Posted on 04/20/2023 1:10:51 PM PDT by ConservativeMind
A score based on four readily available clinical and imaging parameters identifies heart failure patients who benefit most from atrial fibrillation ablation.
Atrial fibrillation and heart failure often coexist.
There is uncertainty about which heart failure patients should be referred for ablation.
"The tools to determine who exactly these selected patients are are elusive and often subjective," said Dr. Marco Bergonti. "The Antwerp score was developed to predict the response to ablation in heart failure patients with impaired (below 50%) ejection fraction."
The score is based on four parameters: QRS width above 120 milliseconds (2 points), known etiology (2 points), paroxysmal atrial fibrillation (1 point) and severe atrial dilation (1 point). Total scores range from 0 to 6, with 0 indicating a greater likelihood of recovery. A previous study showed the ANTWERP score estimated the probability of left ventricular ejection fraction (LVEF) recovery after ablation of atrial fibrillation.
The study included 605 patients. The Antwerp score predicted LVEF improvement after ablation with an area under the curve of 0.86 (95% confidence interval 0.82–0.89; p<0.001). For total scores of 0, 1, 2, 3, 4, and 5-6, the proportion of responders was 94%, 92%, 82%, 51%, 40% and 17%, respectively.
Dr. Bergonti said, "Based on our findings, patients with a low score (2 or less) may benefit from early referral for catheter ablation, with a more than 90% chance of recovery. Patients with a high score (5 or higher) have a very low expected recovery rate (below 20%) and hence may benefit more from alternative strategies such as aggressive rate control. Those in the intermediate zone (score 3-4, expected recovery rate 47%) may benefit from further diagnostic tests such as cardiac magnetic resonance to improve their diagnostic assessment, as the presence of late gadolinium enhancement has been associated with less LVEF improvement."
(Excerpt) Read more at medicalxpress.com ...
“The score is based on four parameters: QRS width above 120 milliseconds (2 points), known etiology (2 points), paroxysmal atrial fibrillation (1 point) and severe atrial dilation (1 point). Total scores range from 0 to 6, with 0 indicating a greater likelihood of recovery.”
This could help a number of people determine what course of action to take.
I had a cryogenic ablation for affib about 8 years ago.
In the week before the operation my affib was so bad I could barely get around without breathing hard. Even then I could do very little.
What happened next felt like a miracle. They put me to sleep. Four hours later I woke up in recovery. I spent the night in the hospital. They released me the next day. A week later I was working out at the gym.
I was full of energy.
amazing. People may say it wasn’t a miracle. It was just a day in the life of the surgical team. But that’s not what it felt like to me.
Wow. Thanx for the post.
I am A-Fib diagnosed about 2 years ago. No ablation.......yet. I have a watchman in my heart to thin the blood to prevent strokes.
If there is a ping list, please include me.
Best wishes!
That’s really interesting. Congrats!
I have heart failure, but not very bad. Spent two days in hospital, now on prescription meds (ugh). Had an appointment for cardioversion to reset heart rhythm but when I got there I had zero a-fib and normal BP. Have an agreement with my cardiologist to keep him informed.
I can take my own blood pressure and check for afib on nice little meter I bought on AMZ. Its set up to work on my Samsung phone. Woman at Samsung store who set its up says she does it all the time. Popular little gadget. You can also get them for other phones.
42
Have had A-fib since early 90’s. Scheduled for ablation in May!
There is a book I’m reading now which I think you’ll want to read so as to be fully armed with precisely the right information presented in precisely the way. The book is called Outlive: The Science and Art of Longevity by Peter Attia https://amzn.to/443Cfwr
Its a four hundred page book. I’ve read about 140 pages so far. I read two or three pages a day. Some days however, the stories are so good that I read a bit longer.
The books has a number of actionable things you can do. I currently use 5 mg of crestor. the book recommends another drug that complements crestor. I don’t think that its a statin. but it helps lower ldl by a completely different path than a statin. I’m going to check in with the cost and if its reasonable—have my doctor prescribe it to me.
I expect to implement many more small changes based on the book.
Thanks. Great title. Will check it out.
I don’t have high LDL, so that’s not a problem for me. A tad of Afib now and then, but I use a biofeedback meter set up on my Samsung phone to check it and it’s fine so far. Blood pressure remains low too.
In good shape for an 86-year-old woman. Weigh 116, so that helps too.
I have two books you might like as well:
How Not to Die by Michael Greger, M.D. and the How Not to Die Cookbook. Available on AMZ of course. My friend, a retired pharmaceutical company exec, recommended it to. me. One of Greger’s ideas is 40 minutes of walking per day. Friend does that and more. She’s not a big or athletic woman but really strong mentally and physically. I can do it, but in 20-minute segments.
Was just diagnosed with heart failure about 6 weeks ago, never felt sick and don’t know how to be sick :).
Wish you the best. We should keep comparing notes via freemail.
good luck. how much risk involved? Do you have watchman installed?
it is a relatively common procedure, was not given any odds.
In January I had a significant episode of AFIB
I ordered Outlive on AMZ this morning. It’s now the #1 bestseller on AMZ and has terrific reviews. Look forward to reading it and so does my friend just diagnosed with a condition that can lead to Alzheimers.
I recently spent 2 days in the hospital with “heart failure”, first time I’ve been there since my last child was born. I’m 86 and never felt sick with heart failure and now on 4 prescription drugs. The queen of side effects, I’ve avoided them too.
Friend and I reading several books about staying alive and each will choose what’s doable.
As for statins, I lowered my LDL so I don’t need them. Read “Wheat Belly” by Wm Davis, MD, who uses a fairly complicated formula to conclude that eating wheat raises your LDL. So I quit eating wheat quite a few years ago and my LDL went down to normal. I do not miss wheat. My local Natural Grocer has a terrific bread made with ground seeds. A little pricey, but utterly delish. Also eat cereal that has no wheat. My fave is Panda Puffs, available at Trader Joe and at Kroger, perhaps other places. Peanut Butter is first ingredient.
BirchBender is a brand that offers wheat-free frozen waffles, pancake mix, cake mix, really delish. Natural Grocer again, sometimes at Grocery Outlet at lower prices. Probably other places too. I don’t use sugar, but a little maple syrup is fine. And stevia drops in coffee.
I’m having too much fun to die. Stay healthy and enjoy life, ckilmer.
On wednesday I was over at my sister’s house. she gave me a taste of her home made kefir made with kefir grains.
that was a taste treat.
Today I picked up some grass fed unpasteurized milk and poured it into my quart jar with the kefir grains.
This combination of grass fed unpasteurized milk and kefir grains will create a kefir with a rich range of fats vitamins and beneficial bacteria.
I like kefir, yours will be great. I prefer goat kefir, Redwood Hills brand is available all over town. I have yogurt every night for dessert, with fruit mixed in it. Frozen organic wild blueberries from Trader Joe are my fave. Did I mention my kombucha addiction? Mojita flavor, which isn’t sweet. It contains 0.06% alcohol and I now understand alcoholics. Can’t go a day without it. Kombucha is loaded with probiotics, one of the best sources.
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