Ablation for Afib

The Watchman is a small mesh, about the size of a thimble, that is pressed into the left atrial appendage, I think maybe sutured into place, not sure about that. The point of it, though, is that over the next five months or so, your endothelial atrial lining will grow into that device and cover it over, just like bricking off the front entrance to an abandoned building. This closure seals the LAA. Or, it is meant to. You will get a trans-esophageal echocardiogram (a TEE) under a light anesthetic like propofol (like they do for endoscopy), and this will show if the Watchman is fully sealed and if the LAA is leaking. The TEE happens at about six months from insertion, maybe later. If there are no leaks, your EP may agree that you can cease taking the Eliquis....HOWEVER...you may have other comorbidities that would make it wise to keep taking it, probably for life. Again, discuss all this with your EP.

Very good info. Thankyou!!

I also have AF about 2% of the time. It has been higher but I’m trying to control it with diet and exercise. I am on a baby aspirin a day and Metoprolol which makes me fatigued. The Cardiologist want me to go on eliquis but I am refusing it at this time. Should it get worse I may reconsider!

No, you don't have to initiate the ECG. As long as you have the setting set to let you know, you will receive an alert if you are in A-fib longer than 10 minutes. You can always initiate the ECG as a backup, after the alert.
I believe the Galaxy Samsung watch also will do the same alert as Apple watch.
I will note here both watches are not medical grade ECG's, they are only single lead.
For me as someone that has no symptoms, I find it helpful.

Hi
During an AF attack do you have rapid AF or high BP?
I'm one who has not had an ablation and have continuous AF.
Metoprolol on Heart monitor showed that it would not control my heart rate and measured H/R 186 avg day. My normal H/R Night 47bpm but surprisingly pauses at night. I was a zonbie on it and could not exert without stopping and having a sleep with exertion sweating uncontrollble.

At 1 year 5months post Embolic Stroke my request for a cardiologist was offered. This hospiytal Cardiologist said Bisopreolol is better for AF patients. But increasing Bisoprolol to 10mg daily did not control my rapid H/R and the heart monitor showed 165 bpm avg Day and 47bpm Night. I was left there. No pauses though and exertion was improved stamina wise.

My Locum Doctor suggested a PRIVATE Cardiologist who had worked for our base hospital.

He did research on my history and introduced the CCB Calcium Channel Blocker Diltiazem 1/2 dose. Also on Bisoprolol I reduced that down to 5mg. Within 2 hours as I monitored my progress with a BP Microlife monitor my H/R dropped to 51 within 2 hours!

Now after reducing Diltiazrem to 120 CD HCL mg early morning (some use it pill in pocket) I have remained on that dose with 2.5mg Biso until last year when I 1/2 and then stopped Biso... because of dizziness. The monitor showed low blood pressure.

Diltiazem functions as an extreme heart rate lowerer and BP is also reduced some (20 points with 2.5 Biso). It also acts as an anti-arrhymic med but a safe one).

I see that ablations help some but others no improvement, with low BP permanent. Or low H/R.

Ablations sap areas of the heart and leave scars which are permanent.

Decision making for me was taken away as abnormal structure of my heart (severe dilation of Left Atrium ) leaves me on meds only. Still I have an unscarred heart. Symptoms even from the Stroke are due to rapid H/R eg sweating and walks are short as I ned to stop for a few secomds and exertion harder on elevation. DAmage due to being left on beta blockers.

An opinion from a Cardiologist would be more reassuring than an EP who would most certainly leaning on the side of having an ablation.

Have you had an ECHO, or heart mRI. An ECG, heart monitor done.

Your decision but I continue to have CONTROL with meds.

Now my monitoring gives me

126-135. /. 75 - 80. 80s Day. 47 Night. all avg.

You decide and I would place the de ision on how bad are your sympoms when in aF and times per years that you have aF.

My stroke and AF was caused by Thyroid Cancer which hospital found with a carotid artery SCAN. Papillary cancer which showed I needed to have the carcinoma in the right lobe out and a bit in left. Throidectomy was done at 4 months post.... where 12 lymph nodes removed and 2 were affected. The bottom lymph bed on right was dissected. Now at 5 years plus last year showed up macro-calcifications in 2 lymphs and thymus. CT SCAN with contrast shows 3 lymphs and thymus but the original areas have shrunk. May next year another VT Scan with contrast.

If you can widdle down what causes your episodes. That would be best action forward. All the best SHERLOCK HOLMES!

cheri JOY. (Tuckie)

On my first episode with A-fib, my cardiologist put me on Eliquis immediately. My brother has had A-fib episodes over the past few years, with cardioversions in the ER and he has never been on Eliquis. He takes baby ASA and his cardiologist has never suggested that he do anything else. I don't have any problems with Eliquis except that 1) I can get a bruise by opening a tight mayonnaise jar 2) I wonder what monitors there should be for deciding if your blood is "thin" or "too thin." (like why don't they have a level to measure routinely?) Lastly, Eliquis is a huge money maker for big pharma; once people get on this, it seems most of them just stay on it forever; is it necessity or fear? My insurance pays for my prescription but many folks pay big bucks for this medication. I know that it is supposed to reduce stroke risk, but when I do the stroke risk scale, I find that age and gender and treatment for B/P seem to weigh heavily in getting a higher score! If someone has a stroke that is a "bleed" and not a clot, is that somehow not a risk factor for the medication? I don't know what to tell you; I have the same questions that you do. I want my cardiologist to decrease the dose to 2.5 twice daily. I have very infrequent episodes as you mention and I don't know if the bigger dose is actually necessary.

Just a note that the direct-acting oral anti-coagulants (DOACs) like rivaroxaban and apixaban are not blood 'thinners'. They are, as I just stated, anti-coagulants. They retard the clotting mechanism, but they don't entirely prevent it. As a person on Eliquis for eight years now, I still clot when I bleed. It just takes longer.

I was only using a terminology that many of us use to describe this category of meds. Sorry that I wasn't being specific. But I think you get the idea; there isn't much done to check any level of its effectiveness. Why 5 mg twice a day? Why not 2.5 or 10 mg? It is a huge money maker for the drug companies and it is taken by millions who are prescribed this drug and never get off.

I was told it is dosed in part by patient’s weight. And dosage changed if there are adverse side effects from current dose like excessive and/or frequent nose bleeds.

I don't have an Apple but a Fitbit so not sure of the methodology of it screening for AFib but it seems that they wait for a specific amount of time to pass while a condition that appears to be AFib is recorded and notifying the individual. So the individual with no symptoms may never know that they have had a short episode. May or may not be an issue for some depends on what your trying to track. Seems as though the medical community really doesn't know what to do about these very short periods of aFib. These personal devices are picking up episodes that at one time would never have been noticed or recorded.