Anyone watched this Utube video by Dr Scott Lee on a fib?

Hi just reviewed his video where is he located ?

Yes, I have been posting on other threads for a few months now about Dr. Lee's Channel. He knows his stuff, clearly, but I like how he takes a balanced approach to the matter of atrial fibrillation. He acknowledges that not everyone is necessarily going to benefit from an ablation, least of at his hands. But he also spells out what individuals can do for themselves to minimize progression and the attendant deterioration of the heart if the disorder does progress to the long-standing persistent and permanent phases. Good education, but he doesn't mince words when he explains that some complex cases need complex interventions, and he does those every single day.

What I found enlightening is his explanation of why many with a fib have multiple ablations given that only the 4 corners or back wall are ablated rather than cells ablated on all ) walls of the L atrium. He also discusses the requirement of a highly skilled electrophysiologist and the necessity of considering “how big the fire” whether a fib is persistent or long standing or occasional stage with persistent and longer standing requiring a much more extensive ablation process. He says deeper cuts and advocates for radio frequency vs cry or pulse. Anyway, definitely worth a watch. Personally, I’m dealing with a cardiologist that won’t even put a referral in to the cardiac surgeons I have researched for opinions because he says I’ll end up with a pig valve and then will require a third surgery in 8-10 years. He is only offering me rate control with drugs or rhythm control with ablation and is anti surgery. Offered me another cardioversion when the first, on March 30 only lasted : days. What’s the point of another? Looks like cardioversion is only a temporary reset. Told me a fib cannot be cured….. cannot be fixed. I’d rather be out of it for 5-10 years than end up with pulmonary hypertension or a fib more locked in due to the passage of time and also a more enlarged L atrium meaning the a fib is almost impossible to fix. But im dealing with valvular stenosis and a fib together….making the situation more challenging. The cox maze 4, gold standard fix for a fib, could be done while the valve is fixed. Attempting to get a new cardiologist but this is Canada and Nova Scotia…. Not exactly progressive.

I'm told metropolol is not doing anything for the fib. It is target specific for the AV node and attempts to block the fib currents from speeding up your ventricles. Flecainide works for some people. Drugs like sotolol and dofetilide can knock you into NSR but not without side effects and they are only 30-40% effective plus with dofetilide you need to spend 3 days in a hospital to get the dosage correct bc it can cause sudden death. Some docs also want a hospital stay with sotolol

Yes I did I like it.
Does he have a associate in the Bay Area

That sounds very scary. I suppose these drugs are for those who have had
failed ablations? I have now got a retired heart surgeon reviewing my
chart. I really believe that I need redo surgery to correct the underlying
stenotic mitral valve. Severe stenosis leads to a fib so how can you
correct persistent a fib with this scenario? The two conditions perpetuate
each other. I’m just confused as I’ve had my former surgeon offer to fix me
but out of province while a young one here in my province say don’t have
surgery. Even walking brings my heart rate to 120-130 bpm but I’m pretty
asymptomatic except for puffing on exertion or walking up any slope. I know
I’m better off than many and thankful for that but I expect things keep
progressing downhill with age. I’ve been told my provincial health care
won’t cover me out of province unless I wait at least 6 months since my
late January pulmonary embolism. Watchful waiting.

@activegal The Canadian system leaves a lot t obe desired. My wife was a nurse case manaer at a local hospital. Canadians in your situation used to take out travelers insurance and come here then have an "episode" and get their problem taken care of in the US.

If you are in fib that heart rate of 120-130 is the ectopic foci electricity getting past the AV node. You could try more metropolol but be sure to ask your doc first. I have a friend that takes 200 mg of metropolol per day. There are 2 types, succinate and tartrate. Succinate is time released and tartrate is rapid release. Only difference I'm told is the exterior coating to slow or provide faster release. None the less you are still in fib even if your pulse is 60. At 60 it just means the metroplol is blocking the ectopic electrity at the AV node. Metropolol is specific for the AV node. The other drugs work sometimes by changing the QT interval and can bring you back to sinus rhytm. For sure prolonged fib will effect the atria causing dialation and eventual heart failure. Best t oget in NSR ASAP.

@activegal
Hello, I'd like to comment to @activegal regarding replacing a mitral valve with a pig valve. I had mine replaced in 2010, after contacting bacterial endocardidtis following oral surgery, done some years before. After the open heart surgery, the surgeon commented he had to use many stitches, and didn't have time to close of the appendage, and I'd need a blood thinner, and also to watch for a-fib, which I do have at times. Looking at my recent echo, the 16 year old pig valve is still intact after 16 years. My electrotopysiogist doc says that mostly calve valves are used....these days. I'm now 85 and hanging in there.

Very impressive! That’s encouraging. You must live a healthy lifestyle.
You had this pig valve inserted at my current age. I had no idea they
could last that long. I guess I’d be happy to gain 16 years of life.
Especially if I could get back to all the activities I love like long
distance cycling and skiing and tennis. I really don’t think my current
mitral valve with scarred annulus showing moderate to severe stenosis will
last. Just 2 years ago it was only mildly stenotic, I figure I may not have
far to go before completely blocked. Then there is
N-terminal pro Brain Natriuretic Peptide result of 914 ng/L when it should
be < 299 ng/L indicating great strain on the heart and heart failure.
I still can’t understand why the cardiologist is against me having surgery
and only wants me to be rate controlled with Metoprolol and apixaban
anticoagulant. Anyway, I’m fighting for a new cardiologist and getting an
opinion from a ex cardiac surgeon through a doctor friend.