Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 In a message dated 7/6/04 4:32:38 PM Eastern Daylight Time, thereshope2002@... writes: > I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? > I used an EP exclusively. My cardio was a plumber, my EP is an electrician. Rich O Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > Wonder if someone would give me their thoughts on this subject. For > 4 years I have seen a Cardio Hi, If you think you are making progress with the current EP, I suspect your cardio would not mind your continuing to see the EP. You don't have to stop being a patient of the cardio to do that. You can do a test run, so to speak, of letting the EP run things for awhile, and see how things go. A good doc will not mind having another doc consulting like this. My guess, based on just what I've read in the group, is that some people have cardiologists as their main afib docs, and some have EPs. I have a cardiologist myself. I was about to consult with an EP when I went thru a bad patch awhile ago, but fortunately things righted themselves. One advantage of cardiologists is that they worry about the whole heart. The two good ones I've had had also been internists for awhile, so they really worry about the whole person. I find that very useful, since I'm kind of holistic. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > Wonder if someone would give me their thoughts on this subject. For > 4 years I have seen a Cardio Hi, If you think you are making progress with the current EP, I suspect your cardio would not mind your continuing to see the EP. You don't have to stop being a patient of the cardio to do that. You can do a test run, so to speak, of letting the EP run things for awhile, and see how things go. A good doc will not mind having another doc consulting like this. My guess, based on just what I've read in the group, is that some people have cardiologists as their main afib docs, and some have EPs. I have a cardiologist myself. I was about to consult with an EP when I went thru a bad patch awhile ago, but fortunately things righted themselves. One advantage of cardiologists is that they worry about the whole heart. The two good ones I've had had also been internists for awhile, so they really worry about the whole person. I find that very useful, since I'm kind of holistic. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > Wonder if someone would give me their thoughts on this subject. For > 4 years I have seen a Cardio Hi, If you think you are making progress with the current EP, I suspect your cardio would not mind your continuing to see the EP. You don't have to stop being a patient of the cardio to do that. You can do a test run, so to speak, of letting the EP run things for awhile, and see how things go. A good doc will not mind having another doc consulting like this. My guess, based on just what I've read in the group, is that some people have cardiologists as their main afib docs, and some have EPs. I have a cardiologist myself. I was about to consult with an EP when I went thru a bad patch awhile ago, but fortunately things righted themselves. One advantage of cardiologists is that they worry about the whole heart. The two good ones I've had had also been internists for awhile, so they really worry about the whole person. I find that very useful, since I'm kind of holistic. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 I believe you will get a bunch of similar responses: Definitely hookup with a competent EP. Did they give you any specific reasons why an ablation wasn't appropriate ? If not, ask them. Thor Cardio vs EP Wonder if someone would give me their thoughts on this subject. - Snip - ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > Wonder if someone would give me their thoughts on this subject... I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? ********* I have never seen a regular cardio. The day he diagnosed me, my PCP referred me directly to my EP, who at that time, 2+ years ago, had only been in private practice for a couple years, after completing his fellowship in electrophysiolgy. He has been with me ever since. So, he was up on all the latest, and clearly laid out all the available options for me, including ablation, and he does afib ablations himself, the first EP to do so locally. Once tests confirmed that my heart was otherwise healthy, he told me that I was an excellent candidate for ablation. Please remember that EPs are cardiologists with extra training. They have already completed residencies in internal medicine and cardiovascular diseases. Then, my EP completed an additional 2 years of training as a fellow in the cardiology subspecialty of electrophysiology, and is board-certified in that as well. So, EPs are qualified to treat diseases of the heart as well as electrical malfunctions. But if you are now experiencing weekly episodes, you do now need an EP. As Rich O and others said, find out the reasons from the EP you like exactly why he/she thinks that you are not a candidate for ablation. I would be interested in hearing his/her reasons. Seems like, these days, EPs at the large medical centers are having success doing ablations on a variety of patients who were not a few years ago considered to be good candidates. Let us hear what you find out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > Wonder if someone would give me their thoughts on this subject... I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? ********* I have never seen a regular cardio. The day he diagnosed me, my PCP referred me directly to my EP, who at that time, 2+ years ago, had only been in private practice for a couple years, after completing his fellowship in electrophysiolgy. He has been with me ever since. So, he was up on all the latest, and clearly laid out all the available options for me, including ablation, and he does afib ablations himself, the first EP to do so locally. Once tests confirmed that my heart was otherwise healthy, he told me that I was an excellent candidate for ablation. Please remember that EPs are cardiologists with extra training. They have already completed residencies in internal medicine and cardiovascular diseases. Then, my EP completed an additional 2 years of training as a fellow in the cardiology subspecialty of electrophysiology, and is board-certified in that as well. So, EPs are qualified to treat diseases of the heart as well as electrical malfunctions. But if you are now experiencing weekly episodes, you do now need an EP. As Rich O and others said, find out the reasons from the EP you like exactly why he/she thinks that you are not a candidate for ablation. I would be interested in hearing his/her reasons. Seems like, these days, EPs at the large medical centers are having success doing ablations on a variety of patients who were not a few years ago considered to be good candidates. Let us hear what you find out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > Wonder if someone would give me their thoughts on this subject... I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? ********* I have never seen a regular cardio. The day he diagnosed me, my PCP referred me directly to my EP, who at that time, 2+ years ago, had only been in private practice for a couple years, after completing his fellowship in electrophysiolgy. He has been with me ever since. So, he was up on all the latest, and clearly laid out all the available options for me, including ablation, and he does afib ablations himself, the first EP to do so locally. Once tests confirmed that my heart was otherwise healthy, he told me that I was an excellent candidate for ablation. Please remember that EPs are cardiologists with extra training. They have already completed residencies in internal medicine and cardiovascular diseases. Then, my EP completed an additional 2 years of training as a fellow in the cardiology subspecialty of electrophysiology, and is board-certified in that as well. So, EPs are qualified to treat diseases of the heart as well as electrical malfunctions. But if you are now experiencing weekly episodes, you do now need an EP. As Rich O and others said, find out the reasons from the EP you like exactly why he/she thinks that you are not a candidate for ablation. I would be interested in hearing his/her reasons. Seems like, these days, EPs at the large medical centers are having success doing ablations on a variety of patients who were not a few years ago considered to be good candidates. Let us hear what you find out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > <snip>Both EP's do not consider > me a good ablation candidate and/or do not feel they can get me off > Sotolal and Coumadin. My problem is: while I like the Cardio very > much (he always responds promptly to any problems I have and he has > even given his cell # and home phone # to my son) he does not go to > the local hospitals and this means a different doc/cardio every > time. I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > <snip>Both EP's do not consider > me a good ablation candidate and/or do not feel they can get me off > Sotolal and Coumadin. My problem is: while I like the Cardio very > much (he always responds promptly to any problems I have and he has > even given his cell # and home phone # to my son) he does not go to > the local hospitals and this means a different doc/cardio every > time. I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 > <snip>Both EP's do not consider > me a good ablation candidate and/or do not feel they can get me off > Sotolal and Coumadin. My problem is: while I like the Cardio very > much (he always responds promptly to any problems I have and he has > even given his cell # and home phone # to my son) he does not go to > the local hospitals and this means a different doc/cardio every > time. I liked the last EP very much and wonder how many of you use > doc's specializing in arrhythmia? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 My experience is a little different than some of those who replied, but probably just a special case. My cardiologist treated my afib and successfully got rid of it with an electro cardioversion. Later diagnosed aflutter when he diagnosed aflutter he referred me to an EP to consider an ablation. The EP took over and in time did the ablation. After my one month check up showed I was still in NSR he said there was no need for any further visits and referred me back to my cardiologist. Suslpect that was at least partly because he didn't want to take the responsibility for taking me off coumadin. The cardio took me off. If there's a lesson here at all, its probably that EPs are the best for treating arrhymthias but the cardiologists are the first line heart doctors. At least that's how I see it. Ed in VA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 >> If there's a lesson here at all, its probably that EPs are the best > for treating arrhymthias but the cardiologists are the first line > heart doctors. At least that's how I see it. > Ed in VA ****** Ed, who can argue with success? Seriously, I am so happy to hear that you have been afib-free since your aflutter ablation! I wish you a long life in NSR. I think that what you say about cardiologists being the first line heart doctors is true, if you have an additional heart problem that your PCP doesn't feel competent to treat. But when your only heart problem is an arrythmia, I don't know why you would go to anyone but an EP. Mine regulates the medications, and has a nurse on staff, who regulates the coumadin. My EP also does his own cardioversions, etc, and I would really not allow anyone else to do a cardioversion on me unless it was an emergency situation. And thankfully, after the first few CVs soon after I was diagnosed, I've never had to have another one for those purposes since I started converting on my own. You have been fortunate with your cardiologist, but some people haven't been. So happy to hear that your flutter ablation was a success! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 >> If there's a lesson here at all, its probably that EPs are the best > for treating arrhymthias but the cardiologists are the first line > heart doctors. At least that's how I see it. > Ed in VA ****** Ed, who can argue with success? Seriously, I am so happy to hear that you have been afib-free since your aflutter ablation! I wish you a long life in NSR. I think that what you say about cardiologists being the first line heart doctors is true, if you have an additional heart problem that your PCP doesn't feel competent to treat. But when your only heart problem is an arrythmia, I don't know why you would go to anyone but an EP. Mine regulates the medications, and has a nurse on staff, who regulates the coumadin. My EP also does his own cardioversions, etc, and I would really not allow anyone else to do a cardioversion on me unless it was an emergency situation. And thankfully, after the first few CVs soon after I was diagnosed, I've never had to have another one for those purposes since I started converting on my own. You have been fortunate with your cardiologist, but some people haven't been. So happy to hear that your flutter ablation was a success! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2004 Report Share Posted July 6, 2004 You have > been fortunate with your cardiologist, but some people haven't been. > So happy to hear that your flutter ablation was a success! > ********************************************************************** - You make a very good point. I have been lucky with my cardiologist and I prefer him to the very competent EP I dealt with. I had seen the cardio many years earlier when an ekg stress test showed some unknown irregularities. Was referred to the cardio for a thalium stress test. A few years later the same cardiologist did an angiogram. So when I went to the ER with afib (but didn't know I had it) they gave him a call. He treated me from there. It seemed to me that the EP he referred me to for the flutter was overly cautious, probably to reduce the risk of a law suit. For instance, they kept me in the hospital for 5 days total for the ablation waiting for coumadin levels to again reach theraputic range. When I challenged them they said if I had a stroke they could be held accountable. They wanted to keep me on coumadin for 6 months following the ablation, but said they would leave that decision to my cardiologist. The point is, and I think you're right, go with who you are most comfortable with. And don't settle for Doctors that won't answer your quetions or listen to your suggestions. We must take some control of our own health care. And many thanks for your good wishes. Ed in VA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 9, 2004 Report Share Posted July 9, 2004 In a message dated 7/6/04 10:32:48 PM Eastern Daylight Time, esmock@... writes: > The point is, and I think you're right, go with who you are most > comfortable with. And don't settle for Doctors that won't answer your > quetions or listen to your suggestions. We must take some control of > our own health care. > Your statement above Ed says it all. Rich O Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 9, 2004 Report Share Posted July 9, 2004 In a message dated 7/6/04 10:32:48 PM Eastern Daylight Time, esmock@... writes: > The point is, and I think you're right, go with who you are most > comfortable with. And don't settle for Doctors that won't answer your > quetions or listen to your suggestions. We must take some control of > our own health care. > Your statement above Ed says it all. Rich O Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 9, 2004 Report Share Posted July 9, 2004 In a message dated 7/6/04 10:32:48 PM Eastern Daylight Time, esmock@... writes: > The point is, and I think you're right, go with who you are most > comfortable with. And don't settle for Doctors that won't answer your > quetions or listen to your suggestions. We must take some control of > our own health care. > Your statement above Ed says it all. Rich O Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 9, 2004 Report Share Posted July 9, 2004 > Your statement above Ed says it all. > Rich O Thanks, Rich. I know many in this forum have reached the conclusion that we can't afford not to be closely involved in making the decisions that affect our lives so directly. And this forum helps provide info that makes it possible to ask intelligent questions and make meaningful suggestions. My flutter ablation on May 5, which has me in nsr now for over two months, was the direct result of my own suggestion. My cardiologist had just said that I'd probably be on meds for the rest of my life to keep me in nsr. I said that if that was the case I'd want to consider an ablation. He said " good idea " , noted that flutter ablations had a very high success rate, and referred me to an EP. He's an excellent cardiologist but not an EP and ablations are not in his bag of tricks. So in the midst of a busy day, it didn't occur to him. Wouldn't have occured to me either without this forum. Ed in VA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2004 Report Share Posted July 10, 2004 > I believe you will get a bunch of similar responses: Definitely hookup with a competent EP. > > Did they give you any specific reasons why an ablation wasn't appropriate ? If not, ask them. > > Thor > > Cardio vs EP > Thanks to so many of you who have answered my question. My EP did spend over an hour with me explaning that an abalation was an option but my age (71) impacts on many aspects of this problem. He was very upfront and open with me and I immedately like him. He told me his usual success rate, number he does in a week, his credentials and freely admitted abalation is a work in process, improving all the time. He stated your rate of sucess decreased with age and would he felt would be about 65% for 1st abalation in my case and he defintely would want me to continue on coumadin as chance of stroke increases with age. He further stated he probably couldn't take me off the beta blockers. Getting off these two meds were my primary reason for checking out an abalation. I am one of those few,lucky, rare people who have very little other problems while in A-Fib other than getting a little tired at the end of day and puffing a little while going up a few flight of stairs. We (EP & I) decided that abalation was not the course for me at this time. It has not been ruled out as he feels I could/would go into persistent or permanent AFib in future and we will have to rethink it then. So who can tell me is Persistent A-Fib determined by the frequency or the duration of the AFibs..I have it almost weekly but never more than 15 to 20 hours and it does not impact my activities. Oh yes, It scares and depresses me when it first starts but I have learned to ignore and keep going and I might add this EP is the one who convinced me this was possible as before I was just sitting around worrying when it would stop. Thanks to all of you I have loads of questions for my visit next Tuesday, like Vagal, magnesium and persistent AFIB, etc. Thank you. > > Wonder if someone would give me their thoughts on this subject. - Snip - > > -------------------------------------------------------------------- ---------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2004 Report Share Posted July 10, 2004 > I believe you will get a bunch of similar responses: Definitely hookup with a competent EP. > > Did they give you any specific reasons why an ablation wasn't appropriate ? If not, ask them. > > Thor > > Cardio vs EP > Thanks to so many of you who have answered my question. My EP did spend over an hour with me explaning that an abalation was an option but my age (71) impacts on many aspects of this problem. He was very upfront and open with me and I immedately like him. He told me his usual success rate, number he does in a week, his credentials and freely admitted abalation is a work in process, improving all the time. He stated your rate of sucess decreased with age and would he felt would be about 65% for 1st abalation in my case and he defintely would want me to continue on coumadin as chance of stroke increases with age. He further stated he probably couldn't take me off the beta blockers. Getting off these two meds were my primary reason for checking out an abalation. I am one of those few,lucky, rare people who have very little other problems while in A-Fib other than getting a little tired at the end of day and puffing a little while going up a few flight of stairs. We (EP & I) decided that abalation was not the course for me at this time. It has not been ruled out as he feels I could/would go into persistent or permanent AFib in future and we will have to rethink it then. So who can tell me is Persistent A-Fib determined by the frequency or the duration of the AFibs..I have it almost weekly but never more than 15 to 20 hours and it does not impact my activities. Oh yes, It scares and depresses me when it first starts but I have learned to ignore and keep going and I might add this EP is the one who convinced me this was possible as before I was just sitting around worrying when it would stop. Thanks to all of you I have loads of questions for my visit next Tuesday, like Vagal, magnesium and persistent AFIB, etc. Thank you. > > Wonder if someone would give me their thoughts on this subject. - Snip - > > -------------------------------------------------------------------- ---------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2004 Report Share Posted July 10, 2004 > So who can tell me is Persistent A-Fib determined by the frequency or > the duration of the AFibs ******************************************************** First, would by you please give us a name to address you by. Just sign at the bottom of your next post. Re persistent afib, it seems to me their are some confusing terms. Chronic, persistent, and permanent afib all mean afib all the time or 24/7 if you will (unless I'm badly mistaken...which has happened before). Some, maybe all, make an additional distinction for permanent afib to mean 24/7 and over a long enough period (a year or more) to make conversion to nsr a doubtful proposition. I was in chronic/persistent afib for five or more months last year before electro cardioversion. The fact that I was in constant afib meant that I didn't worry about an attack coming on and could medicate it with some expectation of the results being pretty much the same day in and day out. My energy level was reduced, but other than that I could live pretty normally. Rate controlled persistent afib, for me at least, did not require wholesale changes in my life style. That's especially true once my doctor insisted that I resume a normal exercise routine -- like a brisk 2 mile walk each day. By the by, the cardioversion kept me in nsr for at least 2 months (my last check up for 5 months. But sometime after that I developed atrial flutter. That was successfully ablated on May 5 and I've remained in nsr since. Docs warn me that a return to afib would not be unusual, but as time goes by I hope the odds of afib returning are being reduced. We'll see. Ed in VA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2004 Report Share Posted July 11, 2004 > > So who can tell me is Persistent A-Fib determined by the frequency > or > > the duration of the AFibs > ******************************************************** > First, would by you please give us a name to address you by. Just > sign at the bottom of your next post. > > Re persistent afib, it seems to me their are some confusing terms. > Chronic, persistent, and permanent afib all mean afib all the time or > 24/7 if you will (unless I'm badly mistaken...which has happened > before). Some, maybe all, make an additional distinction for > permanent afib to mean 24/7 and over a long enough period (a year or > more) to make conversion to nsr a doubtful proposition.. ************************************************************ Ed, thanks for the heads up about my name, it is a mistake I sometimes make and will be sure to correct in the future. After hearing you have had afib for 5 months at a time, 15 or 20 hours seems like a little time. I will remember your experience if and when mine do grow in duration and the fact that you seem to be able to continue your life as normal as possible is very encouraging to me. As I learn more and more from this site I am becoming more capable of dealing with Afib. Barb in PA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2004 Report Share Posted July 11, 2004 > > So who can tell me is Persistent A-Fib determined by the frequency > or > > the duration of the AFibs > ******************************************************** > First, would by you please give us a name to address you by. Just > sign at the bottom of your next post. > > Re persistent afib, it seems to me their are some confusing terms. > Chronic, persistent, and permanent afib all mean afib all the time or > 24/7 if you will (unless I'm badly mistaken...which has happened > before). Some, maybe all, make an additional distinction for > permanent afib to mean 24/7 and over a long enough period (a year or > more) to make conversion to nsr a doubtful proposition.. ************************************************************ Ed, thanks for the heads up about my name, it is a mistake I sometimes make and will be sure to correct in the future. After hearing you have had afib for 5 months at a time, 15 or 20 hours seems like a little time. I will remember your experience if and when mine do grow in duration and the fact that you seem to be able to continue your life as normal as possible is very encouraging to me. As I learn more and more from this site I am becoming more capable of dealing with Afib. Barb in PA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2004 Report Share Posted July 11, 2004 > > So who can tell me is Persistent A-Fib determined by the frequency > or > > the duration of the AFibs > ******************************************************** > First, would by you please give us a name to address you by. Just > sign at the bottom of your next post. > > Re persistent afib, it seems to me their are some confusing terms. > Chronic, persistent, and permanent afib all mean afib all the time or > 24/7 if you will (unless I'm badly mistaken...which has happened > before). Some, maybe all, make an additional distinction for > permanent afib to mean 24/7 and over a long enough period (a year or > more) to make conversion to nsr a doubtful proposition.. ************************************************************ Ed, thanks for the heads up about my name, it is a mistake I sometimes make and will be sure to correct in the future. After hearing you have had afib for 5 months at a time, 15 or 20 hours seems like a little time. I will remember your experience if and when mine do grow in duration and the fact that you seem to be able to continue your life as normal as possible is very encouraging to me. As I learn more and more from this site I am becoming more capable of dealing with Afib. Barb in PA > > Quote Link to comment Share on other sites More sharing options...
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