Re: My meeting with Dr. Morady

[Guest guest]

ssounds exciting and may be worth a shot-does he have any statistics yet on people who have had this procedure and how they are doing or is this too new-

jerry

[Guest guest]

If my doc recommended a new invasive procedure that he pioneered and

refined, and didn't seem too enthusiatic about dofetilide and azimilide, I

would think twice about it.

My meeting with Dr. Morady

I got back this evening from my visit to the University Of Michigan and Dr.

Fred Morady, a leading electrophysiologist; He has been consulting on my

case for about 7 years;

Dr. Morady came straightaway to my room while the nurse was taking my

blood pressure; He was very enthusiastic about something and asked the nurse

to leave us so we could have some privacy;

I knew something must be up since normally I wait almost half an hour

after the nurse takes my history, blood pressure etc, but this time the

doctor was there at the start!!!

After going through all of the medications I have been on the past year

(none of them really helpful except the Lopressor), he mentioned that he and

another colleauge at the University Of Michigan have pioneered and refined a

new radiofrequency ablation procedure which he highly recommends for me; He

said that I was the " perfect candidate " for this procedure;

The procedure, like the baloon ablation, attempts to locate the " foci " or

lesions within the pulmonary arteries that he feels are causing my AF;

Unlike the baloon ablation however, which uses a super heated saline

solution to cauterize (burn) off these lesions, Dr. Moradys procedure

utilizes high frequency radio waves which he feels are much more precise,

and hence the risk of causing damage to a pulmonary artery is much less;

Specifically, the risk of stroke is significant diminished; They will have

to use a micro catheter to pierce my endocardium and enter both right and

left atriums as well as the associated pulmonary arterties. However, he

stated that he wants to keep me in the hospital overnight for observation

afterwards and will institute a " heparin drip " to thin the blood; Then I

have to be on coumadin for two months;

However, after that, he feels my AF will essentially be cured by this

procedure, with no need for any medications;

I asked him if they were going to do an EP study before this type of

ablation, since such a study IS contemplated for the baloon ablation; He

said that no EP study would be performed, but that they would inject

adrenaline into the heart to more precisely measure the source of the foci;

He also stated that I would be completely sedated during the rather long, 6

hour procedure. He also mentioned that they will go into the right atrium

and do some procedures (not explained to me yet) to correct " atrial

flutter " ; Apparently by doing both the ablation and the atrial flutter

procedure, both AF and atrial flutter will essentially be cured; He didnt

use the word " cure " , but in essence thats how I intepreted his comments.

He also ordered a " cardiac CT scan " before the procedure is to be done;

He wont be able to do this procedure until February since he is booked up,

but if I need to have it done sooner, I could go with his colleauge; But I

think I will wait for Dr. Morady to perform this procedure personally; He is

the man with the world renowned credentials;

So all in all, I was very pleased with todays meeting; However, as usual,

upon thinking things through I have some additional questions which I will

present to the doctor; Its a good thing I have a few months to get all these

issues settled in my mind first;

My biggest concern is twofold; First, why they feel it necessary to

sedate me before the procedure is done; Usually, sedation is done as a

precaution when cardioversion is either contemplated or a real possibility;

If in fact, no EP study is to be done, and no deliberate provoking of AF is

contemplated, I dont understand the need for sedation;

Second, the issue of injecting adrenalin into my heart to further

pinpoint the source of the AF foci is troublesome and sounds similar to an

EP study to me;

But I certainly will clarify these issues with Dr. Morady.

We also discussed vagally induced AF briefly, and he stated that there is

no specific definitive test for vagal AF (I suggested an interpretive EKG,

he didnt pick up on it); He stated that Disoprymide is a good vagolytic

medication (which I am tempted to try once again); He also stated that

digestive problems causing AF can easily be caused adrenergically as well;

We didnt go further into this topic; I wish we had;

I mentioned dofetylide and azimilide, and he didnt seem too enthusiastic

about either; Neither was he enthused about any of the newer pacemakers

being used to treat AF; He said in particular that the DAO (dynamic atrial

override) has turned out to be a disappointment in that it is not performing

as desired unless a full ablation of the AV nodes has occurred.

We did not discuss the maze procedure; He seems to feel that those, like

me, who have brief (less than 5 minute AF episodes) but chronic (daily

episodes or near episodes with lots of ectopic beats) are the best

candidates for this radiofrequency ablation procedure; He mentioned nothing

else in fact, unless of course I wished to try some medications which I

havent allready tried thus far like tambocor or flecainide.

I told him I wanted to go ahead with this procedure; When the time comes,

I will have to " bite the bullett " and take the risks involved; But if in

fact, the reward is as great as promised, 6 hours of sedated hell might be

worth it!! HE HE

Just thought I would share this with the group

Web Page /group/AFIBsupport

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[Guest guest]

Wow!!

Thank you very much for your input; This is a prime example of the benefit

of an internet forum such as this!! Who would have thought that within 24

hours of my post, I would encounter a patient who had undergone the same

procedure with the same doctor; Truly amazing!!

I will take your advice and follow it completely; Before checking my e mail

this morning, I must admit to a large degree of apprehension regarding this

matter;

God Bless You

My meeting with Dr. Morady

>

>

> I got back this evening from my visit to the University Of Michigan and

Dr.

> Fred Morady, a leading electrophysiologist; He has been consulting on my

> case for about 7 years;

> Dr. Morady came straightaway to my room while the nurse was taking my

> blood pressure; He was very enthusiastic about something and asked the

nurse

> to leave us so we could have some privacy;

> I knew something must be up since normally I wait almost half an hour

> after the nurse takes my history, blood pressure etc, but this time the

> doctor was there at the start!!!

> After going through all of the medications I have been on the past year

> (none of them really helpful except the Lopressor), he mentioned that he

and

> another colleauge at the University Of Michigan have pioneered and refined

a

> new radiofrequency ablation procedure which he highly recommends for me;

He

> said that I was the " perfect candidate " for this procedure;

> The procedure, like the baloon ablation, attempts to locate the " foci "

or

> lesions within the pulmonary arteries that he feels are causing my AF;

> Unlike the baloon ablation however, which uses a super heated saline

> solution to cauterize (burn) off these lesions, Dr. Moradys procedure

> utilizes high frequency radio waves which he feels are much more precise,

> and hence the risk of causing damage to a pulmonary artery is much less;

> Specifically, the risk of stroke is significant diminished; They will have

> to use a micro catheter to pierce my endocardium and enter both right and

> left atriums as well as the associated pulmonary arterties. However, he

> stated that he wants to keep me in the hospital overnight for observation

> afterwards and will institute a " heparin drip " to thin the blood; Then I

> have to be on coumadin for two months;

> However, after that, he feels my AF will essentially be cured by this

> procedure, with no need for any medications;

> I asked him if they were going to do an EP study before this type of

> ablation, since such a study IS contemplated for the baloon ablation; He

> said that no EP study would be performed, but that they would inject

> adrenaline into the heart to more precisely measure the source of the

foci;

> He also stated that I would be completely sedated during the rather long,

6

> hour procedure. He also mentioned that they will go into the right atrium

> and do some procedures (not explained to me yet) to correct " atrial

> flutter " ; Apparently by doing both the ablation and the atrial flutter

> procedure, both AF and atrial flutter will essentially be cured; He didnt

> use the word " cure " , but in essence thats how I intepreted his comments.

> He also ordered a " cardiac CT scan " before the procedure is to be done;

> He wont be able to do this procedure until February since he is booked

up,

> but if I need to have it done sooner, I could go with his colleauge; But I

> think I will wait for Dr. Morady to perform this procedure personally; He

is

> the man with the world renowned credentials;

> So all in all, I was very pleased with todays meeting; However, as

usual,

> upon thinking things through I have some additional questions which I will

> present to the doctor; Its a good thing I have a few months to get all

these

> issues settled in my mind first;

> My biggest concern is twofold; First, why they feel it necessary to

> sedate me before the procedure is done; Usually, sedation is done as a

> precaution when cardioversion is either contemplated or a real

possibility;

> If in fact, no EP study is to be done, and no deliberate provoking of AF

is

> contemplated, I dont understand the need for sedation;

> Second, the issue of injecting adrenalin into my heart to further

> pinpoint the source of the AF foci is troublesome and sounds similar to an

> EP study to me;

> But I certainly will clarify these issues with Dr. Morady.

> We also discussed vagally induced AF briefly, and he stated that there

is

> no specific definitive test for vagal AF (I suggested an interpretive EKG,

> he didnt pick up on it); He stated that Disoprymide is a good vagolytic

> medication (which I am tempted to try once again); He also stated that

> digestive problems causing AF can easily be caused adrenergically as well;

> We didnt go further into this topic; I wish we had;

> I mentioned dofetylide and azimilide, and he didnt seem too

enthusiastic

> about either; Neither was he enthused about any of the newer pacemakers

> being used to treat AF; He said in particular that the DAO (dynamic atrial

> override) has turned out to be a disappointment in that it is not

performing

> as desired unless a full ablation of the AV nodes has occurred.

> We did not discuss the maze procedure; He seems to feel that those,

like

> me, who have brief (less than 5 minute AF episodes) but chronic (daily

> episodes or near episodes with lots of ectopic beats) are the best

> candidates for this radiofrequency ablation procedure; He mentioned

nothing

> else in fact, unless of course I wished to try some medications which I

> havent allready tried thus far like tambocor or flecainide.

> I told him I wanted to go ahead with this procedure; When the time

comes,

> I will have to " bite the bullett " and take the risks involved; But if in

> fact, the reward is as great as promised, 6 hours of sedated hell might be

> worth it!! HE HE

>

> Just thought I would share this with the group

>

>

>

>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

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>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

> Individual emails: Send a blank message to AFIBsupport-normalegroups

> Read on web only: Send a blank message to AFIBsupport-nomailegroups

>

>

[Guest guest]

Thank you as well for your advice; This group is truly a valuable resources

for AF patients; With the internet and the information revolution in full

swing, the days of patient ignorance or blind faith in the medical

establishment is beginning to wane;

Of course, doctors still are the ones doing the operating and prescribing,

so we have to rely upon them extensively, but they certainly are not the

exclusive source of knowledge regarding medical issues as they once were.

My meeting with Dr. Morady

>

>

> I got back this evening from my visit to the University Of Michigan and

Dr.

> Fred Morady, a leading electrophysiologist; He has been consulting on my

> case for about 7 years;

> Dr. Morady came straightaway to my room while the nurse was taking my

> blood pressure; He was very enthusiastic about something and asked the

nurse

> to leave us so we could have some privacy;

> I knew something must be up since normally I wait almost half an hour

> after the nurse takes my history, blood pressure etc, but this time the

> doctor was there at the start!!!

> After going through all of the medications I have been on the past year

> (none of them really helpful except the Lopressor), he mentioned that he

and

> another colleauge at the University Of Michigan have pioneered and refined

a

> new radiofrequency ablation procedure which he highly recommends for me;

He

> said that I was the " perfect candidate " for this procedure;

> The procedure, like the baloon ablation, attempts to locate the " foci "

or

> lesions within the pulmonary arteries that he feels are causing my AF;

> Unlike the baloon ablation however, which uses a super heated saline

> solution to cauterize (burn) off these lesions, Dr. Moradys procedure

> utilizes high frequency radio waves which he feels are much more precise,

> and hence the risk of causing damage to a pulmonary artery is much less;

> Specifically, the risk of stroke is significant diminished; They will have

> to use a micro catheter to pierce my endocardium and enter both right and

> left atriums as well as the associated pulmonary arterties. However, he

> stated that he wants to keep me in the hospital overnight for observation

> afterwards and will institute a " heparin drip " to thin the blood; Then I

> have to be on coumadin for two months;

> However, after that, he feels my AF will essentially be cured by this

> procedure, with no need for any medications;

> I asked him if they were going to do an EP study before this type of

> ablation, since such a study IS contemplated for the baloon ablation; He

> said that no EP study would be performed, but that they would inject

> adrenaline into the heart to more precisely measure the source of the

foci;

> He also stated that I would be completely sedated during the rather long,

6

> hour procedure. He also mentioned that they will go into the right atrium

> and do some procedures (not explained to me yet) to correct " atrial

> flutter " ; Apparently by doing both the ablation and the atrial flutter

> procedure, both AF and atrial flutter will essentially be cured; He didnt

> use the word " cure " , but in essence thats how I intepreted his comments.

> He also ordered a " cardiac CT scan " before the procedure is to be done;

> He wont be able to do this procedure until February since he is booked

up,

> but if I need to have it done sooner, I could go with his colleauge; But I

> think I will wait for Dr. Morady to perform this procedure personally; He

is

> the man with the world renowned credentials;

> So all in all, I was very pleased with todays meeting; However, as

usual,

> upon thinking things through I have some additional questions which I will

> present to the doctor; Its a good thing I have a few months to get all

these

> issues settled in my mind first;

> My biggest concern is twofold; First, why they feel it necessary to

> sedate me before the procedure is done; Usually, sedation is done as a

> precaution when cardioversion is either contemplated or a real

possibility;

> If in fact, no EP study is to be done, and no deliberate provoking of AF

is

> contemplated, I dont understand the need for sedation;

> Second, the issue of injecting adrenalin into my heart to further

> pinpoint the source of the AF foci is troublesome and sounds similar to an

> EP study to me;

> But I certainly will clarify these issues with Dr. Morady.

> We also discussed vagally induced AF briefly, and he stated that there

is

> no specific definitive test for vagal AF (I suggested an interpretive EKG,

> he didnt pick up on it); He stated that Disoprymide is a good vagolytic

> medication (which I am tempted to try once again); He also stated that

> digestive problems causing AF can easily be caused adrenergically as well;

> We didnt go further into this topic; I wish we had;

> I mentioned dofetylide and azimilide, and he didnt seem too

enthusiastic

> about either; Neither was he enthused about any of the newer pacemakers

> being used to treat AF; He said in particular that the DAO (dynamic atrial

> override) has turned out to be a disappointment in that it is not

performing

> as desired unless a full ablation of the AV nodes has occurred.

> We did not discuss the maze procedure; He seems to feel that those,

like

> me, who have brief (less than 5 minute AF episodes) but chronic (daily

> episodes or near episodes with lots of ectopic beats) are the best

> candidates for this radiofrequency ablation procedure; He mentioned

nothing

> else in fact, unless of course I wished to try some medications which I

> havent allready tried thus far like tambocor or flecainide.

> I told him I wanted to go ahead with this procedure; When the time

comes,

> I will have to " bite the bullett " and take the risks involved; But if in

> fact, the reward is as great as promised, 6 hours of sedated hell might be

> worth it!! HE HE

>

> Just thought I would share this with the group

>

>

>

>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

> Individual emails: Send a blank message to AFIBsupport-normalegroups

> Read on web only: Send a blank message to AFIBsupport-nomailegroups

>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

> Individual emails: Send a blank message to AFIBsupport-normalegroups

> Read on web only: Send a blank message to AFIBsupport-nomailegroups

>

>

[Guest guest]

This one sounds like he might be doing more operating than prescribing.

My personal goal is to stay afib free on one drug, till it eventually stops

working for me. Then I will move to the next, then the next. Until there is

a surgical procedure developed that is safe with a near 100% success rate,

then I go that route and I am cured.

What medications have you tried?

Re: My meeting with Dr. Morady

Thank you as well for your advice; This group is truly a valuable resources

for AF patients; With the internet and the information revolution in full

swing, the days of patient ignorance or blind faith in the medical

establishment is beginning to wane;

Of course, doctors still are the ones doing the operating and prescribing,

so we have to rely upon them extensively, but they certainly are not the

exclusive source of knowledge regarding medical issues as they once were.

[Guest guest]

I have tried in this order

A-Inderal

B-Verapamil

C-Rhythmol

D-Sotalol

E-Attenolol

F-Lopressor

There are more medications I could certainly try; I hesitate with those

that are known to be proarrythmic.

I must admit to a grudging approval of your philosophy; The state of

knowledge concerning AF is still in flux; The theories that I was exposed to

only 6 or 7 years ago, no longer hold true;

In the end, we must recognize that man is limited in his perceptions and

abilities; Only with the help of God can we achieve success in this or any

other disease state;

I remain hopeful that a tremendous breakthrough is at hand; I just hope

it comes in time for me and all others in this club;

Re: My meeting with Dr. Morady

>

>

> Thank you as well for your advice; This group is truly a valuable

resources

> for AF patients; With the internet and the information revolution in full

> swing, the days of patient ignorance or blind faith in the medical

> establishment is beginning to wane;

> Of course, doctors still are the ones doing the operating and prescribing,

> so we have to rely upon them extensively, but they certainly are not the

> exclusive source of knowledge regarding medical issues as they once were.

>

>

>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

> Individual emails: Send a blank message to AFIBsupport-normalegroups

> Read on web only: Send a blank message to AFIBsupport-nomailegroups

>

>

[Guest guest]

>

> My personal goal is to stay afib free on one drug, till it

eventually stops

> working for me. Then I will move to the next, then the next. Until

there is

> a surgical procedure developed that is safe with a near 100%

success rate,

> then I go that route and I am cured.

Bobby, when you say stay afib free on a drug, do you mean you manage

no afib or just occasional weirdnesses like a racing pulse, or do you

mean truly nothing but normal sinus rhythm? Since I'm just starting

out, I'm trying to adjust my expectations. My doc originally put me

on tiazac, then I was switched to toprol xl, a big improvement, but

it is not suppressing everything. Which meds have you tried? How

long have they worked for you? Thanks.

[Guest guest]

> I got back this evening from my visit to the University Of Michigan

and Dr.

> Fred Morady, a leading electrophysiologist; He has been consulting

on my

> case for about 7 years;

> Dr. Morady came straightaway to my room while the nurse was

taking my

> blood pressure; He was very enthusiastic about something and asked

the nurse

> to leave us so we could have some privacy;

> I knew something must be up since normally I wait almost half an

hour

> after the nurse takes my history, blood pressure etc, but this time

the

> doctor was there at the start!!!

> After going through all of the medications I have been on the

past year

> (none of them really helpful except the Lopressor), he mentioned

that he and Call Bob Boehnke for info on this ablation Sunday. 440-

639-8087

> another colleauge at the University Of Michigan have pioneered and

refined a

> new radiofrequency ablation procedure which he highly recommends

for me; He

> said that I was the " perfect candidate " for this procedure;

> The procedure, like the baloon ablation, attempts to locate

the " foci " or

> lesions within the pulmonary arteries that he feels are causing my

AF;

> Unlike the baloon ablation however, which uses a super heated saline

> solution to cauterize (burn) off these lesions, Dr. Moradys

procedure

> utilizes high frequency radio waves which he feels are much more

precise,

> and hence the risk of causing damage to a pulmonary artery is much

less;

> Specifically, the risk of stroke is significant diminished; They

will have

> to use a micro catheter to pierce my endocardium and enter both

right and

> left atriums as well as the associated pulmonary arterties.

However, he

> stated that he wants to keep me in the hospital overnight for

observation

> afterwards and will institute a " heparin drip " to thin the blood;

Then I

> have to be on coumadin for two months;

> However, after that, he feels my AF will essentially be cured by

this

> procedure, with no need for any medications;

> I asked him if they were going to do an EP study before this

type of

> ablation, since such a study IS contemplated for the baloon

ablation; He

> said that no EP study would be performed, but that they would inject

> adrenaline into the heart to more precisely measure the source of

the foci;

> He also stated that I would be completely sedated during the rather

long, 6

> hour procedure. He also mentioned that they will go into the right

atrium

> and do some procedures (not explained to me yet) to correct " atrial

> flutter " ; Apparently by doing both the ablation and the atrial

flutter

> procedure, both AF and atrial flutter will essentially be cured; He

didnt

> use the word " cure " , but in essence thats how I intepreted his

comments.

> He also ordered a " cardiac CT scan " before the procedure is to be

done;

> He wont be able to do this procedure until February since he is

booked up,

> but if I need to have it done sooner, I could go with his

colleauge; But I

> think I will wait for Dr. Morady to perform this procedure

personally; He is

> the man with the world renowned credentials;

> So all in all, I was very pleased with todays meeting; However,

as usual,

> upon thinking things through I have some additional questions which

I will

> present to the doctor; Its a good thing I have a few months to get

all these

> issues settled in my mind first;

> My biggest concern is twofold; First, why they feel it necessary

to

> sedate me before the procedure is done; Usually, sedation is done

as a

> precaution when cardioversion is either contemplated or a real

possibility;

> If in fact, no EP study is to be done, and no deliberate provoking

of AF is

> contemplated, I dont understand the need for sedation;

> Second, the issue of injecting adrenalin into my heart to further

> pinpoint the source of the AF foci is troublesome and sounds

similar to an

> EP study to me;

> But I certainly will clarify these issues with Dr. Morady.

> We also discussed vagally induced AF briefly, and he stated that

there is

> no specific definitive test for vagal AF (I suggested an

interpretive EKG,

> he didnt pick up on it); He stated that Disoprymide is a good

vagolytic

> medication (which I am tempted to try once again); He also stated

that

> digestive problems causing AF can easily be caused adrenergically

as well;

> We didnt go further into this topic; I wish we had;

> I mentioned dofetylide and azimilide, and he didnt seem too

enthusiastic

> about either; Neither was he enthused about any of the newer

pacemakers

> being used to treat AF; He said in particular that the DAO (dynamic

atrial

> override) has turned out to be a disappointment in that it is not

performing

> as desired unless a full ablation of the AV nodes has occurred.

> We did not discuss the maze procedure; He seems to feel that

those, like

> me, who have brief (less than 5 minute AF episodes) but chronic

(daily

> episodes or near episodes with lots of ectopic beats) are the best

> candidates for this radiofrequency ablation procedure; He mentioned

nothing

> else in fact, unless of course I wished to try some medications

which I

> havent allready tried thus far like tambocor or flecainide.

> I told him I wanted to go ahead with this procedure; When the

time comes,

> I will have to " bite the bullett " and take the risks involved; But

if in

> fact, the reward is as great as promised, 6 hours of sedated hell

might be

> worth it!! HE HE

>

> Just thought I would share this with the group

>

>

[Guest guest]

Without meds, I am in afib 100% of the time. On Tambocor with Lopressor, I

am in NSR 100% of the time. I have a breakthrough (afib) maybe once a year.

The last time was New Years Day, which I attribute to partying the night

before. I reverted after about 4 hours after taking an extra Tambocor. I

have what seems like a premature beat maybe once or twice a day. All other

times my heart beat is like clockwork, 60 beats per minute at rest, getting

up to around 100 with extreme activity. My ECG shows normal, but sometimes

" enlarged atria " , as indicated by the ECG machine and printed on the top of

the chart. I am surprised that the ECG shows that after five years of NSR,

but I believe I have been in afib since childhood. I am 39 now.

I have been in on Tambocor and in NSR for over four years. I started on a

dose of 100 mg twice a day (with the Lopressor), but I had a breakthrough

after around a month, and the dosage was increased to 150 mg twice a day,

which I believe is the maximum recommended. Others on this list are on much

smaller doses. I do not expect it to work indefinitely, and feel lucky that

I have gone this lone in NSR.

After diagnosis, I was put on Coumadin and Digoxin, then verapamil, then

Tambocor (flecainide).

Re: My meeting with Dr. Morady

>

> My personal goal is to stay afib free on one drug, till it

eventually stops

> working for me. Then I will move to the next, then the next. Until

there is

> a surgical procedure developed that is safe with a near 100%

success rate,

> then I go that route and I am cured.

Bobby, when you say stay afib free on a drug, do you mean you manage

no afib or just occasional weirdnesses like a racing pulse, or do you

mean truly nothing but normal sinus rhythm? Since I'm just starting

out, I'm trying to adjust my expectations. My doc originally put me

on tiazac, then I was switched to toprol xl, a big improvement, but

it is not suppressing everything. Which meds have you tried? How

long have they worked for you? Thanks.

Web Page /group/AFIBsupport

Afibbers Database- http://www.dialsolutions.com/af

To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

Daily digest mode: Send a blank message to AFIBsupport-digestegroups

Individual emails: Send a blank message to AFIBsupport-normalegroups

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[Guest guest]

I was interested in reading your note about being denied coumadin by your

doctors. That was the first thing my doctors did - put me on coumadin - when

it was discovered I had AFib. I have been taking coumadin for four years (I

must get a blood test every month and adjust my dose now and again) without

any negative effects. I am 62. Maybe I was " close " to 60 when I first began

taking it. Also I take 100mg of toprol once a day but I have been taking

that for only 6 months. After reading all of the postings from other people I

realize I have very conservative cardiologists and general practice doctor.

They all advise a " wait and see " attitude and seem to think that some kind of

cure will come up in the next two to four years. There is so much more work

being done on our affliction now than in previous years.

I like the idea of a foundation. Maybe Bill Bradley will be our honorary

chairman since his condition certainly provided some publicity for our health

problem.

Sharon

[Guest guest]

In a message dated 11/19/2000 9:38:43 AM Eastern Standard Time,

brmorgan@... writes:

> I wonder what state you live in; Also, I was told by all of my doctors, that

> they would refuse to prescribe coumadin to me until I was at least 60 years

> of age; Maybe its because of my young looking face, but I cant get these

> damn doctors to take me seriously; I always suspect that others are getting

> better medical care than I am; No, I am not some wimp, but what the heck

> does it take to get doctors to take you seriously? How many ER trips?

> Perhaps its because I live in Michigan, or maybe I am especially cursed;

> I have wanted coumadin for years;

>

My understanding is that the coumadin is generally prescribed (at any age) if

the affib is having a duration of more than 24-48 hours on a " fairly

consistent basis " -not sure how to define a fairly consistent basis-the

coumadin is being pushed on me now as my affib attacks are lasting longer and

the risk of stroke goes up the longer the affib lasts-I do not want coumadin

and the myriad of blood tests, life style changes,worryabout internal

injuries, cuts etc- on the other hand the antiarrythmics are the real poison

pills to me-but what do you do if the medical people have nothing else too

keep the affib attacks at a low rate and therefore keep your atrium from

becoming enlarged from the affib-too me that is the dilemna of affib-it is

not dangerous in itself but in the percentage of people who eventually have

strokes and/or enlarged hearts from it-

jerry

[Guest guest]

> In a message dated 11/19/00 10:31:45 AM Pacific Standard Time,

> trudyjh@a... writes:

>

> << I know aspirin is less effective, but I am happy to stay on

> aspirin as long as I am not in continuous afib for more than a

day.

> (My doc said the clot danger was at the 2-3 day mark of continuous

> afib.) >>

> My older brother has been in continuous a-fib for an unknown

length of time,

> but his doctor believes it has probably been at least twenty to

thirty years

> or longer. He has never taken Coumadin and didn't take even

aspirin until

> about eight years ago. He has never had a stroke. His doctor told

him that

> going in and out of a-fib, as I do, poses a greater stroke risk

than staying

> permanently in a-fib. Because I think he was just lucky, I take my

Coumadin

> every day. I can live with a-fib, but I know I would find it

catastrophic to

> live with the results of a stroke.

Hi, , the explanation my doc gave me is that during afib, blood

tends to stagnate in the atria and possibly clot and then when one

goes back into sinus rhythm, the clots can get flushed out. So that

sounds right. I have been thinking I am darn lucky that after my

initial week in afib and then my spontaneou reverting to sinus, that

nothing like this happened. I was not taking aspirin at the time,

because I was scheduled for a medical procedure in that week, but my

doc clearly should have said start aspirin right afterwards, I would

think.

[Guest guest]

Good answer!!

Thank you

Re: Re: My meeting with Dr. Morady

> In a message dated 11/19/2000 9:38:43 AM Eastern Standard Time,

> brmorgan@... writes:

>

>

> > I wonder what state you live in; Also, I was told by all of my doctors,

that

> > they would refuse to prescribe coumadin to me until I was at least 60

years

> > of age; Maybe its because of my young looking face, but I cant get these

> > damn doctors to take me seriously; I always suspect that others are

getting

> > better medical care than I am; No, I am not some wimp, but what the heck

> > does it take to get doctors to take you seriously? How many ER trips?

> > Perhaps its because I live in Michigan, or maybe I am especially cursed;

> > I have wanted coumadin for years;

> >

>

> My understanding is that the coumadin is generally prescribed (at any age)

if

> the affib is having a duration of more than 24-48 hours on a " fairly

> consistent basis " -not sure how to define a fairly consistent basis-the

> coumadin is being pushed on me now as my affib attacks are lasting longer

and

> the risk of stroke goes up the longer the affib lasts-I do not want

coumadin

> and the myriad of blood tests, life style changes,worryabout internal

> injuries, cuts etc- on the other hand the antiarrythmics are the real

poison

> pills to me-but what do you do if the medical people have nothing else too

> keep the affib attacks at a low rate and therefore keep your atrium from

> becoming enlarged from the affib-too me that is the dilemna of affib-it is

> not dangerous in itself but in the percentage of people who eventually

have

> strokes and/or enlarged hearts from it-

> jerry

>

>

>

[Guest guest]

,

This sounds like the procedure my cardiologist is recommending. An

electrophysiologist has been doing them in Canada for a year or so

and indicates a 60 to 80% success rate for a " young " patient without

other heart problems. Like you, I have been considering this

option. There is obviously a risk of stroke from the procedure so if

your a/fib is relatively controlled with short episodes then perhaps

it is too soon to try this operation.

Greg

> I got back this evening from my visit to the University Of Michigan

and Dr.

> Fred Morady, a leading electrophysiologist; He has been consulting

on my

> case for about 7 years;

> Dr. Morady came straightaway to my room while the nurse was

taking my

> blood pressure; He was very enthusiastic about something and asked

the nurse

> to leave us so we could have some privacy;

> I knew something must be up since normally I wait almost half an

hour

> after the nurse takes my history, blood pressure etc, but this time

the

> doctor was there at the start!!!

> After going through all of the medications I have been on the

past year

> (none of them really helpful except the Lopressor), he mentioned

that he and

> another colleauge at the University Of Michigan have pioneered and

refined a

> new radiofrequency ablation procedure which he highly recommends

for me; He

> said that I was the " perfect candidate " for this procedure;

> The procedure, like the baloon ablation, attempts to locate

the " foci " or

> lesions within the pulmonary arteries that he feels are causing my

AF;

> Unlike the baloon ablation however, which uses a super heated saline

> solution to cauterize (burn) off these lesions, Dr. Moradys

procedure

> utilizes high frequency radio waves which he feels are much more

precise,

> and hence the risk of causing damage to a pulmonary artery is much

less;

> Specifically, the risk of stroke is significant diminished; They

will have

> to use a micro catheter to pierce my endocardium and enter both

right and

> left atriums as well as the associated pulmonary arterties.

However, he

> stated that he wants to keep me in the hospital overnight for

observation

> afterwards and will institute a " heparin drip " to thin the blood;

Then I

> have to be on coumadin for two months;

> However, after that, he feels my AF will essentially be cured by

this

> procedure, with no need for any medications;

> I asked him if they were going to do an EP study before this

type of

> ablation, since such a study IS contemplated for the baloon

ablation; He

> said that no EP study would be performed, but that they would inject

> adrenaline into the heart to more precisely measure the source of

the foci;

> He also stated that I would be completely sedated during the rather

long, 6

> hour procedure. He also mentioned that they will go into the right

atrium

> and do some procedures (not explained to me yet) to correct " atrial

> flutter " ; Apparently by doing both the ablation and the atrial

flutter

> procedure, both AF and atrial flutter will essentially be cured; He

didnt

> use the word " cure " , but in essence thats how I intepreted his

comments.

> He also ordered a " cardiac CT scan " before the procedure is to be

done;

> He wont be able to do this procedure until February since he is

booked up,

> but if I need to have it done sooner, I could go with his

colleauge; But I

> think I will wait for Dr. Morady to perform this procedure

personally; He is

> the man with the world renowned credentials;

> So all in all, I was very pleased with todays meeting; However,

as usual,

> upon thinking things through I have some additional questions which

I will

> present to the doctor; Its a good thing I have a few months to get

all these

> issues settled in my mind first;

> My biggest concern is twofold; First, why they feel it necessary

to

> sedate me before the procedure is done; Usually, sedation is done

as a

> precaution when cardioversion is either contemplated or a real

possibility;

> If in fact, no EP study is to be done, and no deliberate provoking

of AF is

> contemplated, I dont understand the need for sedation;

> Second, the issue of injecting adrenalin into my heart to further

> pinpoint the source of the AF foci is troublesome and sounds

similar to an

> EP study to me;

> But I certainly will clarify these issues with Dr. Morady.

> We also discussed vagally induced AF briefly, and he stated that

there is

> no specific definitive test for vagal AF (I suggested an

interpretive EKG,

> he didnt pick up on it); He stated that Disoprymide is a good

vagolytic

> medication (which I am tempted to try once again); He also stated

that

> digestive problems causing AF can easily be caused adrenergically

as well;

> We didnt go further into this topic; I wish we had;

> I mentioned dofetylide and azimilide, and he didnt seem too

enthusiastic

> about either; Neither was he enthused about any of the newer

pacemakers

> being used to treat AF; He said in particular that the DAO (dynamic

atrial

> override) has turned out to be a disappointment in that it is not

performing

> as desired unless a full ablation of the AV nodes has occurred.

> We did not discuss the maze procedure; He seems to feel that

those, like

> me, who have brief (less than 5 minute AF episodes) but chronic

(daily

> episodes or near episodes with lots of ectopic beats) are the best

> candidates for this radiofrequency ablation procedure; He mentioned

nothing

> else in fact, unless of course I wished to try some medications

which I

> havent allready tried thus far like tambocor or flecainide.

> I told him I wanted to go ahead with this procedure; When the

time comes,

> I will have to " bite the bullett " and take the risks involved; But

if in

> fact, the reward is as great as promised, 6 hours of sedated hell

might be

> worth it!! HE HE

>

> Just thought I would share this with the group

>

>

[Guest guest]

Deja Vu!!!

My EP told me the same exact thing, I am the perfect candidate for a new

Catheter Ablation technique that will probably cure my AF, it mimics the

maze procedure but it much safer, etc., etc.

I had this experimental procedure done. It did not work. In fact may have

made things worse.

Proceed with caution.

Note: My procedure was not the exact same one that your doc is advising.

Mine was done through CARDIMA. www.cardima.com . They claim an 80% success

rate. These experimental studies always claim high success rate, but they

define success in a strange way that is hard to decipher. They don't tell

you about the " recurrence rate " of 80%.

It seems to me that if there were a catheter ablation technique that had

reasonably good success rates everyone would do it.

Eventually I gave up on all of these new unproven procedures and had the

surgical maze done. No AF since surgery, no medications.

Good Luck and God Bless, Bob Reiley

My meeting with Dr. Morady

I got back this evening from my visit to the University Of Michigan and Dr.

Fred Morady, a leading electrophysiologist; He has been consulting on my

case for about 7 years;

Dr. Morady came straightaway to my room while the nurse was taking my

blood pressure; He was very enthusiastic about something and asked the nurse

to leave us so we could have some privacy;

I knew something must be up since normally I wait almost half an hour

after the nurse takes my history, blood pressure etc, but this time the

doctor was there at the start!!!

After going through all of the medications I have been on the past year

(none of them really helpful except the Lopressor), he mentioned that he and

another colleauge at the University Of Michigan have pioneered and refined a

new radiofrequency ablation procedure which he highly recommends for me; He

said that I was the " perfect candidate " for this procedure;

The procedure, like the baloon ablation, attempts to locate the " foci " or

lesions within the pulmonary arteries that he feels are causing my AF;

Unlike the baloon ablation however, which uses a super heated saline

solution to cauterize (burn) off these lesions, Dr. Moradys procedure

utilizes high frequency radio waves which he feels are much more precise,

and hence the risk of causing damage to a pulmonary artery is much less;

Specifically, the risk of stroke is significant diminished; They will have

to use a micro catheter to pierce my endocardium and enter both right and

left atriums as well as the associated pulmonary arterties. However, he

stated that he wants to keep me in the hospital overnight for observation

afterwards and will institute a " heparin drip " to thin the blood; Then I

have to be on coumadin for two months;

However, after that, he feels my AF will essentially be cured by this

procedure, with no need for any medications;

I asked him if they were going to do an EP study before this type of

ablation, since such a study IS contemplated for the baloon ablation; He

said that no EP study would be performed, but that they would inject

adrenaline into the heart to more precisely measure the source of the foci;

He also stated that I would be completely sedated during the rather long, 6

hour procedure. He also mentioned that they will go into the right atrium

and do some procedures (not explained to me yet) to correct " atrial

flutter " ; Apparently by doing both the ablation and the atrial flutter

procedure, both AF and atrial flutter will essentially be cured; He didnt

use the word " cure " , but in essence thats how I intepreted his comments.

He also ordered a " cardiac CT scan " before the procedure is to be done;

He wont be able to do this procedure until February since he is booked up,

but if I need to have it done sooner, I could go with his colleauge; But I

think I will wait for Dr. Morady to perform this procedure personally; He is

the man with the world renowned credentials;

So all in all, I was very pleased with todays meeting; However, as usual,

upon thinking things through I have some additional questions which I will

present to the doctor; Its a good thing I have a few months to get all these

issues settled in my mind first;

My biggest concern is twofold; First, why they feel it necessary to

sedate me before the procedure is done; Usually, sedation is done as a

precaution when cardioversion is either contemplated or a real possibility;

If in fact, no EP study is to be done, and no deliberate provoking of AF is

contemplated, I dont understand the need for sedation;

Second, the issue of injecting adrenalin into my heart to further

pinpoint the source of the AF foci is troublesome and sounds similar to an

EP study to me;

But I certainly will clarify these issues with Dr. Morady.

We also discussed vagally induced AF briefly, and he stated that there is

no specific definitive test for vagal AF (I suggested an interpretive EKG,

he didnt pick up on it); He stated that Disoprymide is a good vagolytic

medication (which I am tempted to try once again); He also stated that

digestive problems causing AF can easily be caused adrenergically as well;

We didnt go further into this topic; I wish we had;

I mentioned dofetylide and azimilide, and he didnt seem too enthusiastic

about either; Neither was he enthused about any of the newer pacemakers

being used to treat AF; He said in particular that the DAO (dynamic atrial

override) has turned out to be a disappointment in that it is not performing

as desired unless a full ablation of the AV nodes has occurred.

We did not discuss the maze procedure; He seems to feel that those, like

me, who have brief (less than 5 minute AF episodes) but chronic (daily

episodes or near episodes with lots of ectopic beats) are the best

candidates for this radiofrequency ablation procedure; He mentioned nothing

else in fact, unless of course I wished to try some medications which I

havent allready tried thus far like tambocor or flecainide.

I told him I wanted to go ahead with this procedure; When the time comes,

I will have to " bite the bullett " and take the risks involved; But if in

fact, the reward is as great as promised, 6 hours of sedated hell might be

worth it!! HE HE

Just thought I would share this with the group

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[Guest guest]

Good point!!

This is going to be a tough decision, since I do not wish to do anything

which might cause harm; I have to weigh the possible benefits against the

known risks. I have no other structural heart problem (that I know of); I am

definitely going through with the cardiac CT scan; That might clarify things

further, and indicate if there are in fact additional cardiac issues I have

to deal with; I am 43 and not a teenager, But in all other respects, I am

much younger looking and feeling than most men my age; I feel more like 33,

so the demographics arent always illustrative of a persons true age.

I guess it comes down to the dangers of doing nothing at this point, the

status quo, versus doing something with both probable benefit and known

risks;

Its going to go down to the wire; About like the American Presidential

election; LOL, LOL

Re: My meeting with Dr. Morady

>

> ,

>

> This sounds like the procedure my cardiologist is recommending. An

> electrophysiologist has been doing them in Canada for a year or so

> and indicates a 60 to 80% success rate for a " young " patient without

> other heart problems. Like you, I have been considering this

> option. There is obviously a risk of stroke from the procedure so if

> your a/fib is relatively controlled with short episodes then perhaps

> it is too soon to try this operation.

>

> Greg

>

> > I got back this evening from my visit to the University Of Michigan

> and Dr.

> > Fred Morady, a leading electrophysiologist; He has been consulting

> on my

> > case for about 7 years;

> > Dr. Morady came straightaway to my room while the nurse was

> taking my

> > blood pressure; He was very enthusiastic about something and asked

> the nurse

> > to leave us so we could have some privacy;

> > I knew something must be up since normally I wait almost half an

> hour

> > after the nurse takes my history, blood pressure etc, but this time

> the

> > doctor was there at the start!!!

> > After going through all of the medications I have been on the

> past year

> > (none of them really helpful except the Lopressor), he mentioned

> that he and

> > another colleauge at the University Of Michigan have pioneered and

> refined a

> > new radiofrequency ablation procedure which he highly recommends

> for me; He

> > said that I was the " perfect candidate " for this procedure;

> > The procedure, like the baloon ablation, attempts to locate

> the " foci " or

> > lesions within the pulmonary arteries that he feels are causing my

> AF;

> > Unlike the baloon ablation however, which uses a super heated saline

> > solution to cauterize (burn) off these lesions, Dr. Moradys

> procedure

> > utilizes high frequency radio waves which he feels are much more

> precise,

> > and hence the risk of causing damage to a pulmonary artery is much

> less;

> > Specifically, the risk of stroke is significant diminished; They

> will have

> > to use a micro catheter to pierce my endocardium and enter both

> right and

> > left atriums as well as the associated pulmonary arterties.

> However, he

> > stated that he wants to keep me in the hospital overnight for

> observation

> > afterwards and will institute a " heparin drip " to thin the blood;

> Then I

> > have to be on coumadin for two months;

> > However, after that, he feels my AF will essentially be cured by

> this

> > procedure, with no need for any medications;

> > I asked him if they were going to do an EP study before this

> type of

> > ablation, since such a study IS contemplated for the baloon

> ablation; He

> > said that no EP study would be performed, but that they would inject

> > adrenaline into the heart to more precisely measure the source of

> the foci;

> > He also stated that I would be completely sedated during the rather

> long, 6

> > hour procedure. He also mentioned that they will go into the right

> atrium

> > and do some procedures (not explained to me yet) to correct " atrial

> > flutter " ; Apparently by doing both the ablation and the atrial

> flutter

> > procedure, both AF and atrial flutter will essentially be cured; He

> didnt

> > use the word " cure " , but in essence thats how I intepreted his

> comments.

> > He also ordered a " cardiac CT scan " before the procedure is to be

> done;

> > He wont be able to do this procedure until February since he is

> booked up,

> > but if I need to have it done sooner, I could go with his

> colleauge; But I

> > think I will wait for Dr. Morady to perform this procedure

> personally; He is

> > the man with the world renowned credentials;

> > So all in all, I was very pleased with todays meeting; However,

> as usual,

> > upon thinking things through I have some additional questions which

> I will

> > present to the doctor; Its a good thing I have a few months to get

> all these

> > issues settled in my mind first;

> > My biggest concern is twofold; First, why they feel it necessary

> to

> > sedate me before the procedure is done; Usually, sedation is done

> as a

> > precaution when cardioversion is either contemplated or a real

> possibility;

> > If in fact, no EP study is to be done, and no deliberate provoking

> of AF is

> > contemplated, I dont understand the need for sedation;

> > Second, the issue of injecting adrenalin into my heart to further

> > pinpoint the source of the AF foci is troublesome and sounds

> similar to an

> > EP study to me;

> > But I certainly will clarify these issues with Dr. Morady.

> > We also discussed vagally induced AF briefly, and he stated that

> there is

> > no specific definitive test for vagal AF (I suggested an

> interpretive EKG,

> > he didnt pick up on it); He stated that Disoprymide is a good

> vagolytic

> > medication (which I am tempted to try once again); He also stated

> that

> > digestive problems causing AF can easily be caused adrenergically

> as well;

> > We didnt go further into this topic; I wish we had;

> > I mentioned dofetylide and azimilide, and he didnt seem too

> enthusiastic

> > about either; Neither was he enthused about any of the newer

> pacemakers

> > being used to treat AF; He said in particular that the DAO (dynamic

> atrial

> > override) has turned out to be a disappointment in that it is not

> performing

> > as desired unless a full ablation of the AV nodes has occurred.

> > We did not discuss the maze procedure; He seems to feel that

> those, like

> > me, who have brief (less than 5 minute AF episodes) but chronic

> (daily

> > episodes or near episodes with lots of ectopic beats) are the best

> > candidates for this radiofrequency ablation procedure; He mentioned

> nothing

> > else in fact, unless of course I wished to try some medications

> which I

> > havent allready tried thus far like tambocor or flecainide.

> > I told him I wanted to go ahead with this procedure; When the

> time comes,

> > I will have to " bite the bullett " and take the risks involved; But

> if in

> > fact, the reward is as great as promised, 6 hours of sedated hell

> might be

> > worth it!! HE HE

> >

> > Just thought I would share this with the group

> >

> >

>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

> Individual emails: Send a blank message to AFIBsupport-normalegroups

> Read on web only: Send a blank message to AFIBsupport-nomailegroups

>

>

[Guest guest]

You are probably correct; I was talking yesterday to a member who had a

similar procedure done to cure atrial flutter; After undergoing an extensive

procedure, he happened, weeks later, to stop by his doctors office for an

EKG, and discovered that he was in an episode of atrial flutter at the time;

This after his procedure was touted to him as a cure for that;

I am so torn by all of this; I so desperately want there to be a cure, but I

know that it is prudent to proceed with caution and I take very seriously

the comments of many in here to do just that based upon their own personal

experience with similar (and in one case the same procedure, same hospital,

same doctor).

I suppose the maze is an option for me as well, but then again, one of my

EP's tells me to avoid it since, being over the age of 40, the success rate

diminishes to 40%; But I am sure there are those, both within and without

the medical community who would dispute that assessment as well.

When faced with tough decisions, I cannot rely exclusively upon my own

devices, but upon my Lord; Man is man, and God is God; I am his instrument

in this world, and ultimately his child. I dont mean to get too religious in

here, but there is a passage in the Old Testament (cant remember the

specific citation) that states " there is a way unto a man that APPEARS

right and just, but the end thereof is death " ;

My meeting with Dr. Morady

>

>

> I got back this evening from my visit to the University Of Michigan and

Dr.

> Fred Morady, a leading electrophysiologist; He has been consulting on my

> case for about 7 years;

> Dr. Morady came straightaway to my room while the nurse was taking my

> blood pressure; He was very enthusiastic about something and asked the

nurse

> to leave us so we could have some privacy;

> I knew something must be up since normally I wait almost half an hour

> after the nurse takes my history, blood pressure etc, but this time the

> doctor was there at the start!!!

> After going through all of the medications I have been on the past year

> (none of them really helpful except the Lopressor), he mentioned that he

and

> another colleauge at the University Of Michigan have pioneered and refined

a

> new radiofrequency ablation procedure which he highly recommends for me;

He

> said that I was the " perfect candidate " for this procedure;

> The procedure, like the baloon ablation, attempts to locate the " foci "

or

> lesions within the pulmonary arteries that he feels are causing my AF;

> Unlike the baloon ablation however, which uses a super heated saline

> solution to cauterize (burn) off these lesions, Dr. Moradys procedure

> utilizes high frequency radio waves which he feels are much more precise,

> and hence the risk of causing damage to a pulmonary artery is much less;

> Specifically, the risk of stroke is significant diminished; They will have

> to use a micro catheter to pierce my endocardium and enter both right and

> left atriums as well as the associated pulmonary arterties. However, he

> stated that he wants to keep me in the hospital overnight for observation

> afterwards and will institute a " heparin drip " to thin the blood; Then I

> have to be on coumadin for two months;

> However, after that, he feels my AF will essentially be cured by this

> procedure, with no need for any medications;

> I asked him if they were going to do an EP study before this type of

> ablation, since such a study IS contemplated for the baloon ablation; He

> said that no EP study would be performed, but that they would inject

> adrenaline into the heart to more precisely measure the source of the

foci;

> He also stated that I would be completely sedated during the rather long,

6

> hour procedure. He also mentioned that they will go into the right atrium

> and do some procedures (not explained to me yet) to correct " atrial

> flutter " ; Apparently by doing both the ablation and the atrial flutter

> procedure, both AF and atrial flutter will essentially be cured; He didnt

> use the word " cure " , but in essence thats how I intepreted his comments.

> He also ordered a " cardiac CT scan " before the procedure is to be done;

> He wont be able to do this procedure until February since he is booked

up,

> but if I need to have it done sooner, I could go with his colleauge; But I

> think I will wait for Dr. Morady to perform this procedure personally; He

is

> the man with the world renowned credentials;

> So all in all, I was very pleased with todays meeting; However, as

usual,

> upon thinking things through I have some additional questions which I will

> present to the doctor; Its a good thing I have a few months to get all the

se

> issues settled in my mind first;

> My biggest concern is twofold; First, why they feel it necessary to

> sedate me before the procedure is done; Usually, sedation is done as a

> precaution when cardioversion is either contemplated or a real

possibility;

> If in fact, no EP study is to be done, and no deliberate provoking of AF

is

> contemplated, I dont understand the need for sedation;

> Second, the issue of injecting adrenalin into my heart to further

> pinpoint the source of the AF foci is troublesome and sounds similar to an

> EP study to me;

> But I certainly will clarify these issues with Dr. Morady.

> We also discussed vagally induced AF briefly, and he stated that there

is

> no specific definitive test for vagal AF (I suggested an interpretive EKG,

> he didnt pick up on it); He stated that Disoprymide is a good vagolytic

> medication (which I am tempted to try once again); He also stated that

> digestive problems causing AF can easily be caused adrenergically as well;

> We didnt go further into this topic; I wish we had;

> I mentioned dofetylide and azimilide, and he didnt seem too

enthusiastic

> about either; Neither was he enthused about any of the newer pacemakers

> being used to treat AF; He said in particular that the DAO (dynamic atrial

> override) has turned out to be a disappointment in that it is not

performing

> as desired unless a full ablation of the AV nodes has occurred.

> We did not discuss the maze procedure; He seems to feel that those,

like

> me, who have brief (less than 5 minute AF episodes) but chronic (daily

> episodes or near episodes with lots of ectopic beats) are the best

> candidates for this radiofrequency ablation procedure; He mentioned

nothing

> else in fact, unless of course I wished to try some medications which I

> havent allready tried thus far like tambocor or flecainide.

> I told him I wanted to go ahead with this procedure; When the time

comes,

> I will have to " bite the bullett " and take the risks involved; But if in

> fact, the reward is as great as promised, 6 hours of sedated hell might be

> worth it!! HE HE

>

> Just thought I would share this with the group

>

>

>

>

>

>

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>

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>

>

[Guest guest]

, I was a patient of Dr. Marody's up until about two months ago. He is

my hero, because he is the doctor who, after a 30 day monitoring,

definitively said that I had vagal atrial fibrillation. As a result I came

off all of the medications, including Sotalol, because they were making the

condition worse. I'm now not on any medications, except an aspirin a day. I

go into AF about once every six to seven weeks or so, always at night. I now

take 200 mg. Norpace every four hours and usually come out of Af in about

10-15 hours, and discontinue the medication until the next episode.

(Previously, whenever I went into AF, I had to have a cardioversion).For me,

Dr. Marody recommended that I do nothing, since the episodes are so far

apart. If you are concerned about the potential risks, just ask him about

them. He is a very candid man. Dorean

[Guest guest]

In a message dated 11/20/2000 6:06:39 PM Eastern Standard Time,

brmorgan@... writes:

> I suppose the maze is an option for me as well, but then again, one of my

> EP's tells me to avoid it since, being over the age of 40, the success rate

> diminishes to 40%; But I am sure there are those, both within and without

> the medical community who would dispute that assessment as well.

>

You are right to proceed with caution, as its your body and your life-also

there will be no guarantees that this ablation procedure will work-on one

hand its exciting to be doing something about the affib on the other hand ,

the procedure is new and does not really have much of a track record yet-at

the very least you need to analyze it, make a list of questions and meet/call

your dr. before you make any decisioni have not read anywhere that the Maze

goes down to a 40% success when you are over 40, does not sound correct to

me-maze is a big time decision and no one knows if in a year or two something

less invasive will be discovered-i also have considered the maze and my ep

says absolutely not, its too dangerous. with too many risks, but so is living

with affib or treating it with toxic drugs-i do find it strange that the maze

is not done by more drs. and that it is not done by anyone in my state of new

york-tough, tough decisions

jerry

[Guest guest]

I agree with you; I have found Dr. Morady to be conscientious, businesslike,

and frank in his dealings with me; I am sure he will address my concerns

well before February; I even have his e mail address and have posed several

questions to him during the past 6 months; I hate to abuse the privilege

however; LOL

Re: My meeting with Dr. Morady

> , I was a patient of Dr. Marody's up until about two months ago. He

is

> my hero, because he is the doctor who, after a 30 day monitoring,

> definitively said that I had vagal atrial fibrillation. As a result I

came

> off all of the medications, including Sotalol, because they were making

the

> condition worse. I'm now not on any medications, except an aspirin a day.

I

> go into AF about once every six to seven weeks or so, always at night. I

now

> take 200 mg. Norpace every four hours and usually come out of Af in about

> 10-15 hours, and discontinue the medication until the next episode.

> (Previously, whenever I went into AF, I had to have a cardioversion).For

me,

> Dr. Marody recommended that I do nothing, since the episodes are so far

> apart. If you are concerned about the potential risks, just ask him about

> them. He is a very candid man. Dorean

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

> Individual emails: Send a blank message to AFIBsupport-normalegroups

> Read on web only: Send a blank message to AFIBsupport-nomailegroups

>

>

[Guest guest]

Yes these are very difficult decisions; We are sort of like generals

planning a military campaign and being given several different competing

options, each camp denigrating the potential strategic outcome of the others

plans; All of this proves that medicine, and actually life itself, is not

really a pure science, but part science, part art;

The role of intuition in this cannot be ignored.

Re: My meeting with Dr. Morady

> In a message dated 11/20/2000 6:06:39 PM Eastern Standard Time,

> brmorgan@... writes:

>

>

> > I suppose the maze is an option for me as well, but then again, one of

my

> > EP's tells me to avoid it since, being over the age of 40, the success

rate

> > diminishes to 40%; But I am sure there are those, both within and

without

> > the medical community who would dispute that assessment as well.

> >

>

> You are right to proceed with caution, as its your body and your life-also

> there will be no guarantees that this ablation procedure will work-on one

> hand its exciting to be doing something about the affib on the other hand

,

> the procedure is new and does not really have much of a track record

yet-at

> the very least you need to analyze it, make a list of questions and

meet/call

> your dr. before you make any decisioni have not read anywhere that the

Maze

> goes down to a 40% success when you are over 40, does not sound correct to

> me-maze is a big time decision and no one knows if in a year or two

something

> less invasive will be discovered-i also have considered the maze and my ep

> says absolutely not, its too dangerous. with too many risks, but so is

living

> with affib or treating it with toxic drugs-i do find it strange that the

maze

> is not done by more drs. and that it is not done by anyone in my state of

new

> york-tough, tough decisions

> jerry

>

>

>

>

[Guest guest]

>I agree with you; I have found Dr. Morady to be conscientious, businesslike,

>and frank in his dealings with me; I am sure he will address my concerns

>well before February; I even have his e mail address and have posed several

>questions to him during the past 6 months; I hate to abuse the privilege

>however; LOL

perhaps he would like to join the group

--

D

[Guest guest]

Good idea!! I will ask him

Re: My meeting with Dr. Morady

> >I agree with you; I have found Dr. Morady to be conscientious,

businesslike,

> >and frank in his dealings with me; I am sure he will address my concerns

> >well before February; I even have his e mail address and have posed

several

> >questions to him during the past 6 months; I hate to abuse the privilege

> >however; LOL

>

> perhaps he would like to join the group

>

> --

> D

>

>

>

>

>

> Web Page /group/AFIBsupport

> Afibbers Database- http://www.dialsolutions.com/af

> To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

> Daily digest mode: Send a blank message to AFIBsupport-digestegroups

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>

>

[Guest guest]

-

I had this procedure at U of M Sept 21 and again October 26 as part of an

experimental study.

Results are not clear.

Procedure is very extensive.

Recommend you proceed cautiously.

Bob Potocki

Brighton, Mi

My meeting with Dr. Morady

I got back this evening from my visit to the University Of Michigan and Dr.

Fred Morady, a leading electrophysiologist; He has been consulting on my

case for about 7 years;

Dr. Morady came straightaway to my room while the nurse was taking my

blood pressure; He was very enthusiastic about something and asked the nurse

to leave us so we could have some privacy;

I knew something must be up since normally I wait almost half an hour

after the nurse takes my history, blood pressure etc, but this time the

doctor was there at the start!!!

After going through all of the medications I have been on the past year

(none of them really helpful except the Lopressor), he mentioned that he and

another colleauge at the University Of Michigan have pioneered and refined a

new radiofrequency ablation procedure which he highly recommends for me; He

said that I was the " perfect candidate " for this procedure;

The procedure, like the baloon ablation, attempts to locate the " foci " or

lesions within the pulmonary arteries that he feels are causing my AF;

Unlike the baloon ablation however, which uses a super heated saline

solution to cauterize (burn) off these lesions, Dr. Moradys procedure

utilizes high frequency radio waves which he feels are much more precise,

and hence the risk of causing damage to a pulmonary artery is much less;

Specifically, the risk of stroke is significant diminished; They will have

to use a micro catheter to pierce my endocardium and enter both right and

left atriums as well as the associated pulmonary arterties. However, he

stated that he wants to keep me in the hospital overnight for observation

afterwards and will institute a " heparin drip " to thin the blood; Then I

have to be on coumadin for two months;

However, after that, he feels my AF will essentially be cured by this

procedure, with no need for any medications;

I asked him if they were going to do an EP study before this type of

ablation, since such a study IS contemplated for the baloon ablation; He

said that no EP study would be performed, but that they would inject

adrenaline into the heart to more precisely measure the source of the foci;

He also stated that I would be completely sedated during the rather long, 6

hour procedure. He also mentioned that they will go into the right atrium

and do some procedures (not explained to me yet) to correct " atrial

flutter " ; Apparently by doing both the ablation and the atrial flutter

procedure, both AF and atrial flutter will essentially be cured; He didnt

use the word " cure " , but in essence thats how I intepreted his comments.

He also ordered a " cardiac CT scan " before the procedure is to be done;

He wont be able to do this procedure until February since he is booked up,

but if I need to have it done sooner, I could go with his colleauge; But I

think I will wait for Dr. Morady to perform this procedure personally; He is

the man with the world renowned credentials;

So all in all, I was very pleased with todays meeting; However, as usual,

upon thinking things through I have some additional questions which I will

present to the doctor; Its a good thing I have a few months to get all these

issues settled in my mind first;

My biggest concern is twofold; First, why they feel it necessary to

sedate me before the procedure is done; Usually, sedation is done as a

precaution when cardioversion is either contemplated or a real possibility;

If in fact, no EP study is to be done, and no deliberate provoking of AF is

contemplated, I dont understand the need for sedation;

Second, the issue of injecting adrenalin into my heart to further

pinpoint the source of the AF foci is troublesome and sounds similar to an

EP study to me;

But I certainly will clarify these issues with Dr. Morady.

We also discussed vagally induced AF briefly, and he stated that there is

no specific definitive test for vagal AF (I suggested an interpretive EKG,

he didnt pick up on it); He stated that Disoprymide is a good vagolytic

medication (which I am tempted to try once again); He also stated that

digestive problems causing AF can easily be caused adrenergically as well;

We didnt go further into this topic; I wish we had;

I mentioned dofetylide and azimilide, and he didnt seem too enthusiastic

about either; Neither was he enthused about any of the newer pacemakers

being used to treat AF; He said in particular that the DAO (dynamic atrial

override) has turned out to be a disappointment in that it is not performing

as desired unless a full ablation of the AV nodes has occurred.

We did not discuss the maze procedure; He seems to feel that those, like

me, who have brief (less than 5 minute AF episodes) but chronic (daily

episodes or near episodes with lots of ectopic beats) are the best

candidates for this radiofrequency ablation procedure; He mentioned nothing

else in fact, unless of course I wished to try some medications which I

havent allready tried thus far like tambocor or flecainide.

I told him I wanted to go ahead with this procedure; When the time comes,

I will have to " bite the bullett " and take the risks involved; But if in

fact, the reward is as great as promised, 6 hours of sedated hell might be

worth it!! HE HE

Just thought I would share this with the group

Web Page /group/AFIBsupport

Afibbers Database- http://www.dialsolutions.com/af

To Unsubscribe send an email to: AFIBsupport-unsubscribeegroups

Daily digest mode: Send a blank message to AFIBsupport-digestegroups

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