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Congrats and wishing you a quick recovery.by researcher - AFIBBERS FORUM
As my wife reminds me sometimes - men are wimpy, women are tough. Although that's not necessarily a good thing when it comes to AF management.by researcher - AFIBBERS FORUM
Hi Barb, Like others have said, you have one of the best hands in the world working in your case and his complication rate is going to be significantly lower than the average of published data from various centers with different levels of skill and experience. You made the right choice. What Shannon posted in the previous post is most important " It just means a women is wise to selectby researcher - AFIBBERS FORUM
A couple of months ago, someone asked about the differences in results and complications. Natale's J. of Afib just published a review of published experience comparing outcomes and complications. As I have posted previously, vascular complications (because of smaller blood vessels) are significantly higher for women. Registration is required and free.by researcher - AFIBBERS FORUM
Shannon, Burkhardt's complex VT patient population tend to be in much dire shape compared to AF patients so I am guessing that the patient that bumped you is at much HIGHER risk. Best wishes for a procedure well done. You are in good hands. The fact that Dr. N wants B there and not go it alone speaks volumes about B's skill level.by researcher - AFIBBERS FORUM
This idea has been around a few years now. Dr. Natale thought it had potential and ran a trial a few years ago in Austin. What they found was that outcomes were about the same and complications are higher so he dropped it.by researcher - AFIBBERS FORUM
Shannon, RE:"Assuming the EP is highly skilled at transeptal puncture, then the most difficult part of teh procedure will fall to the Doc doing the pericaridal access. It takes some practice to learn how to choose the right angle for first guiding the epicardial Lariat catheter from the puncture just below the xiphoid process ( below the solar plexus and take the correct angle from thereby researcher - AFIBBERS FORUM
Shannon, I am still catching up with the reading on the Lariat procedure and I have a couple of questions that you have probably answered in your head already. First, does it have to be the EP team that handles the procedure? It seems that one EP and a trained group of cardiac cath lab team should be able to do it. The requirement is that the docs involved understand heart anatomy more so thaby researcher - AFIBBERS FORUM
Stich, You may find Shannon's posts on the Lariat procedure helpful if you have concerns about life long maintenance with anticoagulants..by researcher - AFIBBERS FORUM
Shannon, thanks for a thorough write up on the Lariat. I followed the developments of the watchman in the early clinical testing stage and lost interest soon after bad accidents (deaths) in the human trials. Sizing of the watchman (at the time, only two sizes were available) is very important or dislodgement risk is significant. Lariat seems to be a much more elegant solution. If this technolby researcher - AFIBBERS FORUM
My father in law started having AF in his late sixties (we are guessing as we aren't sure). He is now 91 and doing very well.. He takes warfarin and blood pressure meds. Other than occasional visits to ER for bleeding, he has done well.by researcher - AFIBBERS FORUM
RonB, Best wishes for the clean up procedure. Like Shannon, I think you made the right decision to follow Dr. Jais recommendation.by researcher - AFIBBERS FORUM
Adam, Sorry to hear of your late recurrence. CCF put together some data looking at this a few years ago. They followed 831 of their 2005 AF ablation patients for 4.5 years. Below is the link to their full study. You could just be one of the unlucky ones. I would contact Tchou and tell him what's going on and get his opinion. Seems to me clinical solutions are available if suppleby researcher - AFIBBERS FORUM
Understanding of AF did not happen until catheter mapping tools were developed by Webster and Jackman. The next major advance in understanding will probably also come from better mapping tool(s). My guess is that the multi-electrode vest being developed with the help of Haissaguerre will be another leap forward in seeing what's really happening. Before Webster and Jackman, EP's wereby researcher - AFIBBERS FORUM
Oh yeah. Jackman is the original pioneer. He taught a lot of the "elites" out there. OU is still a center of excellence for companies developing tools for ablation. Webster (founder of Biosense division of Johnson and Johnson) did his development work on RF ablation catheters and mapping there before forming a company and selling out to J&J. OU remains an outstanding center. Hby researcher - AFIBBERS FORUM
If cryo ablation is the marketed or GOTO option for your ablation center/specialist, then it would be a yellow flag about their skill level. Cryo is marketed as a safer procedure because of the lower risk for perforation. It was mainly designed for right sided procedure specifically AVNRT ablation where complete heart block risk is present for some cases. For left sided ablation, it is only usby researcher - AFIBBERS FORUM
There have been a number of papers showing that bleeding complications are higher for women so this is something to discuss with your EP about their specific experience and what they do to minimize complications. Intuitively, there will be a size effect. That is why pediatric ablations get referred to specialized centers with the proper equipment and training.by researcher - AFIBBERS FORUM
McHale, Great to hear that you are doing great post procedure and that it went like a breeze. Hopefully, the results continue long term for you.by researcher - AFIBBERS FORUM
Sorry for not getting back to you sooner. PM me your email address and I will send paper. The entire discussion is germain so I find it hard to pick and choose what to cut and paste.by researcher - AFIBBERS FORUM
No doubt. These were consecutive patients. There was no screening for other health issues, interrelated or not. I think I am limited to 300 words so I will try my best to cut and paste discussion(s). I visit Utah a lot and I would say in general that the population there have relatively healthy habits and get their exercise.by researcher - AFIBBERS FORUM
McHale, Wishing you the best.by researcher - AFIBBERS FORUM
RonB - sorry for all the technical jargon and symbols and no glossary to go with them. For starters, the first group of numbers are Days, N= number of people in the group and P= probability that something is NOT random. Let me know what other questions you have. I like the study because it is the same group of ablation specialists and they have a very good reputation so the study applies if youby researcher - AFIBBERS FORUM
This is data from the Intermountain hospital group covering a wide area around Salt Lake City. ===================================================== Article in Press Increasing time between first diagnosis of atrial fibrillation and catheter ablation adversely affects long-term outcomes☆ T. Jared Bunch, MDemail address, Heidi T. May, PhD, Tami L. Bair, RN, David L Johnson, PAC, J. Peter Weiby researcher - AFIBBERS FORUM
Tom, Best wishes for a procedure well done by Natale. Man that EP in Hawaii really screwed you over. He sold you on a flutter ablation as being a simple procedure NOT venturing into the left side(?) Yet he went into the left side and managed ripped up your mitral valve. If that is what he sold you on (a simple right sided procedure for typcial flutter), I would go after them for all the suffby researcher - AFIBBERS FORUM
Hi McHale, same here. The vest IMO is better because it is completely non-invasive and you get the whole picture in one measurement. With the Topera device used in FIRM, you will have blind spots LA (septum for example) and you have to move the spline into the RA to get a picture of what's happening in the RA. There is one advantage with the Topera, it would be possible to do re-mapping dby researcher - AFIBBERS FORUM
Ron - There are two very different "robotic" systems out there and I wasn't sure which system you were referring to at first. Looking at the hospital's web site show that it is a magnetic system. The other system is mechanical and uses cables to control catheter movement. The link below suggest that the hospital was using the system once a week back in 2010. They shouby researcher - AFIBBERS FORUM
In the paper, one cohort had FIRM+conventional ablation (which probably means PVI only). The other cohort had conventional ablation only. No one received FIRM alone. I think the Cadio Insight vest is the way to go for locating re-entrant circuits and FIRM is in danger of becoming a marketing campaign for the Topera device(s) and software. The Boston AF meeting notes posted here a few weeks agby researcher - AFIBBERS FORUM
Why would a competent doctor even mention Maze for flutter? I would look for a different EP right away. As Hans said, look for somebody skilled in ablations in case there is something more complex than flutter.by researcher - AFIBBERS FORUM
Some cardiologists are still way behind the curve. If the basis of the thought of less is more is that we don't yet have understanding of AF origins, then everything is suspect including drugs, cardioversion, etc ... It is a really weak argument against ablation when the benefits on reducing stroke risks are so stark. I think if the cardiologist's argument is valid, then less is moreby researcher - AFIBBERS FORUM
Heather, Best wishes for a successful procedure.by researcher - AFIBBERS FORUM