I was diagnosed with afib at 27. I am 33 now. I have also always been healthy and into exercising. Never been overweight. I am on daily flecainide and metropolol and for the most part I don’t get any afib at all (i was in afib 14% of the time when I was diagnosed according to the holter monitor). I get loud palpitations quite a bit but it feels to be in NSR. Aside from making sleep difficult someby Will1789 - AFIBBERS FORUM
Atrial fibrillation begets more of it. So, I tend to favor getting it under control sooner than later, and that means medication...for now. But the most durable intervention, and that's ablation usually, should be undertaken sooner rather than when and as the disorder gains ground on you. Get that ball rolling, and meanwhile you can enjoy less stress and more normalcy with your heart in NSRby gloaming - AFIBBERS FORUM
Brian, First of all, your worry about going into persistent is not evidence based. Wherever you heard "24 hours" is simply wrong. It would take many months in afib 24/7 before you got to that point. I get that you want a one and done with the best possible method, but I think you're over estimating how successful ablations are. They could be a one and done, but often just thby mjamesone - AFIBBERS FORUM
Just personal history: I took antiarrythmics for 6 years, requiring increasing doses which meant more side-effects until I finally got a very serious side-effect from the high dose. The meds became less effective until by the time my ablation came around I was getting episodes most every day. By that time I had become a complicated case requiring an extensive ablation including LAA isolation. Theby Daisy - AFIBBERS FORUM
QuoteBrian Also, with regards to persistent Afib, I had heard elsewhere that being in Afib after "24 hours" will cause the ablation to be that much less effective, being after that time, it already caused enough structural/substrate change to the heart. That's not true. Remodeling happens over weeks and months, not hours. One 24-hour episode of afib won't change your chancesby Carey - AFIBBERS FORUM
Thank you all for the replies and insight: Replying to mjamesone: The plan to see if medications can stop my afib/pacs/allow me to get back to life is definitely an option. And thank you for for the insight truly. I just however read some new articles "EARLY AF" by Dr. Jason Andrade, claiming that while successful ablations have data that show it can "halt" the progressiby Brian - AFIBBERS FORUM
The majority of people who get an ablation use whatever EP they happen to find or whatever EP the country's health service assigns, they undergo a single PVI-only procedure, and that's it. They're done and afib-free. I don't know how to describe such patients other than "simple cases." These are the people who make cryo look good. Granted, you can't know in advaby Carey - AFIBBERS FORUM
Hi Brian, Read all your posts and I think maybe you should step back for moment and decide whether or not getting an ablation now is the best course of action. When my afib started acting up the way yours is now -- several time a month -- I went on a course of daily Flecainide, an anti-arrhythmic. It stopped my afib episodes, stopped my PACs and allowed me to carry on normally. The main reaby mjamesone - AFIBBERS FORUM
I don't think paying for Natale is cost effective. Verma has a lot of experience and you're a simple case, so paying $45K in "insurance" is a bit over the top. Very unlikely he'll make anything worse. If the Verma ablation doesn't prove successful THEN go see Natale. Pierre Jais probably is the best in Bordeaux, but I don't think he's better than Nataleby Carey - AFIBBERS FORUM
Thank you for the replies. Would you say I should just suck it up and pay the $ for an ablation that can give me the highest chance of success and an ablation that will be the longest lasting? I'm scared that going to Dr. Atul Verma for the reason to save a buck will leave me regretting if I have an ablation that didn't work or made things worse. Is Pierre Jais the best in Bordby Brian - AFIBBERS FORUM
Some thoughts on these choices.... Now that PFA has been approved in the US by the FDA, I would expect Natale to use PFA where appropriate since he's highly experienced with it. Not sure about the others, but I don't believe it's approved in Canada yet. I don't believe your numbers for Natale's annual number of ablations can be right since he does more in Texas thaby Carey - AFIBBERS FORUM
If Dr. Atul Verma is free, get him to do your ablation after all he has done 8000 of them. You've got to get good after 8000, I would think.by colindo - AFIBBERS FORUM
Hello, I am from Canada and I am still debating which doctor to perform my ablation. In Canada it is Free, but I am debating whether to travel to Bordeaux or USA for Pierre Jais or Andrea Natale. Is Pierre Jais the best at Bordeaux? Would you say its neccessary for my Afib, (24 years old, Paroxysmal Afib, Longest Episode 12 hours, 2 years since Diagnosis, Most likely only need PVI) or would you sby Brian - AFIBBERS FORUM
Expanding my thoughts on Verma vs. Natale. With Verma, you are getting a very good EP. This should be good for your index (first) ablation, which may be all it takes. Natale normally reserves work on isolating the left atrial appendage (LAA) till ablation #2 as LAA isolation has a 60% risk of requiring lifetime anticoagulation or placement of a Watchman device (or similar) - LAA isolation isn&by GeorgeN - AFIBBERS FORUM
Hi Brian, First, on Verma. I've never had an ablation (and I live in the US), but have been on this board for 19.5 years, so am relating what I recall. Here is a search on the terms Verma ablation, so you can see what others have said. On flec vs ECV in the hospital. I've never had an ECV and I've used flec as PIP for 19 years. My use has generally been infrequent, but hby GeorgeN - AFIBBERS FORUM
Thank you everyone for the replies. GENERAL QUESTION TO ALL: Just a weird question, and I am sorry to ask. I have a fiancee and sexual activity was a big trigger to my PAC’s, leading to Afib, so I had completely stopped having any sexual activity, fearing it will worsen my disease. This has greatly affected my relationship with my fiancee and we are just in our early 20’s… Can I take any adviby Brian - AFIBBERS FORUM
Hello, I am a 24 year old male living in Vancouver BC, Canada. I have had symptomatic paroxysmal a-fib since 2022, and I am a professional weight lifter and boxer, so you can imagine how much it has affected my athletic career. (Exercise is a big afib/PAC trigger for me). I feel that each time I get an episode now, it lengthens every time greatly. I fear that my next episode will last over 12-24by Brian - AFIBBERS FORUM
I know Dr. Natale is the most recommended EP here on this forum. But I'm in Canada and for financial reasons, I really need to stay within my health system. So I've been trying to find the best in Canada. Specifically, one that will be on the cutting edge for pulsed field ablation. Who I'm considering is Dr Atul Verma at Mcgill (7 hour drive for me). He did a previous PFA trialby SamIAm - AFIBBERS FORUM
I'm wondering if anyone here knows if there are any electrophysiologists in Canada that are doing pulsed field ablation yet. Dr Atul Verma was doing it for a while, but looks like he has stopped working now...by SamIAm - AFIBBERS FORUM
A family member with AFib needs an ablation and is very interested the PFA procedure. We are aware that although PFA catheter systems by Medtronic and Boston Scientific have been approved for use in Europe, no PFA devices have yet been approved by the FDA for use in the U.S. We are looking for a clinical trial that my AFibber could possibly join. There is a PFA study listed on ClinicalTrials.gby Rothko - AFIBBERS FORUM
I will definitely be inquiring about the possibility of having Dr. Verma perform my ablation, if I choose to go that route. I do have another question. Is it possible for premature ventricular contractions to precede the development of atrial fibrillation? I'm curious, because apparently I have them.by Kev - AFIBBERS FORUM
QuoteKev My cardiologist has told me to head to the ER when I'm having an episode and get cardioverted; the less time I'm in AFib the better he says—I'm assuming he knows what he's talking about lol. While the less time in afib the better is correct. Cardioversion several times a month as a long term strategy is not. I recall 17 years ago, during my 2 1/2 month episode, thby GeorgeN - AFIBBERS FORUM
QuoteLorraine After 2 days of heavenly NSR, I went back into Afib a few hours ago and my HR has shot back up fluctuating between 109-136 on last 3 readings. Systolic BP is high too at 150. Damn! The only good news today is that the chest soreness has subsided a bit. I've talked to someone on Verma's team in Newmarket. Instructions are to increase the amiordarone from 100 mg BID to 200 mby The Anti-Fib - AFIBBERS FORUM
After 2 days of heavenly NSR, I went back into Afib a few hours ago and my HR has shot back up fluctuating between 109-136 on last 3 readings. Systolic BP is high too at 150. Damn! The only good news today is that the chest soreness has subsided a bit. I've talked to someone on Verma's team in Newmarket. Instructions are to increase the amiordarone from 100 mg BID to 200 mg BID for 2 weby Lorraine - AFIBBERS FORUM
QuoteLorraine Wow. What a scary time. I admire your calmness. Did the ablation itself cause this? I may sound calm now, but believe me I was quite anxious and stressed out during the worst of it. Thank goodness I had Shannon for support. No idea if the ablation caused this, but I suspect so. Dr Verma said it can happen sometimes. Lorraine Well, I'm hoping that it's smooby katesshadow - AFIBBERS FORUM
Quotekatesshadow Wow. What a scary time. I admire your calmness. Did the ablation itself cause this? I may sound calm now, but believe me I was quite anxious and stressed out during the worst of it. Thank goodness I had Shannon for support. No idea if the ablation caused this, but I suspect so. Dr Verma said it can happen sometimes. Lorraineby Lorraine - AFIBBERS FORUM
Lorainne, So sorry to hear of your traumatic experience, but happy to know it seems to be resolving. Yahoo, indeed! It's wonderful that Shannon was able to get in touch with Drs. Natale and Verma for you. I remember when I was first in afib, I was sent to a cardiologist at UC San Diego. She was a specialist in pacemakers. Guess what her recommendation was? Right, a pacemaker, which hadby ln108 - 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
Well, afibbers, to say this has been an eventful couple of weeks for me is an understatement. This is going to be a long post, but hopefully it will be of interest to some of you on this forum. Background: Twelve years ago I was diagnosed with paroxysmal atrial fibrillation. In the beginning, episodes were quite infrequent. However, because of my worsening condition (this year I have been inby Lorraine - 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