Our third issue of 2014 was unavoidably delayed a month due to a combination of a pair of pre-planned events prior to my taking over editorial duties last January, including a several week European trip, followed by several unwelcomed surprises in succession with a serious fire near Sedona forcing relocation to Phoenix for a time. And last, but certainly not least, a small cerebral vascular event that happened to me in May and which forced sudden trips to first Austin, and then to La Jolla over the last month in order to complete the requisite imaging and analysis to identify that this TIA was, indeed, the result of a late-forming leak in my previously sealed left atrial appendage (LAA), nine months subsequent to my initially successful Lariat LAA ligation last August.

We’ll take a thorough look at the lessons learned from this Lariat experience in the next issue in August after I have gone though a repair procedure toward the end of July at Scripps Clinic to plug a 4mm diameter leak in my LAA seal. My Lariat closure had been affirmed as tightly sealed during the actual procedure last summer, and via two subsequent TEE tests at both 6 and 10 weeks post procedure, and yet clearly reopened slightly many months later, becoming the apparent source of my small cerebral infarct event. Stay tuned for the full story in the August issue.

In this issue, we start with summaries of two interesting reports right up our alley with a review of complementary and alternative treatments for arrhythmias. This survey conducted jointly by teams at two large medical centers in the US, offers an encouraging look at how allopathic disciplines are taking greater interest in understanding the potential therapeutic properties of herbal formulas and other modalities considered ‘alternative’. It also highlights important warnings and caveats for the end user of such agents as well.

Our second and final study review follows in a similar ‘holistic’ track, if you will, with an important finding regarding the place for stringent life-style modification methods in conjunction with, in this case, catheter ablation and/or anti-arrhythmic drugs for those with pre-existing metabolic syndrome and/or obstructive sleep apnea. Once again, as with the first review in this issue, the central message of being open to using every viable tool available to us, when appropriate, in the battle for sustained NSR is reinforced by this recent study from the largest ablation research center in the US.

We wrap up this issue of The AFIB Report with a Case Study of a long-term friend of mine whom I followed from onset of his recent diagnosis of persistent AFIB through an ablation by Dr. Andrea Natale, witnessed first hand and in person to convey a bit of personal color and a sense of what it is like going through the process since this is one of the more common inquiries on our website forum; “what is an ablation process really like?” This procedure also contained some unusual factors as well including a patient with a significantly enlarged left atrium, which only a relatively smaller number of EPs would typically even attempt to ablate at that size. I trust you each find something of interest and relevance in this issue.

Finally, I much appreciate the patience shown with my unavoidable delay in publishing this issue and we aim to have things pretty much back on schedule going forward.

Wishing you all good health and lots of NSR!

Shannon