EP's Nurse Practitioner follow up appt.

[DeltaDawn23]

just saw my cardiologist's nurse practitioner.  She said my ekg looked fine, I am just having an extra beat every so often.  I am getting a 24 hour Holter monitor at the end of the month to check it, then will see her again for follow-up.  She told me to take one half of a 25 mg. Atenolol at night and see how that works.  But not to let my heart rate up go up too high because it can lead to afib.  I tried that, need a little more during the day.  She says Atenolol is a 24 hour drug, but it doesn't stay in my system that long.  I am very discouraged about this.  Today my heart is irregular due to digestive upset -- vagal nerve irritation I guess -- and it's giving me fits.  This nurse practitioner was very negative about ablations when I told her I was going to OSU med ctr for an evaluation.  She said they (meaning people who perform the ablations) overstate their success rates and they can cause damage.  It seems like you can get as many different answers as doctors you ask -- it is discouraging to say the least.

[DeltaDawn23]

I almost wish there was a clear way to treat this condition and then there wouldn't be so many decisions, and mulling over and muddling thru medical papers to try to make sure I am making an informed decision.  I had cancer years ago and that was a "cut and dried" situation:  have the surgery, or surely die from the cancer.  This situation, however, seems to have no standard treatment.  My regular ep asked me to participate in a study (CABANA) in which the computer would pick the treatment, meds or ablation and then they will learn in a few years, which is best.  That's all well and good, but unfortunately I'm afraid I may not have the luxury of waiting a few years to find out which is best.  I am not interested in "rolling the dice" on a decision that will have a huge effect on my life.  Many things  in life are a trade-off and decisions like this are a calculated risk.  I am going to keep gathering information and see what I think.  I am on the schedule for September if the OSU doctor thinks I am a good candidate.  My pcp of many years is retiring August 1, and I am going to run the FIRM ablation and OSU by him.  He has generally suggested that when making my decision I should be considering my quality of life.  I would be happy to feel better and stay out of the hospital -- not such lofty goals:)  Thank you both for your input. DD

[Jerry_NJ]

:My primary care doctor is teamed with a female nurse practitioner.   On those rare occasions I need some quick medical attention (rare, happily) it is easier to get an appointment with the NP.  I have been happy with her services and have found her prescription calls generally good - not so good on my nasal congestion, but then the doctor doesn't do any better on that problem.

I am surprised to read someone in the EP business would be opposed to ablations in general.  The EP who examined me an made one try to convert my AFib with an electrocardio advised against ablation in my case, he did not say anything in general negative about ablation.  He went so far as to say he would give the same advice to his own father if he were in the same heart condition I am in... guess that's supposed to make me feel better, just makes me feel older.  I still remember when doctors were always older than me.  Some things are better forgotten.

As we have discussed I suffer from chronic AFib and have even undergone a mini-maze when I had open heart surgery... that didn't stop the AFib.  At the time of the surgery I had been in AFib for about 6 months.  Prior to that time I was NSR following electrocardioversion and using drugs like Rythmol to hold me there... I took Propafenone.  So my case is different, and less likely, I believe, to be corrected by ablation, than is your case.

But as it is with life, everything has risks.  Indeed, doing nothing has associated risks.  That's why we seek professional advice to decide to take action or not to take action.  In my case, I am on "rate control", the decision has been not to take action/ablation.

[seaweib]

I agree that it is very odd that there are such varying opinions on ablations, particularly with respect to afib.  On this website, there seems to be a decidedly pro-ablation vibe even in regard to afib.  However, the EP that I met with gave me his high-level opinion on afib and and stated that ablations do not help afib.  It would be nice if there were more of a consensus for such and intricate and expensive procedure.