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Suggestions for a productive cardio appointment
Thank you doctors for participating on this board.
I have my annual check-up with my cardio in a few weeks (actually it's been almost two years since I last saw him) and want this appointment to be productive. My first check-up lasted only about 15 minutes and I left feeling kind of disappointed. I would like your advice on what kind of questions and issues I should be bringing up (especially if he doesn't).
My story:
55 yr. old male, afib for four years, occurrences start almost always at night in bed, usually terminated via some physical activity like long walks, tennis, etc., episodes average 12-14 hrs., twice a week; am taking metoprolol 25 mg. daily in two 12 1/2 pills (I cut up a 50 mg. pill into quarters) late morning and late afternoon, also take a baby aspirin daily, and no coumadin because I'm not 75 yet (because of my frequency and length, do you think coumadin is indicated?). I reduced the dosage because I read where vagal afibbers like myself should not be taking beta-blockers. Your opinion on this?
Here's something interesting, I was only averaging a few hours per episode until I tried accupuncture about a year and a half ago and immediately, my episodes shot up to 10 hrs. plus. Maybe a coincidence but any effects from that accupuncture should be gone by now - but the frequency and duration are still here.
Am also taking a host of supplements per stuff I've learned about like magnesium, fish oil, taurine, co-enzyme 10, etc.
What suggestions do you have as to potential talking points? And how often are echos or stress tests done?
Thanks,
Keven
I have my annual check-up with my cardio in a few weeks (actually it's been almost two years since I last saw him) and want this appointment to be productive. My first check-up lasted only about 15 minutes and I left feeling kind of disappointed. I would like your advice on what kind of questions and issues I should be bringing up (especially if he doesn't).
My story:
55 yr. old male, afib for four years, occurrences start almost always at night in bed, usually terminated via some physical activity like long walks, tennis, etc., episodes average 12-14 hrs., twice a week; am taking metoprolol 25 mg. daily in two 12 1/2 pills (I cut up a 50 mg. pill into quarters) late morning and late afternoon, also take a baby aspirin daily, and no coumadin because I'm not 75 yet (because of my frequency and length, do you think coumadin is indicated?). I reduced the dosage because I read where vagal afibbers like myself should not be taking beta-blockers. Your opinion on this?
Here's something interesting, I was only averaging a few hours per episode until I tried accupuncture about a year and a half ago and immediately, my episodes shot up to 10 hrs. plus. Maybe a coincidence but any effects from that accupuncture should be gone by now - but the frequency and duration are still here.
Am also taking a host of supplements per stuff I've learned about like magnesium, fish oil, taurine, co-enzyme 10, etc.
What suggestions do you have as to potential talking points? And how often are echos or stress tests done?
Thanks,
Keven
Yes, we are considering the procedures (ablations) a success. So far, so good. Each post ablation echo revealed incremental improvements. The last 2-3 echos showed an EF of 60%. WOOHOO!!
Great news on the Cardiolite scan!!
Great news on the Cardiolite scan!!
I can suggest that vitamin E and garlic can "lubricate" your blood, in a sense making it thinner, but not like a blood thinner.
As I understand it, the risk of afib is throwing clots, is that correct? Maybe I'm over simplifying it.
But if you keep your vessels healthy with antioxidants and your blood "thinner", that is supposed to give you a protective affect against the afib. Correct?
So antioxidants like vit C & E, & selenium may be helpful in protecting your vessels from damage. AND Garlic is a good anti-viral, anti-bacterial agent and in some studies has been found to be helpful in lowering mild hypertension, so a possible link to "thinner" blood, because it dilates the blood vessels and inhibits platlet aggregation. It also lowers serum cholesterol levels. That should be helpful to lower the chance of producing any clots in the first place. A good brand is Kyolic.
All the above being said, these are MY suggestions only and you should always talk to your own doctor. When I made a comment before about my personal experience with C0-Q10, that was my experience only. It still is shown to be helpful for other people. But even RX medications can have serious side effects in some people and work wonders for others.
As I understand it, the risk of afib is throwing clots, is that correct? Maybe I'm over simplifying it.
But if you keep your vessels healthy with antioxidants and your blood "thinner", that is supposed to give you a protective affect against the afib. Correct?
So antioxidants like vit C & E, & selenium may be helpful in protecting your vessels from damage. AND Garlic is a good anti-viral, anti-bacterial agent and in some studies has been found to be helpful in lowering mild hypertension, so a possible link to "thinner" blood, because it dilates the blood vessels and inhibits platlet aggregation. It also lowers serum cholesterol levels. That should be helpful to lower the chance of producing any clots in the first place. A good brand is Kyolic.
All the above being said, these are MY suggestions only and you should always talk to your own doctor. When I made a comment before about my personal experience with C0-Q10, that was my experience only. It still is shown to be helpful for other people. But even RX medications can have serious side effects in some people and work wonders for others.
Maybe I should clarify--highlight--that 20% of high frequency PVC sufferers *MAY*--*MAY* --not will, develop cardiomyopathy.
But now with Tickertocks post I'm wondering if the statistic was 20% of your heart beats being PVCs. Sorry if there is any confusion. I'll recheck the site where I read that. I don't want to alarm anybody. Goodness knows we have enough to think about. It IS a very small amount of people, even if you have had extremely high frequency, for years and years.
ps. I haven't tried the extended inderal yet. Wanted to go off the toperol for a little while and "see" what my heart does. I'm feeling pretty good today without anything so far.
But now with Tickertocks post I'm wondering if the statistic was 20% of your heart beats being PVCs. Sorry if there is any confusion. I'll recheck the site where I read that. I don't want to alarm anybody. Goodness knows we have enough to think about. It IS a very small amount of people, even if you have had extremely high frequency, for years and years.
ps. I haven't tried the extended inderal yet. Wanted to go off the toperol for a little while and "see" what my heart does. I'm feeling pretty good today without anything so far.
Thanks Tickertock, Upbeat, Connie...
Upbeat, don't worry, you're not alarming anyone. It's OK to know the truth! But I tend to think Tickertock's interpretation is correct, otherwise doctors wouldn't tell us we need to take meds only for symptomatic relief. 20% of our beats all the time would be a whole lot...
Glad you're feeling good today!
Connie, I'm so glad to know that even if I were to develop CM, that can be cured, like in your case!
Tickertock, I'm like you. My PVCs come and go. I remember on New Year's day this year I developed tachy and PVCs from tiredness and too much alcohol...There I was at 5 in the morning looking for my Inderal tablets and couldn't even remember where they were! Then come the months you feel bad and you think it will never go away...But fortunately it can!
Thanks everyone for your support.
Upbeat, don't worry, you're not alarming anyone. It's OK to know the truth! But I tend to think Tickertock's interpretation is correct, otherwise doctors wouldn't tell us we need to take meds only for symptomatic relief. 20% of our beats all the time would be a whole lot...
Glad you're feeling good today!
Connie, I'm so glad to know that even if I were to develop CM, that can be cured, like in your case!
Tickertock, I'm like you. My PVCs come and go. I remember on New Year's day this year I developed tachy and PVCs from tiredness and too much alcohol...There I was at 5 in the morning looking for my Inderal tablets and couldn't even remember where they were! Then come the months you feel bad and you think it will never go away...But fortunately it can!
Thanks everyone for your support.
The responses have been kind of a downer. Has anyone tried ANY supplements (basically non-pharmaceutical stuff)that has had some positive (lessening of duration or frequency of episodes)effect on their afib?
I was told for YEARS that pvcs were benign. Despite the frequency of my pvcs, I was not really afraid of them (a good thing for an anxious person). And, under most circumstances, they are benign. Even when I had over 20,000/day, there was no concern other than to help control them. I was only taking the medicine for symptomatic relief. Even with high numbers of pvcs, the majority will live normal, healthy lives. It's just good to be aware of the small possibility that persistent pvcs can (but don't usually) lead to CM.
Have a great day!
Connie
Have a great day!
Connie
Hi Upbeat! Great to hear from you again. It's so strange you felt better in trigeminy than with less PVCs! :-) I hope so much that changing BB will help you. Inderal seems to work fine for me now though it certainly does not eliminate PVCs completely. I'm taking 10 mg twice a day, and that has also decreased the sensation of tiredness.
20% of patients with frequent PVCs may develop a cardiomyopathy??? Sounds crazy if you think that every single cardio we've talked to or read about tells us frequent PVCers that PVCs are almost always benign...Would they say this if there was a 20% chance that we develop cardiomyopathy?? My cardio just told me the prognosis is certain and it's benign. What does he have to gain in telling me this if it wasn't true? Also all doctors n this board say cardiomyopathy caused by PVCs is very unlikely. 20% is a whole lot.
I do want my PVCs controlled, but for the quality of life. I just found out my focus is in the left ventricle and it would be risky to ablate it so if I get worse I think I will go for antiarrhythmics, if my cardio agrees. For now BBs are helping.
I know of people who had PVCs and they got better, so that's a great reason to hope mine will get better too. I think Tickertock is one such exampoe on this board.
Tickertock, please remind us that your tachy and PVCs have improved...that will make us hopeful! LOL
Good luck everyone!
Fran
20% of patients with frequent PVCs may develop a cardiomyopathy??? Sounds crazy if you think that every single cardio we've talked to or read about tells us frequent PVCers that PVCs are almost always benign...Would they say this if there was a 20% chance that we develop cardiomyopathy?? My cardio just told me the prognosis is certain and it's benign. What does he have to gain in telling me this if it wasn't true? Also all doctors n this board say cardiomyopathy caused by PVCs is very unlikely. 20% is a whole lot.
I do want my PVCs controlled, but for the quality of life. I just found out my focus is in the left ventricle and it would be risky to ablate it so if I get worse I think I will go for antiarrhythmics, if my cardio agrees. For now BBs are helping.
I know of people who had PVCs and they got better, so that's a great reason to hope mine will get better too. I think Tickertock is one such exampoe on this board.
Tickertock, please remind us that your tachy and PVCs have improved...that will make us hopeful! LOL
Good luck everyone!
Fran
Hi Fran,
I have always been an episodic PVC sufferer, they will disappear from months to years, then reappear for a few days to as long as 6 months. This is longest break I've had from a prolonged episode in 14 years, I have only felt about 5 pvcs in the last month. The tachycardia is completely controlled with atenolol.
I think that when 20% of all your total heartbeats are PVCs on constant daily basis then you stand a small chance of developing cardiomyopathy, not that 20% of all frequent PVCs sufferers will develop cardiomyopathy, at least that is my understanding, I could be completely wrong unless there is another study out that confirms otherwise. Take care.
I have always been an episodic PVC sufferer, they will disappear from months to years, then reappear for a few days to as long as 6 months. This is longest break I've had from a prolonged episode in 14 years, I have only felt about 5 pvcs in the last month. The tachycardia is completely controlled with atenolol.
I think that when 20% of all your total heartbeats are PVCs on constant daily basis then you stand a small chance of developing cardiomyopathy, not that 20% of all frequent PVCs sufferers will develop cardiomyopathy, at least that is my understanding, I could be completely wrong unless there is another study out that confirms otherwise. Take care.
I developed a cardiomyopathy from very frequent pvcs. No postpartum cardio. Maybe the person who had the post pregnancy CM will see the post and respond to your questions.
Hope you and your baby are doing great!
Connie
Hope you and your baby are doing great!
Connie
That's a good question about afib. I went to my family GP yesterday to ask about a different beta-blocker because either the toperol is making me tired and feeling dizzy again, or the change from trigeminy to "irregularily-irregular" (all over the board PVCs) is making me tired.
Funny I was feeling really good for awhile on 25mg toperol and constant trigeminy.
Anyhow, while in the dr's office she was listening with steth and thought I was in A-fib and it freaked me out. Another EKG later and it was all PVCs. But she's referring me to a cardio now because I asked how frequently I should get an echo and she didn't know! ((according to the American Academy of Cardiology 20% of high frequency PVCs sufferers "may" develop a cardiomyopathy----high frequency being defined as 30 or more PVCs an hour----I get more than a 1000/hr, but I must add, I had 400+/hr for years and years and years and no changes to heart structure, just an increase in PVCs)).
And one last thought on supplements, I still take them, they do have benefit, antioxidants (C, E) garlic, magnesium. Calcium in supplement "seems" to irritate my heart so I make sure it's in my diet sufficiently and it seems ok then. As with prescription medications, side effects may occur. Just be knowledgeable.
Funny I was feeling really good for awhile on 25mg toperol and constant trigeminy.
Anyhow, while in the dr's office she was listening with steth and thought I was in A-fib and it freaked me out. Another EKG later and it was all PVCs. But she's referring me to a cardio now because I asked how frequently I should get an echo and she didn't know! ((according to the American Academy of Cardiology 20% of high frequency PVCs sufferers "may" develop a cardiomyopathy----high frequency being defined as 30 or more PVCs an hour----I get more than a 1000/hr, but I must add, I had 400+/hr for years and years and years and no changes to heart structure, just an increase in PVCs)).
And one last thought on supplements, I still take them, they do have benefit, antioxidants (C, E) garlic, magnesium. Calcium in supplement "seems" to irritate my heart so I make sure it's in my diet sufficiently and it seems ok then. As with prescription medications, side effects may occur. Just be knowledgeable.
Hello,
A-FIB felt fast, fluttery and kind of breathless to me. Sort of like being out of control and hard to concentrate. It's been a few years, but that is how I remember it. Hope to never repeat it. Then of course they run the test, and document it. That's how it was for me. Once at the Dr. office, once at the hospital.
I did not have a good response to L-Carnitine and L-Taurine. I've tried it a couple times, and decided to give it a rest.
I've had a favorable response to Inderal and Toprol for many years.
Thank you
cristabelle
A-FIB felt fast, fluttery and kind of breathless to me. Sort of like being out of control and hard to concentrate. It's been a few years, but that is how I remember it. Hope to never repeat it. Then of course they run the test, and document it. That's how it was for me. Once at the Dr. office, once at the hospital.
I did not have a good response to L-Carnitine and L-Taurine. I've tried it a couple times, and decided to give it a rest.
I've had a favorable response to Inderal and Toprol for many years.
Thank you
cristabelle
I've taken the co-enzyme, fish oil, magnesium, potassium, etc. because I read this on another board and felt like I had to do SOMETHING PROACTIVE to try to beat this thing. But that's good point, maybe this stuff may not be the best thing for me.
This is a really good point that some of these supplements maynot be good for me - I have to give this some thought and try to remember if my episodes have increased since I started taking all this stuff. It did not start out to be as frequent or as long.
Thanks everyone for this insight.
By the way, how do you feel about taurine and L-Carnitene?
This is a really good point that some of these supplements maynot be good for me - I have to give this some thought and try to remember if my episodes have increased since I started taking all this stuff. It did not start out to be as frequent or as long.
Thanks everyone for this insight.
By the way, how do you feel about taurine and L-Carnitene?
Hey there!
I took both forms of Inderal. The LA80mg was great for sustained "relief." Now, I'm back to 20mg occasionally.
My daughter took the LA80's and had no side effects at all.
Good luck on the new RX!
A-fib?? I know whenever I mention to my doctor that I feel something "different," she gets another holter. Maybe she suspected A-fib, but I don't think it ever turned up. Keep us posted.
BTW, I'm glad you cleared up the mix up about the 2 "upbeat" posters....I was wondering what happened : )
I took both forms of Inderal. The LA80mg was great for sustained "relief." Now, I'm back to 20mg occasionally.
My daughter took the LA80's and had no side effects at all.
Good luck on the new RX!
A-fib?? I know whenever I mention to my doctor that I feel something "different," she gets another holter. Maybe she suspected A-fib, but I don't think it ever turned up. Keep us posted.
BTW, I'm glad you cleared up the mix up about the 2 "upbeat" posters....I was wondering what happened : )
Hello. I could only tell the difference between PVC's and A-fib by the what the Dr. told me via the EKG. It felt like nothing I had ever felt before and continued on and on. I do not know if a Dr. can hear it with a stethoscope.
Anybody out there know??????
Great timing that you brought up the question about Inderal verses InderalLA. I've been on the regular stuff for years, and was just given a script for the long acting 80mg. stuff from my Dr. He said "Here try this, you may get better coverage, so I believe I will try it. I already dropped off the script at the pharmacy.
Would love to hear how anyone out ther is tolerating this med.
Most appreciative,
cristabelle
Anybody out there know??????
Great timing that you brought up the question about Inderal verses InderalLA. I've been on the regular stuff for years, and was just given a script for the long acting 80mg. stuff from my Dr. He said "Here try this, you may get better coverage, so I believe I will try it. I already dropped off the script at the pharmacy.
Would love to hear how anyone out ther is tolerating this med.
Most appreciative,
cristabelle
Hi all,
could anybody tell me what AF feels like? Can you tell if you're having AF or just sinus tachy?
Thanks!
Fran
could anybody tell me what AF feels like? Can you tell if you're having AF or just sinus tachy?
Thanks!
Fran
I think Taurine is put in "energy" drinks like Redbull. I'd avoid this one since it probably acts in some way like caffiene.
I took fish oil for a couple of months and my PVCs actually got quite worse while on it, both in numbers and types.
I took fish oil for a couple of months and my PVCs actually got quite worse while on it, both in numbers and types.
uhmm, I've had the fluttery, bubbling, weird beats, seemed different than the "usual" PVCs. And like you, felt a little lightheaded, only momentarily, and unable to concentrate, but for a lot longer than the lightheaded sensation.
I've wondered if it were something other than PVCs, but every time I've listened with stethescope,it seems like PVCs. I have had nsvt--6 or 7 pvcs in a row without any normal beats. I always thought the fluttery different sensation was the nsvt.
But can you really tell afib unless it's recorded on an EKG??
Anybody? Can you hear the difference with a stethescope??
I've had a 48 hr holter and it recorded only unifocal PVCs. I guess I'm thankful for that even at such high numbers. But every once in awhile I get those really weird ones and I can't help wonder if something is different. Like, why I can tolerate the PVCs for so long then, wham, same number of pvcs but I feel really ill over them.
Also, my dr gave me propanolol (I think it's extended release inderal). But it's only available in 80mg tabs and undividable. She said it might make me more tired than the toperol, jiminy crickets I'm trying to avoid the fatigue. Any comments on fast acting inderal versus slow acting would be appreciated.
I've wondered if it were something other than PVCs, but every time I've listened with stethescope,it seems like PVCs. I have had nsvt--6 or 7 pvcs in a row without any normal beats. I always thought the fluttery different sensation was the nsvt.
But can you really tell afib unless it's recorded on an EKG??
Anybody? Can you hear the difference with a stethescope??
I've had a 48 hr holter and it recorded only unifocal PVCs. I guess I'm thankful for that even at such high numbers. But every once in awhile I get those really weird ones and I can't help wonder if something is different. Like, why I can tolerate the PVCs for so long then, wham, same number of pvcs but I feel really ill over them.
Also, my dr gave me propanolol (I think it's extended release inderal). But it's only available in 80mg tabs and undividable. She said it might make me more tired than the toperol, jiminy crickets I'm trying to avoid the fatigue. Any comments on fast acting inderal versus slow acting would be appreciated.
Hello,
I must say I agree with mrhb and upbeat at least about the Co-enzyme Q10. I've only had a couple bouts of afib, but they occurred when a well-meaning associate reccommended a natural suppplement to strengthen the heart muscle. Well, it could have been a coincident, but I would be careful. I am not a physician, however, I would be cautious with some of these supplements because they are potent.
Kind regards,
cristabelle
I must say I agree with mrhb and upbeat at least about the Co-enzyme Q10. I've only had a couple bouts of afib, but they occurred when a well-meaning associate reccommended a natural suppplement to strengthen the heart muscle. Well, it could have been a coincident, but I would be careful. I am not a physician, however, I would be cautious with some of these supplements because they are potent.
Kind regards,
cristabelle
Greetings,
Thanks for the response. I'm certainly not giving up, but I think it is fair to say that a whole load of circumstances (since 1992) make me have my doubts.
You are correct, of course, that when it comes to healthcare, be it allopathic, nutritional, whatever...it is definitely not "one size fits all." What is good for one may be bad for another. That is life. How we deal with the unintended consequences is another subject for another day.
Be well.
Thanks for the response. I'm certainly not giving up, but I think it is fair to say that a whole load of circumstances (since 1992) make me have my doubts.
You are correct, of course, that when it comes to healthcare, be it allopathic, nutritional, whatever...it is definitely not "one size fits all." What is good for one may be bad for another. That is life. How we deal with the unintended consequences is another subject for another day.
Be well.
I think you went to the wrong chiropractor.
I would just like to repeat that not everything works for everybody, but a body should keep trying.
Medicine, in all it's forms, chemical medicine, physical medicine and energetic medicine doesn't have an answer for everything whether it's using drugs, supplements, or any of the multitude of treatments. Just be educated.
I've had a lot of bad experiences with medical doctors and dentists, and, well you get the point, but I don't give up on the whole profession. I would however give up on a doctor who only gives me two minutes of their precious time for my healthcare.
I would just like to repeat that not everything works for everybody, but a body should keep trying.
Medicine, in all it's forms, chemical medicine, physical medicine and energetic medicine doesn't have an answer for everything whether it's using drugs, supplements, or any of the multitude of treatments. Just be educated.
I've had a lot of bad experiences with medical doctors and dentists, and, well you get the point, but I don't give up on the whole profession. I would however give up on a doctor who only gives me two minutes of their precious time for my healthcare.
Just a thought.....while all the supplements you mentioned *should* be cardio-protective, I think some of them can excite or irritate the heart tissue too. It may be only coincidence but I started taking a really high quality EPA-DHA (fish oil) and co-enzyme Q10 about a year ago because I thought it was about time to do all I could for my heart.
That was about the same time that my high frequency PVCs went REALLY high (10,000PVCs/day to about well over 20,000/day)
Recently I thought I would try C0-Q 10 again because I've been in trigeminy it seems like forever (Christmas for sure)and I thought, again, I should try to do everything I possibly can for my heart health.
Well, my constant trigeminy went irregularily-irregular. I can't tell, it's trigeminy sometimes and others it's 10 or 20 normal beats. While I used to think that would be heaven, to have a string of regular beats, I now feel horrible!! I was begining to feel really good despite the trigeminy, feeling comfortable with it I guess. I was feeling "well". But now I feel "unwell" again. I don't advocate that anyone start or stop anything they think may give them benefit, but like everything else out there, not everything works the same for everyone. Keep trying though.
That was about the same time that my high frequency PVCs went REALLY high (10,000PVCs/day to about well over 20,000/day)
Recently I thought I would try C0-Q 10 again because I've been in trigeminy it seems like forever (Christmas for sure)and I thought, again, I should try to do everything I possibly can for my heart health.
Well, my constant trigeminy went irregularily-irregular. I can't tell, it's trigeminy sometimes and others it's 10 or 20 normal beats. While I used to think that would be heaven, to have a string of regular beats, I now feel horrible!! I was begining to feel really good despite the trigeminy, feeling comfortable with it I guess. I was feeling "well". But now I feel "unwell" again. I don't advocate that anyone start or stop anything they think may give them benefit, but like everything else out there, not everything works the same for everyone. Keep trying though.
Hi,
I'm not a doctor, but my experience has been that CoQ-10 may possibly be a factor in your afib episodes. I have used this popular supplement twice in my life, nine years apart, and it put me in the hospital both times. Afib devolving into SVT, HR of 160 (first episode was 202). Not good!
I'm also wondering about your accupuncture comments. After a network chirpractor used a device called an activator on my neck, I have had PVC's. This is a small rubber mallet thingy that is clicked like a ball point pen against your neck and spine. Like you, I have often questioned if there may possibly be a link between the chiro nonsense and the palps.
Just my uneducated opinion, but I would knock off the fish oils and the CoQ-10. Too many unanswered questions are out there. In your quest to help yourself, the possibility exists that you could unintentionally make things worse.
Discuss it with your doctor.
BTW...15 minutes? Good for you! My cardio doc gives me 2 minutes and literally pushes me out the door.
Good Luck!
I'm not a doctor, but my experience has been that CoQ-10 may possibly be a factor in your afib episodes. I have used this popular supplement twice in my life, nine years apart, and it put me in the hospital both times. Afib devolving into SVT, HR of 160 (first episode was 202). Not good!
I'm also wondering about your accupuncture comments. After a network chirpractor used a device called an activator on my neck, I have had PVC's. This is a small rubber mallet thingy that is clicked like a ball point pen against your neck and spine. Like you, I have often questioned if there may possibly be a link between the chiro nonsense and the palps.
Just my uneducated opinion, but I would knock off the fish oils and the CoQ-10. Too many unanswered questions are out there. In your quest to help yourself, the possibility exists that you could unintentionally make things worse.
Discuss it with your doctor.
BTW...15 minutes? Good for you! My cardio doc gives me 2 minutes and literally pushes me out the door.
Good Luck!
Hi Kevin,
These are good, practical questions.
1. do you think coumadin is indicated?
Age less than 75 is a good indicator unless the following are present.
Independent clinical risk factors were
a. prior thromboembolism,
b. age (over 75 years in women), and
c. systolic hypertension (greater than 160 mmHg on 2 consecutive measurements).
I have also seen diabetes on this list.
2. I reduced the dosage because I read where vagal afibbers like myself should not be taking beta-blockers. Your opinion on this?
This is good theory but has never been looked at in a randomized trial.
3. What suggestions do you have as to potential talking points?
are you symptomatic with your AF? If so, would you try antiarrhythmic medications? would you be willing to try an AF ablation if the medications fail?
4.And how often are echos or stress tests done?
Depends on your clinical circumstances. For lone atrial fibrillation (AF with no other medical problems), only as symptoms require them, there are no stict guidelines.
I hope this helps. good luck with your appointment.
These are good, practical questions.
1. do you think coumadin is indicated?
Age less than 75 is a good indicator unless the following are present.
Independent clinical risk factors were
a. prior thromboembolism,
b. age (over 75 years in women), and
c. systolic hypertension (greater than 160 mmHg on 2 consecutive measurements).
I have also seen diabetes on this list.
2. I reduced the dosage because I read where vagal afibbers like myself should not be taking beta-blockers. Your opinion on this?
This is good theory but has never been looked at in a randomized trial.
3. What suggestions do you have as to potential talking points?
are you symptomatic with your AF? If so, would you try antiarrhythmic medications? would you be willing to try an AF ablation if the medications fail?
4.And how often are echos or stress tests done?
Depends on your clinical circumstances. For lone atrial fibrillation (AF with no other medical problems), only as symptoms require them, there are no stict guidelines.
I hope this helps. good luck with your appointment.
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