Atrial fibrillation

Posted by normanchester @normanchester, 5 days ago

How many people have been through it all, all the procedures, had everything done to correct atrial fibrillation, to end up still having atrial fibrillation? Thank you and happy New Year

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Unfortunately, the answer is unknown largely, but it would be in the order of 30/100 treated with drugs or via catheter ablation. The ultimate step, a bit drastic if you ask me, and it depends on what the patient experiences in the way of nasty symptoms that greatly degrade his/her quality of life, is to implant a pacemaker/ICD to keep the heart running as smoothly as possible. Even those don't control AF in all patients. Some will die with AF happening, but almost always from other causes...NOT from AF.

If an ablation or two or three have been tried, or numerous cardioversions, and the patient is still in AF or having multiple PACs each hour, you can often blame the skill and experience of the electrophysiologist. The very best EPS on any continent really know what they're doing and their success rates show it. This applies to complex cases where the average EP would just do a few burns around the pulmonary veins and call it a day. Just as there are sculptors and sculptors, and car mechanics and car mechanics, there are electrophysiologists and electrophysiologists. The individual surgeon matters...a lot!

And one other critical factor, which you may already know only too well....is that the patient also matters. How they come across at an initial consultation, how informed they are, how apparently motivated they are to succeed, how badly they are affected by symptoms, how few other comorbidities they have running inside them...these all affect how sanguine the EP will feel about taking them on as a case. You don't have to be an aggressive and surly old man to have things happen, but if you sound like you've done a fair bit of inquiry and reading, and you say things during the interview that make you sound like a good and cognitively bright prospect, chances are better that the EP would feel better about attempting to rid you of your symptoms at least.

This is getting long, which alas is typical for me, but I think you might realize that about 25% of all initial, or index, ablations fail, and this is pretty much across the board for the average EP anywhere...EXCEPT for...the very best ones who routinely tackle those complex cases. Dr, Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin is one such electrophysiologist, and so is Dr. Pasquale Santangeli at Cleveland Clinic.

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Thank you very much, I'm going to save this message

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Profile picture for gloaming @gloaming

Unfortunately, the answer is unknown largely, but it would be in the order of 30/100 treated with drugs or via catheter ablation. The ultimate step, a bit drastic if you ask me, and it depends on what the patient experiences in the way of nasty symptoms that greatly degrade his/her quality of life, is to implant a pacemaker/ICD to keep the heart running as smoothly as possible. Even those don't control AF in all patients. Some will die with AF happening, but almost always from other causes...NOT from AF.

If an ablation or two or three have been tried, or numerous cardioversions, and the patient is still in AF or having multiple PACs each hour, you can often blame the skill and experience of the electrophysiologist. The very best EPS on any continent really know what they're doing and their success rates show it. This applies to complex cases where the average EP would just do a few burns around the pulmonary veins and call it a day. Just as there are sculptors and sculptors, and car mechanics and car mechanics, there are electrophysiologists and electrophysiologists. The individual surgeon matters...a lot!

And one other critical factor, which you may already know only too well....is that the patient also matters. How they come across at an initial consultation, how informed they are, how apparently motivated they are to succeed, how badly they are affected by symptoms, how few other comorbidities they have running inside them...these all affect how sanguine the EP will feel about taking them on as a case. You don't have to be an aggressive and surly old man to have things happen, but if you sound like you've done a fair bit of inquiry and reading, and you say things during the interview that make you sound like a good and cognitively bright prospect, chances are better that the EP would feel better about attempting to rid you of your symptoms at least.

This is getting long, which alas is typical for me, but I think you might realize that about 25% of all initial, or index, ablations fail, and this is pretty much across the board for the average EP anywhere...EXCEPT for...the very best ones who routinely tackle those complex cases. Dr, Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin is one such electrophysiologist, and so is Dr. Pasquale Santangeli at Cleveland Clinic.

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@gloaming thank you very much, I'll be saving this information for future reference

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I went through none of the procedures and had severe afib for 7 years in my teens. Eliminated ALL by eliminating caffeine from my diet.

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Profile picture for lindy9 @lindy9

I went through none of the procedures and had severe afib for 7 years in my teens. Eliminated ALL by eliminating caffeine from my diet.

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@lindy9 , the kind I have causes rapid fast heartbeat, is that the kind you had? I don't drink caffeine, thank you,

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Yes, very fast heartbeat, but during an episode would go thru several phases. Fast, then jumping around, perhaps skipping beats, then pounding real hard, and sometimes felt very still like it was not beating at all even though I am sure it was. When it went back to normal, all at once I would feel really weird, and FELT like my heart was very slowly turning over which of course was not the case but felt like it. I would just be real still and then it would resume regular beating. OR I would go to sleep and when I woke up, it was okay.

But the whole thing was very draining and made me weak and tired for a time.

Just double checking, Mountain Dew has more caffeine than colas, and those energy drinks etc. and chocolate??

If you do not, then I hope you can find the culprit.

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Profile picture for lindy9 @lindy9

Yes, very fast heartbeat, but during an episode would go thru several phases. Fast, then jumping around, perhaps skipping beats, then pounding real hard, and sometimes felt very still like it was not beating at all even though I am sure it was. When it went back to normal, all at once I would feel really weird, and FELT like my heart was very slowly turning over which of course was not the case but felt like it. I would just be real still and then it would resume regular beating. OR I would go to sleep and when I woke up, it was okay.

But the whole thing was very draining and made me weak and tired for a time.

Just double checking, Mountain Dew has more caffeine than colas, and those energy drinks etc. and chocolate??

If you do not, then I hope you can find the culprit.

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@lindy9 I quit all caffeine a long time ago, I'm glad I did, for about 2 years all I drink is water,

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