. I have read plenty of his material, and he has a stronger grasp of inferential statistics in epidemiology as it applies to heart disease than many EP's. That doesn't mean he is always correct, but it says a lot. In any case, you have mischby safib - AFIBBERS FORUM
Quotesafib Also, adversarial opinions with a factual basis are a good thing. Of course, but maybe you should go read Shannon's rebuttal before you conclude how much of a factual basis Mandrola operates on. He has repeatedly written articles and made statements on twitter that demonstrate a less than thorough understanding of his subjects.by Carey - AFIBBERS FORUM
QuoteCarey Mandrola seems more interested in recent years in building a following on WebMD by writing adversarial opinions. To hear him tell it, ablations are bad, LAA isolation is bad, isolating the posterior wall is bad, LAA occlusion devices (eg, Watchman) are bad. In fact, to hear him tell it, afib is your fault for leading a bad lifestyle and if you'd just lose weight, eat right, andby safib - AFIBBERS FORUM
QuoteGeorgeN "lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib." This is interesting as 3 of the 4 people I know personally with afib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's. I don't doubt it can be controlled with extreme adherence toby rocketritch - AFIBBERS FORUM
Looks like we have a lot to learn about genetics and epigenetics before we can claim what an optimal diet is for any individual? On a population basis an optimal diet prescription is easier - no or minimal refined sugar/carbs especially in combination with fats. If on a high carb diet then minimize fats. Eat what maintains a healthy gut-biom. Maintain a steady low blood glucose level. Exerciseby Joe - AFIBBERS FORUM
Quoterocketritch "lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib." This is interesting as 3 of the 4 people I know personally with afib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's. I don't doubt it can be controlled with extreme adherence tby GeorgeN - AFIBBERS FORUM
You know, I was going to mention that but I thought it might seem prejudicial. When a widely-known EP gets slam dunked by a non-physician in a published rebuttal, it's a pretty sure fire bet that EP isn't who you should be listening to.by Carey - AFIBBERS FORUM
Dr. John has been rebutted in a medical journal by our own moderator here. That should tell you something.by wolfpack - AFIBBERS FORUM
"lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib." This is interesting as 3 of the 4 people I know personally with affib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's. I don't doubt it can be controlled with extreme adherence to diet, suplimenby rocketritch - AFIBBERS FORUM