Re: Extra Beats or are they Skipped Beats

[Guest guest]

Fran,

In my opinion, if you are on the verge of passing out and having near death

experiences, you should be treated more aggressively. An EP study may be in

order depending on the origination of these arrhythmias.

Dwight

Frances Ross wrote:

>

> Fran,

> They are either originating from the ventricles or the atria. They would

be PVC's, or PAC's respectively. If they are coming in runs, then you are

talking about tachycardia. You want to make sure that these runs are not

originating from the ventricles. Atrial tachycardia can be atrial flutter,

SVT etc.

> Dwight

I would hope that all the testing in the past would have seen if they were

from the ventricles. But as i have had periods when I have conked out and

convulsed with near death experiences in the dead of night, it does remain a

worry with me. I was waiting to see the cardio again who was going to look

at recent holter recordings, but that was cancelled in June as I still have

not had the monitor. Hmph. NHS. But it may also be due to the fact they are

sending me to Glasgow to see a neurologist who has facilities to do tests on

the ANS. I have had to postpone that as I got a letter yesterday saying to

be there on the 29th July, which just can't be done due to school holidays,

kids etc. So they are sending me one for later the next month.

Thanks.

Fran

[Guest guest]

on Fri, 19 Jul 2002 at 23:54:47, Driscoll

wrote :

>I don't know enough about it to say after an ablation whether they

still

>happen and propagation is prevented because of the scar or whether the

>rogue cells are also ablated?

I think the situation is that the electrical impulses in the PVs still

occur (they probably aren't actual e-beats at this point - " discharges "

- see below) but fail to get through to the atrium because of the PV

isolation. A paper back in Feb 2002 by Haissaguerre and co suggests

they don't really know what the impulses are, or why they happen, just

that in 94% of cases the discharges that set off AF are located in the

PVs.

[ " The exact mechanism of such activity is uncertain - hence the term

'discharges' " . " Current perspectives on curative catheter ablation of

atrial fibrillation. " D C Shah, M Haïssaguerre, P Jaïs, Heart

2002;87:6–8]

I have been recently reading stuff that indicates (though some is old)

that AF actually changes the cell structure and orientation - hence the

PV ectopic sources change the tissues surrounding and this begets the

AF. What I visualise is that when isolation occurs, the remodelling can

go back in the opposite direction.

Another point - the video on the Italian ablation site

(www.af-ablation.org) suggests that the " isolations " are not complete

electrical isolations - just a very significant change on electrical

resistance and time to transmit across them - hence some impulses do

carry but they are too weak to do anything - I think this is what I am

feeling occasionally.

Best of health to all,

Vicky

[Guest guest]

on Fri, 19 Jul 2002 at 23:54:47, Driscoll

wrote :

>I don't know enough about it to say after an ablation whether they

still

>happen and propagation is prevented because of the scar or whether the

>rogue cells are also ablated?

I think the situation is that the electrical impulses in the PVs still

occur (they probably aren't actual e-beats at this point - " discharges "

- see below) but fail to get through to the atrium because of the PV

isolation. A paper back in Feb 2002 by Haissaguerre and co suggests

they don't really know what the impulses are, or why they happen, just

that in 94% of cases the discharges that set off AF are located in the

PVs.

[ " The exact mechanism of such activity is uncertain - hence the term

'discharges' " . " Current perspectives on curative catheter ablation of

atrial fibrillation. " D C Shah, M Haïssaguerre, P Jaïs, Heart

2002;87:6–8]

I have been recently reading stuff that indicates (though some is old)

that AF actually changes the cell structure and orientation - hence the

PV ectopic sources change the tissues surrounding and this begets the

AF. What I visualise is that when isolation occurs, the remodelling can

go back in the opposite direction.

Another point - the video on the Italian ablation site

(www.af-ablation.org) suggests that the " isolations " are not complete

electrical isolations - just a very significant change on electrical

resistance and time to transmit across them - hence some impulses do

carry but they are too weak to do anything - I think this is what I am

feeling occasionally.

Best of health to all,

Vicky

[Guest guest]

on Fri, 19 Jul 2002 at 23:54:47, Driscoll

wrote :

>I don't know enough about it to say after an ablation whether they

still

>happen and propagation is prevented because of the scar or whether the

>rogue cells are also ablated?

I think the situation is that the electrical impulses in the PVs still

occur (they probably aren't actual e-beats at this point - " discharges "

- see below) but fail to get through to the atrium because of the PV

isolation. A paper back in Feb 2002 by Haissaguerre and co suggests

they don't really know what the impulses are, or why they happen, just

that in 94% of cases the discharges that set off AF are located in the

PVs.

[ " The exact mechanism of such activity is uncertain - hence the term

'discharges' " . " Current perspectives on curative catheter ablation of

atrial fibrillation. " D C Shah, M Haïssaguerre, P Jaïs, Heart

2002;87:6–8]

I have been recently reading stuff that indicates (though some is old)

that AF actually changes the cell structure and orientation - hence the

PV ectopic sources change the tissues surrounding and this begets the

AF. What I visualise is that when isolation occurs, the remodelling can

go back in the opposite direction.

Another point - the video on the Italian ablation site

(www.af-ablation.org) suggests that the " isolations " are not complete

electrical isolations - just a very significant change on electrical

resistance and time to transmit across them - hence some impulses do

carry but they are too weak to do anything - I think this is what I am

feeling occasionally.

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 10:50:04, Frances Ross

wrote :

>Yes the thought of pulmonary ablation is quite frightening. You just don't

>know if it will work, will go wrong, will leave you with another problem or

>just cure it. If only there was something solid to base the reason on why it

>can work. It is not something I will ever do lightly. But I will keep

>abreast of what is going on.

Fran,

I think as with any operation, who does it is crucial. There are some

names who are quoting notably higher success rates than others, and

other quite eminent names who just can't seem to get their success rates

up. I was told by my cardiologist long before I was found to be

suitable for an ablation that " the success rate is 50%, and the problem

is we don't know the reason for the 50% failures. "

Having now had a (hopefully fully successful) ablation (still in the

" wait " period) I think that who does it, and what general sort of

medical regime they adopt when having you in, is a significant part of

the success rate. But of course Drs can never ascribe success or

failure to individuals and need to couch things in impersonal terms like

" techniques " .

For me the ablation was a breeze.

There's another point - even 1 year ago, ablations seemed to me to be

aimed at finding ectopic foci in the atria and ablating them away. Now

the Pulmonary Vein Isolation seems to be the primary technique and is

much less prone to the chance appearance of ectopics. The paper by

Haissaguerre I have mentioned elsewhere in this thread discusses this.

It is this shift that appears to be behind higher success rates. Even

so, some EP's don't feel confident enough to do PVI's, in particular one

of the PVs which is less accessible than the other 3, but Haissaguerre's

paper says that this vein is responsible for 35% of the foci. I was

scheduled for an ablation with one of these and backed out when I found

out that the full left-atrial work was not going to be done. I am now

very pleased with my decision, though it was hard at the time.

If anyone ever wants to get specific advice on names to consider and

not, I am happy to do this (off the board) and I'm sure others like

C would, too.

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 10:50:04, Frances Ross

wrote :

>Yes the thought of pulmonary ablation is quite frightening. You just don't

>know if it will work, will go wrong, will leave you with another problem or

>just cure it. If only there was something solid to base the reason on why it

>can work. It is not something I will ever do lightly. But I will keep

>abreast of what is going on.

Fran,

I think as with any operation, who does it is crucial. There are some

names who are quoting notably higher success rates than others, and

other quite eminent names who just can't seem to get their success rates

up. I was told by my cardiologist long before I was found to be

suitable for an ablation that " the success rate is 50%, and the problem

is we don't know the reason for the 50% failures. "

Having now had a (hopefully fully successful) ablation (still in the

" wait " period) I think that who does it, and what general sort of

medical regime they adopt when having you in, is a significant part of

the success rate. But of course Drs can never ascribe success or

failure to individuals and need to couch things in impersonal terms like

" techniques " .

For me the ablation was a breeze.

There's another point - even 1 year ago, ablations seemed to me to be

aimed at finding ectopic foci in the atria and ablating them away. Now

the Pulmonary Vein Isolation seems to be the primary technique and is

much less prone to the chance appearance of ectopics. The paper by

Haissaguerre I have mentioned elsewhere in this thread discusses this.

It is this shift that appears to be behind higher success rates. Even

so, some EP's don't feel confident enough to do PVI's, in particular one

of the PVs which is less accessible than the other 3, but Haissaguerre's

paper says that this vein is responsible for 35% of the foci. I was

scheduled for an ablation with one of these and backed out when I found

out that the full left-atrial work was not going to be done. I am now

very pleased with my decision, though it was hard at the time.

If anyone ever wants to get specific advice on names to consider and

not, I am happy to do this (off the board) and I'm sure others like

C would, too.

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 10:50:04, Frances Ross

wrote :

>Yes the thought of pulmonary ablation is quite frightening. You just don't

>know if it will work, will go wrong, will leave you with another problem or

>just cure it. If only there was something solid to base the reason on why it

>can work. It is not something I will ever do lightly. But I will keep

>abreast of what is going on.

Fran,

I think as with any operation, who does it is crucial. There are some

names who are quoting notably higher success rates than others, and

other quite eminent names who just can't seem to get their success rates

up. I was told by my cardiologist long before I was found to be

suitable for an ablation that " the success rate is 50%, and the problem

is we don't know the reason for the 50% failures. "

Having now had a (hopefully fully successful) ablation (still in the

" wait " period) I think that who does it, and what general sort of

medical regime they adopt when having you in, is a significant part of

the success rate. But of course Drs can never ascribe success or

failure to individuals and need to couch things in impersonal terms like

" techniques " .

For me the ablation was a breeze.

There's another point - even 1 year ago, ablations seemed to me to be

aimed at finding ectopic foci in the atria and ablating them away. Now

the Pulmonary Vein Isolation seems to be the primary technique and is

much less prone to the chance appearance of ectopics. The paper by

Haissaguerre I have mentioned elsewhere in this thread discusses this.

It is this shift that appears to be behind higher success rates. Even

so, some EP's don't feel confident enough to do PVI's, in particular one

of the PVs which is less accessible than the other 3, but Haissaguerre's

paper says that this vein is responsible for 35% of the foci. I was

scheduled for an ablation with one of these and backed out when I found

out that the full left-atrial work was not going to be done. I am now

very pleased with my decision, though it was hard at the time.

If anyone ever wants to get specific advice on names to consider and

not, I am happy to do this (off the board) and I'm sure others like

C would, too.

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 07:32:26, Dwight Broeman

wrote :

>

>Fran,

>In my opinion, if you are on the verge of passing out and having near death

>experiences, you should be treated more aggressively. An EP study may be in

>order depending on the origination of these arrhythmias.

>

>Dwight

Fran and Dwight,

I have had some indication that the PV discharges and their results can

actually *create* autonomic imbalances, such as vagal tendencies etc.

Some EPs have noticed strange co-conditions disappearing after a PVI.

There is some thought also that an ablation can influence some of the

autonomic system nerves directly and help with these aspects.

This is possibly the case with me.

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 07:32:26, Dwight Broeman

wrote :

>

>Fran,

>In my opinion, if you are on the verge of passing out and having near death

>experiences, you should be treated more aggressively. An EP study may be in

>order depending on the origination of these arrhythmias.

>

>Dwight

Fran and Dwight,

I have had some indication that the PV discharges and their results can

actually *create* autonomic imbalances, such as vagal tendencies etc.

Some EPs have noticed strange co-conditions disappearing after a PVI.

There is some thought also that an ablation can influence some of the

autonomic system nerves directly and help with these aspects.

This is possibly the case with me.

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 07:32:26, Dwight Broeman

wrote :

>

>Fran,

>In my opinion, if you are on the verge of passing out and having near death

>experiences, you should be treated more aggressively. An EP study may be in

>order depending on the origination of these arrhythmias.

>

>Dwight

Fran and Dwight,

I have had some indication that the PV discharges and their results can

actually *create* autonomic imbalances, such as vagal tendencies etc.

Some EPs have noticed strange co-conditions disappearing after a PVI.

There is some thought also that an ablation can influence some of the

autonomic system nerves directly and help with these aspects.

This is possibly the case with me.

Best of health to all,

Vicky

[Guest guest]

Vicky,

Regarding the imbalance in the ANS. There is a good book out there called

" Confronting Mitral Valve Prolapse Syndrome " by Lynn Frederickson. MVPS is

caused by an imbalance in the ANS. She goes into great detail regarding this.

Note: it is possible to have MVPS without having Mitral Valve Prolapse....very

interesting. It might be a good book to read.

Dwight

Vicky wrote:on Sat, 20 Jul 2002 at 07:32:26, Dwight Broeman

wrote :

>

>Fran,

>In my opinion, if you are on the verge of passing out and having near death

>experiences, you should be treated more aggressively. An EP study may be in

>order depending on the origination of these arrhythmias.

>

>Dwight

Fran and Dwight,

I have had some indication that the PV discharges and their results can

actually *create* autonomic imbalances, such as vagal tendencies etc.

Some EPs have noticed strange co-conditions disappearing after a PVI.

There is some thought also that an ablation can influence some of the

autonomic system nerves directly and help with these aspects.

This is possibly the case with me.

Best of health to all,

Vicky

[Guest guest]

Vicky,

Regarding the imbalance in the ANS. There is a good book out there called

" Confronting Mitral Valve Prolapse Syndrome " by Lynn Frederickson. MVPS is

caused by an imbalance in the ANS. She goes into great detail regarding this.

Note: it is possible to have MVPS without having Mitral Valve Prolapse....very

interesting. It might be a good book to read.

Dwight

Vicky wrote:on Sat, 20 Jul 2002 at 07:32:26, Dwight Broeman

wrote :

>

>Fran,

>In my opinion, if you are on the verge of passing out and having near death

>experiences, you should be treated more aggressively. An EP study may be in

>order depending on the origination of these arrhythmias.

>

>Dwight

Fran and Dwight,

I have had some indication that the PV discharges and their results can

actually *create* autonomic imbalances, such as vagal tendencies etc.

Some EPs have noticed strange co-conditions disappearing after a PVI.

There is some thought also that an ablation can influence some of the

autonomic system nerves directly and help with these aspects.

This is possibly the case with me.

Best of health to all,

Vicky

[Guest guest]

Vicky,

Regarding the imbalance in the ANS. There is a good book out there called

" Confronting Mitral Valve Prolapse Syndrome " by Lynn Frederickson. MVPS is

caused by an imbalance in the ANS. She goes into great detail regarding this.

Note: it is possible to have MVPS without having Mitral Valve Prolapse....very

interesting. It might be a good book to read.

Dwight

Vicky wrote:on Sat, 20 Jul 2002 at 07:32:26, Dwight Broeman

wrote :

>

>Fran,

>In my opinion, if you are on the verge of passing out and having near death

>experiences, you should be treated more aggressively. An EP study may be in

>order depending on the origination of these arrhythmias.

>

>Dwight

Fran and Dwight,

I have had some indication that the PV discharges and their results can

actually *create* autonomic imbalances, such as vagal tendencies etc.

Some EPs have noticed strange co-conditions disappearing after a PVI.

There is some thought also that an ablation can influence some of the

autonomic system nerves directly and help with these aspects.

This is possibly the case with me.

Best of health to all,

Vicky

[Guest guest]

>

> Fran,

> In my opinion, if you are on the verge of passing out and having near

death experiences, you should be treated more aggressively. An EP study may

be in order depending on the origination of these arrhythmias.

>

> Dwight

Exactly. I have passed out on more than 5 occasions with seizures and near

death experiences, but not like epileptic grand mal. Told that my whole body

shudders and trembles, but although I am not aware of my body or whats going

on around me I am aware in my head that I am fighting for my life. I go into

a dark tunnel and the rest.

When I asked my GP about being reffered to an EP she said whats one of

those! I explained. She said there is not one. When I asked my cardio to

refer me to one he dismissed them and said that they are the experts in

arrhythmia's. So I am up against the powers that be. So I have been put down

the road of sleep tests etc. They wanted my turns to be a form of hypnogogic

hallucination. So I had the whole narcolepsy testing, but this has proved

negative, despite the gene testing they did (which proved positive on two

accounts).

So next it is the neuro in Glasgow. He can do full ECG and EEG at the same

time, as well as a variety of autonomic tests. I think the problem they are

having is determining the cause between epilepsy or cardiac syncope (the

problem is that I was misdiagnosed with E twenty years ago, but I never had

the conciousness or near death experiences then, but did have AF). Of course

it does not happen to order, just when it wants too. And I live in fear of

them ever happening again.

Of course my diet has helped tremendously and I have not had one since a

year ago last march. I just don't want to go back to them, but I need to

really know what causes them. They are few and far between and in away I

want to eat all that I know I shouldn't before the testing to bring one on,

but I am too scared.

Sorry to go on, but .....

that is our NHS system for you.

Thanks

Fran

[Guest guest]

>

> Fran,

> In my opinion, if you are on the verge of passing out and having near

death experiences, you should be treated more aggressively. An EP study may

be in order depending on the origination of these arrhythmias.

>

> Dwight

Exactly. I have passed out on more than 5 occasions with seizures and near

death experiences, but not like epileptic grand mal. Told that my whole body

shudders and trembles, but although I am not aware of my body or whats going

on around me I am aware in my head that I am fighting for my life. I go into

a dark tunnel and the rest.

When I asked my GP about being reffered to an EP she said whats one of

those! I explained. She said there is not one. When I asked my cardio to

refer me to one he dismissed them and said that they are the experts in

arrhythmia's. So I am up against the powers that be. So I have been put down

the road of sleep tests etc. They wanted my turns to be a form of hypnogogic

hallucination. So I had the whole narcolepsy testing, but this has proved

negative, despite the gene testing they did (which proved positive on two

accounts).

So next it is the neuro in Glasgow. He can do full ECG and EEG at the same

time, as well as a variety of autonomic tests. I think the problem they are

having is determining the cause between epilepsy or cardiac syncope (the

problem is that I was misdiagnosed with E twenty years ago, but I never had

the conciousness or near death experiences then, but did have AF). Of course

it does not happen to order, just when it wants too. And I live in fear of

them ever happening again.

Of course my diet has helped tremendously and I have not had one since a

year ago last march. I just don't want to go back to them, but I need to

really know what causes them. They are few and far between and in away I

want to eat all that I know I shouldn't before the testing to bring one on,

but I am too scared.

Sorry to go on, but .....

that is our NHS system for you.

Thanks

Fran

[Guest guest]

>

> Fran,

> In my opinion, if you are on the verge of passing out and having near

death experiences, you should be treated more aggressively. An EP study may

be in order depending on the origination of these arrhythmias.

>

> Dwight

Exactly. I have passed out on more than 5 occasions with seizures and near

death experiences, but not like epileptic grand mal. Told that my whole body

shudders and trembles, but although I am not aware of my body or whats going

on around me I am aware in my head that I am fighting for my life. I go into

a dark tunnel and the rest.

When I asked my GP about being reffered to an EP she said whats one of

those! I explained. She said there is not one. When I asked my cardio to

refer me to one he dismissed them and said that they are the experts in

arrhythmia's. So I am up against the powers that be. So I have been put down

the road of sleep tests etc. They wanted my turns to be a form of hypnogogic

hallucination. So I had the whole narcolepsy testing, but this has proved

negative, despite the gene testing they did (which proved positive on two

accounts).

So next it is the neuro in Glasgow. He can do full ECG and EEG at the same

time, as well as a variety of autonomic tests. I think the problem they are

having is determining the cause between epilepsy or cardiac syncope (the

problem is that I was misdiagnosed with E twenty years ago, but I never had

the conciousness or near death experiences then, but did have AF). Of course

it does not happen to order, just when it wants too. And I live in fear of

them ever happening again.

Of course my diet has helped tremendously and I have not had one since a

year ago last march. I just don't want to go back to them, but I need to

really know what causes them. They are few and far between and in away I

want to eat all that I know I shouldn't before the testing to bring one on,

but I am too scared.

Sorry to go on, but .....

that is our NHS system for you.

Thanks

Fran

[Guest guest]

> Fran and Dwight,

>

> I have had some indication that the PV discharges and their results can

> actually *create* autonomic imbalances, such as vagal tendencies etc.

> Some EPs have noticed strange co-conditions disappearing after a PVI.

> There is some thought also that an ablation can influence some of the

> autonomic system nerves directly and help with these aspects.

>

> This is possibly the case with me.

>

> Best of health to all,

> Vicky

Vicky

ITs great that you are going from strength to strength and if anyone, you

would be the person I would base my hopes on when it comes (if it comes) to

pulmonary vein ablation.I feel my AF had more in common with yours.

What you wrote above strikes a cord with me. The strange co- existing

conditions. I can almost pin point the day that Af appeared and caused a

series of strange conditions. I have always told my GP and cardio that they

are all tied up, but too no avail as they 'know better'. Can you point me in

a direction to read more on this. I am beginning to think this is my total

cure too, even though the AF has gone for the time being, my heart rhythm is

not right and I want to feel normal again. I am sick of it.

Cheers

Fran

[Guest guest]

> Fran and Dwight,

>

> I have had some indication that the PV discharges and their results can

> actually *create* autonomic imbalances, such as vagal tendencies etc.

> Some EPs have noticed strange co-conditions disappearing after a PVI.

> There is some thought also that an ablation can influence some of the

> autonomic system nerves directly and help with these aspects.

>

> This is possibly the case with me.

>

> Best of health to all,

> Vicky

Vicky

ITs great that you are going from strength to strength and if anyone, you

would be the person I would base my hopes on when it comes (if it comes) to

pulmonary vein ablation.I feel my AF had more in common with yours.

What you wrote above strikes a cord with me. The strange co- existing

conditions. I can almost pin point the day that Af appeared and caused a

series of strange conditions. I have always told my GP and cardio that they

are all tied up, but too no avail as they 'know better'. Can you point me in

a direction to read more on this. I am beginning to think this is my total

cure too, even though the AF has gone for the time being, my heart rhythm is

not right and I want to feel normal again. I am sick of it.

Cheers

Fran

[Guest guest]

> Fran and Dwight,

>

> I have had some indication that the PV discharges and their results can

> actually *create* autonomic imbalances, such as vagal tendencies etc.

> Some EPs have noticed strange co-conditions disappearing after a PVI.

> There is some thought also that an ablation can influence some of the

> autonomic system nerves directly and help with these aspects.

>

> This is possibly the case with me.

>

> Best of health to all,

> Vicky

Vicky

ITs great that you are going from strength to strength and if anyone, you

would be the person I would base my hopes on when it comes (if it comes) to

pulmonary vein ablation.I feel my AF had more in common with yours.

What you wrote above strikes a cord with me. The strange co- existing

conditions. I can almost pin point the day that Af appeared and caused a

series of strange conditions. I have always told my GP and cardio that they

are all tied up, but too no avail as they 'know better'. Can you point me in

a direction to read more on this. I am beginning to think this is my total

cure too, even though the AF has gone for the time being, my heart rhythm is

not right and I want to feel normal again. I am sick of it.

Cheers

Fran

[Guest guest]

on Sat, 20 Jul 2002 at 18:54:43, Frances Ross

wrote :

>Can you point me in

>a direction to read more on this. I am beginning to think this is my total

>cure too, even though the AF has gone for the time being, my heart rhythm is

>not right and I want to feel normal again. I am sick of it.

All I can remember offhand was I think a case where someone had an

ablation and their sleep apnea was ended. Also there was something

about a pacemaker installed to speed up the rate helping to stop sleep

apnea. However, I can't find anything in the way of hard data. Medline

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

turns up a few interesting things if you put in

<atrial fibrillation AND sleep apnea>

and of course

<atrial fibrillation AND autonomic>

turns up hundreds of papers.

(leave the < > out)

The way I understand it is that the whole thing is not understood well

at all, even by those at the forefront of ablations, but they have

noticed " strange " things happening. I mentioned after my ablation that

my stomach pains had just about stopped dead and he was very interested

and said he would keep that in mind. The pulmonary veins seem to

respond differently to different stimuli - some to vagal stimuli, some

to postural, and I guess that from the oddities happening there may be

some reciprocal action - i.e. the AF upsets the ANS as well as the ANS

accentuating certain AF triggers.

Hope this helps, some at least!

Best of health to all,

Vicky

[Guest guest]

on Sat, 20 Jul 2002 at 18:54:43, Frances Ross

wrote :

>Can you point me in

>a direction to read more on this. I am beginning to think this is my total

>cure too, even though the AF has gone for the time being, my heart rhythm is

>not right and I want to feel normal again. I am sick of it.

All I can remember offhand was I think a case where someone had an

ablation and their sleep apnea was ended. Also there was something

about a pacemaker installed to speed up the rate helping to stop sleep

apnea. However, I can't find anything in the way of hard data. Medline

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

turns up a few interesting things if you put in

<atrial fibrillation AND sleep apnea>

and of course

<atrial fibrillation AND autonomic>

turns up hundreds of papers.

(leave the < > out)

The way I understand it is that the whole thing is not understood well

at all, even by those at the forefront of ablations, but they have

noticed " strange " things happening. I mentioned after my ablation that

my stomach pains had just about stopped dead and he was very interested

and said he would keep that in mind. The pulmonary veins seem to

respond differently to different stimuli - some to vagal stimuli, some

to postural, and I guess that from the oddities happening there may be

some reciprocal action - i.e. the AF upsets the ANS as well as the ANS

accentuating certain AF triggers.

Hope this helps, some at least!

Best of health to all,

Vicky

[Guest guest]

> Another point - the video on the Italian ablation site

> (www.af-ablation.org) suggests that the " isolations " are not

complete

> electrical isolations - just a very significant change on

electrical

> resistance and time to transmit across them - hence some impulses

do

> carry but they are too weak to do anything - I think this is what I

am

> feeling occasionally.

Vicky,

By " what I am feeling occasionally " do you mean the ectopics you were

mentioning awhile ago, or " something else " ?

How long has it been since your ablation now? Are things settling

down?

[Guest guest]

on Sun, 21 Jul 2002 at 02:04:20, trudyjhagain wrote :

>

>>hence some impulses do carry but they are too weak to do anything -

>>I think this is what I am feeling occasionally.

>

>By " what I am feeling occasionally " do you mean the ectopics you were

>mentioning awhile ago, or " something else " ?

Trudy,

Sorry, I'm referring here to the benign ectopics that I have had since

the day after the ablation. The run of ectopics I had at +1 month were

quite different - much more aggressive and feeling like the " old " ones.

>How long has it been since your ablation now? Are things settling

>down?

It's now 7 weeks, and I *think* it is settling down (stop tempting

fate!!). I've certainly not had the continuous ectopics runs for a

couple of weeks now. I'm still on the Flecainide and not desperate to

get off it until I get, say, a run of a couple of months with nothing,

but I shall be discussing this with my Cardio and EP this week, so

hopefully they will agree. I'm still getting the odd hour or two of

slightly-threatening ectopics and the odd very short feeling of AFL, but

these stop very quickly. Fingers crossed :-)

Best of health to all,

Vicky

[Guest guest]

Vicky, the news of your apparently successful ablation is grand. I have all

fingers crossed. And I'm very grateful for all the

informative posts you have made on the PVA/PVI topic, going back to your 3

emails of June 21, which first made clear to me the

difference between " locate-and-ablate " and complete isolation of the pulmonary

veins. I have pretty much decided to go ahead with the

a PVI, and I have a few questions about your current post.

Vicky wrote:

> There are some names who are quoting notably higher success rates than

others, and

> other quite eminent names who just can't seem to get their success rates

> up.

Are there sources for these success rates other than just asking each EP you're

interested in?

> . . . one of the PVs which is less accessible than the other 3, but

Haissaguerre's

> paper says that this vein is responsible for 35% of the foci. I was

> scheduled for an ablation with one of these and backed out when I found

> out that the full left-atrial work was not going to be done.

You backed out of an ablation for the less accessible PV? And what do you mean

by the " full left-atrial work " ?

> If anyone ever wants to get specific advice on names to consider and not, I am

happy to do this . . .

Do you have information on names in the US? And last, if I should decide to go

somewhere like Boston for a PVI, do you think the

followup would be difficult or compromised?

Thank you very much for all your help, Vicky. I'll be sending sinus thoughts

your way. S.

..

[Guest guest]

>

> > There are some names who are quoting notably higher success

rates than others, and

> > other quite eminent names who just can't seem to get their

success rates

> > up.

>

> Are there sources for these success rates other than just asking

each EP you're interested in?

On our website, database -> ablations has some personal results for

people. Fairly discouraging if you look at them, but the success

rate has been increasing a lot recently, I think, for some docs.

It would certainly be interesting to see a disinterested report of

success rates with a common definition of success - totally getting

rid of afib vs. substantial improvement, etc.