Hi Nancy, I guess I am lucky in that my GP is open minded about supplements and actually suggested one (DHEA) that I wasn't aware of when warranted by my blood panel. However, we work together and treat the supplements just like drugs in that I get baseline blood panel and then periodic blood panels after to see if the supplement is working or if dosage needs adjustment (or eliminated if nby researcher - AFIBBERS FORUM
Nancy, How are you doing? Hope things went well with your local EP appt. yesterday.by researcher - AFIBBERS FORUM
Thank you Hans for all you have done for the AF community.by researcher - AFIBBERS FORUM
Shannon, RE - contact force sensing catheters They are out in the market and used in the EU already. Look up Endosense - fiber optic based and very precise. That was the catheter used as reference for recording human heart measurements to see how "feel" of the dozen top guns (including Natale, Jais, Haissaguerre, etc) correspond to actual tip contact force. The paper was pretty iby researcher - AFIBBERS FORUM
It has been a while since I reviewed the Mayo papers on ablation energy. Energy is a force-power time-integral mathematically so there are 3 factors. If power is reduced, then time is lengthened to arrive at the same amount of energy delivered to the spot. Ask Natale's staff whether they plan to lengthen the time for the 30W arm as needed. There is higher risk for clot formation near theby researcher - AFIBBERS FORUM
Kittymama - I don't know how Medi-cal works. However, like others wrote, don't assume that the top EPs refuse that coverage. Nademanee is the top gun EP in LA and his profile indicates that he will accept MediCal and Medicare coverage.by researcher - AFIBBERS FORUM
I am sure the offices are open during the holidays so if talking to one of the nurses can relieve stress for Nancy, then it is a great ideaby researcher - AFIBBERS FORUM
Nancy, Hang in there. I am sure Dr Hongo and his team will do their best to fit you in. Call them on the 2nd about your EKG and Holter reviews.by researcher - AFIBBERS FORUM
Merry Christmas and a great new year to all my freinds here. After a few days of what seems like non stop eating, I am anxious to get back to my healthier routine..by researcher - AFIBBERS FORUM
Regarding vitamins and supplements in general, not specifically AF related.by researcher - GENERAL HEALTH FORUM
Good for you Nancy. Let us know how it goes with Hongo.by researcher - AFIBBERS FORUM
posted this on your original topic. Nancy, Hongo and Burkhardt do AF ablations too. But not AF and VT at the same time I think although I suppose they can try if the VT is left sided too and the catheter is in the left side already - ask them. Sounds like you have many things going on SVT, VT and AF and the first thing to do is send Hongo, Natale or Burkhardt a copy of your EKG and Holter daby researcher - AFIBBERS FORUM
Nancy, Hongo and Burkhardt do AF ablations too. But not AF and VT at the same time I think although I suppose they can try if the VT is left sided too and the catheter is in the left side already - ask them. Sounds like you have many things going on SVT, VT and AF and the first thing to do is send Hongo, Natale or Burkhardt a copy of your EKG and Holter data and see what they think. I suspectby researcher - AFIBBERS FORUM
Thanks Jackie for clarifying. It seems to me that Warfarin would have done a better job in preventing LAA clot formation whereas Natto may have helped you in dissolving the clot afterwards. Given the choice, I think preventing the clot formation in the first place would be a safer way to go. I am glad everything worked out for you in the end. In a similar vane, it looks like the Watchman devby researcher - AFIBBERS FORUM
Nancy, Dr. Hongo in CPMC-SF has the following video to explain VT ablation. It is a very simple right sided example in this case. Burkhardt would use the same procedure and equipment at Scripps. edit - Not sure if Burkhardt has privaledges at Scripps Memorial EP labs which has the VT ablation equipment. He is based out of Scripps Green. You will have to ask. If not, he may ask you toby researcher - AFIBBERS FORUM
Nancy, I just got this off the Scripps web site. See if it works. If not PM me and I can send you more direct contact info.by researcher - AFIBBERS FORUM
Hi Nancy, Do you know if your VT is right or left sided? Huge difference in risk and in clinical risk profiles. I agree you best choice is Natale/Burkhardt (Scripps San Diego). Natale will consult on your SVT/AF and Burkhardt for both AF and VT. Natale refers to Burkhardt for left sided VT and they have been working as a team since the Cleveland Clinic days. The VT is not good and coulby researcher - AFIBBERS FORUM
Just to complicate things further, I looked up stroke studies and statistics on Japan vs other developed countries. Still at it and in the mean time found the following study comparing native Japanese ro Japanese descendents living in Hawaii to confuse things even more. The one clear thing is to keep your BP in control and move to paradise if you can. Stroke. 1984 Jan-Feb;15(1):15-23. Epideby researcher - AFIBBERS FORUM
Jackie, RE: "About six weeks later, I received my copy of the CT scan report which indicated a clot in the LAA. At that time, I phoned his EP nurse who was shocked when I told her about the clot findings and said he'd talk with Dr. Natale. I commented to her that it was a good thing I had been on Nattokinase or I might not have been around to be making the phone call. In the returnby researcher - AFIBBERS FORUM
Treat the svt first. Ablation success rate is high 90s for that at experienced centers. A competent doctor would not be using drugs to treat that. Where are you in Calif?by researcher - AFIBBERS FORUM
Barb, My heartfelt condolences.by researcher - AFIBBERS FORUM
George and Hans, from the Bordeaux review published in August issue of JoAF. AF progression gets you sooner or later unless you are in the "lucky" 2%. ========================================================================= Lone AF Without Any Comorbidities: A Small Fraction of AF Population In a population-based study, 3623 residents of Olmsted County,MN, with the diagnosis oby researcher - AFIBBERS FORUM
Phil, Yes. Sunny Po is still researching the question of what is the minimum amount of GP ablation needed for various arrhythmias including AF. They are looking at arrhythmia from a very fundamental basis and GP seems to be a big piece of the puzzle. To be fair, we can say that there is still a lack of understanding of AF mechanisms. We are just running around trying to insulate the heart froby researcher - AFIBBERS FORUM
Phil, Thanks for posting and it is interesting. GP ablation has been in development for several years now. Dr. Sonny Jackman's (he is retired now but still consults) group at Oklahoma U did the original research. That's the same group that help develop the Carto system and a lot of the tools that are now main stream. Most of that stuff is now under the umbrella of Biosense-Websterby researcher - AFIBBERS FORUM
Gill, I don't know that there is a distinction between frequency of occurrence and risks. A recent article I read (don't recall the journal) stated that AF patients that have been ABLATED successfully has the same risk profile as non-AF patients. The difference I recall is that stroke risk is about 5X greater for someone with un-managed AF compared to someone that doesn't have AFby researcher - AFIBBERS FORUM
JAFIB article reviewing available LAA occlusion devices for those that cannot handle side effects of anti-coagulants. Registration required - free.by researcher - AFIBBERS FORUM
Some statistics on Dr Winkle's Sequoia hospital is available in the following write-up. I don't agree with some of the things he wrote and it is self-promotional but I believe the stats are valid. The other busy center in bay area is Mills-Peninsula - Dr. Hoa and Hongo are listed as providers there too. Stanford I am not too sure about. They used to have a great reputationby researcher - AFIBBERS FORUM
Hi Gill, Thanks for taking the notes. RE "AF patients have long term stroke risk similar to patients without AF, regardless of Chads2vasc score. " I think this is an error.by researcher - AFIBBERS FORUM
Without question Natale is your best choice. He is one of the best ablation specialist in the world and you will find many happy customers here in this forum. I highly respect your UCSF doctors for recommending him since they could have easily suggested you stay within the UCSF system.by researcher - AFIBBERS FORUM
Article today talked about research showing taking aspirin just before bed time gives the best benefit to counteract the peak of clotting risk in the morning. This has been an interesting discussion. The original post by Jayhawk indicates, at least to me, that Natale is comfortable with aspirin.by researcher - AFIBBERS FORUM