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Jackie, RE "It definitely prevented a stroke or MI for me when I had the clot form in the LAA after cardioversion." I was already confused by the mechanism by which NK interferes with clot formation. Now I am even more confused, if the CT detected clot formation in your LAA, then how does NK actually prevent clotting. I am trying to wrap my head around the irony. I am glad the clby researcher - AFIBBERS FORUM
Mayo has a nice write up on daily aspirin risks and benefits.by researcher - AFIBBERS FORUM
I would ask them if it is OK to lower the dosage to 81 mg. Do they have research to indicate that anything higher than that works better without added bleeding risks? Perhaps there are other considerations specific to your case..by researcher - AFIBBERS FORUM
Shannon, agree and smiling in agreement with your comments regarding the difference in AF management between first line EPs and clinically skilled EPs in general. I think the study was interesting in that it looked at ONE hospital group and the variance within one group that supposedly should act cohesively in AF management of patients. Seems like there is an "urge" to own a patient oby researcher - AFIBBERS FORUM
Ron, The FIRM trials may yet prove that AF can be cured by ablation just as right sided SVT can be cured. There were a couple of presentations that looked at whether the rotor locations via phase mapping are stable (a way of looking at repeatability) and they found them to be. If so proven, then there is a possibility that AF can be cured to the same degree as SVT with more precise mapping andby researcher - AFIBBERS FORUM
Poster on referral bias. A nice study. ==================================================== REFERRAL BIAS AMONG ELECTROPHYSIOLOGISTS PERFORMING ATRIAL FIBRILLATION RADIO-FREQUENCY ABLATION (AF-RFA) VS ELECTRPHYSIOLOGISTS NOT PERFORMING AF-RFA: A RANDOMIZED EVALUATION N. Al-Shoaibi, H. Quiroga, A. Ha, C.A. Morillo, J. Healey, S. Ribas, S. Menon, S.J. Connolly Hamilton General Hospital,by researcher - AFIBBERS FORUM
This is the annual Italian conference founded and organized by Natale. The October 2013 meeting abstracts are now available at the JoAF web site and covers a variety of AF topics of interest. Registration for JoAF is required and free.by researcher - AFIBBERS FORUM
Jean, Re "my tissues are thin from years of prednisone". That is an important concern that I am sure you will want to discuss directly with Wharton.by researcher - AFIBBERS FORUM
I hope I didn't scare you in the other thread about robotics. There are different types of robotics out there. Amigo and Hansen systems are similar in that they use cables to control catheter movement. There is also the Stereotaxis system that uses magnets to move the catheter without any cables. Big difference in safety profiles due to stiffness of the different catheter used. I see Wby researcher - AFIBBERS FORUM
Shannon, thanks for clarifying about situation in San Diego. Between all the different locations and conference demands, Natale is spread pretty thin. I don't know how he does it, and he spends time giving detailed replies to email questions too. I see he made the "dream team" (see dreamteamatwork.com)by researcher - AFIBBERS FORUM
I will put in my 2 cents. Ablation is not the highest priority for someone who is asymptomatic, stoke prevention is. I think rate control combined with something like the Lariat or Watchman could be a way forward. BTW, I don't see Natale's name prominently display in Scripps SD website anymore. Burkhardt is still available on occasion and he would be an excellent choice if your frieby researcher - AFIBBERS FORUM
SVT is right sided only and single ablation procedure success rate is in the mid 90s at experienced centers.by researcher - AFIBBERS FORUM
John, Glad to see you well enough to post. I don't know if I would have done differently not knowing your available options as far as EPs and centers. Leicester region has a population of around 330K and that would be considered a small region here in the US. Glenfield center is no doubt the ablation center for the region. They are still very young on the learning curve and that would beby researcher - AFIBBERS FORUM
I did some searches to see if I can recognise any names of the EPs working at Glenfield center. I don't recognise any names. However, I found that they are quite proud of their work on robotic ablation using a system that they helped trial for FDA clearance. The name of the system is Amigo. I don't know whether the system was used in John's procedure or not. Link below provideby researcher - AFIBBERS FORUM
Best wishes for a speedy recovery.by researcher - AFIBBERS FORUM
Hans, That is the paper I referred to. My bad recalling the percentage the authors mentioned. My surprise when reading the article was the unexpected low percentage LAF found. It appears to be a surprise to the authors too. From a practical stand point given the the low incidence of LAF, it may be more useful for patients to understand whether their AF is a primary or secondary disease.by researcher - AFIBBERS FORUM
George, In the review published recently in the JoAF authored by Haissaguerre's group. They found that only 5% of the AF patient population belong to the "lone" AF cohort. Perhaps Hans can comment on criteria differences if any.by researcher - AFIBBERS FORUM
Janet, good to hear from you again and that your NSR is holding up. Thanks for your referral to my cousin, she is doing great.by researcher - AFIBBERS FORUM
My family has a lot of allergies and asthma. My experience is that once your body develops a sensitivity, it takes a while (several weeks to a few months) for the immune system to get back to normal. Your initial reaction to dyed warfarin may have tricked your system into attack mode when any form of warfarin is ingested. .by researcher - AFIBBERS FORUM
Gary, you can do a search on Dr Sirak here. Are you in chronic AF?by researcher - AFIBBERS FORUM
Shannon, agree completely. The essence of the study in terms of real world practice for AF patients is as you succinctly put it "The only real advantage, I can see, of including an additional expensive pre-screening DE-CMRI scan for LAS before an ablation, is basically so that you can warn any patient with more scarring to avoid those EPs who are only skilled at anatomical PVI work, forby researcher - AFIBBERS FORUM
What Douglas Zipes said sums it up. ======================= Zipes, who was not involved in the trial, said that the pulmonary veins are important triggers for arrhythmia in patients with paroxysmal atrial fibrillation. As the disease progresses, however, the atria remodel, and as they remodel, fibrosis develops. When this happens, the atrial body itself can be responsible for the perpetuatiby researcher - AFIBBERS FORUM
Karen, best wishes for finding a skilled EP for managing your AF. I would be skeptical of any EP that says "cryoablation" apriori without first mapping your atria. The best EP's don't confine themselves to a single tool. 95% of cases are done with RF at the high volume centers like CCF and Natale's group. The reason is probably that cryoablation can only do PVI and suby researcher - AFIBBERS FORUM
Sam, Glad Nademanee worked out well for you. Sounds like you in NSR with good long term prognosis. He is the top gun in the LA region. Best wishes for continued NSR. The French group (Hocini, Jais, Haissaguerre et al) have an article out in the latest JAFib about the consequences of allowing the progression from paroxysmal to persistent AFib. It is a heavy penalty in terms of ablation succby researcher - AFIBBERS FORUM
Best wishes for a procedure well done and NSR.by researcher - AFIBBERS FORUM
Barb, I don't think there is an easy answer to your question in general because literature talks about average exposure. For mammography, the range is relatively narrow and predictable. It is less so for AF ablation because a fast procedure may only last 45 minutes (ablation time only - not including periprocedure things like set up, wait, post ablation tests, etc..) and a complex one mayby researcher - AFIBBERS FORUM
Article made it to the current issue of Heart Rhythm Journal as featured article with editorial comments.by researcher - AFIBBERS FORUM
Buster - I think Shannon is saying that if the velocity is too low in the LAA (whether because of AF or caused by LAA isolation to get rid of the AF), there are now viable minimally invasive surgical choices in addition to life long anticoagulation. There are risks to life long anticoagulation and the surgical choices maybe the lower risk way to go for many. It probably depends how susceptibleby researcher - AFIBBERS FORUM
Andrea is his first name.by researcher - AFIBBERS FORUM