Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
Good day,
I finally saw my EP!
It's funny how things never go the way you imagined it. Since September I have been looking forward to see my EP and finally get to ask him a hole bunch of questions that I was sure were important.
At the end her eis the only thing I had time to ask:
Doctor, I have no issues during the day. Maybe the seldom PVCs here and there but by God when I go to bed, it's a different story. When it is time to go sleep I am tired and my HR is 54 to 60 BPM (again the occasional PVC here and there....like 1 an hour). But almost every night, after I sleep for about 2 hours I wake up with PVCs and PACs (can't tell which one is which) and my HR is up to about 84 BPM. The PVCs/PACs get worst and worst until they are every other beat and hen 5 times in the past 6 months it has triggered bouts of afib ranging from 30 min to 5 hours. All bouts of afib stops by them self once morning came.
Those 5 bouts all happened in the span of about 4 weeks. I quickly realized that if I sit up the PVCs/PACs recedes quickly and within minutes completely disappear and using this method I have had no other bouts of afib ever since (well 3months now)
Well! I told exactly that to my EP and he seems like he didn't care what so ever. I felt awkward and really like the appointment was a waste. I had a Echo earlier that morning and he was looking at the result. He then said, "I do 3 types of ablation. For patient like you I do RF Ablation with the circular tip and isolate your pulmonary veins and arteries. If there is a need of further ablation then I will redo touch ups with 2 tips RF or cryo balloon. There is no need for an EP study at this time as we will go only for the pulmonary veins and arteries. My success rate is over 80% on first try for paroxysmal afib for 1 year and with a 5 % chance or reoccurrence per year following the first year. My definition of success is off all meds and free of afib for 1 year."
Then he went on to tell me that it was a progressive condition and he would do his best to keep it down to a minimum for as long as he can. Once I reach the age of retirement and I become too hold for ablation then he may simply use the rate control approach but for now we are a long way from there. I will do your ablation shortly after the holidays. Do you have any questions?"
Well I of course asked what with all the PVCs and PACs about and he said following the review of my echo, my heart was in very good shape and he is not concerned with extra systolic beats. He said to go see my GP for blood work and a holter but not to get my hopes up. Sometimes people just get a jumpy heart.
So. I am happy that I will get a ablation done soon but disappointed about the fact that he just didn't care about PVCs and PACs. Tomorrow I will see my GP for some blood work to check my electrolytes and thyroid functions but my guess is that he will send me to my Cardio for the holter.
I really hope I can get these darn palpies under control. They really bother me and keep me up for a good part of almost every night.
Do I want the ice cream, chocolate and the cherry? yes! I want the complete damn sundae. I just wish one guy could of done it all and I mean....I was under the impression that the EP was in fact my last line of defence.
Well now you know. I guess I can't complain but I just wish.....I would of had better news.
Do any of you think I forgot to ask something?
Cheers
Scooby
I finally saw my EP!
It's funny how things never go the way you imagined it. Since September I have been looking forward to see my EP and finally get to ask him a hole bunch of questions that I was sure were important.
At the end her eis the only thing I had time to ask:
Doctor, I have no issues during the day. Maybe the seldom PVCs here and there but by God when I go to bed, it's a different story. When it is time to go sleep I am tired and my HR is 54 to 60 BPM (again the occasional PVC here and there....like 1 an hour). But almost every night, after I sleep for about 2 hours I wake up with PVCs and PACs (can't tell which one is which) and my HR is up to about 84 BPM. The PVCs/PACs get worst and worst until they are every other beat and hen 5 times in the past 6 months it has triggered bouts of afib ranging from 30 min to 5 hours. All bouts of afib stops by them self once morning came.
Those 5 bouts all happened in the span of about 4 weeks. I quickly realized that if I sit up the PVCs/PACs recedes quickly and within minutes completely disappear and using this method I have had no other bouts of afib ever since (well 3months now)
Well! I told exactly that to my EP and he seems like he didn't care what so ever. I felt awkward and really like the appointment was a waste. I had a Echo earlier that morning and he was looking at the result. He then said, "I do 3 types of ablation. For patient like you I do RF Ablation with the circular tip and isolate your pulmonary veins and arteries. If there is a need of further ablation then I will redo touch ups with 2 tips RF or cryo balloon. There is no need for an EP study at this time as we will go only for the pulmonary veins and arteries. My success rate is over 80% on first try for paroxysmal afib for 1 year and with a 5 % chance or reoccurrence per year following the first year. My definition of success is off all meds and free of afib for 1 year."
Then he went on to tell me that it was a progressive condition and he would do his best to keep it down to a minimum for as long as he can. Once I reach the age of retirement and I become too hold for ablation then he may simply use the rate control approach but for now we are a long way from there. I will do your ablation shortly after the holidays. Do you have any questions?"
Well I of course asked what with all the PVCs and PACs about and he said following the review of my echo, my heart was in very good shape and he is not concerned with extra systolic beats. He said to go see my GP for blood work and a holter but not to get my hopes up. Sometimes people just get a jumpy heart.
So. I am happy that I will get a ablation done soon but disappointed about the fact that he just didn't care about PVCs and PACs. Tomorrow I will see my GP for some blood work to check my electrolytes and thyroid functions but my guess is that he will send me to my Cardio for the holter.
I really hope I can get these darn palpies under control. They really bother me and keep me up for a good part of almost every night.
Do I want the ice cream, chocolate and the cherry? yes! I want the complete damn sundae. I just wish one guy could of done it all and I mean....I was under the impression that the EP was in fact my last line of defence.
Well now you know. I guess I can't complain but I just wish.....I would of had better news.
Do any of you think I forgot to ask something?
Cheers
Scooby
On my next visit, I had a notebook with me with all my questions written in it. As he answered my questions, I marked them off the list. Several times during the conversation he got up to try to leave, but I stopped him until I had all my questions answered. He's a fantastic doctor, one of the best in the country, and that's probably why he was so busy. But this is still your health we're talking about, and you deserve to have all your questions answered to your satisfaction, no matter how long that takes.
One question I would ask if I were facing another ablation at this point is, "what do you think of the hybrid technique?" That's where the EP goes in with standard arterial catheters, but he's assisted by a cardiac surgeon who goes in with catheters via several small incisions in the chest, so that both the inside and the outside of the heart can be ablated at the same time. It's a relatively new procedure, but one that I think will become the standard surgical treatment in the long run.
I too write my questions down and mark down in my own short hand
what Doc answers.
A-Fib.
I do disagree with your EP about being too old for an Ablation. I'm past retirement age - I'm 70 and had one done. Even after having Heart Failure last March and three failed cardioversions.
I pull up my report on the last visit to this doctor, then modify the document to include a summary of each of my areas of my life at impact the specialty of the particular doctor (I see a PCP, cardiologist, EP, endocrinologist and a gastroenterologist). These would include (by the numbers):
1: the status of my diet, weight, exercise routine, and work (since I recently have been working nights, that has an impact;
2: the status of my AFIB;
3: the status of my hyperthyroid;
4: any issue with my meds;
5: any other health issues of interest;
6: then I write out all the questions I have for the doctor.
I FAX the entire document to the doctors office at least a week prior to my visit. If he/she doesn't read it, its time for a new doctor.
At the day of my visit I bring the document, a copy of my blood pressure reading over the previous few months (I take my BP several times a week), a copy of my meds, and a copy of any lab work done by any doctor since the last visit to this particular doctor.
I keep a copy of all lab work, blood, heart (EKG, ultrasounds), thyroid, legs (history of DVT and PE). I have lab work going back over ten years. I read each carefully and compare any odd results to previous tests. Doctors function in the here and now, however, historical analysis is very important, and they often can't be bothered. There's no billing code for this sort of good judgment.
Remember, the doctor works for you. You are his employer. If he/she doesn't do his job to your satisfaction, fire him!
That said, it's reasonable to have a well organized series of questions ready and for the ep to answer them. I certainly took this approach.
After my ablation, my advice nurse told me not to call the EP who performed my procedure a 'surgeon'. "EP's are not common surgeons!' she said laughing. As a class they may tend to be a bit arrogant.