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New Guidelines: This is somewhat complex and will not all fit in 400 characters so I am creating initials. 1. Ischemic cardiomyopathy, i.C., with ejection fraction, ef, >30% but <35%, newyork heartassoc, nyha, class ii or iii, and >30 days post mi/revascularization. 2. Ic, ef <30%. 3. Ic, ef between 36-40% with inducible ventricular fibrillation or tachycardia, 4. Non-ic with ef <35% and nyha class ii or greater. ...Read moreSee 1 more doctor answer
For young (<60), asymptomatic, paroxysmal atrial fibrillation patients on NOACs with LVH, should the patient seek out catheter ablation for treatment?
Depends: on left atrial size and function, frequency. Ablation is a big deal and frequently unsuccessful. I would try to suppress with a beta blocker like Bystolic, get magnesium level to 2.1-2.4, potassium to 4.1-4.5, stay off stimulants/alcohol, use hawthorne berry, avoid many other supplements, get general labs checked. Why the LVH? HRS, MD, FACC. www.thepmc.org ...Read more
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CPR: less than 10% of people with cardiac arrest and CPR survive overall. After 10 min of CPR survival is miniscule. Early CPR and defibrillation within less than 4-5min give the best outcomes. Las Vegas casinos with abundant automated defibrillators, trained staff and people watching on monitors have the fastest response and best results. ...Read more
Definitive Control: We don't generally do this with surgery, but rather with a "catheter" based procedure (wire we thread into the heart that cauterizes the av node). This procedure provides complete control of the heart rate in the lower chamber and excellent symptom control, but makes people dependent on the pacemaker that *must* be implanted with this procedure. ...Read moreSee 3 more doctor answers
What is your opinion about doing pul.v.isolation ablation for 73 hypertensive male with paroxysmal afib (feel palpitation only) &amiodarone failure?
What makes atrial fibrillation not immediately life threatening while ventricular fibrillation is?
A circuit breaker: The rhythms in the top chamber during atrial fibrillation can reach and exceed 600 bpm. If this were conducted directly to the lower chamber, it would be as fatal as ventricular fibrillation. However, nature built in a circuit breaker called the av node between the two such that only some of the top chamber heartbeats in fibrillation make it to the bottom chamber. ...Read moreSee 1 more doctor answer
Yes: Catheter ablation is considered a first line therapy for symptomatic WPW syndrome. It's highly effective in the majority of cases. It's generally safe with a low incidence of serious complications and since WPW can (rarely) result in sudden death, the benefit of ablation justifies the small risk. ...Read moreSee 3 more doctor answers