Carey
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Posts posted by Carey
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I've been on Tikosyn as have several others here. It's usually an effective drug and it becomes more effective the longer you take it. Assuming you're able to take it at all, which that 3-day hospital stay will determine, the side effects are usually few to none (I experienced none). Its biggest drawbacks are the hospital stay and it tends to be expensive. You should look it up on your insurance plan and make sure you'll be able to afford it.
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I've done both procedures multiple times and there's really nothing to be afraid of. An ablation isn't a terrifying experience at all, and a cardioversion is a total nothing.
As for going home the same day, that would be unusual but it is done sometimes with cryo ablations. Is that the type of ablation your EP has in mind?
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3 hours ago, mailman52 said:
I don't remember the removal of the sheaths being a fun experience.
The two nurses applying direct pressure is even less fun, but thoughtful EPs do both before waking you up.
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Nothing even remotely similar between the two.
A cardioversion takes minutes and there are no catheters inside your heart. There's just an IV in your arm and large electrode pads on your chest (or could be one on your chest and one on your back). They knock you out with anesthesia, push a button, and zap you. If you resume normal rhythm, that's it. It's over. They let the anesthesia wear off then send you home. Typically the whole thing from start to finish is 1-2 hours, with most of that time being you just lying there bored after the procedure.
An ablation is entirely different. In an ablation you'll have to stop your antiarrhythmic and rate control meds a few days beforehand. They may also require a chest CT first. On the day of the procedure, they'll put you in one of those silly gowns, insert an IV, attach ECG leads, and then wheel you into an EP lab, which looks like a cross between an operating room and the bridge of the Enterprise. They'll put you on an operating table, put an oxygen mask on your face, and tell you to take deep breaths. While you're doing that, they'll start anesthesia in the IV and you'll be out like a light a few seconds later. During the procedure, they'll insert large sheaths in your femoral veins in your groin, and possibly a third one in your neck or wrist. The doctor will then insert catheters (long thing metal wires) into those sheaths and snake them into your heart. First, he'll examine your right atrium, using the electrodes on the end of the catheters to measure electrical activity directly. Those are known as mapping catheters. If he finds a source of afib in the right atrium, he'll use another catheter known as an ablation catheter to make burns around that source, fencing it in so those errant signals are contained and can't cause afib. Once your right atrium is cleared, he'll puncture the septum with a needle and insert those catheters into the left atrium. In the left atrium, he'll use the ablation catheter to make burns around the area where your pulmonary veins connect to the atrium. This is because the pulmonary veins are almost always the prime culprits in causing afib. After he's done with that, he'll infuse a drug called isoproterenol for about 10 minutes and try to stimulate your heart into afib again by applying tiny shocks in the atrium. If he can provoke afib again, he'll use the mapping catheters to search for the sources and ablate those too. Once he's no longer able to provoke afib, you're done. He'll withdraw all the catheters, remove the sheaths, and two nurses will press hard on your groin insertion sites for 15 minutes to stop the bleeding, then they'll bandage the sites up.
This will have taken hours (how many hours can vary widely). You'll wake up in a recovery room with a nurse attending to you. Once you're lucid and your room is ready, they'll wheel you to a room, hook you up to a monitor, and offer you a menu to order food and drink. You'll be required to lay flat on your back for 2-6 hours, depending on whether they're using collagen plugs or not (2 hours if, 6 hours if not). Once that period is up, and there's no bleeding from the insertion sites, you'll be allowed to sit up and even walk around the halls if you want. You'll probably have a Foley catheter when you come out of the procedure. The nurses may offer to remove it right away, but I recommend waiting until you're allowed to get out of bed. You were given a LOT of fluid during the procedure so you're going to be peeing a LOT. This is why I recommend leaving the Foley in.
You'll stay overnight, and probably won't sleep well because they'll keep waking you up every 4 hours to take vitals. The next day if all is well, you'll be given instructions and discharged to home. You won't be allowed to lift more than 10 pounds for 5 days but otherwise you can do whatever else you want.
My description above of the ablation is for a radio frequency ablation performed by an experienced EP. If it's a cryo ablation, it's a bit different, but not a whole lot different from the patient experience perspective.
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Okay, so CBD prolongs the effects of warfarin and NSAIDs. Good to know. Now if only there was data on CBD interaction with the NOACs.
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Um... You're referring to Dr. Sanjiv Narayan at Stanford?
And what do you mean what's the difference? Difference in what way? A little more detail about what you're asking would be helpful.
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Yes. No known problems with it and afib, Eliquis, or any other drugs commonly used with afib. In fact, to my knowledge there are no problems with it with any drug.
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What Daisy said. There are a number of people here who've had ablations with Natale and only a single visit to Austin, including me. And I wasn't exactly an uncomplicated case.
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Any sort of inflammation tends to trigger afib, and flu is a great big dose of inflammation, so quite possibly. Not much to be done other than what you're doing. Just make sure you see your doc quickly if it gets worse. You really don't want it morphing into pneumonia or bronchitis or something that would postpone your procedure.
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I had a feeling this was going to work out well for you. I'm so happy to hear that it is.
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Great news! Has it helped with your near-syncope episodes?
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Right, but the same approach was tried with afib. It apparently didn't work.
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There is (or was) such a thing as cardiac resynchronization therapy for afib. I asked my local EP about it a year or two ago and got a very succinct answer: "It doesn't work."
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46 minutes ago, Daisy said:
They actually did tell me to check in a 7 am for an 8:30 procedure. Not sure what they will do with me for that hour and a half but I'll bring a book!
Fill out a ton of paperwork.
Wait.
Change into ridiculous hospital johnny.
Wait.
Start IV.
Wait.
ECG, vitals, etc.
Wait.
Answer same questions five times for five different people.
Wait.
Get left lying there bored and lonely.
Did I mention there's some waiting?
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44 minutes ago, Daisy said:
I am to check in at the hospital at 7 a.m. and they said that the procedure would be about an hour and a half
Ha! That old line, eh? Notice that what they didn't say was when the procedure would actually begin. I have never shown up for any hospital procedure without waiting at least one and often two hours longer than expected.
The old phrase "hurry up and wait" wasn't invented in the army like everyone thinks; it was invented in hospitals.
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4 minutes ago, Daisy said:
I am somewhat skinny, so that might mean that a deeper implantation would protect it more.
It's pretty solidly built and doesn't need protection. I've even seen a photo of a pacemaker that stopped a bullet.
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They usually use conscious sedation and a local anesthetic, so prep should be pretty minimal. They might give you some antibiotic soap to shower with before the procedure, and they might restrict food/drink before the procedure, but that should be about it. This is a decent explanation of the procedure.
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35 minutes ago, Martha Boesing said:
What do the initials LAA mean?
Left atrial appendage. It's a little finger-like appendage that juts out from the side of your atrium (both atria have one). The LAA is where over 90% of clots form in the left atrium because blood can pool inside it. If it's been electrically isolated and no longer contracts, the risk of a clot forming in the LAA goes way up so you may have to remain on anticoagulants for life, although it can be surgically removed or closed off with a device inserted via catheter.
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1 hour ago, markflint said:
He's pretty robust. I would have guessed him at 50 or even late forties.
He's older than that. We definitely nailed down his age in a previous thread but I can't find it now.
Hey, did you see my question about dofetilide? You said Natale put you on it and I'm surprised by that and thought maybe you were mixing it up with dronaderone.
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11 minutes ago, li2017 said:
Great to hear! Feel happy for you and see the hope for the rest of us. You think Dr Natale would be still in practice in 10 years?
Thank you.
We established his age recently in a thread I can't find at the moment, but as I recall we figured he's 58 (I could be off a bit). Will he still be practicing at 68? Maybe, maybe even probably, but I wouldn't be surprised if he's doing more teaching and research at that stage and fewer procedures. I'm astonished that he keeps the schedule he keeps now.
What I would bet on is there will be a lot more like him in 10 years... OR... ablations may even be a thing of the past.
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4 minutes ago, li2017 said:
Carey, is your ablation still promising? No afib or ectopic at all?
No ectopics at all. Zero. After seven years of failures I find it hard to believe myself.
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3 minutes ago, Deirdre Dame said:
I met him in November. I trust what you say but still wonder how he can go in there and fix me without truely knowing me - silly I guess eh?
You're confusing Natale with a psychiatrist.
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2 hours ago, Deirdre Dame said:
I'm hoping so because I feel I'm jumping to Austin almost blind and praying he GETS me?,!,?
I went into Natale's lab having met the guy once the day before for a grand total of maybe 20 minutes. The information he had was my prior medical history forwarded by my local EP, blood work, a CT scan, and the 20 minutes he spent talking to me, which was mainly him answering my questions, not the other way around. And that was enough. He had all he needed to go in, fix what three other EPs couldn't, and do it in less time than any previous ablation. Keep in mind that I was such a complex case that my local EP, who is a top guy himself, was relieved that I didn't ask him to do it. So if Natale "got" me well enough to do that without batting an eye, you'll be a piece of cake for him. You'll have no doubt about that once you meet him.
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1 hour ago, Deirdre Dame said:
HOW CAN HE REALLY CARE ABOUT MY CASE ?!
I think he sincerely cares about every case. Make a twitter account and follow him for a while. It's pretty obvious from the things he says and does that he's in it for the patients, not the money or fame.
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Athletic Heart Rate Monitors - Do they work?
in Afib and Exercise
Posted
Investigate the limitations. It won't identify afib with a heart rate over 120, which makes it useless for a huge percentage of people with afib. And Apple won't support its use in people who have been diagnosed with afib, which makes it utterly useless for them in my opinion.