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Carey

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  1. Carey,  who is dr. Natalie.  I’m also,from New England. Just wondering who did your successful oblation

    1. Carey

      Carey

      Hi (got a name?),

      Dr. Andrea Natale (note the spelling) is among the top EPs in the world and is arguably THE best. Last I heard he's done over 11,000 afib ablations and pioneered many techniques and methods that are considered standard today. 

      He is Italian, and his name is not pronounced like the female name Natalie. It's pronounced ahn-DRAY-a  na-TAL-ay. He's the head of electrophysiology at the Texas Cardiac Arrhythmia Institute (TCAI) in Austin, TX. After 5 failed ablations I was finally convinced to go see him in 2017, so he's the one who did my one and only successful ablation. A year later he implanted my Watchman device. I remain completely afib and flutter-free to this day, not even PACs.

      I still kick myself for not going to him first. If I had to do it over again, I'd be in Austin without question. Sure, I had to travel, but that's an absolute nothing compared to living with afib and flutter for years and taking a bunch of dangerous drugs with lousy side effects.

      Natale sort of specializes in taking on the most difficult cases and has many patients from around the world, including a number of famous/wealthy people. But he also does first-time ablations on Joe Average. So they've got the out-of-town patient experience down pat. An ablation with him involves you flying to Austin and staying about 4 days. 

      If you want to pursue this I can get contact info for you and tell you how to get the ball rolling.

  2. Carey been away for quite some time, had two ablations that held for a long time but developed extra beats after Covid. Any way just had my third ablation last Friday and my numbers are up above where they were previously. Resting heart rate was in the 70,s with the extra beats, now I woke up this morning at mid eighties? Walking around the golf course today I was in the 90’s and 100’s? Is this normal?

    1. Carey

      Carey

      Yes, it is. Your resting heart rate will be elevated for probably quite some time, possibly up to a year. It's nothing to worry about as long as it remains below 100 when you're not active. It will eventually return back to your normal baseline rate. 

    2. (See 1 other reply to this status update)

  3. After going without any AFIB since my first event 7/17/19,  yesterday 8/7/20, I was just about to tee off on the first hole my local golf course, when I felt "something" .  I knew within a couple of minutes that my heart was in AFIB because my pulse was very erratic and high.  Had to leave the course to see if I could potentially settle down.  After about an hour, I went to the ER (which in our town is a huge COVID risk just to walk in) and fortunately was converted with an IV of metoprolol.  

    Can I just assume my regular golf activities again? or do I need to relax for a few days?  I currently take Losartan 50 mg for BP but that is it.  The EP that I went to last year for my echo cardiogram (which was normal) had referred me back to my regular  doctor for BP medication prI escription.  

    I have had a bit of work related stress lately and been drinking a lot of decaf coffee (which I guess is still very dehydrating) and I am, admittedly a Type A personality that has trouble relaxing.  Always on the go.  What next?  Do I go back to the EP ?  

    I walk 45 minutes daily up hills etc with my dog and play golf about 4 times/week.  I want to keep up my activity but I am wondering if I need to rest for awhile after this recent AFIB?  Of course, I was hoping I would never get it again. 

    The ER doc prescribed 12.5 mg metoprolol until I see my regular doctor due to the ER visit.  I feel fine today, except I notice the metoprolol is making me a bit tired.  

    I am thinking that my BP meds were not lowering my diastolic enough.  It was really never under 80-85.

    Any thoughts?  I am bummed that this event happened out of the blue and all I can think of as a trigger is that I had been running from one thing to the next for a couple of days.  I seriously need to learn how to meditate or something !

     

     

    Hi Carey,

    I would value your opinion on this for me:  

    So, after much research (mostly from this Forum and attending the Stop Afib Conference in October)    I cautiously & "courageously"  had my ablation for afib/aflutter on January 13, 2021.  The EP  was in Seattle at Virginia Mason Hospital  (MD, FACC, FHRS   -  Section Head, Cardiology and Medical Director, Electrophysiology & Medical Director, Regional Clinicians)   He's been there since 1986 and is considered to be one Seattle's Best.   I was confident in his experience and his team.  The procedure went "great"  (CRYO for the afib & RF for the flutter)  I was very careful with the groin incision and it healed perfectly. 

     So far, in the past 30 days, I have been afib-free and been getting lots of rest so that my heart can heal (was told it takes 2 months)  Here is my question:   I was not taking any rhythm control meds prior to the ablation (I was only taking losartan, metoprolol (12.5) and Eliquis.    The morning after the procedure I was visited by the EP and the PA to discuss my not wanting to take any rhythm control drugs after the ablation.  My thinking was that I had not taken any beforehand, and my whole point of having an ablation was to do it early so as to avoid taking rhythm control meds.  The EP and I came to an agreement that I would take Amiodarone for one month only (he had wanted to prescribe 2 months)  post ablation.  (he prescribed 400 mg for the first 7 days and then 200 mg for the next 24 days)   After reading up on Amiodarone, when I got home, I decided to take the first week dose as prescribed, but then I cut the 200 mg pills in half and have taken only 100 mg for the past month)     

    Now that time is up (of taking the 100 mg for 24 days) and I can discontinue or continue on for the next month with the 100 mg dose by cutting those 200's in half, as I've been doing.   I am just trying to avoid many of the dreadful, horrific side effects I have read about from the use of this drug. 

    Thanks for reading!

    sous

     

    1. Carey

      Carey

      Sounds good. Good luck and let me know how it goes.

    2. (See 6 other replies to this status update)

  4. After going without any AFIB since my first event 7/17/19,  yesterday 8/7/20, I was just about to tee off on the first hole my local golf course, when I felt "something" .  I knew within a couple of minutes that my heart was in AFIB because my pulse was very erratic and high.  Had to leave the course to see if I could potentially settle down.  After about an hour, I went to the ER (which in our town is a huge COVID risk just to walk in) and fortunately was converted with an IV of metoprolol.  

    Can I just assume my regular golf activities again? or do I need to relax for a few days?  I currently take Losartan 50 mg for BP but that is it.  The EP that I went to last year for my echo cardiogram (which was normal) had referred me back to my regular  doctor for BP medication prI escription.  

    I have had a bit of work related stress lately and been drinking a lot of decaf coffee (which I guess is still very dehydrating) and I am, admittedly a Type A personality that has trouble relaxing.  Always on the go.  What next?  Do I go back to the EP ?  

    I walk 45 minutes daily up hills etc with my dog and play golf about 4 times/week.  I want to keep up my activity but I am wondering if I need to rest for awhile after this recent AFIB?  Of course, I was hoping I would never get it again. 

    The ER doc prescribed 12.5 mg metoprolol until I see my regular doctor due to the ER visit.  I feel fine today, except I notice the metoprolol is making me a bit tired.  

    I am thinking that my BP meds were not lowering my diastolic enough.  It was really never under 80-85.

    Any thoughts?  I am bummed that this event happened out of the blue and all I can think of as a trigger is that I had been running from one thing to the next for a couple of days.  I seriously need to learn how to meditate or something !

     

     

    Hi Carey,

    I would value your opinion on this for me:  

    So, after much research (mostly from this Forum and attending the Stop Afib Conference in October)    I cautiously & "courageously"  had my ablation for afib/aflutter on January 13, 2021.  The EP  was in Seattle at Virginia Mason Hospital  (MD, FACC, FHRS   -  Section Head, Cardiology and Medical Director, Electrophysiology & Medical Director, Regional Clinicians)   He's been there since 1986 and is considered to be one Seattle's Best.   I was confident in his experience and his team.  The procedure went "great"  (CRYO for the afib & RF for the flutter)  I was very careful with the groin incision and it healed perfectly. 

     So far, in the past 30 days, I have been afib-free and been getting lots of rest so that my heart can heal (was told it takes 2 months)  Here is my question:   I was not taking any rhythm control meds prior to the ablation (I was only taking losartan, metoprolol (12.5) and Eliquis.    The morning after the procedure I was visited by the EP and the PA to discuss my not wanting to take any rhythm control drugs after the ablation.  My thinking was that I had not taken any beforehand, and my whole point of having an ablation was to do it early so as to avoid taking rhythm control meds.  The EP and I came to an agreement that I would take Amiodarone for one month only (he had wanted to prescribe 2 months)  post ablation.  (he prescribed 400 mg for the first 7 days and then 200 mg for the next 24 days)   After reading up on Amiodarone, when I got home, I decided to take the first week dose as prescribed, but then I cut the 200 mg pills in half and have taken only 100 mg for the past month)     

    Now that time is up (of taking the 100 mg for 24 days) and I can discontinue or continue on for the next month with the 100 mg dose by cutting those 200's in half, as I've been doing.   I am just trying to avoid many of the dreadful, horrific side effects I have read about from the use of this drug. 

    Thanks for reading!

    sous

     

    1. Carey

      Carey

      The epinephrine in novocaine shouldn't set off afib. After all, you've had an ablation, and if it's fully successful then you can just stop worrying about triggers. They won't matter anymore. All the epi will do is increase your heart rate a bit, but if it worries you then you can ask for the epi-free novocaine. 

      As for the diminished heart beats, that may be the amiodarone. I've never heard anyone describe that following an ablation.

    2. (See 6 other replies to this status update)

  5. After going without any AFIB since my first event 7/17/19,  yesterday 8/7/20, I was just about to tee off on the first hole my local golf course, when I felt "something" .  I knew within a couple of minutes that my heart was in AFIB because my pulse was very erratic and high.  Had to leave the course to see if I could potentially settle down.  After about an hour, I went to the ER (which in our town is a huge COVID risk just to walk in) and fortunately was converted with an IV of metoprolol.  

    Can I just assume my regular golf activities again? or do I need to relax for a few days?  I currently take Losartan 50 mg for BP but that is it.  The EP that I went to last year for my echo cardiogram (which was normal) had referred me back to my regular  doctor for BP medication prI escription.  

    I have had a bit of work related stress lately and been drinking a lot of decaf coffee (which I guess is still very dehydrating) and I am, admittedly a Type A personality that has trouble relaxing.  Always on the go.  What next?  Do I go back to the EP ?  

    I walk 45 minutes daily up hills etc with my dog and play golf about 4 times/week.  I want to keep up my activity but I am wondering if I need to rest for awhile after this recent AFIB?  Of course, I was hoping I would never get it again. 

    The ER doc prescribed 12.5 mg metoprolol until I see my regular doctor due to the ER visit.  I feel fine today, except I notice the metoprolol is making me a bit tired.  

    I am thinking that my BP meds were not lowering my diastolic enough.  It was really never under 80-85.

    Any thoughts?  I am bummed that this event happened out of the blue and all I can think of as a trigger is that I had been running from one thing to the next for a couple of days.  I seriously need to learn how to meditate or something !

     

     

    Hi Carey,

    I would value your opinion on this for me:  

    So, after much research (mostly from this Forum and attending the Stop Afib Conference in October)    I cautiously & "courageously"  had my ablation for afib/aflutter on January 13, 2021.  The EP  was in Seattle at Virginia Mason Hospital  (MD, FACC, FHRS   -  Section Head, Cardiology and Medical Director, Electrophysiology & Medical Director, Regional Clinicians)   He's been there since 1986 and is considered to be one Seattle's Best.   I was confident in his experience and his team.  The procedure went "great"  (CRYO for the afib & RF for the flutter)  I was very careful with the groin incision and it healed perfectly. 

     So far, in the past 30 days, I have been afib-free and been getting lots of rest so that my heart can heal (was told it takes 2 months)  Here is my question:   I was not taking any rhythm control meds prior to the ablation (I was only taking losartan, metoprolol (12.5) and Eliquis.    The morning after the procedure I was visited by the EP and the PA to discuss my not wanting to take any rhythm control drugs after the ablation.  My thinking was that I had not taken any beforehand, and my whole point of having an ablation was to do it early so as to avoid taking rhythm control meds.  The EP and I came to an agreement that I would take Amiodarone for one month only (he had wanted to prescribe 2 months)  post ablation.  (he prescribed 400 mg for the first 7 days and then 200 mg for the next 24 days)   After reading up on Amiodarone, when I got home, I decided to take the first week dose as prescribed, but then I cut the 200 mg pills in half and have taken only 100 mg for the past month)     

    Now that time is up (of taking the 100 mg for 24 days) and I can discontinue or continue on for the next month with the 100 mg dose by cutting those 200's in half, as I've been doing.   I am just trying to avoid many of the dreadful, horrific side effects I have read about from the use of this drug. 

    Thanks for reading!

    sous

     

    1. Carey

      Carey

      Hi ksous, I'm going to have to re-read everything you've written and what I replied to answer your question because it's been over a week since we discussed all this. I'll try to get back to you tomorrow, and if I do could you please respond within a day or two? 

    2. (See 6 other replies to this status update)

  6. After going without any AFIB since my first event 7/17/19,  yesterday 8/7/20, I was just about to tee off on the first hole my local golf course, when I felt "something" .  I knew within a couple of minutes that my heart was in AFIB because my pulse was very erratic and high.  Had to leave the course to see if I could potentially settle down.  After about an hour, I went to the ER (which in our town is a huge COVID risk just to walk in) and fortunately was converted with an IV of metoprolol.  

    Can I just assume my regular golf activities again? or do I need to relax for a few days?  I currently take Losartan 50 mg for BP but that is it.  The EP that I went to last year for my echo cardiogram (which was normal) had referred me back to my regular  doctor for BP medication prI escription.  

    I have had a bit of work related stress lately and been drinking a lot of decaf coffee (which I guess is still very dehydrating) and I am, admittedly a Type A personality that has trouble relaxing.  Always on the go.  What next?  Do I go back to the EP ?  

    I walk 45 minutes daily up hills etc with my dog and play golf about 4 times/week.  I want to keep up my activity but I am wondering if I need to rest for awhile after this recent AFIB?  Of course, I was hoping I would never get it again. 

    The ER doc prescribed 12.5 mg metoprolol until I see my regular doctor due to the ER visit.  I feel fine today, except I notice the metoprolol is making me a bit tired.  

    I am thinking that my BP meds were not lowering my diastolic enough.  It was really never under 80-85.

    Any thoughts?  I am bummed that this event happened out of the blue and all I can think of as a trigger is that I had been running from one thing to the next for a couple of days.  I seriously need to learn how to meditate or something !

     

     

    Hi Carey,

    I would value your opinion on this for me:  

    So, after much research (mostly from this Forum and attending the Stop Afib Conference in October)    I cautiously & "courageously"  had my ablation for afib/aflutter on January 13, 2021.  The EP  was in Seattle at Virginia Mason Hospital  (MD, FACC, FHRS   -  Section Head, Cardiology and Medical Director, Electrophysiology & Medical Director, Regional Clinicians)   He's been there since 1986 and is considered to be one Seattle's Best.   I was confident in his experience and his team.  The procedure went "great"  (CRYO for the afib & RF for the flutter)  I was very careful with the groin incision and it healed perfectly. 

     So far, in the past 30 days, I have been afib-free and been getting lots of rest so that my heart can heal (was told it takes 2 months)  Here is my question:   I was not taking any rhythm control meds prior to the ablation (I was only taking losartan, metoprolol (12.5) and Eliquis.    The morning after the procedure I was visited by the EP and the PA to discuss my not wanting to take any rhythm control drugs after the ablation.  My thinking was that I had not taken any beforehand, and my whole point of having an ablation was to do it early so as to avoid taking rhythm control meds.  The EP and I came to an agreement that I would take Amiodarone for one month only (he had wanted to prescribe 2 months)  post ablation.  (he prescribed 400 mg for the first 7 days and then 200 mg for the next 24 days)   After reading up on Amiodarone, when I got home, I decided to take the first week dose as prescribed, but then I cut the 200 mg pills in half and have taken only 100 mg for the past month)     

    Now that time is up (of taking the 100 mg for 24 days) and I can discontinue or continue on for the next month with the 100 mg dose by cutting those 200's in half, as I've been doing.   I am just trying to avoid many of the dreadful, horrific side effects I have read about from the use of this drug. 

    Thanks for reading!

    sous

     

    1. Carey

      Carey

      Hi Sous,

      By all means go play golf again! It had nothing to do with your AF episode and an ablation is no reason to restrict reasonable physical exercise. If you experience another AF episode, it will occur at a random time. AF starts and stops when it wants and it usually has nothing whatsoever to do with what you were doing at the time, what you had to eat or drink, etc. People put way too much stock in the idea of "triggers."

      Being a couch potato does NOT rest your heart as people think. In fact, sitting around being sedentary is the worst thing you can do for a healing heart (or any organ, really). Your heart needs exercise and benefits from it, even in the days and weeks following an ablation. Ask anyone who's been through cardiac rehab for something far more serious such as a heart attack or chest surgery, and they'll tell you the doctors had them up and moving by the next day, and doing more intensive exercise than golf just days later. A bitter lesson learned by medicine in the 20th century is that the old prescriptions for bedrest and prohibitions on exercise were absolutely the wrong thing to do.

      Activity leads to health, idleness leads to sickness.

      As for the amio, I think that's a bigger cannon than needed after an ablation and a milder antiarrhythmic would have been a better choice, but some EPs like it for the reason that's it's extremely effective. And who am I to question them? He's the doc, not me. But as long as you keep the time you're on it short, it shouldn't do you any harm. When can you stop it? You know, that's really up to you. The worst case scenario if you stop it is you go back into AF. If that happens, you resume the amio and try again a month later. No harm, no foul. That's how I got off Multaq 3 weeks after my ablation rather than the 2 months Natale wanted me on it. And he had no problem with me doing that. He said, "Go ahead and try it. It it doesn't work, you can just resume taking it."

       

    2. (See 6 other replies to this status update)

  7. Hi Carey, I need to learn how to get back on board. Can u help me please? 

     

     

    1. Carey

      Carey

      I see you posted but you said you're having trouble doing so. I can help you with this but I think we need to have a phone conversation to do it. I'd be happy to help you with this. Just give me a phone number, your time zone, and a good time for me to call.

    2. (See 5 other replies to this status update)

  8. Hi Carey, I need to learn how to get back on board. Can u help me please? 

     

     

    1. Carey

      Carey

      No one is blocking you. The fact that you can send me messages is proof of that. 

      Try clicking this https://forum.stopafib.org/index.php?/forum/21-afib-forum-general-discussion/

      That should take you to the General Discussion forum where the thread you started is the most recent one. Let me know if that works for you. 

    2. (See 5 other replies to this status update)

  9. Hi Carey, I need to learn how to get back on board. Can u help me please? 

     

     

    1. Carey

      Carey

      Yeah, you posted just fine. You've already got lots of welcome backs. 

      Sorry about the stroke but glad there's minimal impairment. 

    2. (See 5 other replies to this status update)

  10. Hi Carey, I need to learn how to get back on board. Can u help me please? 

     

     

    1. Carey

      Carey

      Whoa! Look who's here! I was seriously worried about you not showing up for months and not responding to my messages. Glad to see you back, buddy! I hope you're well. 

      Since you sent me a message, you must have logged on successfully. What is it you're having trouble with? Are you looking for the forums? If so, you can find them by clicking this https://forum.stopafib.org

    2. (See 5 other replies to this status update)

  11. Just had my second ablation yesterday to fix atrial flutter. Dr said it went well so we will see. Definitely feeling it today but I’m sure better tomorrow. Thanks for all your help in the past, you’re a great resource and give me great info that I can follow up on. Again thx.

    1. Carey

      Carey

      Good to hear. I hope all goes well and this fixes the problem once and for all. Let me know how it goes, okay? And glad I could help a little. 

  12. Dear Carey.  Thank you for reading my "blog" , and for your advice for me to change location to "general topic".  I have done so.  Curious, having seen my over view......do you think I have been set on a reasonable course/plan.  I know you have amassed a lot of information re A-Fib.  I do feel very vulnerable about my A Fib. - just seems to take ages to make any progress.  Received a letter asking me to attend Cardiac clinic on 1st July. -for ECG, and update with a CCU nurse specialist.     Ed. 

    1. Carey

      Carey

      I would attend the cardiac clinic if I were you. The care you're receiving so far sounds pretty standard for the NHS, which means they're taking a very conservative approach and moving slowly. I don't think there's much you can do to speed things along unless you go private and pay out of pocket. The one thing I would suggest is asking if they can switch you off the digoxin and onto something else. Digoxin is a poor choice of meds for afib. 

  13. How do I update info that is on bottom of posts ? I need to update . Thanks, Didi

  14. Hi Carey

    im a midnight RN

    you should be sleeping

     

    1. Carey

      Carey

      LOL... I'm an incurable night owl.

  15. Hi Carey,

    I haven't researched the issue at all.  Your LVEF is marvelous.  Is there a connection between FIB/AFL and damage to the ejection fraction?  I would think not unless the blood circulation is extensively poor and/or the FIB/AFL has been present for many many years.  Your thoughts?

    Rob

    1. Carey

      Carey

      I think you must be confusing my EF with Baba's. She's the one with the 69%. Mine is more like 60%. Pretty good, but nothing like hers, which is fantastic.

      At least during an AF/AFL episode I would bet EF is reduced, but unless you've gone without treatment for so long that you're experiencing heart failure from it, I doubt that AF/AFL have much effect on EF.

       

    2. (See 1 other reply to this status update)

  16. Carey: I believe your thorough experience with potassium and afib needs to be disseminated. My suggestion would be either a single case report of your experience or probably, easier and perhaps better, a letter to the editor in one of the medical journals. As you probably know, the letters are not usually peer reviewed and are more readily accepted. I would suggest the NEJM (go for the gold) for the letter or perhaps one of the emergency medicine journals or perhaps the J of Clinical Cardiology. My thought is that some enthusiastic Resident or Post grad Fellow will hone in and pursue a larger group to study and the issue will gain acceptance. There is nothing an ER  doc would love is to see than an afib patient role in  and  be able to start an IV with D10W and 80 mEq KCl (after appropriate renal function tests show normal kidney function) and discharge the patient "cured"  after several hours. They need something in the literature to back that approach up. It could be called the Carey method or something like that. Do it. Good luck. And I appreciate your posts

    1. Carey

      Carey

      Funny you would suggest that. You're not the first to do so. I do need to put this down on paper if for no other reason than it gets tiresome repeating it, and having it published in a journal indeed would be nice to see. The timing might also be good with results from the Swedish trial expected in 2017.

       

       

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