Podcasts about llv

30-Day Wellness Reset With Dr. Josie Aisha welcomed everyone to the Visionary Leaders Collective podcast and announced a 30-day Spring into Summer - Wellness Reset starting  April 8th to May 6th, led by Dr. Josie and the Visionary Leaders Collective.. The focus is on improving physical, mental, and emotional health through the program's emphasis on using new Doterra products for foundational wellness, particularly in cleansing and detoxifying. Seasonal Cleansing and Product Discussion Dr. Josie and Mica discussed the importance of seasonal cleansing, recommending a biannual reset. Products for the reset include Metapower Advantage, Metapower Recharge, Metapower Oil, PB Assist, Lifelong Vitality Packs, and Zendocrine Oil Blend, with a focus on layering oils and the symphony of cells concept. Incorporating Daily Practice and Symphony of Cells Dr. Josie emphasized the importance of a daily practice, focusing on the "symphony of the cells" method. Participants are encouraged to prepare with a two-week homework period, familiarizing themselves with resources on the team's website, leading up to a detailed session on the 8th. Essential Oils and Elimination Pathways Three options for using essential oils in topical work were discussed, along with supporting the body's elimination pathways. Dr. Josie suggested lifestyle changes and product additions and reductions to aid detoxification. Liver Detoxification and Mindset Reset Dr. Josie highlighted the importance of water intake and vegetable consumption for liver detoxification. She encouraged reducing caffeine, alcohol, sugar, and gluten intake while focusing on mental and emotional wellbeing, with upcoming sessions on mindset, meditation, and breath work. Lifelong Vitality Pack and Cellular Nutrition Dr. Josie discussed the significance of the Lifelong Vitality Pack, emphasizing its cellular nutrition benefits and support for detoxification and healing processes. Gradual Reset and Gut Health Support A gradual approach to resetting was outlined, along with introducing products to support gut health and electrolyte balance. Product Benefits and Serenity Complex Dr. Josie discussed the benefits of their products, particularly emphasizing the advantages of LLV and Metapower oil blend, as well as recommending digestive enzymes and vitamins for digestive issues. She introduced Serenity restful complex and adaptive system for addressing sleep and stress issues. Upcoming Sessions and Collagen Powder Advantage The schedule for upcoming sessions was announced, along with the introduction of a new collagen powder advantage. Participants were encouraged to join the Facebook group for further customization of product usage. About the Hosts: This podcast is a collaborative effort between doTERRA Presidential Diamond Aisha Harley, doTERRA Blue Diamond Dr. Josie Schmidt, doTERRA Blue Diamond Arin Fugate, and doTERRA Diamond Ariana Harley They are the founders of the Visionary Leaders Collective. Connect with us: Aisha Harley- www.aishaharley.com / Instagram @aisha.essentialwellness  Ariana Harley - https://www.arianaharley.com/ Josie Schmidt- FB Personal Page: https://www.facebook.com/josie.h.schmidt Arin - https://msha.ke/jasmineandjuniper/ Contact Email: ariningraham@gmail.com Welcome to the Visionary Leaders Podcast Here you will gain the knowledge you need to bring essential oils, plant medicine, wisdom, supplementation, and functional medicine into your life. We have a weekly show: “Learn to Be the Healer in Your Home,” where we hear stories from our community on how they integrated essential oils, supplementation, and functional medicine into their lives as a pathway to healing.  

In this episode, we talk to a veteran rural carrier about RRECS, LLV's, her on-the-job work injuries, mistreatment by management (including targeting, retaliation, and even wrongful termination), and privacy act violations, all of which revolve around a toxic work culture that most, if not all, USPS employees deal with. We even talk about the negative slogan that accompanies the USPS ("Going Postal") which while often a taboo topic, is still something we all should recognize as a problem. 

Roberto Maiorana, Trafikverkets generaldirektör, säger att han räknar med att den nya planeringssystemet som skapat tågstrul under senaste året ska vara i ordning i december. I veckan var det på håret att det bröt ut en tågstrejk, främst på grund av tågpersonalens missnöje med sena schemaändringar. En orsak till de sena ändringarna är Trafikverkets nya digitaliserade planeringssystem som sjösattes i december förra året. Systemet fungerar fortfarande inte fullt ut. Enligt EU-regler ska Trafikverket ge tågföretagen besked om ändringar, tex pga banarbete, 18 veckor i förväg, men nu kan det handla om några dagars framförhållning. Generaldirektör Roberto Maiorana tror att Trafikverket kommer att klara kravet på 18 veckors framförhållning i december i år.– Det är klart att vi förstod redan vid införandet att det här kunde ge oss utmaningar, men det har gett oss större utmaningar än vad vi hade förväntat oss, säger Roberto Maiorana.Syftet med det nya digitala planeringssystemet är att järnvägsspåren ska kunna utnyttjas bättre, med mer tågtrafik. Men införandet har alltså skapat stora problem i tågtrafiken det senaste året, för både tågföretag, anställda och resenärer - med sena besked om avgångar och schemaändringar för tågpersonal. Även näringslivet har drabbats då godstrafiken krånglat.Ber regeringen om två miljarder mer till vägunderhållVägar byggda före 70-talet som inte är anpassade till dagens tyngre fordon - i kombination med varmare vintrar - gör att många av de statliga vägarna är slitna. I årets budget fick Trafikverket en miljard extra till vägunderhåll. Men pengarna räcker ändå inte och nu har Trafikverket begärt 2 miljarder till för nästa år. I Trafikverkets budgetunderlag till regeringen står att "Nuvarande ekonomiska ramar innebär att vägnätet bryts ner i allt snabbare takt".– Under förra året investerade vi över 16 miljarder på förbättringsåtgärder men det blir för mycket ad hoc och nödreparationer och det gör att vägstandarden försämras på sikt och det är jag väldigt bekymrad över, säger Roberto Maiorana.– Vi vill ha bra vägar i Sverige och det blir ju till slut även kopplat till en trafiksäkerhet på väg.Kommer vi behöva acceptera att vissa vägar får hålla lägre standard än vad vi är vana vid?– Det blir ju i värsta fall en fråga om en prioritering och då blir det ett lågtrafikerat vägnät som kanske får stå i vägen för det. Men vi vill inte hamna där så därför jobbar vi med att få en förståelse för att vi behöver med medel. Och det här är något som är jätteviktigt för att vi ska få hela Sverige att fungera, säger Roberto Maiorana.Skenande kostnaderUnder flera år har Trafikverket kritiserats för dålig kostnadskontroll på infrastrukturprojekt. Enligt en granskning från Riksrevisionen 2021 så underskattar Trafikverket systematiskt kostnaderna för föreslagna investeringar. Och i Trafikverkets senaste förslag till infrastrukturplan stå det: ”De beräknade kostnaderna för ännu ej påbörjade investeringar i vägar och banor har i genomsnitt ökat med 50 procent sedan gällande plans fastställelse". Hur kommer det sig att de så ofta räknar fel?Gäst: Roberto Maiorana, generaldirektör på Trafikverket Programledare: Cecilia Strömberg WallinKommentar: Bo-Lennart Nelldal, professor emeritus i tågplanering vid KTHTekniker: Oscar ThorProducent: Maja LagercrantzIntervjun spelades in fredag den 19 maj i radiohuset i Stockholm.

Episode Summary:    In this weeks episode of our podcast, we have special guest Sandra Freemont discussing the topic of the Pineal Gland.    Highlights:    *Learn how specific, simple daily practices can support detoxification of the brain    *Learn to bring in an awareness of “energy, frequency, and vibration” when using your oils and how that mindset will amplify their efficacy.   *We'll practice using essential oils together with breath and visualization to connect with the pineal gland and the associated energy center, which is considered by many to be a bridge to our inner wisdom and intuition.   *We get a glimpse into what science as well as different cultures, philosophies, and religions say about this mysterious gland.   *What are the connections between the Pineal and the Third Eye?   *This gland can calcify over time, diminishing its psychic as well as physical capacities. Certain substances are known to enhance calcification- Learn what is toxic to the Pineal, and ways to start eliminating and avoiding these from your daily life.    *Dr. Mica reminded us all that if we take LLV and daily habits and the doTERRA  fiber and greens we are doing what we need to do to cleanse the pineal gland! Also recommended is the Neurological SOC   *Dr. Josie shares her  Neuro formula A blend of equal parts: Frankincense, Copaiba, Turmeric, Pink Pepper, Green Mandarin, YarrowPom  take 3-5 drps sublingual daily PLUS:    Follow Arin's podcast and please share the episoses on Human trafficking that is released onMay 9th   https://podcasts.apple.com/us/podcast/jasmine-juniper-with-arin-fugate-essential-tools-for/id1572190095   Join her street team - https://www.facebook.com/groups/1340986413130271  

En Europa, la leishmaniosis debida a L. infantum es endémica en toda la cuenca mediterránea. Sin embargo, en los últimos años la enfermedad ha alcanzado los Alpes en el norte de Italia, los Pirineos en Francia y la cornisa cantábrica en España como consecuencia de la presencia de vectores competentes y el cambio climático, que tiene un efecto sobre el desarrollo y abundancia del vector. Expertos en Leishmaniosis Autoras: Ana Montoya, LV, PhD, Acreditada AVEPA, Diplomada por el Colegio Europeo, Profesor Contratado Doctor del Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid y Marta Mateo, LLV, PhD, Profesora Ayudante Doctora. Facultad de Farmacia. Universidad Complutense de Madrid

Tour de France, pickleball, no more QB controversy in Denver, Von Miller choosing Bills over Cowboys, Baker Mayfield vs Sam Darnold in Carolina, made-up drama for football fans

In this week's episode, we are joined by Linda DeCarlo, the Postal Service's Senior Director of Occupational Safety and Health to talk about how important safety is at such a large and diverse organization. We'll learn more about employee training and how the Postal Service is focused on building a better workplace for all of its employees. We'll also talk about the impacts technology has made, things you can do to help with mail carrier safety, and more.

Catching up on all the adventures of the day. Jungle night, searching for the "right" couple (as in right now), pool sex with Phoebe.  Where to find us:Website: SwingerUniversity.comE-mail: SwingerUniversity@gmail.comSend us your questions: SwingerUniversity.com/contact/TikTok: TikTok.com/SwingerUniversityTwitter: Twitter.com/SwingerUPodcastInstagram: @swingupodcastYouTube: Youtube.com/c/SwingerUniversityPodcastGet Kasidie Full Membership for 30 days FREE*Some links may contain affiliate links!Support the show (https://www.patreon.com/SwingerUniversity)

Another day in Costa Rica at a fabulous adults only, all swinger takeover.  More fun, friends and frolicking in the sun, and on the dance floor. Where to find us:Website: SwingerUniversity.comE-mail: SwingerUniversity@gmail.comSend us your questions: SwingerUniversity.com/contact/TikTok: TikTok.com/SwingerUniversityTwitter: Twitter.com/SwingerUPodcastInstagram: @swingupodcastYouTube: Youtube.com/c/SwingerUniversityPodcastGet Kasidie Full Membership for 30 days FREE*Some links may contain affiliate links!Support the show (https://www.patreon.com/SwingerUniversity)

It's January (well it was when I posted this on Mixcloud), and that means looking back with my #housemusic recap from the past year. A journey through various styles of house and the tracks that caught my attention in 2021 including songs & remixes from #moodymann #ampfiddler #jimpster #osunlade #natashadiggs #yuksek #artoftones #&me #rampa #adamport #atjazz #shimza #LLV #miguelmigs #Channeltres #purplediscomachine #rufusdusol and more (as well as my own #Wizkid retouch) Say it with me #houseisafeeling !Subscribe on Apple Podcasts: https://podcasts.apple.com/podcast/id306968245Follow on Instagram: https://www.instagram.com/dj_j_meBookings & Merch: jamiewichartz @ yahoo.ca (hats, hoodies, tees, tanks & mugs)

And you thought this podcast smelled bad on the outside! This week on the show I share some cold weather case studies we get the joy of experiencing in the auto repair industry living in the northern states. I also go off on a tangent about the post office LLV vehicles. Website- https://autodiagpodcast.com/Facebook Group- https://www.facebook.com/groups/223994012068320

LLV

LLV

Back by popular demand, Brian and Drew perform another round of the hit segment Will it Sequel? The contestants this time … two Nic Cage flicks with very different tones but more in common that you may think. Honeymoon in Vegas is all about the promise of young love, while Leaving Las Vegas is, well, pretty damn bleak. The question is … what happened in the roughly three years between the end of Honeymoon and the start of LLV. Join us in Vegas to find out! Get on the email list at vcrworld.substack.com

How do you pivot a successful travel business during one of the worst times for travel, into a successful world wide luxury brand in a niche (adults only travel) and vice (sex) travel business? Join me, Taylor Sparks, your host as I interview Pepe and Claudia Aguirre, aka Mr. and Mrs. LLV, owners of Luxury Lifestyle Vacations Club as we discuss the business pivot after the tragedy of 9/11 that set them on an even more successful path offering their clients the best experiences while traveling the world with like minded discerning couples and singles. Pepe and Claudia Aguirre Bio: A wise man once said, “if you do what you love you'll never work a day in your life”. This is a genuine embodiment of this couple. Claudia and Pepe may own this company, but what makes them different is in the name; Luxury Lifestyle Vacations. It wasn't random, or a spin on words, it's a true definition of their brand, and dedication to this community. Meeting in Puerto Vallarta 28 years ago, was no fluke. It proved what kind of kingdom love at first sight can build, and being married for over 24 years – it's evident there's no stopping this powerhouse. These Mexican natives, capitalized on this industry coming out of their experiences within the hospitality, proving their vision, had a big impact 10 years ago. They have put together an outstanding platform for elite couples and singles around the world, to come together in a like-minded environment. Redefining the ideals of class and entertainment with every trip, the clientele they have obtained remain loyal, and continuously grows. They have not only built an empire, they have raised the bar within event production – offering the only service specifically designed for the discerning lifestyle couples who seek something truly extraordinary, with the highest level of sophistication. With 18 years in the lifestyle, Claudia & Pepe may run this business, but feel every “job” is a “workcation”. They don't believe in clients, they just see a room full of friends – and can't wait to enjoy every moment with you. Stay up to date with Pepe and Claudia and all things LLV: Website: www.LLVCLUB.com Instagram: @LLVCLUB Twitter: @LLVCLUB Stay up to date with Sisters of Sexuality: Website: www.sistersofsexuality.com Email: sistersofsexuality@gmail.com Instagram: @sistersofsexuality Facebook: @sexysostour Twitter: @sistersofsex LIKE THE SHOW? Leave a REVIEW SHARE SUBSCRIBE AND SUPPORT --- Send in a voice message: https://anchor.fm/sistersofsexuality/message Support this podcast: https://anchor.fm/sistersofsexuality/support

Long time friend of Andy and Coy, lifetime Car Guy Garret joins the show to give us some hot takes on cool cars and way way more information about mail trucks than we needed to know. The boys discuss the newly announced Toyota GR Corolla and Supra GR 2.0, and the all new Jeep Grand Wagoneer. For OLAF, how does a flying jetski sound? Wildly dangerous? Ultimate offroad vehicle? The quickest way to die a horrible death? Smokin Deal or Smokin a Doob is everyone's favorite LLV, a retired US Mail Truck! Hit the links down below to check it all out!2022 Corolla GR: https://www.caranddriver.com/toyota/gr-corollaToyota Supra GR 2.0: https://media.toyota.co.uk/2021/01/the-toyota-gr-supra-2-0Jeep Grand Wagoneer: https://www.caranddriver.com/news/a33825502/jeep-grand-wagoneer-concept-revealed/Flying Jetski Deathtrap: https://speedsociety.com/you-dont-need-a-pilots-license-to-fly-this-jet-ski-planeCome check out the livestream every Sunday at 8pm! www.Twitch.tv/boostboozebbqwww.facebook.com/boostboozebbqwww.Twitter.com/boostboozebbqwww.Instagram.com/boostboozebbq

Proč pořád omíláme na spoustě webinářích ta tři písmenka LLV?

Free Healthy Habits Checklist + Full Show Notes available at ww.valerielavignelife.com/94 Today I'm sharing some of my favourite natural tools and solutions to support healthy daily habits and rituals. I'll be sharing the products, how I use them, and also how you can get yours if you are someone who is ready to elevate your everyday health and wellness! [1:09] The products in today's episode are some of dōTERRA's most popular oils and products, and the kit they are packaged in is part of our team's annual Healthy Habits Program. Each year we run a Healthy Habits Program using these products, and a few others. Consider today a sneak peak or introduction into the program and the products it's based around.   Let's jump into the Healthy Habits Collection! This kit includes five life changing essential oils including a unique grounding blend that smells like a magical forest. It also has five supplements for foundational nutrition and health, and lastly it includes everyone's favourite natural muscle rub. This Healthy Habits Collection is available in the US and Canadian market, however I encourage purchasing from the US warehouse as it includes the fifth supplement that the Canadian warehouse does not yet have.   SHOP THE HEALTHY HABITS COLLECTION HERE   For those of you who don't already know me, my name is Valerie LaVigne. I am a Health Coach, Business Owner, and lover of life. When people ask me to help them live a healthier lifestyle, the first thing I ask them is: “How much water do you drink every day?” You would be amazed by how many of us are chronically dehydrated. You'll be even more amazed at what happens when you start drinking the correct amount of quality water your body needs daily. Yes it can be THAT SIMPLE (sometimes).   [2:50] Drink More Quality Water Drink at least half your bodyweight in ounces of water per day. If you need a reminder, there is a Water Reminder App, you can set up your own reminders to track your progress. If you're hungry between or right after a meal, it's usually because you're thirsty. Drink up! dōTERRA's citrus oils are incredible and cleansing when you add them to your water! They have a chemical constitution called limonene in them. Lemon comes in the Healthy Habits kit, but you could also use Wild Orange, Green Mandarin, or my favourites: Grapefruit and Tangerine! Some other popular oils to add to water are Smart + Sassy and Peppermint!  I add 1-2 drops of oil per Litre of water. Any time you're adding oils to your water, you must use your glass or stainless steel water bottle. No plastic! You can add on additional citrus oils to your purchase if you like.   [4:23] Now the true foundation to health and wellness is nutrition, which is why I take dōTERRA's Lifelong Vitality Pack aka LLV daily. Hello amazing daily supplements! After a few weeks of consistently taking these natural solutions, you may notice more energy, less pain, glowing skin, and stronger nails! I've noticed so many different areas of my body improving after taking these supplements, like less sugar cravings and more mental energy. This package of three supplements was designed to be the perfect compliment of a balanced wholefood diet with the nutrient equivalent of 12 servings of fruits and veggies in every serving. LLV Testimonials The first of these three powerhouse supplements is the Microplex VMz This is a complete vitamin mineral. It's “complete” because the body is able to digest it AND use all the vitamins. The body treats it, absorbs it, and eliminates it just like it does with food. Microplex VMz solves the absorption issues of vitamins and minerals in other supplements by using a glycoprotein matrix to help the body absorb vitamins, and chelated minerals (meaning the minerals bound to an amino acid). Basically it makes the supplement recognizable as food nutrients. Some of the many vitamins and minerals in this supplement are: vitamins A, D, E, C and B, and minerals calcium, magnesium, and zinc. The second supplement in the LLV Pack is xEO Mega Say hello to the ONLY omega supplement I have ever finished an entire container of. I used to dislike fish and would try to supplement it with omegas and I honestly tried them all. The fish burps, the chalky tablets, the liquid versions, the flavoured versions - GROSS. ALL OF THEM. I eventually just started eating fish because I hated the supplements I was trying… UNTIL dōTERRA's xEO Mega!  It's combination of sea and land based Omega 3's - which are crucial for our brains, and unique blend of essential oils (clove, frankincense, thyme, cumin, wild orange, peppermint, ginger, caraway, and german chamomile) add antioxidant protection - and the best part. No nasty burps! This supplement is also available in the vegan package, however not part of the Healthy Habits Kit. And finally the Alpha CRS+ A super powerful antioxidant that also gives us energy at the cellular level = natural energy for consistently feeling good :) No energy drink sugar crashes after those garbage (fake) energy boosters. The Alpha CRS+ stimulates overall cellular health which protects our DNA from being attacked by damaging free radicals.   [7:54] TerraZyme This supplement supports healthy digestion and metabolism of enzyme-deficient, processed foods. You want to take 1 capsule with each meal, possibly two if your meal is mostly cooked or processed so that the food nutrients get properly absorbed. TerraZyme also supports the conversion of food nutrients to cellular energy and promotes comfort for mild food intolerances. It contains a proprietary blend of 10 active whole-food enzymes that help your body digest complex carbs, fats, sugars, fiber, and proteins!   [8:31] PB Assist+ Probiotic This supplement is available in the US version of the kit, however it is not yet available in Canada. Canadian dōTERRA current or new members can access the US kit through the US warehouse. What I love about this probiotic is it has both pro AND pre biotic fibers that are double encapsulated for better absorption in the needed areas of the GI tract. They also look really cool and a little alien-like from other supplements you have have used or seen. AND you don't have to keep them in the fridge! Which is amazing because I always forgot to take supplements I had to keep in the fridge. PB Assist+ promotes balance and proliferation of beneficial bacteria. It helps to maintain healthy intestinal microflora balance. The way I like to explain is, is that this keeps the flowers in your belly garden happy and healthy.   [9:46] Daily healthy habits are not only what you're putting into your body, but also how you are moving your body. Daily movement is key in creating a healthy lifestyle, as I always say, “a body in motion, stays in motion.” Getting into a movement practice is a lot easier than it sounds. Most people overthink or over complicate starting a new workout routine or fitness schedule, but really it's super simple, and the key is finding an exercise you love! Personally, I really enjoy lifting weights at the gym. I also love yoga and pilates. I do not do well in Zumba, but once in a while I'll pop into a spin class. Since I'm not very consistent with spin, it's a little add on when I can, and I focus on getting to the gym instead. Now that we have chosen our favourite workout style, we can create a realistic routine. Take a peek at your calendar and see if there are any gaps where you can schedule a workout in. Start with 2-3 times per week.  If this is new for you, I recommend investing in a personal trainer, or signing up for group classes in advance. Keeping your schedule the same every week will help you make your workouts a habit. Be kind to yourself and do your best. Remember, you're just starting out! If your body isn't used to lots of movement and/or exercise, your muscles will probably start telling you about. Which is why I LOVE dōTERRA's Deep Blue Rub! The Deep Blue Rub is a blend of different essential oils including: Wintergreen, Camphor, Peppermint, Ylang Ylang, Helichrysum, Blue Tansy, Blue Chamomile, and Osmanthus blending together in a convenient and soothing cream. This rub provides a comforting sensation of cooling and warmth to problem areas. You can apply this to your feet and knees before or after exercise. My boyfriend loves this rub before because he says it helps him to activate his muscles. I enjoy the rub post because I like the cooling and soothing sensation. It's also great when you massage it into the neck and shoulders after a long day of work to ease muscle tension.   [12:22] Now I mentioned the Healthy Habits Collection also contains different essential oils and essential oil blends. If you've been listening to the Women's Empowerment Podcast, you'll know that I teach a lot about essential oils and how to use them, so I will include those previous episodes in the show notes for you if you want to go back and re-listen. Or if you're new to the show and you want some more information, everything you need can be found in the episodes listed below: E90: Q&A: dōTERRA & Essential Oils E88: Elevate Your Daily Routine with Essential Oils E80: Q&A: My Monthly Wellness Boxing's  E76: Green Cleaning with Essential Oils E49: Raising Your Vibration with Essential OilsE35: The Simplest Ways to Use Your Essential Oils E32: Summer Essentials to Optimize Your Health E24: Natural Solutions: Informed Self Care E23: Natural Solutions: Reduce Synthetic Exposure E22: Natural Solutions: Rest & Stress Management E21: Natural Solutions: Nutrition & Exercise E09: Top 10 Essential Oils Master Class E02: Hormone Essentials   [12:52] Let's talk about The Oils that come in the kit! The first is Lavender. Most people have heard of, and could probably recognize this scent. What you may not know is that Lavender essential oil is known as “The Swiss Army Knife” of essential oils because it has SO MANY USES! I will include more information about lavender in the Healthy Habits Checklist freebie available in the show notes page for you. One of the most common uses of lavender is for its calming effect. You can add a few drops to your diffuser before bed, or place a drop on your pillow as part of your evening ritual. This helps with the transition from a busy day to a restful night.   Lemon is also part of the Healthy Habits Collection. It is one of my most used oils because I love the smell so much, and it's great for making household cleaners! There are heaps of uses for lemon oil that I have put in the Healthy Habits Checklist (Big Yellow Button Below) but my most favourite lemon oil hack is when I need to get something sticky off a surface! For example a price tag that leaves goo on a new flower pot. Or when you miss the mail person and the sticker they leave on the window leaves guck when you take it off. SImply add 5-8 drops of lemon EO onto a piece of paper towel and gently rub until the goo is gone! You might need a few more drops depending on the stickiness of the goo.   The “King of Essential Oils” is Frankincense and a small bottle of this oil is included in the Healthy Habits Collection. This oil is POWERFUL! It has many uses including soothing and warming the body, as well as helping glowing skin, and balancing mood. This oil is a wonderful companion to lavender in the diffuser before bed, or with lemon in the diffuser throughout the day for a fresh and warm mood boosting scent.   The Healthy Habits Collection comes with two different essential oil blends. The first is On Guard. This is also known as dōTERRA's Protective Blend as it was designed to support immunity and fight harmful germs. I use On Guard and Lemon together in all purpose cleaning spray as it is safe and great for green cleaning kitchen surfaces. It's wonderful in the diffuser and has a warm and spicy aroma.   Balance Blend is the other of the essential oil blends in the Healthy Habits Collection. This is also known as the Grounding Blend and it was the first of dōTERRA's oils that I truly fell in love with. You see, the reason why I got into essential oils in the first place was because I was searching for a holistic approach to coping with anxiety. I started with the aromatherapy oil collection and really loved those oils, however something shifted deeply within me when I was introduced to Balance blend. I'm not sure what it was, but I'll call it love at first smell! I diffused this all day every day, and I would put a drop on the bottoms of my feet morning and night. It was an absolutely life-changing ritual for me that really helped me with my anxious feelings. I am still very much in love with this blend and I always recommend it to friends who are looking to find some relaxation and stability. It's so simple to incorporate and very gentle and supportive. I'll share more information about this blend and the other oils in the Healthy Habits Checklist (Big Yellow Button Below)   [16:33] If you're listening to this podcast episode and you're thinking, “OH EM GEE this all sounds amazing and I would LOVE to get these natural tools into my home!” You can go to the show notes page and at the bottom you will see a link with information on how to join our essential oil community. When you purchase this collection through my link you will be sent the products I talked about today. Please send me an email with a picture or copy of your receipt so that I can support you in the products you purchased. You can refer back to this episode and the Healthy Habits Checklist (Big Yellow Button Below) as a guide for the specific oils and supplements I discussed today. How to Join the VLL Essential Oil Community! If you have any more questions you can contact me through my contact page. I would be happy to answer any of your questions!  

www.valerielavignelife.com/88 for the full show notes + links [00:25] Hello and welcome back to the women's empowerment podcast, I am your host Valerie LaVigne, and I am so grateful that you are choosing to listen to this particular podcast today. I recently learned that there are over 1 million different podcasts out there, and to know that you are listening to this one, well it is an absolute honour.  Another really exciting moment for the podcast this month was that we have officially reached over 10,000 unique downloads, and I could not have done that without you. Thank you so much! Honestly, it means the world. If you haven't already, I would love for you to write your honest review over on iTunes. It helps me to create more episodes and for more people to find and benefit from the show.  Also if you want to connect with me personally, leave a comment at the bottom of this page. I love meeting the listeners and getting to know you all better, so don't be shy! You can also connect with me on instagram @vallavignelife! Speaking of instagram! I usually use this platform to connect with my audience to learn more about what you'd love to hear on the show. I find that I pop into the stories and slide into dms asking some of my listeners turned followers or followers turned listeners and ask them if they have any ideas, suggestions, or questions.  I was pleasantly surprised about how many essential oil questions I got! WHOA! I actually got so many that I've decided to make the upcoming Q&A episode about the most popular questions, and while I was organizing all the questions I discovered a very interesting theme or idea for a separate episode. [2:24] This underlying theme was how I use dōTERRA products and oils in my everyday life, and as I was thinking of how to answer I realized that it's a huge part of my lifestyle and it needed it's own episode. So today I bring to you: How to Elevate Your Daily Routines with Essential Oils. I'll speak more about this in episode 90, but for now I'll explain one of the main reasons I chose dōTERRA for all my essential oils instead of any other company. And the main reason is because of their quality and transparency. When it comes to essential oils, high quality is the most important factor. If an essential oil isn't 100 percent pure, it's not going to work. The problem is, essential oils have become very popular, very mainstream over the last few years, and although this is exciting, it's also very concerning for people like me who actually understand the power of oils and the industry. There is no governing body that regulates the essential oil industry. This means that anyone and everyone can label their bottle of “essential oil” as 100 percent pure even if it's mostly synthetic fragrance AKA FAKE! dōTTERA is the leader in the essential oil market and natural health space for many reasons, but one of those reasons is transparency. They label each bottle and batch of essential oil with a code which you can then use to look up the exact chemical constituents of that bottle. They tell you exactly what's in it, no problem, because they know that they have an incredible product and the highest quality. They have the highest standard and have created their own quality standard called CPTG Certified Pure Tested Grade. Which means each of their oils and products go through multiple forms of testing to ensure the highest quality of oils. If you have other oils at home that you purchased from a health food store or another essential oil company, you could definitely get it tested to better understand the quality of that specific bottle, but to get these test results you'll need to pay about $200 per test. I bet you can guess why most people don't get their $8 dollar bottle of Frankincense that they bought from Whole Foods tested. In fact, I'll save you the $8 + $200 right now to tell you that a bottle of pure frankincense oil is going to cost you more than $8 (and less than $100!) But anyways, the point I'm trying to make is that I trust dōTERRA, and only dōTERRA for all my essential oils. I've mentioned that essential oils have become more popular, and you've probably even heard of dōTERRA before, that's great! Did you know that dōTERRA is way more than oils? They actually have heaps of other everyday lifestyle products that include oils for extra benefits and natural solutions! How incredible is that!? [5:37] In fact, Heather, one of the listeners asked: How do you use dōTERRA in your life? To answer this question I thought I would take you a little behind the scenes into some of my daily routines. Starting with Wake Up: I get up, open the windows and make the bed every morning. Some mornings I will put the diffuser on, or I'll choose an oil or blend to wear as “PUREfume”  Here are 4 of my favourite morning diffuser blends: LIQUID SUNSHINE3 drops Cheer Blend 4 drops Grapefruit 1 drop Peppermint FRUITY PEBBLES2 drops Lemongrass 2 drops Grapefruit 2 drops Bergamot FIND A BALANCE2 drops Hawaiian Sandalwood 4 drops Balance Blend NO WORRIES3 drops Lime 2 drops Wild Orange 1 drop Easy Air (aka Breathe) Blend dōTERRA makes roller bottles that are pre-diluted called “touch” bottles for convenient topical use and I like those for the PUREfumes. Usually the floral oils like: Rose touch Lavender touch Magnolia touch Jasmine touch  Neroli Touch I will either choose one, or blend a couple together. Usually putting them on my pulse points, or drawing them in a heart-shape around my chest. [6:54] Next I drink water and take my morning dōTERRA supplements. The ones I take first thing are: Deep Blue Polyphenol complex This is a blend of powerful polyphenols clinically tested to help soreness and discomfort from physical activities and daily life. I'll usually take these when I've changed up my workout routine, or when I've done more hiking, trekking, climbing, that sort of thing.  Mito 2 Max This is a blend of adaptogenic herbs and extracts with energy co-factors made to increase mitochondrial biogensis and overall energy while correlating the stress response due to physical activity and daily life. I will take them for a month and then take a break, and then take them again, alternating. I do this because I like my body to be able to do things without external support, but I also know that I don't always get the support I need and I feel really great when I'm consistently taking this supplement.  On Guard Softgel One of my favourite softgels by dōTERRA is this blend of several essential oils in a convenient softgel that protects the immune system from foreign invaders (pathogens). I take this daily when I'm building my immune system or if I feel like I'm more susceptible to getting sick.  Yarrow | Pom Cellular Beauty ComplexThis is one of dōTTERA's newer supplements, it combines clinically studied extracts and a powerful blend of essential oils to provide powerful antioxidant support for healthy, luminous skin with an irresistible glow from the inside out. (doterra.com) [8:32] Sometimes when I make my morning coffee I'll add a drop of essential oil to mix up the taste, some of my go-to oils for coffee are: Peppermint, and I'll add some organic hot chocolate mix or cacao for a peppermint mocha flavour Wild Orange is a fun flavour to add into a frozen coffee or a hot one! Cassia is like a sweeter cinnamon bark oil and I was obsessed with this in my macchiato shots for a little while! You could also try Cardamom, Ginger, Spearmint, or Lavender! [9:03] I like to workout in the mornings and you better believe I use dōTTERA's oils and products to support my physical health.  Mito2Max is an excellent energy booster in the morning, but I also like the “Energy” Roller bottle I make! I use this on my forearms and neck before working out. The recipe is: ENERGY ROLLER BOTTLE 10 drops Motivate Blend 8 drops Spearmint 5 drops Peppermint Add oils to a 10ml roller bottle, top with FCO (fractionated coconut oil), shake well and use for a burst of good vibes! [9:36] My boyfriend LOVES dōTTERA's Deep Blue Rub, and he likes to use it before the workout because he says it activates his muscles, I usually use it after my workout to soothe my muscles. You can use it for both! Easy Air, aka Breathe Blend is one of my absolute favourite oils. I use this for hiking, spinning, working out, breath work, yoga classes, before bed. I love it SO MUCH! It comes in a touch roller, in a regular essential oil bottle, and it's also available in a vapour stick form. Personally I love the touch roller and keep it in my gym bag or when we hike in the backpack LOVE! LOVE! LOVE! [10:18] So I don't always lift weights, but sometimes i do yoga and pilates. dōTTERA has a yoga collection of three oils called Align, Anchor, and Arise Align is the “Centering Blend” some complimentary yoga poses to use this oil with are: Seated mediation, warrior 2, triangle, gate pose, and extended side angle. Anchor is the “Steadying Blend” which is also great for seated meditation, seated twists, Bhu Mudra which is also known as the mother earth mudra. And Arise is the “Enlightened Blend” is great with volcano pose, standing side stretch, and half moon. You don't have to do these poses with the oils, but they're complimentary to the blends. I'll diffuse these when I teach and when I do my self practice. Another one of my favourite blends was the second dōTTERA blend I fell in love with (the first was Easy Air) the second was Balance blend. This is the “Grounding Blend” and it is very earthy and lovely and I'm totally obsessed with it still. When I'm feeling anxious I'll rub it onto the soles of my feet morning and night and it is really a calming and relaxing ritual for me. [11:38] Speaking of rituals… Candice, another listener asked: Do you have a ritual when using oils? I do have a few rituals that I use the oils with, and some of them I do daily, others I do occasionally. Some of the “occasional rituals” would be more spiritual like during the new moon or full moons, or during intention setting/goal setting. Sometimes I make diffuser blends or rollers based on the energy of the moons, or I will grab an oil I'm most drawn to for manifesting.  A ritual that I love is creating a bath salt recipe with oils. My favourite epsom salt blends: RELAXATION5 drops Lavender 3 drops Frankincense HIGH VIBE3 drops Copaiba 5 drops Balance Blend CLARIFYING5 drops Wild Orange 2 drops Eucalyptus  RECOVERY8 drops Deep Blue Blend 8 drops AromaTouch Blend [12:32] Another sort of “oil ritual” I have is before I go on a live show, or before I record a podcast I will use spearmint which is the “Oil of Confident Speech” Lavender is another great oil for this as it is the oil of “Communication and Calm” Most of the time I am drawn to an oil intuitively and I will diffuse it or put it on the back of my neck, on my chest, or put a drop in my palms and take a few deep breaths before presenting or recording a podcast. [13:03] Getting back to more of a daily ritual, I use other supplements that dōTTERA has: Their LifeLong Vitality Pack or LLV which contains three supplements: ALPHA CRS+This is packed with nature's most potent anti-oxidants, natural anti-inflammatories, and energy cofactos, this blend of synergistic herbs will give life and energy to the cells and a sense of well being to the body. MicroPlex VMzA revolutionary micronutrient supplement providing naturally balanced amounds of all vitamins, minerals, trace elements, phytonuritines and antioxidants that give your body the most beneficial and safe amounts needed for long term health and vitality.  xEO MEGA A blend of marine base and land base omega essential fatty acids in a unique assimilation capsule with essential oils and fat-soluble vitamins. This is the only omega supplement I've ever stuck with my entire life. I know we've been talking about a lot of oils and products, and like I've mentioned, it's a lifestyle! [14:16] So let's get into showering… haha I have a dry brush self care habit that I do before the shower and I know I've shared this on instagram, here are two of the recipes I use: DRY BRUSH SPRAY ONE: Gentle CirculationAdd 20 drops of each to a 60ml spray bottle, top with FCO (Fractionated Coconut Oil), shake up, and spray. Cypress Eucalyptus Frankincense Rosemary DRY BRUSH SPRAY TWO: Citrus ExfoliationAdd 30-50 drops of Smart & Sassy Blend (aka Slim & Sassy) to dōTERRA's verage skin care toner. Shake well and spray. I spray the oil mixture + FCO onto the dry brush and use it on my skin before the shower. In the shower I use eucalyptus or easy air for a eucalyptus steam shower vibe. I also use dōTTERA's body wash because I'm obsessed with it! And I am also obsessed with dōTTERA's verage skincare collection. [14:50] Now post shower things start to get a little more interesting… I finish with the verage skin care routine: toner, serum, moisturizer, with a drop of yarrow pom oil. For my body I either use the yarrow pom serum or the hydrating body mist with beautiful blend, they're both amazing, you can't go wrong.  As I was preparing this episode I honestly thought to myself, how don't I use these products in my life? That would have been a much shorter episode hahaha dōTTERA also has other great bathroom products like their foaming hand wash, body wash, whitening toothpaste, and mouth wash! We have a hand wash in each bathroom + in the kitchen as well. [15:38] Speaking of the kitchen, this is where we also keep our On Guard cleaner concentrate which is a safe, natural, and effective cleaning solution that can be easily diluted and used on almost every surface. We also use it to wash produce, 1 tbsp + couple drops of Lemon EO.  If I'm missing an herb or spice I'll use oils in cooking but I haven't played with this myself too much. Usually make a salad dressing if anything. HOL:FIT HERBACEOUS LOVE DRESSING¼ c ACV or white wine vinegar ¼ c Olive Oil 1 tbsp Yellow Mustard 1 drop dōTTERA Celery Seed oil 2 drops dōTTERA Lemon oil [16:20] For laundry we use dōTTERA's On Guard Laundry Detergent with a few drops of Tea Tree oil. You can also use oils like lavender or eucalyptus or balance blend for your dryer balls. [16:33] Before bed I take a few more supplements…. Serenity Soft Gels Turmeric Capsules Copiaba Soft Gels Adaptive Capsules Quick + Important Disclaimer for Legal Purposes: Since I sell essential oils, it's important for me to tell you that I have to comply to certain regulations since essential oils aren't regulated by Health Canada or the FDA. So the benefits and claims made on this website and in the podcast are not approved by these parties.  I like using easy air in the diffuser or on my chest/bottoms of the feet before bed. There is also Serenity, the restful blend that works great for transitioning into sleep either a drop on the pillow or in the diffuser with Cedarwood is also amazing. [18:08] Most of these oils and products I use every single day, but some of them I use most days.There isn't a day that I go without using some sort of oil or oil infused dōTTERA product! But it wasn't always like this. I actually started with a handful of oils and since then my collection of oils and products has grown! I like to try a new oil or product each month. Or play with an oil I don't use very often and try new things with it. [18:36] Another one of our listeners, Michelle, asked: How to start integrating them into your every day practice? This is a really amazing question, and I wanted to save it for last. Because yes, listening to this whole daily routine of how I use ALL of these incredible and supportive products for my health does seem a little overwhelming, and when you're first getting into dōTTERA it can be a lot. I know because I totally felt that in the beginning. But the key comes back to some of my basic teachings on habits and creating a healthy lifestyle that you can be excited about and consistent with. The first basic principle is to pick ONE area of your health to focus on at a time. Some examples would be: NUTRITION SLEEP EXERCISE EMOTIONS MEDITATION CLEANING/HOME Choose ONE area of your health and start there. I promise you, whatever you want to “elevate” or “upgrade” there is an oil for that. And when I offer wellness consultations for people who are interested in bringing these powerful natural solutions into their home, I always ask them what are their top three health goals? This is our starting point! Once you have your health goals/starting point, we figure out which oils would best support your goal and make it into a daily routine/habit/ritual that is specific to you. [20:01] Something I love to do is meditate in the morning, or hold space with some deep breaths before I start the day. Some great oils that can elevate your centering practice are: Easy Air (akak Breathe blend), Peppermint, and Eucalyptus, Cypress. To use these in your meditation practice, place a drop of the oil in your palm, rub the hands together gently and then cup both hands over your nose and mouth creating a hand diffuser. Breathe deeply setting the intentions for your day. If you have goals to support happy, glowing skin, you could start with some of dōTTERA's essential oils for skin, or one of their wonderful skincare collections. As a daily ritual, use the oils on your skin (face, body, or both - depending), and speak kindly to yourself in the mirror as you use the products on your skin. Tell yourself what you love about you, give a coy wink to yourself in the mirror, or repeat positive affirmations. If you have goals for better sleep, we can look at which oils are best for a bedtime routine, and create the perfect evening routine for you, using the support of your new oils, diffuser, or other products! Along with all the other products, resources, and recipes I shared, I'm going to include a free copy of my monthly wellness box guide with the yellow button below. It's a free resource I created to share with you some different dōTTERA products I use based on different health goals.

TITRE: Soigner et soulager les Bobo post partum avec de l’Aromathérapie. On sait toute que le retour à la maison après l’accouchement n’est vraiment pas simple, même si on a le bébé dans le bras et qu’on est au ange ... le corps réclame!  Petit à petit tout doit se remettre en place. L'utérus doit retrouver sa position initiale, l'allaitement ou les biberons, les hormones en yoyo et cette sensation étrangère et magnifique d'être  un mammifère au taquet du moindre petit bruit. Là dessus on rajoute les petits bobos de l’accouchement … bref,  Préparer le post partum vaut vraiment la peine !! Les suppléments après l’accouchement, c’est super important ! Ce trio de complément LLV est très important pour la récupération après l'accouchement ! Prendre 2 gélules de chaque bouteille au repas du midi et du soir.  https://www.mydoterra.com/ShoppingCart/index.cfm?FuseAction=CategoryShop&CategoryID=2379 ALPHA CRS Supporte l'énergie cellulaire, la clarté mentale, le bon fonctionnement du cerveau, la prolifération de cellules saines et le système immunitaire.  XEO MEGA  Supporter la santé cardio-vasculaire, le bon fonctionnement du cerveau, le confort au niveau des articulations et le système immunitaire.  MICROPLEX VMz Contient 22 vitamines et minéraux essentiels, vitamine A, C et E. Combat les radicaux libres, supporte la santé des os et le système digestif et favorise un métabolisme sain.  Recette pour une maman calme (le Baby Blues) Diffuser des huiles : Lavande, Orange sauvage, Pamplemousse, Bergamote, Encens ou les mélanges tout fait  Balance ou Elévation de Doterra. https://www.mydoterra.com/ShoppingCart/index.cfm?FuseAction=CategoryShop&CategoryID=4545 CLARYCALM, régule les hormones en yoyo et atténue les symptome prémenstruelle. Appliquer à volonté sur les poignet, plexus solaire, bas du ventre , bas du dos.  On peut aussi mettre quelques gouttes dans le diffuseur ou se faire masser quelques gouttes de ce mélange. https://www.mydoterra.com/ShoppingCart/index.cfm?FuseAction=CategoryShop&CategoryID=3261 

 Recette Soin du périnée Vaporiser sur le périnée des HE a chaque fois que vous faite vos besoins, ce mélange va qui permettre, de soulager la sensation de brûlure, de cicatriser plus vite sans oublier de désinfecter.  (Pratiquement, prendre un flacon de 250 ml avec un vaporisateur :  Mélanger 2 gtte d’encens + 5 gtte d'hélichryse + 5 gtte de myrrhe + une cuillère a café de sel de mer Himalaya ou gros sel + une cuillère à soupe d’huile de coco fractionné) https://www.mydoterra.com/ShoppingCart/index.cfm?FuseAction=CategoryShop&CategoryID=7793 Serviette hygiénique Aromatisée a utilisé les premières semaines après l’accouchement. Préparez à l’avance des serviettes hygiénique Aromatisée, que vous tremper dans l’eau et vaporiser le mélange d’HE dessus et HOP au congélateur !! Cela va soulager et calmer les douleurs et favoriser la guérison.  (Pratiquement: Mouillez 6/12 serviettes naturelle (Natracare) /Vaporiser le mélange pour le périnée dessus mettre dans un tupper et mettre au congélateur). Recette Massage de l’abdomen Appliquer ce mélange pour soulager les tranchées souvent douloureuses pendant les premières semaines après l’accouchement.  (Pratiquement: Mélanger 50 ml d’huile de coco francionée Doterra avec 7 gttes du mélange Whisper, 5 gtte de lavande, 5 gtte de géranium). https://www.mydoterra.com/ShoppingCart/index.cfm?FuseAction=CategoryShop&CategoryID=8595 Soutient émotionnelle pour le Papa et les émotions de toutes la famille. HE de Laurier noble ou les délicieux mélange de Doterra qui aide a mieux vivre les émotions. Appliquer 3 fois par jour sur les poignets, prendre le temps de le sentir. https://www.mydoterra.com/ShoppingCart/index.cfm?FuseAction=CategoryShop&CategoryID=655 Plus d’info & de conseil : Marie De Cort Aromathérapeute et spécialisé en Haptonomie, accompagnement affectif.

Questions this week: How can I better promote LLV? What if upline won't sponsor me in Diamond Club? How can I mentor my downline if they outrank me? Do I have to spend thousands of dollars on mentoring?

EXCELLENT RantCast here. Davis Ford, the creator of AOS Reminders and a HOT NEW PROGRAM INCOMING (watch to find out, it has to do with deployment ;) ) joins me to discuss his contributions to the Sigmar community and the importance of parity in gaming. Remember to check out AOS Reminders at [https://aosreminders.com/](https://aosreminders.com/) and be sure to toss him a follow on Twitter @daviseford to keep up with updates and releases. Also be sure to watch for the cameos by LLV and The Honest Wargamer himself, then watch for Rob weekly on Twitch. Chat Gang was SPICY in this one, if you want to join Chat Gang and be a part of the show watch live at https://www.twitch.tv/mr_mephisto

Supplements, why should we supplement? What's the big deal? How do you choose? We have answers! Click on the link to set up your order of LLV! https://doterra.me/bZow5DQw --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Lake Las Vegas Live broadcasts The 2nd Annual Rudolph’s Neon Lights Parade from The Village at Lake Las Vegas. The event is presented by Del Webb, Lake Las Vegas. In addition to the parade, Del Webb’s Bridjette Shelfo gives us updates on the new LLV community. Help Keep Them Warm: Don’t forget the Dasco Sweater […]

Lake Las Vegas Live broadcasts The 2nd Annual Rudolph’s Neon Lights Parade from The Village at Lake Las Vegas. The event is presented by Del Webb, Lake Las Vegas. In addition to the parade, Del Webb’s Bridjette Shelfo gives us updates on a new LLV community. Help Keep Them Warm: Don’t forget the Dasco Sweater […]

Broadcasting live outside Season Grocery & Deli on the shores of Lake Las Vegas, Ryan Cooper (Fitness Coach, Lake Las Vegas Sports Club) discusses what it took to train Andy for his Rose Regatta debut. Also on this show: Sherry Alexis (Development Manager, Susan G. Komen Nevada): A member of the LLV rowing team, she […]

Broadcasting live outside Season Grocery & Deli on the shores of Lake Las Vegas, Ryan Cooper (Fitness Coach, Lake Las Vegas Sports Club) discusses what it took to train Andy for his Rose Regatta debut. Also on this show: Sherry Alexis (Development Manager, Susan G. Komen Nevada): A member of the LLV rowing team, she […]

This episode Ange Peters informs you about how you can avoid toxins in your daily life. She'll describe how you can help detox your body daily, as well as which essential oils can help you remove toxins daily from your body.

Sometimes in our lives, we make things too complicated for ourselves. We create these elaborate plans for ourselves, set intense daily intentions and routines, and struggle to keep up with them all. Join me, in today's podcast, as I chat more about the basics when it comes to essential oil usage and go over how to maximize your Medicine Cabinet. Learn more at www.mydoterra.com/katrinapotter

This episode Mandy Sommers takes a deeper dive into how a multivitamin can help your body. She'll look at the doTERRA Lifelong Vitality Pack and breakdown how the three supplments included, Alpha CRS+, Mito2Max and xEO Mega, impact your health and wellness.

Broadcasting live from the Lake Las Vegas Sports Club at Lake Las Vegas, Andy and Tony are joined by. . . Dann Battistone (GM, Lake Las Vegas Sports Club): Pickleball 101 and what’s happening at the LLV Sports Club Debby Dempsey (Pickleball Ambassador/LLV Sports Club Member): The Pickleball community at LLV and an explanation of […]

Broadcasting live from the Lake Las Vegas Sports Club at Lake Las Vegas, Andy and Tony are joined by. . . Dann Battistone (GM, Lake Las Vegas Sports Club): Pickleball 101 and what’s happening at the LLV Sports Club Debby Dempsey (Pickleball Ambassador/LLV Sports Club Member): The Pickleball community at LLV and an explanation of […]

Broadcasting live from Seasons Grocery at Lake Las Vegas, Andy and Tony are joined by. . . Tammy Temple (Director, Lake Las Vegas Real Estatate): The latest information on LLV real estate Robin Yates (Windemere Lake Las Vegas): “Resort Stays” via LakeLasVegasVacations.com Gene Northup (Synergy Sotherby’s International Realty): Looking for waterfront lots? Gene can help. […]

Broadcasting live from Seasons Grocery at Lake Las Vegas, Andy and Tony are joined by. . . Tammy Temple (Director, Lake Las Vegas Real Estatate): The latest information on LLV real estate Robin Yates (Windemere Lake Las Vegas): “Resort Stays” via LakeLasVegasVacations.com Gene Northup (Synergy Sotherby’s International Realty): Looking for waterfront lots? Gene can help. […]

Once again it’s on!!! Welcome back to your favorite podcast, ya filthy animals! Episode 22 is here! Grab a deuce-deuce and enjoy! This one’s for you, Vonnie! #LLV. Be sure to subscribe, rate, and share!! Topics: - Long Live Vonnie #LLV (3:25) - #QOTW (7:45) - Serena demands respeck (13:50) - NFL Week 1 Recap (32:25) - Insecure (54:40) - Power (1:19:00) Follow us on Twitter and IG: @ktcpod Email us: ktcpodcast@gmail.com Available on SoundCloud, iTunes, & Google Play --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/ktcpod/support

Listen in to learn awesome info and tools all about Influenza Season. You will learn to arm yourself with education to make a informed decision when it comes to you and your family.  She discusses how to boost your immune system for prevention and if you come down with illness. Your body is amazing and if supported will do amazing things:) Important info from this episode:  (Recorded during 2017-2018 flu season) To vaccinate or not? This is a personal choice. Most importantly, educate yourself on the pros and cons in order to make an informed decision. The CDC estimates that the vaccine will be effective against roughly 30-40% of H3 viruses this year Additional class on the flu vaccination and other preventive measures Prevention: Use these 2 essential oils daily doTerra’s On guard essential oil blend doTerra’s Frankincense essential oil blend Promotes good gut health (80% of our immunity lives in our gut) Increases WBC activity White blood cells (WBC) are part of the immune system involved in protecting the body against both infectious disease and foreign invaders doTerra’s Life Long Vitality Pack (LLV) includes high quality omegas Watch this video to see why everyone needs LLV according to Dr. Josh Axe Probiotics Fermented foods like sauerkraut, fermented veggies, kimchi Vitamin D plays a key role in boosting the immune system Not enough sun exposure during winter months decreases our Vitamin D levels So what to do? Testing your levels is an option Eat more foods high in vitamin d (fatty fish, egg yolks, liver) Best source is sunlight (20 minutes per day) I choose to take extra supplementation (1000-4000mg) Too much can be harsh on your stomach, no more than 2000mg daily Eat more foods high in vitamin c (oranges, grapefruit, strawberries, peppers, broccoli) Handwashing Ensure a strong immune system Omega fatty acids Good gut health Vitamin D Vitamin C What if you get the flu? FLOOM blend: Frankincense, Lemon, Onguard, Oregano, Melaleuca Topical or internal Elderberry Syrup Appears to short circuit flu symptoms and boost immune system check out this easy recipe Detox bath 1/2 cup epsom salt 1/2 cup baking soda 1/4 cup hydrogen peroxide 1/4 cup ACV( apple cider vinegar) doTERRA lavender essential oil 5 drops doTERRA deep blue essential oil blend 3 drops Arming yourself with these tools to increase your immune system is key and also having simple solutions on hand are crucial when illness strikes because at some point, it will!!!  If you want to learn more about how these oils work and how simple they are to use, watch this video!   Connect with us:  Visit our website: www.anaturalshift.com email: info@anaturalshift.com  Follow us on social media: Facebook:www.facebook.com/anaturalshift  Instagram: www.instagram.com/anaturalshift/ follow Julie-->www.instagram.com/julie_ann_davey/  follow Kari--> www.instagram.com/karicoody/  

"You do you. You be the lighthouse. You attract other people just by being in your own beautiful light. You don't have to tug people along this journey. They'll see it." Thank goodness for this thing called technology because this Alice (right here, me) called another Alice (Abba) on Skype from Australia to Mexico, to chat about doTERRA, family, travel, abundance, and what it means to raise a grounded family where abundance lives. (let's chat about empty LLV bottles being toys huh?  Alice Abba is a happiness and business mentor, a wellness guide (using her fave tools, essential oils) and a doTERRA Blue Diamond leader, running a multi-million-dollar-team who live all over the world. She's known for living an aligned life, and being authentic in her mum life and my biz life (no ‘perfection' filters over on Alice's page). She's known for working with passionate, intelligent and self-driven mums who are ready and open to receive my guidance and support as they unearth—and lean into—their potential and grow their businesses (especially in the post-motherhood journey). We chat: Travelling with family while needing the time to invest in her business. Honouring what the other person needs in the family dynamic What being a shining example of the opportunity is + how to get all the people you want to join you in the business to do it! How the doTERRA opportunity can be used to support a family 'before' it's begun so that difficult experiences during work/maternity leave don't need to occur. Throwing off the bough-lines and living 'The Coconut Life'. Purpose and Meaning, why this is so important and comes in many flavours Cultivating imagination, creativity and grounded-ness in kids even when abundance lives How Alice attracted empowered leaders 'finding leaders', 'finding builders' We are 'failing' at every level of this business. And why that helps us all. Why allowing our team the ability to grow into their rank is so important to Alice How is your business asking you to fumble... [note Alice was going to the gym everyday when she rank-advanced to Blue Diamond! You know I always speak about our physical health being so impactful for our business success!] Show notes: Facebook: https://www.facebook.com/alicemabba/ Instagram: http://instagram.com/aliceabba Website: http://www.aliceabba.com/ How to buy doTERRA oils: http://thewholedaily.com.au/how-to-buy-doterra-oils/  

Paul Wang:         Welcome to the monthly podcast “On The Beat”, for Circulation: Arrhythmia and Electrophysiology. I am Dr. Paul Wang, Editor-in-Chief, with some of the key highlights from this month's issue. We'll also hear from Dr. Suraj Kapa, reporting on new research from the latest journal articles in the field.                                 In our first article, Adetola Ladejobi and associates studied 1,433 patients, between 2000 and 2012, who were discharged alive after sudden cardiac arrest. A reversible and correctable cause was identified in 792 patients, or 55%. A reversible cause for sudden cardiac arrest was defined as significant electrolyte or metabolic abnormality, evidence of acute myocardial infarction or ischemia, recent initiation of antiarrhythmic drug, or illicit drug use, or other reversible circumstances.                                 Of the 792 sudden cardiac arrest survivors, due to reversible or correctable cause, 207 or 26% of the patients received an ICD after their indexed sudden cardiac arrest. During a mean follow-up of 3.8 years, 319 or 40% of patients died. ICD implantation was highly associated with a lower all-cause mortality, p < 0.001, even after correcting for unbalanced baseline characteristics.                                 In subgroup analyses, only patients with sudden cardiac arrest, were not associated with myocardial infarction, extracted benefit from the ICD, p < 0.001.                                 The authors concluded that in survivors of sudden cardiac arrest, due to a reversible and correctable cause, ICD therapies associated with lower all-cause mortality, except if the sudden cardiac arrest was due to myocardial infarction.                                 Further prospect of multi-center randomized control trials will be needed to confirm this observation.                                 In our next study, Carlo Pappone and associates, studied 81 patients with persistent atrial fibrillation, randomized to undergo high density electrophysiological mapping, to identify repetitive regular activities, before modified circumferential pulmonary vein ablation, or modified circumferential pulmonary vein ablation alone. The primary endpoint was freedom from arrhythmia recurrence at one year.                                 In the 81 patients with persistent atrial fibrillation, there were 479 regions exhibiting repetitive regular activities in these patients, or 5.9 repetitive regular activities per patient. There were 232 regions in the mapping group, which consisted of 41 patients, and 247 regions in the control group, consisting of 40 patients. Overall, 39% of the repetitive regular activities were identified within pulmonary veins, whereas 61% were identified in non-pulmonary vein regions.                                 Mapping-guided ablation resulted in higher arrhythmia termination rate, as compared to conventional strategy, 61% vs. 30%, p < 0.007. Total RF duration, mapping, and fluoroscopy times were not significantly different between the groups. No major procedure related adverse events occurred.                                 After one year, 73% of the mapping group of patients were free of recurrences, compared to 50% of the control group, p = 0.03.                                 The authors concluded that targeted ablation of regions showing repetitive regular activities provided adjunctive benefit in terms of arrhythmia freedom at one year in treatment of patients with persistent atrial fibrillation. These findings should be confirmed by additional larger randomized multi-centered studies.                                 In the next article, Maciej Kubala and associates examine repolarization abnormalities in 40 patients with arrhythmogenic right ventricular cardiomyopathy, comparing extent and location of abnormal T-waves of one millimeter or greater in depth, downsloping elevated ST segment in two or more adjacent leads to the area and location of endocardial bipolar and unipolar, and epicardial bipolar voltage abnormalities. They found an abnormal unipolar right ventricular endocardial area of 33.4% with presence in eight patients without negative T-waves. Patients with negative T-waves extending beyond V3, seen in 20 patients, had larger low bipolar and unipolar endocardial areas, and larger epicardial low bipolar areas, compared to those with negative T-waves limited to leads V1 to V3.                                 ECG localization of negative T-waves regionalized to the location of substrate. Patients with downsloping elevated ST segment, all localized to leads V1, V2 had more unipolar endocardial abnormalities involving outflow in mid-right ventricle, compared to patients without downsloping elevated ST segment.                                 The authors concluded that in arrhythmogenic right ventricular cardiomyopathy, abnormal electric current areas were proportional to the extent of T-wave inversion on the 12 lead electrocardiogram. Marked voltage abnormalities can exist without repolarization changes. Downsloping elevated ST segment patterns in V1 and V2 occurs with more unipolar endocardial voltage abnormalities, consistent with more advanced trans neural disease.                                 In the next manuscript, Teresa Oloriz and associates examine the timing and value of program stimulation after catheter ablation for ventricular tachycardia. They performed 218 program ventricular stimulations six days after ablation in 210 consecutive patients, 48% with ischemic cardiomyopathy in the median left ventricular ejection fraction of 37%. After ablation, ICDs were programmed according to NIPS results. Class A were noninducible, Class B non documented inducible VT, and Class C documented inducible VT. Concordance between the programmed ventricular stimulation at the end of the procedure and at six days was 67%. The positive predictive value and negative predictive value were higher for the programmed ventricular stimulation at day six. Ischemic patients and those with preserved ejection fraction showed the highest negative predictive value.                                 Among noninducible patients at the end of the procedure, but inducible at day six, 59 patients had VT recurrence at one year follow-up. Recurrences were 9% when both studies were noninducible. There were no inappropriate shocks, incidents of syncope with 3%, none harmful. The rate of appropriate shocks per patient per month according to NIPS was significantly reduced, comparing the month before and after the ablation.                                 The authors concluded that programmed ventricular stimulation at day six predicts VT recurrence.                                 In the next study, Tor Biering-Sørensen and associates examined ECG global electrical heterogeneity, GEH, in its longitudinal changes, are associated with cardiac structure and function, in their Atherosclerosis Risk and Community study, ARIC, consisting of 5,114 patients, 58% which were female and 22% African Americans. Using the resting 12-lead ECGs, and echocardiographic assessments of left ventricular ejection fraction, global strain, left ventricular mass index, end diastolic volume index, end systolic volume index at visit five.                                 Longitudinal analysis included ARIC participants with measured GEH at visits one to four. GEH was quantified by spatial ventricular gradient, the QRST angle, and the sum of the absolute QRST integral. Cross sectional and longitudinal regressions were adjusted for manifest subclinical cardiovascular disease.                                 Having four abnormal GEH parameters was associated with a 6.4% left ventricular ejection fraction decline, a 24.2 gram/meter square increase in left ventricular mass index, a 10.3 milliliter/meter square increase in left ventricular end diastolic volume index, and a 7.8 milliliter/meter square increase in left ventricular end systolic index. All together, clinical and ECG parameters accounted for approximately one third of the left ventricular volume in 20% of the systolic function variability.                                 The associates were significantly stronger in patients with subclinical cardiovascular disease. The QRST integral increased by 20 millivolts/meter second for each three year period participants who demonstrated left ventricular dilatation at visit five. Sudden cardiac death victims demonstrated rapid GEH worsening, while those with left ventricular dysfunction demonstrated slow GEH worsening.                                 The authors concluded that GEH is a marker of subclinical abnormalities in cardiac structure and function.                                 In the next manuscript, Takumi Yamada and associates studied 19 patients with idiopathic ventricular arrhythmias, originating in the parietal band in 14 patients, in the septal band in 5 patients. Among 294 consecutive patients with right ventricular arrhythmia origins, parietal band and septal band ventricular arrhythmias exhibited a left bundle branch block, with left inferior in 12 patients', superior in 2 patients' axes, in left or right inferior axis pattern in four and one patients respectively.                                 In Lead 1, all parietal band ventricular arrhythmias exhibited R-waves, while septal band ventricular arrhythmias often exhibited S-waves. A QS pattern in lead AVR, in the presence of a knock in the mid QRS were common in all infundibular muscle ventricular arrhythmias. During infundibular muscle ventricular arrhythmias, a far-field ventricular electrogram, with an early activation, was always recorded in the His bundle region, regardless of the location of ventricular arrhythmia regions. With 9.2 radiofrequency applications in a duration of 972 seconds, catheter ablation was successful in 15 of the 19 patients. Ventricular arrhythmias recurred in four patients during a fallout period of 43 months.                                 In the next paper, Uma Mahesh Avula and associates examine the mechanisms underlying spontaneous atrial fibrillation, in an Ovine model of left atrial myocardial infarction. The left atrial myocardial infarction was created by ligating the atrial branch of the left anterior descending artery. ECG loop recorders were implanted to monitor atrial fibrillation episodes.                                 In seven sheep, Dantrolene, a Ryanodine receptor blocker, was administered in vivo, during the observation period. The left atrial myocardial infarction animals experienced numerous episodes of atrial fibrillation during the eight day monitoring period, that were suppressed by Dantrolene. Optical mapping showed spontaneous focal discharges originating through the ischemic/normal-zone border. These spontaneous focal discharges were calcium driven, rate dependent, and enhanced by isoproterenol, but suppressed by Dantrolene.                                 In addition, these spontaneous focal discharges initiated atrial fibrillation-maintaining reentrant rotors anchored by marked conduction delays at the ischemic/normal-zone border. Nitric oxide synthase one protein expression decreased in ischemic zone myocytes, or NADPA oxidase in xanthine oxidase enzyme activities in reactive oxygen species increased. Calmodulin aberrantly increased, Ryanodine binding to cardiac Ryanodine receptors in the ischemic zone. Dantrolene restored the physiologically binding of Calmodulin to the cardiac Ryanodine receptors.                                 The authors concluded that atrial ischemia causes spontaneous atrial fibrillation episodes in sheep, caused by spontaneous focal discharges that initiate re-entry. Nitroso redox imbalance in the ischemic zone is associated with intensive reactive oxygen species production, and altered the Ryanodine receptor responses to Calmodulin. Dantrolene administered normalize the Calmodulin response and prevents left atrial myocardial infarction, spontaneous focal discharges in atrial fibrillation initiation.                                 In the next study, Wouter van Everdingen and associates examine the use of QLV for achieving optimal acute hemodynamic response to CRT with a quadripolar left ventricular lead. 48 heart failure patients with left bundle branch block were studied. Mean ejection fraction 28%, mean QRS duration 176 milliseconds. Immediately after CRT implantation, invasive left ventricular pressure volume loops were recorded during biventricular pacing, with each separate electrode at four atrial ventricular delays.                                 Acute CRT response, measured as a change in stroke work compared to intrinsic conduction, was related to the intrinsic interval between the Q on the electrocardiogram and the left ventricular sensing delay, that is the QLV, normalized for the QRS duration, resulting in QLV over QRS duration in the electrode position.                                 QLV over QRS duration was 84% and variation between the four electrodes was 9%. The change in stroke work was 89% and varied by 39% between the electrodes. In univariate analysis, an anterolateral or lateral electrode position in a high QLV to QRS duration ratio had a significant association with a large change in stroke work, all P less than 0.01.                                 In a combined model, only QLV over QRS duration remained significantly associated with a change in stroke work, P less than 0.5. However, a direct relationship between QLV over QRS duration in stroke work was only seen in 24 patients, while 24 other patients had an inverse relation.                                 The authors concluded that a large variation in acute hemodynamic response indicates that the choice of stimulated electrode on the quadripolar electrode is important. Although QLV to QRS duration ratio was associated with acute hemodynamic response at a group level, it cannot be used to select the optimal electrode in the individual patient.                                 In the next study, Antonio Pani and associates conducted a multi-centered prospective study evaluating the determinance of zero-fluoroscopy ablation of supraventricular arrhythmias. They studied 430 patients with an indication for EP study and/or ablation of SVT. A procedure was defined as zero-fluoroscopy when no fluoroscopy was used. The total fluoroscopy time inversely was related to number of procedures previously performed by each operator since the study start. 289 procedures, or 67%, were zero-fluoro. Multi-variable analyses identified as predictors of zero-fluoro was the 30th procedure for each operator, as compared to procedures up to the ninth procedure, the type of arrhythmia, AVNRT having the highest probability of zero-fluoro, the operator, and the patient's age. Among operators, achievement of zero-fluoro varied from 0% to 100%, with 8 operators, or 23%, achieving zero-fluoro in 75% of their procedures. The probability of zero-fluoro increased by 2.8% as the patient's age decreased by one year. Acute procedural success was obtained in all cases.                                 The authors concluded that the use of 3D mapping completely avoided the use of fluoroscopy in most cases, with very low fluoro time in the remaining, and high safety and effectiveness profiles.                                 In the next paper, Demosthenes Katritsis and associates examine the role of slow pathway ablation from the septum as an alternative to right-sided ablation. Retrospectively, 1,342 undergoing right septal slow pathway ablation for AV nodal reentry were studied. Of these, 15 patients, 11 with typical and 4 with atypical AVNRT, had a left septal approach following unsuccessful right sided ablation, that is, the righted left group. In addition, 11 patients were subjected prospectively to a left septal only approach for slow pathway ablation, without previous right septal ablation, that is, left group. Fluoroscopy times in the right and left group, and the left groups were 30.5 minutes and 20 minutes respectively, P equals 0.6. The rate of [inaudible 00:18:24] current delivery time for comparable, 11.3 minutes and 10.0 minutes respectively.                                 There are no additional ablation lesions at other anatomical sites in either group, and no cases of AV block were encountered. Recurrence rate for arrhythmias in the right and left group was 6.7% and 0% in the left group, in the three months following ablation.                                 The authors concluded that the left septal anatomical ablation of the left inferior nodal extension is an alternative to ablation of both typical and atypical AV nodal reentry when ablation at the right posterior septum is ineffective.                                 In our next study, Mark Belkin and associates reported prior reports of new-onset device-detected atrial tachyarrhythmias. Despite the clear association between atrial fibrillation and the risk of thromboembolism, the clinical significance of new-onset device-detected atrial tachyarrhythmias and thromboembolism remains disputed.                                 The authors aim to determine the risk of thromboembolic events in these patients. Using the Ovid Medline, Cochrane, SCOPUS databases to identify 4,893 reports of randomized control trials, perspective or retrospective studies of pacemaker and defibrillator patients reporting the incidence of device detected atrial tachyarrhythmias.                                 The authors examine 28 studies, following a total of 24,984 patients. They had an average age of 69.9 years and a mean study duration of 21.8 months. New-onset device-detected atrial tachyarrhythmias was observed in 23% of patients. Among nine studies, consisting of 8,181 patients, reporting thromboembolism, the absolute incidence was 2.1%. Thromboembolic events were significantly greater among patients with new-onset device-detected arrhythmias, with a relative risk of 2.88, compared to those who had less than one minute of tachyarrhythmias, 1.77 risk ratio.                                 The authors concluded that new-onset device-detected atrial tachyarrhythmias is common, affecting close to one quarter of all patients with implanted pacemakers and defibrillators.                                 In our last paper, Sanghamitra Mohanty and associates performed a meta-analysis systematically evaluating the outcome of pulmonary vein isolation with and without thermoablation in patients with atrial fibrillation. For pulmonary vein ablation alone, only randomized trials conducted in the last three years reporting single procedure success rates, off antiarrhythmic drugs at 12 months or greater follow-up were included. In the PVI plus FIRM group, all public studies reporting a single procedure off antiarrhythmic drug success rate with at least one year follow-up were identified.                                 Meta-analytic estimates were derived, using the DerSimonian and Laird Random-effects Models, and pooled estimates of success rates. Statistical heterogeneity was assessed using the Cochran Q test and I-square. Study quality was assessed with the Newcastle-Ottawa Scale.                                 15 trials were included, 10 with PVI plus FIRM, with 511 patients, non-randomized perspective design, and 5 pulmonary vein isolation-only trials, consisting of 295 patients, all randomized.                                 All patients in the pulmonary vein only trials had 100% non paroxysmal atrial fibrillation, except for one study, and no prior ablations. About 24% of the PVI plus FIRM patients had paroxysmal atrial fibrillation.                                 After 15.9 months of follow-up, the off antiarrhythmic drug pooled success was 50% with FIRM plus PVI, compared to 58% in the PVI alone. The difference in the effect size between the groups was not statistically significant. No significant heterogeneity was observed in this meta-analysis.                                 The authors concluded that the overall pooled estimate did not show any therapeutic benefit of PVI FIRM over PVI alone.                                 That's it for this month, but keep listening. Suraj Kapa will be surfing all journals for the latest topics of interest in our field. Remember to download the podcast On The Beat. Take it away, Suraj. Suraj Kapa:          Thank you, Paul, and welcome back to “On The Beat”. Again, my name is Suraj Kapa and I'm here to review with you articles across the cardiac electrophysiology literature that were particularly hard hitting in the month of February.                                 To start, we review the area of atrial fibrillation, focusing on anticoagulation. Reviewing an article published in this past month's issue of the Journal of the American Heart Association, by Steinberg et al., entitled Frequency and Outcomes of Reduced Dose Non-Vitamin K Antagonist Anticoagulants, results from ORBIT AF II. The ORBIT AF II registry, also called the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, is a prospective national observational registry of AF patients.                                 The author sought to describe the frequency, appropriateness, and outcomes of patients prescribed reduced doses of NOACs in the community practice. They reviewed the records of almost 8,000 patients receiving NOACs and noted that the vast majority, nearly 84%, received a standard dose of NOACs, consistent with the U.S. FDA labeling. While only 16% received a reduced dose, only 43% of these were consistent with labeling instructions. Those who received reduced dose NOACs inappropriately more often tended to be younger and have, interestingly, lower overall bleeding risks scores.                                 Furthermore, compared with those appropriately receiving dosing, patients receiving inappropriately reduced dose NOACs had a higher unadjusted rates of thromboembolic events and death.                                 These data are important to understand, in that, discussion with patients, that inappropriate reduction of NOACs does not necessarily offer appropriate protection against long-term risk of thromboembolic events. Thus, close attention must be paid to consideration of the use cases and instructions for use.                                 While the registry cannot get into the details of why the dose was reduced in the spectrum of patients, it does highlight the fact that this continues to be a problem in general practice.                                 Further data is needed to understand what leads to inappropriate dose reduction, which could include factors such as patient preference, or physician education.                                 Staying within the realm of anticoagulation and understanding individual needs, we next review an article published in this past month's issue of Circulation, by Nielsen et al., entitled Female Sex Is a Risk Modifier Rather Than a Risk Factor for Stroke in Atrial Fibrillation. Should we use a CHA2DS2-VA score rather than CHA2DS2-VASc? In this review, the authors sought to evaluate whether female sex is truly an overall risk factor, as opposed to a risk modifier.                                 Using three nationwide registries, they identified patients with nonvalvular atrial fibrillation between 1997 and 2015, and they calculated two sets of scores. The first score, they termed a CHA2DS2-VA score, calculated for men and women with follow-up of one year in the Danish National Patient Registry. They wanted to calculate the risk based on this pseudo-value method. They then reviewed female sex as a prognostic factor by inclusion as an interaction term on the CHA2DS2-VA score, to calculate overall thromboembolic risk.                                 Amongst over 200,000 patients with atrial fibrillation, almost half of whom are women, they noted that the mean CHA2DS2-VA score, where sex is excluded, was a tad higher in women than men, namely 2.7 vs. 2.3. However, women had an overall higher one year thromboembolic rate of 7.3 vs. 5.7 per 100 person-years. Interestingly, with a CHA2DS2-VA score of zero, the absolute risk of thromboembolism was equal amongst men and women, around .5%. Once overall points increased above one, however, women exhibited a higher stroke risk. This interaction was statistically significant.                                 Thus, the authors indicated that female sex is a risk modifier for stroke in patients with atrial fibrillation, rather than a risk factor. The terminology is important to consider. Essentially, what they are noting is that at the lower risk level, female sex, in and of itself, is not something that necessarily puts somebody in the higher risk cohorts. Instead, at higher risk levels, because of other factors, a woman may have a higher overall risk of stroke than men. Thus, stroke risk is accentuated in women, who would have been eligible for oral anticoagulating treatment anyway, on the basis of a CHADS score above one.                                 These data highlight the importance of thinking about the fact that at the lower risk score level, female sex alone might not be sufficient to say that a patient has reached the CHA2DS2-VASc score of one and above. But, really, you need an overall CHA2DS2-VA score, or a risk score, inclusive of at least two other risk factors to indicate that now, being a female is going to modify the risk and further accentuate it.                                 Now, one thing to note is, these data are very consistent with the guidelines. The European guidelines indicates that female sex alone, which in the CHA2DS2-VASc score would confer a risk score of one, should not, by itself, construe the need to put somebody on anticoagulation.                                 However, it's important to highlight that these data show that at a CHA2DS2-VASc score of one in females, they should really be construed as equivalent to a CHA2DS2-VASc score of zero in men.                                 Using the CHA2DS2-VA score, where sex is excluded, but considering that women overall have a higher incidence of stroke at any given CHA2DS2-VA level above one, will help better counsel women about the importance of being on anticoagulants.                                 The next article we review relates to long-term risk related to atrial fibrillation, published in February's issue of Heart Rhythm, by Nishtala et al., entitled Atrial Fibrillation and Cognitive Decline in the Framingham Heart Study. While there's much out there about the potential long-term role of cognitive decline in atrial fibrillation patients, longitudinal research investigating the relationship is relatively sparse. Thus, the authors sought to investigate the association between atrial fibrillation and cognitive performance, cross-sectionally and longitudinally.                                 They chose patients within the Framingham study who are dementia and stroke-free at the time of baseline neuropsychological assessments. They evaluated atrial fibrillation status as a two level variable, namely prevalent atrial fibrillation vs. no atrial fibrillation in cross-sectional analyses. And they also separated into prevalent atrial fibrillation at baseline, interim development of atrial fibrillation, and those who didn't develop any atrial fibrillation in longitudinal analysis.                                 They studied 2,682 participants in the Framingham Heart study, including original and offspring cohorts. They noted that a baseline of about 4% had diagnosed atrial fibrillation. Prevalent AF was noted to be significantly associated with poorer attention. Interestingly, sex differences were noted, with men performing worse on test of abstract reasoning and executive function than women.                                 They noted that prevalent atrial fibrillation was significantly associated with the longitudinal decline in executive function, in both the original cohorts, as well as interim atrial fibrillation being significantly associated with longitudinal decline in executive function of the offspring cohorts. Thus, they noted that atrial fibrillation is associated with a profile of long-term change in cognitive function.                                 The importance of these data are to further highlight the potential contribution of atrial fibrillation to cognitive decline. While the exact mechanisms remain to be fully elucidated, the question of how to get ahead of the cognitive decline associated with atrial fibrillation is further put out by these data.                                 Whether the relationship between atrial fibrillation and cognitive decline is due to recurrent thromboembolic events vs. the therapies used vs. other factors such as humid anatomic factors resulting in poor brain perfusion, are relatively unclear.                                 Certainly it is also possible that atrial fibrillation simply reflects a process associated with other factors that might lead to cognitive decline. However, again, further mechanistic studies and potential treatment interventions to mitigate the risk of cognitive decline are still needed.                                 Speaking of this, we next review a paper published in the European Heart Journal this past month, by Friberg and Rosenqvist, entitled Less Dementia with Oral Anticoagulation in Atrial Fibrillation.                                 Speaking of treatments to avoid long-term cognitive decline, the authors sought to evaluate if oral anticoagulant treatment might offer protection against long-term dementia risk in atrial fibrillation.                                 These retrospective registry studies of patients with the hospital diagnoses of atrial fibrillation and no prior diagnosis of dementia in Sweden, including patients between 2006 and 2014. The study included a total of 444,106 patients over 1.5 million years. They noted that patients who were on anticoagulant treatment at baseline were associated with a 29% lower risk of dementia than patients without anticoagulant treatments. Thus, there is an overall 48% lower risk on treatments with the appropriate anticoagulation. There is no difference on whether Warfarin or the newer oral anticoagulants were used.                                 Thus, the authors concluded that the risk of dementia is higher without oral anticoagulant treatment in patients with atrial fibrillation, suggesting that early initiation of anticoagulant treatment in patients with atrial fibrillation could be of value to preserve long-term cognitive function.                                 This relates directly back to the previous paper, which focused more on the epidemiologic risk, while this paper focuses on elements that might construe mechanism or treatment options.                                 Many authors have concluded the incredible importance of early recognition of the need for anticoagulant initiation in patients with atrial fibrillation. While the exact mechanism of cognitive decline and dementia in atrial fibrillation remains to be completely elucidated, certainly recurrent thromboembolic events that might be relatively silent as they occur, but result in a long-term cumulative risk might be helped by placing patients on anticoagulants.                                 This becomes another reason to counsel patients on the importance of long-term anticoagulant therapy. Certainly, the limitations of these studies, however, are the retrospective nature and the fact that there might be some subtle differences that may not be otherwise able to be construed from retrospective registry data regarding the relative role of anticoagulants in truly protecting against long-term cognitive decline. However, the data are certainly provocative.                                 Continuing within realm and discussing outcomes associated atrial fibrillation, we next review an article by Leung et al., entitled The Impact of Atrial Fibrillation Clinical Subtype on Mortality, published in JACC: Clinical Electrophysiology this past month.                                 The author sought to investigate the prognostic implications of a subtype of atrial fibrillation, paroxysmal or persistent, on long-term prognosis. They sought to evaluate differences in mortality between paroxysmal or persistent atrial fibrillation amongst 1,773 patients. They adjusted for comorbid diseases associated with atrial fibrillation, as well as CHA2DS2-VASc score. In the study, a total of about 1,005 patients or about 57% had persistent atrial fibrillation. Over the follow-up period, about 10% of those with paroxysmal atrial fibrillation and 17% of those with persistent atrial fibrillation died.                                 They noted that persistent atrial fibrillation, after correcting for other comorbidities, was independently associated with worse survival. Thus, they concluded that persistent atrial fibrillation is independently associated with increased mortality in the long term.                                 These data are relevant in that they highlight that persistent atrial fibrillation in its nature might construe an overall higher risk cohort. It remains to be fully understood what are the true mechanistic differences between persistent and paroxysmal atrial fibrillation. Overall, however, the community grossly agrees that persistent atrial fibrillation likely suggests a higher degree of atrial myopathy. If we believe this, then it is reasonable to believe that the risk associated with this specific form of atrial fibrillation might result in higher long-term harm.                                 Of course, these data are subject to the same limitations of all retrospective data. Namely, these persistent atrial fibrillation patients might have received different therapies or been more sick to start with that cannot be construed by comorbidities alone.                                 Furthermore, these data do not necessarily get to the point of whether treating atrial fibrillation in the persistent patient more aggressively necessarily reduces the risk equivalent to that of paroxysmal patients. Thus, further understanding is needed to understand how to use these data to reduce this mortality difference.                                 Continuing within the realm of epidemiology of atrial fibrillation, we next review an article published in this past month's issue of Circulation, by Mandalenakis et al., entitled Atrial Fibrillation Burden in Young Patients with Congenital Heart Disease. It is assumed that patients with congenital heart disease are vulnerable to atrial fibrillation because of multiple factors. These include residual shunts, hemodynamic issues, atrial scars from previous heart surgery, valvulopathy and other factors.                                 However, there's limited data on the overall risk of developing atrial fibrillation and complications associated with it, especially in children and young adults with congenital heart disease. Furthermore, these children and young adults with congenital heart disease have never been compared with overall risk and control subjects.                                 The authors use the Swedish Patient and Cause of Death Registries to identify all patients with diagnoses of congenital heart disease born from 1970 to 1993. They then matched these patients with control subjects from the Total Population Register in Sweden. They noted amongst almost 22,000 patients with congenital heart disease and almost 220,000 matched control subjects that 654 patients amongst the congenital heart disease cohort developed atrial fibrillation, while only 328 amongst the larger control group developed atrial fibrillation. The mean follow-up overall was 27 years.                                 They noted the risk of developing atrial fibrillation was almost 22 times higher amongst patients with congenital heart disease than control subjects. They noted the highest risk with a hazard ratio of over 84 was noted in patients with conotruncal defects. Furthermore, at the age of 42 years, over 8% of patients with congenital heart disease had a recorded diagnosis of atrial fibrillation.                                 Interestingly, heart failure was a particularly important complication in patients with congenital heart disease and atrial fibrillation, with over 10% of patients developing atrial fibrillation and [inaudible 00:38:20] congenital heart disease developing a diagnosis of heart failure as well.                                 These data are important in that they help in counseling the importance of close follow-up of patients with congenital heart disease and their long-term risk of other complications. Even if patients might be perceivably well managed, incident atrial fibrillation might increase risk of stroke in these patients. It is further important to note that many of these patients cannot be evaluated according to traditional risk or evaluations. Thus, it is important to consider whether or not a patient should be treated with anticoagulation once they develop atrial fibrillation.                                 The high risk of overall atrial fibrillation incidents, particularly in patients with more complex congenital defects, needs to be taken into consideration when advising on the frequency of follow-up.                                 It is important to further note that we must think of this overall risk as the minimum possible risk, namely, counseling a congenital heart disease patient that up to one in ten of them may develop atrial fibrillation by the age of 42 years, is likely the minimum amount. The reason for this is many patients, due to either lack of follow-up or lack of sufficient monitoring, and the asymptomatic nature of atrial fibrillation in many patients might have not been diagnosed.                                 Implications or treatments remain to be seen, and whether or not there are methods to reduce the overall risk of atrial fibrillation is unclear. However, engaging congenital heart disease experts and advising patients, especially at younger ages, on the importance of close electrocardiographic monitoring for a potential atrial fibrillation risk is critical.                                 Next within the realm of atrial fibrillation, we switch to the topic of ablation. And review an article by Pallisgaard et al., published in this last month's issue of European Heart Journal, entitled Temporal Trends in Atrial Fibrillation Recurrence Rates After Ablation, between 2005 and 2014: a nationwide Danish cohort study.                                 Ablation has been increasingly used as a rhythm control strategy for patients with atrial fibrillation. Over this time, we have all noted evolution in both the experience and the techniques used. Thus, the authors sought to evaluate whether recurrence rate of atrial fibrillation has changed over the last decade. They included all patients with first-time AF ablation done between 2005 and 2014 in Denmark. They then evaluated recurrent atrial fibrillation based on a one year follow-up. They included a total of 5,425 patients undergoing first-time ablation.                                 They noted, interestingly, that the patient median age increased over time, and the median AF duration prior to ablation decreased over time. However, the rates of recurrent atrial fibrillation decreased from 45% in 2005 to 31% in the more recent years of 2013, 2014. With the relative risk of recurrent atrial fibrillation almost being cut in half.                                 They noted that female gender, hypertension, atrial fibrillation duration more than two years, and cardioversion with one year prior to ablation were all associated with an increased risk of recurrent atrial fibrillation, regardless of year.                                 These data, again, are retrospective and thus must be taken in the context of that consideration. However, they highlight that it is possible either our selection of appropriate patients for atrial fibrillation ablation or our techniques have improved overall success.                                 The fact that atrial fibrillation ablation is still a relatively young field, with evolving approaches and evolving techniques, needs to be taken into consideration when advising patients on success rates. Using data from many years prior to informed discussion today is fraught with potential error, especially as our catheter design and mapping system use and understanding of appropriate lesion set changes.                                 Of course, some criticism is required as well. While the patients included were relatively older in more recent years, the total AF duration prior to ablation decreased over the years. This suggests that patients are being ablated earlier than they were in the early days of atrial fibrillation ablation.                                 There is some data out there to suggest that earlier ablation for atrial fibrillation might result in a lower long-term recurrence rate. Thus, this might account for some of the difference. However, it is unlikely that it accounts for all of it, given the degree of reduction in overall risk of occurrence.                                 Staying within the trend of talking about changes in techniques for atrial fibrillation ablation, we next review an article published in this past month's issue of Heart Rhythm, by Conti et al., entitled Contact Force Sensing for Ablation of Persistent Atrial Fibrillation: A Randomized, Multicenter Trial. Contact force sensing is one of the newer techniques being used to optimize the success rates for atrial fibrillation ablation. It is generally felt that understanding when one is in contact will optimize atrial fibrillation ablation outcomes by ensuring the physician knows each time they are in contact, and also potentially reducing complications by avoiding excessive contact.                                 Thus, the authors designed the TOUCH AF trial to compare contact force sensing-guided ablation vs. contact force sensing-blinded ablation. They included a total of 128 patients undergoing first-time ablation for persistent atrial fibrillation, and thus randomized them to a situation where the operator was aware of the contact force vs. blinded to the contact force. While the force data was hidden in the blinded cohort, it was still recorded on the backend.                                 In all patients, wide antral pulmonary vein isolation plus a roof line was performed, and patients were followed at 3, 6, 9, and 12 months, with clinical visits, ECGs, and 48-hour Holter monitoring.                                 The primary endpoint was cumulative radio frequency time for procedures, and atrial arrhythmia is greater than 30 seconds after three months is considered a recurrence.                                 They noted that average force was higher in the contact force-guided arm than contact force-blinded arm, though not statistically significant, with an average of 12 grams in the latter and 14 grams in the former.                                 Interestingly, the total time of ablation did not differ between the two groups. Furthermore, there was no difference in the single procedure freedom from atrial arrhythmia, computing to about 60% in the contact force-guided arm vs. the 63% in the contact force-blinded arm. They did notice, however, that lesions with associated gaps were associated with significantly less force and less force-time integral.                                 The authors concluded from this, the contact force-guided ablation did not result in significant decrease in total radio frequency time or 12-month outcomes in terms of freedom from atrial arrhythmias.                                 These data are important to help guide us in terms of thinking about how the tools we use, as they change, actually alter outcomes. Sometimes we may perceive benefits based on logical thinking that's knowing more about what is happening when we are performing a procedure should optimize that procedure. However, this is not necessarily always the case, and thus highlights the importance of randomized trials to directly compare different situations, such as awareness of contact force vs. lack of awareness of contact force.                                 The relevance of these particular articles is that when we compare catheters with different designs, it does not necessarily highlight the importance of the force number itself. Namely, comparing a contact force catheter vs. non-contact force catheter implicates use of essentially two completely different catheters. To understand the incremental utility of force in making decisions, it is important to consider the same catheter, but simply with awareness or lack of awareness of the actual force number.                                 One of the limitations, however, is that individuals who might have been trained on using the same force sensing catheter might have some degree of tactile feedback and understanding of the amount of force being applied to the tip of the catheter, based on having been repeatedly exposed to contact force numbers during use of said catheter. Thus, there might be a difference in being blinded to contact force in early stage operators than in later stage operators who might have been trained based on repeated feedback.                                 Thus, it's difficult to conclude, necessarily, that contact force is not offering mental benefit. In fact, there's a fair chance that it does. However, offering a skeptical viewpoint to help guide the importance of continually evolving technology in actually improving outcomes is important.                                 Finally, within the realm of atrial fibrillation, we review an article published by Pathik et al., in this past month's issue of Heart Rhythm, entitled Absence of Rotational Activity Detected Using 2-Dimensional Phase Mapping and the Corresponding 3-Dimensional Phase Maps in Human Persistent Atrial Fibrillation.                                 Current clinically used phase mapping systems involve 2-dimensional maps. However, this process may affect accurate detection of rotors. The authors sought to develop 3-dimensional phase mapping technique that uses a 3D location of the same basket electrodes that are used to create the currently available 2-dimensional maps. Specifically, they wanted to determine whether the rotors detected in 2D phase maps were present in the corresponding time segments and anatomical locations in 3D phase maps.                                 They used one minute left atrial atrial fibrillation recordings obtained in 14 patients, using the basket catheter, and analyzed them offline, using the same phase values, based on 2-dimensional vs. 3-dimensional representations.                                 They noted rotors in 3.3% using 2D phase mapping, 9 to 14 patients demonstrated about 10 transient rotors, with a mean rotor duration of about 1.1 seconds. They noted none of the 10 rotors, however, were seen at the corresponding time segments and anatomical locations in 3D phase maps. When looking at 3D phases maps, 4 of the 10 corresponded with single wavefronts, 2 of 10 corresponded with simultaneous wavefronts, 1 of 10 corresponded with disorganized activity, and 3 of 10 had no coverage by the basket catheter at the corresponding 3D anatomical locations.                                 These data are important, in that they highlight the importance of when we consider reflecting 2-dimensional systems in a 3-dimensional world of atrial fibrillation. The role of ablating rotors is still in question. However, it is still an important question, and it requires continued study. The best way of identifying a rotor, knowing a rotor is a rotor, and understanding where the rotor is, are going to be critical to further evaluating whether actual ablation of these rotors has any relevance to long-term atrial fibrillation ablation.                                 The truth is, that we need to be sure that we are properly identifying all the rotors in order to help guide whether or not we are actually being successful in ablating atrial fibrillation. The importance of the study is in reflecting whether 2-dimensional representations of the 3-dimensional geometry is sufficient to reflect what is actually happening in that 3-dimensional geometry. These authors suggest that it is not.                                 One of the limitations, however, might be that when we wrap a 2-dimensional framework into 3 dimensions and perform additional post-processing, this might result in some degree of attenuation of the data. However, it does highlight the importance for continued rigorous evaluation of current approaches to phase mapping.                                 Several articles have been published in recent months as well, about different single processing techniques to evaluate whether or not a rotor is, in fact, a rotor and to help optimize identification of them.                                 The jury is still out on whether or not targeted ablation of rotors will, in fact, improve overall long-term atrial fibrillation ablation outcomes. The limitations might not necessarily be that rotors are not an appropriate target, but that we just don't understand entirely where rotors are, based on limited single processing options, or based on limitations of anatomical localization.                                 Next, delving into the realm of ablation at large, we review an article by Iwasawa et al., published in this past month's issue of Europace, entitled Trans Cranial Measurement of Cerebral Microembolic Signals During Left-Sided Catheter Ablation with the Use of Different Approaches - the Potential Microembolic Risk of a Transseptal Approach.                                 The authors note the importance of considering microemolization in subclinical brain damage during catheter ablation procedures. They evaluated microembolic signals detected by transcranial Doppler during ablation of supraventricular or ventricular arrhythmias with the use of either a transseptal or a retrograde approach.                                 The study set was small, only including 36 patients who underwent catheter ablation. They noted in about 11 patients left-sided ablation was done with transaortic approach, and in 9 patients a transseptal approach was used. The other 16 patients were not included, as they only had right-sided ablation.                                 The total amount of microembolic signature, based on transcranial Doppler were counted throughout the procedure and then analyzed offline. There is no significant difference in number of radio frequency applications, total energy delivery time, total application of energy, or total procedure time between the different groups. However, they did note that the mean total number of microembolic signals was highest in those undergoing transseptal approach to left-sided ablation. It was significantly lower in those having retrograde aortic approach, and lowest in those having right-sided only ablation.                                 Interestingly, many of the microembolic signals were detected during the transseptal puncture period, and then during the remainder of the procedure there was relatively even distribution of emboli formation. A frequency analysis suggested that the vast majority of microembolic signals are gaseous, in particularly Group 1 and Group 3, though only 91% in Group 2. No neurological impairment was observed in any of the patients after the procedure.                                 Recently, there's been a lot of focus on the potential long-term risk of cognitive impairments due to microembolic events in the setting of ablation. At least one recent paper in ventricular arrhythmias and several recent papers in atrial fibrillation ablation have suggested a fairly high risk of incidence cerebral emboli noted on MRI post ablation. While these results do not necessarily get at MRI lesions, they do suggest microembolic events. And what is most interesting, they look at microembolic events that occur throughout the entire ablation period with different approaches.                                 Interestingly, there is a massive spike in overall microembolic signals during the transseptal puncture period, and relatively even distribution throughout ablation, irrespective of application of radio frequency or not. Furthermore, while nearly all microembolic signals are gaseous, based on frequency analysis, with retroaortic approach or in those having right-sided only ablation, significantly less seem to be due to gaseous events in those having a transseptal approach.                                 It is known that there's possible damage to the internal dilation system when exposing it to transseptal needles or wires. Thus, one has to wonder whether some of the embolization could be from material associated with the actual transseptal puncture, either from portions of the punctured septum itself, or perhaps from the plastic material that which is being pushed transseptally.                                 These data still need to be considered and we have yet to see what the long-term applications of these kinds of findings are. It may be possible that while transseptal approach seems to offer more instant microembolic signals, if the long-term risk is no different, does it really matter?                                 However, these findings are provocative in the sense that they highlight potential significant differences and the risk of silent cerebral damage, based on the approach we use to ablation.                                 Changing gears, we next focus on the role of devices. And the first paper review is in the last month issue of JACC: Heart Failure, by Gierula et al., entitled Rate Response Programming Tailored to the Force Frequency Relationship Improves Exercise Tolerance in Chronic Heart Failure.                                 The authors sought to examine whether the heart rate at which the force frequency relationship slope peaks can be used to tailor heart rate response in chronic heart failure patients with cardiac pacemakers, and to see whether this favorably influences exercise capacity.                                 They performed an observational study in both congestive heart failure and healthy subjects with pacemaker devices. They then evaluated in a double-blind, randomized, controlled crossover study, the effects of tailored pacemaker rate response programming on the basis of a calculation of force frequency relationship based on critical heart rate, peak contractility, and the FFR slope.                                 They enrolled a total of 90 patients with congestive heart failure into the observational study cohorts, and 15 control subjects with normal LLV function. A total of 52 patients took part in the crossover study. They noted that those who had rate response settings limiting heart rate rise to below the critical heart rate were associated with greater exercise time and higher peak oxygen consumption, suggesting the tailored rate response program can offer significant benefit, particularly in congestive heart failure patients.                                 The importance of this trial is in that it highlights the importance of thoughtful decision-making in programming devices, and that group decision-making involving exercise physiologists, alongside pacemaker programming, and involving our congestive heart failure specialists might be the most critical in optimizing the approach to programming.                                 It might be that more aggressive measures are needed in congestive heart failure patients to decide on what optimal programming is, than it is in otherwise normal patients.                                 Staying within the realm of devices, we next focus on a publication by Sanders et al., published in this past month's issue of JACC: Clinical Electrophysiology, entitled Increased Hospitalizations and Overall Healthcare Utilization in Patients Receiving Implantable Cardioverter-Defibrillator Shocks Compared With Antitachycardia Pacing.                                 The authors sought to evaluate the effect of different therapies and healthcare utilization in a large patient cohorts. Specifically comparing antitachycardia pacing with high voltage shocks. They used the PROVIDE registry, which is a prospective study of patients receiving ICDs for primary prevention in 97 U.S. centers. They categorized these patients by type of therapy delivered, namely no therapy, ATP only, or at least one shock. They then adjudicated all ICD therapies, hospitalizations, and deaths.                                 Of the 1,670 patients included, there was a total follow-up of over 18 months. The vast majority, 1,316 received no therapy, 152 had ATP only, and 202 received at least one shock.                                 They noted that patients receiving no therapy and those receiving only ATP had a lower cumulative hospitalization rate and had a lower risk of death or hospitalization. The cost of hospitalization was known to be significantly higher for those receiving at least one shock than for those receiving only ATP therapy.                                 They noted no difference in outcomes or cost between patients receiving only ATP and those without therapy. Thus, the authors concluded that those receiving no therapy or those receiving only ATP therapy had similar outcomes, and had significantly reduced hospitalizations, mortality, and costs compared to those who received at least one high voltage shock.                                 The relevant findings from this study is similar to prior studies that suggest that any shock over follow-up is associated with potential increase in long-term mortality. The difficulty in assessing this, however, is the fact that it might be that those who have VT that can be appropriately ATP terminated, might be at a somewhat lower risk than those who need to be shocked to get out of their VT. Thus, the presumption of needing a shock to restore normal rhythm might suggest a higher risk cohort, it cannot be gleaned from traditional evaluation of morbid risk factors.                                 This is why the importance of considering how devices are programmed and whether or not a patient who has received shocks can be reprogrammed to offer ATP only therapy to terminate those same VTs, needs to be taken into consideration. How to best tailor this therapy, however, is still remaining to be determined, though more and more clinical trials are coming out to suggest in terms of optimal overall population-wide programming for devices.                                 Staying with the realm of devices, we next review an article by Koyak et al., in this past month's issue of Europace, entitled Cardiac Resynchronization Therapy in Adults with Congenital Heart Disease.                                 Heart failure is one of the leading causes of morbidity and mortality amongst patients with congenital heart disease. But there's limited experience in the role of cardiac resynchronization therapy amongst these patients. Thus, the authors sought to evaluate the efficacy of CRT in adults with congenital heart disease.                                 They performed a retrospective study on a limited number of 48 adults with congenital heart disease who received CRT, amongst four tertiary referral centers. They have defined responders as those who showed improvement in NYHA functional class or improvement in systemic ventricular ejection fraction. The median age at CRT implant was 47 years, with 77% being male. There was a variety of syndromes included.                                 They noted that the majority of patients, nearly 77%, responded to CRT, either by definition of improvement of NYHA functional class, or systemic ventricular function, with a total of 11 non-responders.                                 They noted that CRT was accomplished with a success rate comparable to those with acquired heart disease. However, the anatomy is much more complex and those technical challenges in achieving success o

After Jo embarked on a doTERRA 30 day challenge, we decided we should share just how much our health has benefited from these incredible supplement packs. After the challenge, Jo tells her personal story of forgetting to take her supplements for 10 days, through the stress and business of life. It wasn't until she stopped taking them, when she realised how good she felt on them. While we can't promise to explain anything on a scientific level, even though everything is science backed, instead we discuss the impact of stress on our bodies, particularly on a cellular level and how these supplements can support you. If you're constantly feeling sluggish and tired then you'll gain some insight into why. From metabolism to immune support, stress management, circulation and everything in between, you'll learn how this vitality pack truly complements your health. You'll find out how you can signup for wholesale prices and even how to receive this entire pack for free! By listening to this episode, we hope to take away the overwhelming decisions, when it comes to all the different types of supplements you should be taking, and bundle them all into the doTERRA vitality pack. If you're interested in a FREE dōTERRA Lifelong Vitality Pack® ($153.00 AUD Retail Value), you've got until Aug 31 to get them for free! – Simply order an enrolling order over 100pv – Order the following month with an order over 100pv and they'll be posted to you! check out terms and conditions here Want to know more about the LLV? Watch Jo's Facebook Live Signing up wholesale with doTERRA: https://www.sistermixin.com/instructions/ The primary causes of stress with Damien Kristof : www.sistermixin.com/podcast65/ Instagram: @sistermixin Facebook page Email: info@sistermixn.com Nutrient reference values: www.nrv.gov.au/nutrients

En este episodio nos sentamos a cotorrear con Brown y Yellow (Twitter @brownandyellow1) que además de ser excelentes amigos son una pareja que va iniciando su camino en este mundo feliz, son unos chavos que hablan desde el corazón y fueron muy generosos platicándonos su punto de vista desde la experiencia que ya tienen. Yellow nos contó un poco de más sobre lo que pasó en los playroom de Euphoria, aparentemente alguien le agarro la mano muy duro a la Sra. Brown y lo mejor de todo es que hicieron muy pero muy buen uso de los cuartos oscuros. También al volver de los playroom la fiesta había cambiado para bien, ya todo mundo andaba en el encueradero y eso siempre es bienvenido. La Sra. Brown hizo una petición importante a los hombres que estamos en Twitter y en redes sociales, y créanme que cuando Brown pide algo muchos hombres corremos a cumplirle lo que pida (sí, es sumamente simpática, extraordinariamente guapa y perfectamente bien acompañada de Mr. Yellow) y la petición es que los hombres enseñemos un poquito más en nuestras fotos, algo así como #FreeTheManNipple Platicamos también con Ana y Fer de LLV (los encuentran en Twitter como @AnayFer_friends) sobre los planes macabros de LLV de llevarnos a más fiestas y take overs y cruceros, pura putería con LLV!, nos platicaron un poco más sobre la fiesta que LLV va a tener en CDMX este 9 de Julio así que no se pierdan los detalles. Nos encanta leer sus correos en swingermexicopodcast@gmail.com prometemos contestar todos los correos (hasta los de los haters), manden sus dudas, preguntas, comentarios y cualquier cosa que se les ocurra.  No olviden seguirnos en Twitter @swingermexico_ donde Ale contesta personalmente a todos los podescuchas, y para los más atrevidos también está la cuenta personal de  Twitter de Ale @aleytiago donde hace de las suyas y pone fotitos de su día a día. Pueden visitar nuestra página swingermexico.wordpress.com para ver actualizaciones, leer las notas del show y en general hacernos el día con su visita. ¡MUCHAS GRACIAS POR ESCUCHAR!   Escúchanos en: iTunes  https://itunes.apple.com/mx/podcast/swinger-mexico-podcast/id1086751509?l=en SoundCloud  https://soundcloud.com/swinger-mexico-podcast Stitcher  http://www.stitcher.com/s?fid=84744&refid=stpr Web (Libsyn) http://swingermexicopodcast.libsyn.com/  

En esta nueva edición del Podcast de la Factoría hablamos de los posibles baneos del día 20 y damos un repaso a algunas de las muchas ligas pequeñas con gente de la ELL, LLC y LLV.