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1 day ago · Recent Ablation: Wait and See If Working in Heart Rhythm Conditions

@crashnam Hi Larry… I was wondering if your EP mentioned the 3 month 'blanking' period where you are expected to have episodes/PVCs etc as you recover from the procedure. I have done quite a bit of research about success rates for ablations and note that there really is no consensus about what that means. Generally though 1 or 2 months after is a little too soon but it is great that you are feeling better and that the ablation only lasted 4 hours, which to me means that it was not too challenging to fix I did ask my EP a year after my second ablation, when I have not had an episode – and he did confirm then that it was successful. He had given it only a 50/50 chance so either I was very lucky or I had a really good EP or both. Never mind that I may have to do it again. It feels strange in a way to think of it as a success when the procedure keeps you free from afib for 'only' a year but that is what it is. Mary

1 day ago · Pacemaker recipients. in Heart Rhythm Conditions

@lacudia Hello – I was wondering how you are doing after the AV node ablation and pacemaker implant. I find that most pacemaker recipients have it because of bradycardia or some sort of heart block. I am particularly interested in dual chamber PMs meant for Afib and flutter and how it all works. My EP is advocating it as a last resort should all the other options – 3rd ablation, propafenone, amiodarone, etc. does not work. Thanks.

Tue, Jun 18 12:25pm · Anyone going to 2019 NTM Physician/Patient Conference in Texas? in MAC & Bronchiectasis

@poppins I agree it is rather overwhelming — even more so at the conference itself. I was very interested in the epidemiologists presentations but that's me. If you are interested in treatments I would focus on those that cover these topics (the conference agenda might be helpful and I will paste it below). I thought the most entertaining speaker was Jakko van Ingen and I did learn a few things about how they test for mycobacteria so I might start with that. Also, not all presentations have been posted as yet. I could not find the one on managing side effects – perhaps later today or tomorrow.

8:40 – 9:15 a.m. Epidemiology Around the World

9:15 – 9:45 a.m. Patient Panel Moderated by Anne E. O’Donnell, MD & Gregory Tino, MD

9:45 – 10:15 a.m. Environmental Factors & Reducing Exposure Rachel Thomson, PhD, MBBS

10:30 – 11:00 a.m. Evaluating & Treating Bronchiectasis Patients Gregory Tino, MD

11:30 a.m. – 12 p.m. NTM: Who, How & Where to Treat Charles L. Daley, MD & David E. Griffith, MD

1 – 1:30 p.m. The Role of the Laboratory Jakko van Ingen, MD, PhD

2 – 2:30 p.m. Comorbidities of NTM & Bronchiectasis

2:30 – 3 p.m. The Importance of Airway Clearance for Patients Patrick A. Flume, MD

3:15-3: 45 New Therapies Kevin L. Winthrop, MD, MPH

3:45 – 4:15 p.m. Patient-Focused: Nutrition & Mental Health
Kristen E. Holm, PhD, MPH

Tue, Jun 11 8:58am · Post Ablation Recovery – Need Help!! in Heart Rhythm Conditions

@jaqueela I find sometimes the medical profession does not do a great job of telling patients what to expect after a big procedure. A little reassurance sometimes goes a long way. I am a big fan of Dr. John who is an EP who has first hand experience with afib. He does a great job on his website and I hope you find the following helpful…

https://www.drjohnm.org/2014/12/ten-things-to-expect-after-af-ablation/

Fri, Jun 7 10:13am · Weaning off Metoprolol in Heart Rhythm Conditions

I've been on metoprolol for more than 10 years but it has always been made clear to me why. Metoprolol is a beta blocker and can be prescribed for high blood pressure so it is a surprise to learn that it can actually raise BP for some? For the most part though it is quite often used for rate control when your heart rate is on the high side and you are prone to PVCs — extra beats etc. That said I am not a medical professional and probably not explaining this well or thoroughly. Taking metoprolol has not been an issue for me as I am very sensitive to it and take an extremely low dose. I started out at only 12.5 mg daily and only recently went up to 25 mg. At those doses it is probably not causing the usual problems like sluggishness, low energy, brain fog… I would never adjust my dosage either way without consulting with the doctor who prescribed it or the EP who is managing my care. However, I would definitely be concerned if I was taking a high dose (that is subjective of course) and was experiencing symptoms. Even so, do discuss with the doctor as it is never a good idea to suddenly increase or decrease medication on your own.

Fri, Jun 7 8:30am · Electrophysiology Study in Heart & Blood Health

@ilnapenny Hello… I'm afraid I can't explain what is happening in your particular situation but I have been dealing with Afib and atrial flutter for decades and understand your nervousness and frustration. I think the heart's electrical system is really complicated for mere mortals like us and I have struggled as well to understand exactly what my EPs are telling me and what it all means. The best thing you can do is to do a little research online (I typed 'heart block' in google and very quickly got a basic understanding of what it is). I am sure I have type 1 heart block occasionally but it does not appear to be a problem. It sounds like they plan another ablation for you once they figure out exactly where to go and the test will certainly help them do that. I was on propafenone as well for many years until it stopped working — they tend to do that. I also have had two ablations and am considering a third one. I could potentially go for cardioversions every time I get a sustained episode since the other two options presented did not appeal to me. It is all very overwhelming and it is important that you take care of your overall health (diet, sleep, some exercise) and try and stay strong. It also helps to have someone to help you deal with all this. The only thing to watch for in researching all this is that it can get overwhelming and confusing in a hurry. A lot of the material online may not be specific to your situation and in language that is not very friendly. I hope this helps in some way. All the best. Mary

Wed, Jun 5 8:40am · Post Ablation Recovery – Need Help!! in Heart Rhythm Conditions

@rubywitch67 So glad you're slowly feeling and doing better. Actually the cardioversions are the easiest thing to deal with – I've had to deal with much more – open heart surgery, lung issues, etc.. BUT – they were all manageable and behind me and and it certainly could be a lot worse. I feel fortunate that I am able to do the things I like — bake, exercise, hike etc. and only have to deal with the occasional bumps in the road (as my EP calls it) You raise an important question about how success rates are calculated for ablations — there really is no consensus in the EP medical community (someone else can call me on that!) There is the blanking period of course of 3 months. Then you need to be free of sustained episodes (where you do not come out of it for days/weeks) for a year. Based on that definition my second ablation was a success, never mind that I will most likely need a third one either this year or next. Most of it really is based on how you feel and how the episodes impact your quality of life. My doctors are fine if I am in persistent afib or flutter if my symptoms are tolerable and my heart rate stays below 120 at rest. If you get a lot of episodes that come and go they might order a 2 week heart monitor called Ziopatch which will tell them what's going on. You are right that an ECG only captures for that moment in time and only helpful if you are not in sinus. BTW, my EP did not want to raise my expectations so he only gave me a 50% success rate for my ablations. Some will say that is huge – I thought it was dismal! The EP who actually did my ablations (mine was super booked up) said he would be happy if it lasted 2 years and it has been 3 months shy of that. So what's next? It depends of course. My EP laid it all out for me in an email and I will see him in a few days to discuss the 3 options he proposed. I suggest that you not worry too much and focus on getting well because anxiety and stress is not good for overall health. I know that is difficult if you have an anxiety disorder but good to hear you are going to try and stay positive. That is so important I think. Cheers and hang in there! Mary