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  1. #101
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    My ablation was paid for by my insurance company (GEHA). Occassionally people have trouble getting coverage with their insurance companies depending on exactly what type of ablation is being performed and their past history. You will need to talk to your insurance company to see if they consider your proposed treatment experimental or approved. FYI, my PVI ablation cost about $50K "retail" which the insurance company got for about $25K under their prenegotiated rates.

  2. #102
    Senior Member skydive69's Avatar
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    Quote Originally Posted by Bacco
    My ablation was paid for by my insurance company (GEHA). Occassionally people have trouble getting coverage with their insurance companies depending on exactly what type of ablation is being performed and their past history. You will need to talk to your insurance company to see if they consider your proposed treatment experimental or approved. FYI, my PVI ablation cost about $50K "retail" which the insurance company got for about $25K under their prenegotiated rates.
    I am curious as to your and others situation prior to choosing abalation. Where you having constant or frequent (how frequent) symtoms when the decision was made. I would think anyone with infrequent episodes would probably not go that route, but that is what I am trying to determine.
    www.brokennecktobrokenrecords.com

  3. #103
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    Quote Originally Posted by Bacco
    My ablation was paid for by my insurance company (GEHA). Occassionally people have trouble getting coverage with their insurance companies depending on exactly what type of ablation is being performed and their past history. You will need to talk to your insurance company to see if they consider your proposed treatment experimental or approved. FYI, my PVI ablation cost about $50K "retail" which the insurance company got for about $25K under their prenegotiated rates.
    My insurance company HMO is "networked" - but it is a medicare wraparound. That means that I can always use the medicare portion of it, at least. I will check further.

    I talked with the Cleveland Clinic today, and they accept Medicare. It is difficult to get them to give me an estimate of my out-of-pocket cost, but I will try again later. Perhaps I wil get someone more knowledgeable.

    I also talked with Dr. Natale's office, and they have suggested I have my cardio and my PCP forward my med records. I see my cardio tomorrow and will discuss with him.


    Quote Originally Posted by skydive69
    I am curious as to your and others situation prior to choosing abalation. Where you having constant or frequent (how frequent) symtoms when the decision was made. I would think anyone with infrequent episodes would probably not go that route, but that is what I am trying to determine.
    I am in continuous AFib - that mean I do not go in and out of AFib - I just stay there. No meds have been able to control it, nor have any electric cardioversions.

    The good thing is I don't have to suffer going in and out, which causes dizziness and trips to the ER for folks with paroxysmal (sp) (in and out) AFib. They get quite scared.

    It does mean that I am constantly producing only about 2/3rd's of my cardiac output, which reduces my endurance and power noticeably. It also means that my heart rate is controlled by meds, although my heart does beat faster when I exercise, and I must take warfarin (rat poison) to prevent coagulation in the Atria and subsequent strokes.

    All-in-all, it isn't a lot of fun!

    The ablation can cure it permanently, if all goes well.

  4. #104
    Senior Member skydive69's Avatar
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    Quote Originally Posted by DnvrFox



    I am in continuous AFib - that mean I do not go in and out of AFib - I just stay there. No meds have been able to control it, nor have any electric cardioversions.

    The good thing is I don't have to suffer going in and out, which causes dizziness and trips to the ER for folks with paroxysmal (sp) (in and out) AFib. They get quite scared.

    It does mean that I am constantly producing only about 2/3rd's of my cardiac output, which reduces my endurance and power noticeably. It also means that my heart rate is controlled by meds, although my heart does beat faster when I exercise, and I must take warfarin (rat poison) to prevent coagulation in the Atria and subsequent strokes.

    All-in-all, it isn't a lot of fun!

    The ablation can cure it permanently, if all goes well.
    I guess one thing I am not clear about is that you (I believe) indicate that the medication controls your heart rate, hence while controlled, is it still considered being in AFib? What is it controlled to?

    I ask all of these questions hoping that my solo episode will remain a solo episode, but then again I am well aware of the non existence of Santa Claus.

    Keep us in the loop as you progress through the system. BTW, I also assume from your post that electrical cardioversion is the first step in a try for a permanent cure. I wonder what percentage beat it at that stage?
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  5. #105
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    Quote Originally Posted by skydive69
    I guess one thing I am not clear about is that you (I believe) indicate that the medication controls your heart rate, hence while controlled, is it still considered being in AFib? What is it controlled to?

    I ask all of these questions hoping that my solo episode will remain a solo episode, but then again I am well aware of the non existence of Santa Claus.

    Keep us in the loop as you progress through the system. BTW, I also assume from your post that electrical cardioversion is the first step in a try for a permanent cure. I wonder what percentage beat it at that stage?
    Sorry, I see the confusion now.

    It is the atrial (top and smaller) chambers that are in continuous fibrillation, even as I type.

    The ventricles (lower and harder working chambers) take their cue from the atrial contractions. So, if my atrium is fibrillating at 300-400 times per minute, the ventricles attempt to do the same thing, but not all of the verntricular signals get through. So,

    1. My artria are always in fibrillation.

    2. My ventricles were ticking along about 158-160 BPM (resting - and that is a dangerous continuous rate) before the meds (digoxin and beta blockers), and the meds keep it as slow as I and the doc want, depending on the dosage. I no longer take digoxin, as my HR was too slow. Right now I keep the ventricles at about 65-72 BPM with the beta blocker. The rate increases some as I exercise.

    3. The reduction in heart output comes from the fact that the atria are not pumping blood into the ventricles, giving less volume.

    4. The fact that the atria are not pumping, but are instead in fibrillation, leads to the possibility (5% chance) that the blood will pool in the atria and coagulate and then be sent to the brain, causing a stroke. That is why I take a blood thinner to stop any coagulation.

    Sorry I did not explain it more clearly earlier. There are a lot of good web site. Check out the Heart section of ClevelandClinic.org and they have a whole manual on AFib which can be downloaded.

    And, I will keep posting, despite the naysayers!
    Last edited by DnvrFox; 01-10-05 at 07:37 PM.

  6. #106
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    I started out having afib episodes about once a week for a few hours at a time. Within a couple months, I was having them about every three days and they would last 6-24 hours. In retrospect, I'm sure I had some afib episodes before Bike Florida, but I just didn't recognize them as such.

    Afib can be caused by many factors, e.g., too much alcohol, drug reactions, inadequate diet, which can cause a single episode. Generally, if you have several episodes, without a clear reason for them occurring, then you are likely to have more, increasing in frequency and duration as you age (but, not as quickly as mine progressed).

    The decision as to when to have maze surgery or an ablation to cure afib depends on several medical factors that have to be evaluated. In the end, I would say you are ready for a cure when your quality of life is decreased enough that you don't want to live with afib any longer. There is up to a 1 or 2% risk that something may go wrong during the procedures to eliminate the afib. The consequences can range from minor annoyances to serious medical problems(e.g., a stroke or severe pulmonary stenosis). At the best centers that treat afib, the risks are less than 1%. Living with afib and taking drugs to control it also has risks. Only you can decide which risk to take. I chose the risk of being cured.

  7. #107
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    I started out having afib episodes about once a week for a few hours at a time.
    And mine just started one day and never stopped!

  8. #108
    Senior Member skydive69's Avatar
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    Quote Originally Posted by DnvrFox
    Sorry, I see the confusion now.

    It is the atrial (top and smaller) chambers that are in continuous fibrillation, even as I type.

    The ventricles (lower and harder working chambers) take their cue from the atrial contractions. So, if my atrium is fibrillating at 300-400 times per minute, the ventricles attempt to do the same thing, but not all of the verntricular signals get through. So,

    1. My artria are always in fibrillation.

    2. My ventricles were ticking along about 158-160 BPM (resting - and that is a dangerous continuous rate) before the meds (digoxin and beta blockers), and the meds keep it as slow as I and the doc want, depending on the dosage. I no longer take digoxin, as my HR was too slow. Right now I keep the ventricles at about 65-72 BPM with the beta blocker. The rate increases some as I exercise.

    3. The reduction in heart output comes from the fact that the atria are not pumping blood into the ventricles, giving less volume.

    4. The fact that the atria are not pumping, but are instead in fibrillation, leads to the possibility (5% chance) that the blood will pool in the atria and coagulate and then be sent to the brain, causing a stroke. That is why I take a blood thinner to stop any coagulation.

    Sorry I did not explain it more clearly earlier. There are a lot of good web site. Check out the Heart section of ClevelandClinic.org and they have a whole manual on AFib which can be downloaded.

    And, I will keep posting, despite the naysayers!
    Thank you for taking the time to explain - quite fascinating (and scary).
    www.brokennecktobrokenrecords.com

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    Quote Originally Posted by skydive69
    Thank you for taking the time to explain - quite fascinating (and scary).
    To say the least!

    I am likely to go the ablation route.

    When I had Trigeminal Neuralgia (terrible, terrible facial pain - "universally considered to be the most painful affliction known to medical practice") a lot of folks (scared of surgery) opted to take powerful meds the rest of their lives to control (sort of) the pain. They said that meds were "less intrusive." I opted for brain surgery because I felt that a one-time surgery was much less intrusive than filling my cells with dope the rest of my life, and offered a greater chance of cure.

    I think I will follow the same reasoning here, but still don't have all the facts.
    Last edited by DnvrFox; 01-10-05 at 08:39 PM.

  10. #110
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    Best wishes. I am sure that you will make the best possible decision and will soon be healthy again.

  11. #111
    Senior Member skydive69's Avatar
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    Quote Originally Posted by DnvrFox
    To say the least!

    I am likely to go the ablation route.

    When I had Trigeminal Neuralgia (terrible, terrible facial pain - "universally considered to be the most painful affliction known to medical practice") a lot of folks (scared of surgery) opted to take powerful meds the rest of their lives to control (sort of) the pain. They said that meds were "less intrusive." I opted for brain surgery because I felt that a one-time surgery was much less intrusive than filling my cells with dope the rest of my life, and offered a greater chance of cure.

    I think I will follow the same reasoning here, but still don't have all the facts.
    I would have done the same as you!
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    Well, tonight I once again will try to sleep with 22 wires attached to me, a mask over my face attached by elastic around my head and two tight straps around my chest and waist.

    Wish me luck!

    Update: slept about 4 hours, enough for them to get the data they needed. Left a 4am, went to the Waffle House for breakfast.
    Last edited by DnvrFox; 01-17-05 at 06:51 AM.

  13. #113
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    Dnvr.Fox, I wish that I had more time to send you a longer message, but may I say that you and your family are in my prayers, and just hang in there. I hope the best for you, and keep on riding. Those are some beutiful photos from Colorado. Chicharron.

  14. #114
    Senior Member skydive69's Avatar
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    Quote Originally Posted by DnvrFox
    Well, tonight I once again will try to sleep with 22 wires attached to me, a mask over my face attached by elastic around my head and two tight straps around my chest and waist.

    Wish me luck!

    Update: slept about 4 hours, enough for them to get the data they needed. Left a 4am, went to the Waffle House for breakfast.
    That's an incredible ordeal, but hopefully the light at the end of the tunnel will make it all worth it.
    www.brokennecktobrokenrecords.com

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    Just got back from sleep doc.

    My Oxygen is so low at night (84%) - due to sleep Apnea and the chest pressure of being somewhat overweight, that he is ordering oxygen during the night in addition to the CPAP machine, which I also got today.

    WOW, what a change of lifestyle.

    He thinks that if I lose about 10-15 more pounds, the SA may well go away, and there is the possibility of a reversal of the AFib and lowering of SA-associated hypertesion.

    I have already lost about 15 pounds last couple of months. I have asked to see a nutritionist for further assistance.

    Saw an Electro-Physiologist yesterday who explained the different types of ablations available, but also stated that treatment or removal of sleep apnea may reverse heart Atrial Fibrillation.

    I am going to delay any ablation procedures for about 5 months to see what the effect of the CPAP, O2 and weight loss have on the AFib.
    Last edited by DnvrFox; 01-21-05 at 01:55 PM.

  16. #116
    Senior Member jazzy_cyclist's Avatar
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    Good luck, Fox - hope this is the one that does it for you.

    Although, I don't understand the relation between SA and afib. Isn't SA just not getting a good breath of O2 because your airway is blocked?

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    Quote Originally Posted by jazzy_cyclist
    Good luck, Fox - hope this is the one that does it for you.

    Although, I don't understand the relation between SA and afib. Isn't SA just not getting a good breath of O2 because your airway is blocked?
    It is more than that - it is actually stopping breathing for up to a minute.

    The negative effects is that your heart must work much harder to keep your cells oxygenated, which over many years essentially puts a great deal of strain on your heart and also ups your blood pressure, which causes the damage which causes AFib, as I understand it. Your BP is supposed to drop 10 points at night. Mine doesn't - my highest BP during the day is just after I awaken.

    I think this is an area in which more research will be helpful. The correlation between SA and AFib was only found about 5 months ago. This is new stuff.

  18. #118
    Senior Member jazzy_cyclist's Avatar
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    Thanks for the explanation. My wife (who works in medicine) claims that I have SA mostly because I can snore heavily if I sleep on my back. My BP is okay - get some premature beats from time to time over the last several years. So -- the treatment is a device that keeps your airway open by not permitting you to lie on your back? Or is there more to it than that?

    Keep us posted - this is interesting. And of course, good luck.

  19. #119
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    Quote Originally Posted by jazzy_cyclist
    Thanks for the explanation. My wife (who works in medicine) claims that I have SA mostly because I can snore heavily if I sleep on my back. My BP is okay - get some premature beats from time to time over the last several years. So -- the treatment is a device that keeps your airway open by not permitting you to lie on your back? Or is there more to it than that?

    Keep us posted - this is interesting. And of course, good luck.
    NOPE!

    Lying on your back is what you are supposed to do. Lying on your tummy is bad.

    The CPAP machine is a positive pressure device - sort of like an old-fashioned tube type vacuum cleaner with air blowing out the non-vacuum end, but much more refined, blowing into a mask that keeps your airway poen.

    It is the "snoring and stopping" then snoring and stopping that is an indicator of SA. It amy or may not cause increased blood pressure. During the stopping, you are getting no air.

    Other typical symptoms (but not mine) are extreme sleepiness and falling asleep during the day.

    http://www.sleepapnea.org/geninfo.html#defined

    The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

    Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.

    Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.

    Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.
    Last edited by DnvrFox; 01-23-05 at 12:30 PM.

  20. #120
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    Well, I just joined this club.

    I have not really looked at the 50+ threads, as I have been busy arguing with folks on the Commuter thread about Vehicular Cycling, and I am 48.

    This has been good reading so far.

    My entrance into the AF club was quite a surprise as some of you have also expressed... I have been a biker and swimmer since high school, the last thing I expected were heart/lung problems.

    I was just leaving the office the other night and my heart suddenly felt as if it was trying to jump out of my chest... (no pain, just big thumps) I could not get a good pulse... felt as if I was sending Morse code (sounded like it too later on a heart monitor). I went home and was about to eat dinner, but complained to my wife that I just did not feel right. She took me to ER right away. (insisted, actually). Was the fastest I ever saw a Doc in my life... I was on a table and hooked up to EKG before she could park the car. Glad I left Kaiser some 15 years ago... Jeeze those clowns sound downright scary. I am with Sharp San Diego.

    I was all over the place on the EKG... from 120 to as high as 172. My BP was way low... down to 80/60 and that was a huge issue as I was quite dizzy from time to time. My normal resting heart rate is usually around 50 or so, but if I am very relaxed I get down to low 40s. This was cause for concern when I left the Navy in the '80s; they had a hard time believing that low pulse... at the time I was cycling 20 miles a day and swimming 1/2 mile a day. I hate running though.

    I was in AF for about 12 hours... this was my first time as far as I know. I auto de-fibbed in the morning just as they were getting ready to hook me up to a recording EKG. The technician was quite disappointed, said it would have been real cool to record the event.

    Sonogram of the heart was very good (years of exercise pay off I suppose).

    Saw a Cardio Doc that day and am now on some drugs to lower my heart rate and of course the Coumadin (Warfarin) to prevent clots and strokes.

    Reading this thread is something of a relief as my first thoughts were "crap, this changes everything." While indeed there will be changes... obviously many of you are just as active as before... if not simply more cautious and obviously more aware.

    How some of you can be in Fib for days or even years is amazing... It would certainly slow me down. Especially that annoying thumping of the heart... it is if it was beat beat pause thump beat pause beat thump pause... very irregular.

    At any rate... I am going to take the drugs, go to monitoring and keep riding...

    Of course no more alcohol, but they told me not to change my diet... which is quite rich in veggies.

    I'll keep watching here to see how we all do and what others do. Comments on the various surgeries are quite interesting, but since this was my first episode, I have to wait and see what is really going on.

    Take care.

  21. #121
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    How some of you can be in Fib for days or even years is amazing... It would certainly slow me down. Especially that annoying thumping of the heart... it is if it was beat beat pause thump beat pause beat thump pause... very irregular.
    That sort of fades away if you are permanently in AFib and on something like metropolol. I do not notice my AFib at all right now,

  22. #122
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    Was the fastest I ever saw a Doc in my life... I was on a table and hooked up to EKG before she could park the car. Glad I left Kaiser some 15 years ago... Jeeze those clowns sound downright scary. I am with Sharp San Diego.

    Amen, brother

  23. #123
    Senior Member skydive69's Avatar
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    Quote Originally Posted by genec
    Well, I just joined this club.

    I have not really looked at the 50+ threads, as I have been busy arguing with folks on the Commuter thread about Vehicular Cycling, and I am 48.

    This has been good reading so far.

    My entrance into the AF club was quite a surprise as some of you have also expressed... I have been a biker and swimmer since high school, the last thing I expected were heart/lung problems.

    I was just leaving the office the other night and my heart suddenly felt as if it was trying to jump out of my chest... (no pain, just big thumps) I could not get a good pulse... felt as if I was sending Morse code (sounded like it too later on a heart monitor). I went home and was about to eat dinner, but complained to my wife that I just did not feel right. She took me to ER right away. (insisted, actually). Was the fastest I ever saw a Doc in my life... I was on a table and hooked up to EKG before she could park the car. Glad I left Kaiser some 15 years ago... Jeeze those clowns sound downright scary. I am with Sharp San Diego.

    I was all over the place on the EKG... from 120 to as high as 172. My BP was way low... down to 80/60 and that was a huge issue as I was quite dizzy from time to time. My normal resting heart rate is usually around 50 or so, but if I am very relaxed I get down to low 40s. This was cause for concern when I left the Navy in the '80s; they had a hard time believing that low pulse... at the time I was cycling 20 miles a day and swimming 1/2 mile a day. I hate running though.

    I was in AF for about 12 hours... this was my first time as far as I know. I auto de-fibbed in the morning just as they were getting ready to hook me up to a recording EKG. The technician was quite disappointed, said it would have been real cool to record the event.

    Sonogram of the heart was very good (years of exercise pay off I suppose).

    Saw a Cardio Doc that day and am now on some drugs to lower my heart rate and of course the Coumadin (Warfarin) to prevent clots and strokes.

    Reading this thread is something of a relief as my first thoughts were "crap, this changes everything." While indeed there will be changes... obviously many of you are just as active as before... if not simply more cautious and obviously more aware.

    How some of you can be in Fib for days or even years is amazing... It would certainly slow me down. Especially that annoying thumping of the heart... it is if it was beat beat pause thump beat pause beat thump pause... very irregular.

    At any rate... I am going to take the drugs, go to monitoring and keep riding...

    Of course no more alcohol, but they told me not to change my diet... which is quite rich in veggies.

    I'll keep watching here to see how we all do and what others do. Comments on the various surgeries are quite interesting, but since this was my first episode, I have to wait and see what is really going on.

    Take care.
    In that you went out of AF without drugs, I am curious as to why your cardiologist put you on drugs with only one event. I had an event about three weeks ago, but went back to normal in a couple of hours. I have my fingers crossed in that I am not anxious to take drugs.
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  24. #124
    Banned. DnvrFox's Avatar
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    Quote Originally Posted by skydive69
    In that you went out of AF without drugs, I am curious as to why your cardiologist put you on drugs with only one event. I had an event about three weeks ago, but went back to normal in a couple of hours. I have my fingers crossed in that I am not anxious to take drugs.
    From my listserv on AFib - the worst scenario seems to be for those folks who pop back in and out of AFib (paroxysmal). Those folks in NSR (normal sinus rhythm) dread when they go into AFib and will do practically anything to avoid it, including all sorts of special diets, etc. They get dizzy, strange feelings, shortness of breath, etc.

    Those of us permanently in AFib seem to be better off - the meds keep the heart rate down, and I do not even notice the AFib any more. And, today, riding my HEAVY (rack, panniers, loaded) mtn bike, I did pretty good kicking along at 18-20 mph, with no shortness of breath or anything like that. Even passed a roadie or two.

  25. #125
    Senior Member skydive69's Avatar
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    [QUOTE=DnvrFox]From my listserv on AFib - the worst scenario seems to be for those folks who pop back in and out of AFib (paroxysmal). Those folks in NSR (normal sinus rhythm) dread when they go into AFib and will do practically anything to avoid it, including all sorts of special diets, etc. They get dizzy, strange feelings, shortness of breath, etc.
    QUOTE]

    Good point. I know that it was not a fun experience as a guy with a resting heart beat of 44 to suddenly be 100 beats above that exacerbated by an irregular rhythm. I must admit I am not excited about the feeling of wondering and waiting to see if and/or when I might suffer another episode.
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