Re: PVA SCHEDULED?

[Guest guest]

In a message dated 9/9/04 2:27:29 PM Eastern Daylight Time,

trairden@... writes:

> Compounding the side effects and electrical " interference " is the very

> extended serum half-life of amiodarone: generally cited as 40-58 days.

>

Thanks for the excellent information Tony. Some guys really want you on that

rat poison.

Rich O

[Guest guest]

I'd been in AFib/RVR (120-130BPM) for at least 11 or 12 weeks, been

through Toprol 100Mg BID (did a fair job of rate control) and an

unsuccessful cardioversion, then switched by Dr. Natale to Sotalol 120

Mg BID, converted after four days on the Sotalol, then flipped back to

AFib/RVR, had my Sotalol upped by my local cardiologist to 160 Mg BID,

converted again three weeks later, and have now been NSR at 40-46BPM

(with many ectopics) for six days.

While I was last in AFib/RVR, I had a cardioversion scheduled for next

Monday, and was discussing (via eMail) with my local cardiologist next

steps should the cardioversion fail or should I break through the

Sotalol 160 Mg. after the cardioversion. He likes Amiodarone as third

try; I indicated I wasn't particulary entranced with that option, due

to side effects. I also told him that Dr. Natale had indicated that

Tikosyn (dofetilide) was his next step, and that they never use

Amiodarone.

I was keeping Dr. Natale's office in the loop with copies of the

eMails, and discussion of amiodarone brought a very prompt response

from Minerva in Dr. Natale's office: She stated unequivocally that

amiodarone affects the electrical pathways, making mapping for an

ablation unreliable.

Compounding the side effects and electrical " interference " is the very

extended serum half-life of amiodarone: generally cited as 40-58 days.

Tony Rairden

(SNIP)

> My question for anyone that has had the PVA HAS TO DO WITH

> STOPPING MEDS BEFORE THE PROCEDURE ! My EP and Cardio took me off

> Plavix (mild heart attack and stenting after thrombectomy in June)

> and this sat. the warfarin will go....in it's place I'll have

> to inject Fragmin several days before the procedure.

>

> I'm also on Amioderone 400 mgs and Toprol 100 mgs Accupril 20

> mgs 325 ecotrin

> I just heard some disturbing information re; the

Amioderone....I

> was told it can block the pathways so a true pacing cannot be

> accomplished...which would result in having to go throught the

> whole thing again. My EP has me taking all my meds except

plavix

> and warfarin right up to the day before the procedure ! Has

> anyone had this experience? Any help will be appreciated . I will

> be calling the EP later today but thought perhaps someone here

> might have more insight on what I would ask....thanks so much

> for being here Virginia

[Guest guest]

> .....................

> During my consult with Natale I was told the same thing. And that

I

> would have to wait a few months for the Ami to wash out before he

> could do an PVI. ly he was more concerned with the side

> effects. I also had a consult with an other nationally known EP

who

> stated that since he would make the same burn patterns around the

> PV's whether someone was on Ami or not that it shouldn't be that

big

> an issue. Maybe it's because Natale does the French versus the

> Italian procedure.

I thought that besides the burn patterns around the pulmonary veins,

they also zapped any hot spots they could find elsewhere in the

heart. It may be those that the amiodont makes hard to find.

[Guest guest]

> The real rat poison is Wafarin/Coumadin. And not some but every

> doctor wants you on that.

>

> P <MI>

No, it's inappropriate for some people, it's a balancing act between

the risk of blood clots from afib vs. hemorrhagic (sp?) stroke from

the rat poison, and depends on risks factors, age, etc.