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Since you are a Canuck (like my wife Magdalena) Atul Verma at Southlake is very good Lorraine. I’ve sent a number of people to Dr Verma who did well and Dr Verma did train with Dr Natale long ago back in the Cleveland Clinic early glory days for AFIB ablation under Natale’s vision and guidance back then up though late 2007. What ever you do though Lorraine, please Do NOT make an AFIB ablationby Shannon - AFIBBERS FORUM
Check the link below for a nice editorial about our very familiar Dr. Andrea Natale taking over as Editor-in-Chief of The Journal of Interventional Electrophysiology, taking the place of the journal’s founding Editor-in-Chief of JICE, the eminent and always kind Dr. Sanjeev Saksena. https://link.springer.com/content/pdf/10.1007/s10840-018-0492-2.pdf Cheers! Shannonby Shannon - AFIBBERS FORUM
FYI, mcwf The approximate figures are close to the mark for Prof's Jais and Haissaguerre, though they should closer to around 9,000 each at this stage of their careers, while Dr Natale is easily above the 11,000+ mark by now as the single most experienced ablationist on the planet. Though, off course, it goes without saying that anyone with approx 9,000 ablations under their belts obby Shannon - AFIBBERS FORUM
A robustly consistent A wave as seen at the mitral valve inflow is one of the three main confirmations required on the 6 month post LAA-Isolation TEE scan for the patient to be considered eligible to possibly stop their OAC drug after an LAA-iso. They also need to pass the LAA emptying velocity measure with at least 40cm/sec flow velocity from the LAA to possibly get a pass on absolutely needingby Shannon - AFIBBERS FORUM
Hi Folks, I'll post an update to the now very old NOAC report Jackie refernces above and that I shared here before takingover ownership of this wonderful resource for Afibbers founded by Hans and Judi Larsen from one of the highest volume level one trauma centers in the US from 2010/2011 time frame. This was in the initial roll-out days of Pradaxa and including insights and front line expby Shannon - AFIBBERS FORUM
Wishing everyone here a very Happy Thanksgiving who collectively make this forum such a valuable resource for Afibbers everywhere! I’m very thankful for so many things in life, including this special community who all share such a common history of the heart. And many thanks for the great support and generous spirit of sharing so many of you give freely to so many others! Best holiday wisheby Shannon - AFIBBERS FORUM
The caveat at the moment is that the evidence is still highly preliminary. Now that doesn’t mean it might not pan out and provide another good option in the treatment toolkit down the road a bit further, and the nature of the drug ... if it truly can lessen ventricular impact ... makes it worth investigating for sure, but I caution anyone that is ready to proclaim it the next second coming to holby Shannon - AFIBBERS FORUM
Thanks for the kind consideration Carey and Joywin, while I didn’t envision this thread about my sister’s death morphing into a Coumadin/OAC discussion, I certainly recognize the connection. And perhaps exploring the issue in a separate thread is a good idea. I basically just wanted to share a bit with all of my friends here in this thread about what my sister meant to me and all of us who had thby Shannon - AFIBBERS FORUM
No it is NOT automatically and inherently safe to say that just because your Electrically isolated LAA that means you can safely stop all OAC! The >40mm/sec metric refers to the LAA emptying velocity and it is only ONE of THREE metrics you must pass with flying colors to only 'potentially' earn the right to stop OAC therapy for good. Now in your case Andy, since you made the smaby Shannon - AFIBBERS FORUM
Many thanks, my friends, for all of your kind thoughts regarding Bonnie. She was, and always will be, very special to me and so many others whose paths fortunately crossed with hers. I just returned home to Sedona this afternoon, yet Magdalena is currently in British Columbia getting her elderly 93yr old mother situated in a hospice facility as well. Take care all! Shannonby Shannon - AFIBBERS FORUM
Dear Afibber's, While I have been absent from these Afibber's Forum pages for a number of months (more on all that in another post once I return from Houston), I have been anything other than idle. As usual, I have been more than occupied with the flood of Afibbers who happen to be at that point in their journeys from diagnosis to better understanding their options, where an expert aby Shannon - AFIBBERS FORUM
Hi Tom, No de hearing from you again! You know what I'll say ... what everyone above already said and I emphasize too ... you know just where to go and with no 'dread' at all! just get this thing buttoned down and out of your life for good! Cheers Shannon PS Send me a PM with your number again and Ill help get things expedited if you wish!by Shannon - AFIBBERS FORUM
Hi Barb, first it is important to emphasize that a left ventricular ejection fraction is an entirely different messurement than is the LAA emptying velocity and the two numbers have very little correlation. And a 58.5cm/sec LAA emptying velocity is not “too high” it’s very good, but you would still have to pass the Doppler A-Wave into the Mitral valve in-flow test that requires a robust and coby Shannon - AFIBBERS FORUM
Hi Beach Bill,. The convergent procedure is not as consistently effective as Natale's all endocardial approach for persistent and LSPAF ablation with many thousands more patients having undergone successful Natale Extended PVAI plus Posterior Wall Isolation, SVC Isolation and Non-PV trigger detection and ablation along with, as needed, LAA/CS isolation, and as underscored in the BELIEF rby Shannon - AFIBBERS FORUM
Hi AnnaC, Yes indeed, early onset (Prior to 70yrs old) cognitive dysfunction, dementia and Alzheimers are a significant risk for poorly addressed Afibbers. There have been a wave of good studies on the topic over the last 8 to 10 years with some excellent work done by Dr. Jared Bunch and the group at Intermountain Medical Center in Utah. You can also find at least two articles I summarizedby Shannon - AFIBBERS FORUM
Good Sunday Ducati, A Ducati Multistrada1200, is a very nice bike indeed! ... they really know how to make a first class motorcycle. It’s certainly not wise to dive right back into intensive exercise too soon after a big Index Ablation, not because your body can’t withstand the added stress of physical exertion post ablation, but simply because it’s wise to give your heart time to heal andby Shannon - AFIBBERS FORUM
Nope Mike, I would not postpone Bordeaux for another 10 years were I currently in your shoes, in hopes something cool might come from Perinexus research. As I've often suggested, learning to make peace with living in the present is a real gift and a handy talent to cultivate in my experience, including making medical decisions based on our best available evidence in the hear and now.by Shannon - AFIBBERS FORUM
Quotejpeters Shannon, It's interesting that in "Lone Atrial Fibrillation Towards a Cure", Hans Larsen described Ablation as a cure, which it certainly is not. Yes, stem cell therapy is part of the search for a cure, in this case for Atrial Fib, so the topic already has over 400 views. Via discussion, we learn the risks, false claims, and promise of any potential "cure."by Shannon - AFIBBERS FORUM
Hi Whitehaven, As for the Vitamin K2-MK7 study you quoted, the majority of studies Ive seen on the topic of Warfarin and K2-MK7/MK4 ... and Ive read a good number of them over the years ... fully support using 45mcg daily dose of K2-MK7 with a stable dose of Warfarin. Adding the K2-MK7 has been shown to help stabilize INR in many folks in whom INR was unstable and all over the map when they eby Shannon - AFIBBERS FORUM
Welcome DucatiRider (and nice bike by the way!) There is nothing inherently wrong with going for an index ablation so early in one's AFIB history, but it does make it a lot tougher to make the best decision on who you will partner with. Especially, since its very unlikely for a very new Afibber to have truly been exposed this early in the game, to the reality that making a highly-discrimiby Shannon - AFIBBERS FORUM
Good report Mike, They had a talk on this perinexus research at HRS in Boston last month, it’s stillnin early stages but certainly interesting. And of course, electrolyte imbalance contribution toward an unstable heart is no news to our forum readers. Take care, Shannonby Shannon - AFIBBERS FORUM
Many thanks for posting the links Carey! And I, too, highly recommend attending the StopAFIB Conference for those who wish to hear directly from, and ask questions of, some excellent world-class EPs including Dr Andrea Natale and Dr Luigi DiBiase (who has been Dr Natale's longest running right hand protege for well over 10 years now until taking over directorship AFIB ablation center at Mby Shannon - AFIBBERS FORUM
Elizabeth, You may have forgotten that I have long reserved the right to relocate to the General Health forum the periodicaly reappearing claims on this forum (and on most other AFIB forums from time to time) of an AFIB ‘cure’ ... in addition to other less directly related to AFIB health topics for the sake of keeping the focus on this Afibbers Forum not only on AFIB related topics, but also tby Shannon - AFIBBERS FORUM
If you sign up with Dr Natale at any of his center’s I can totally confirm that only he will be working inside your heart. His centers are NOT classic teaching hospitals and no fellows take over performing a Natale ablation. That is a cardinal rule of his that he has maintained since early in his unprecedented career as the world’s most prolific and experienced AFIB ablationists ... bar none! Dr.by Shannon - AFIBBERS FORUM
Many thanks Jackie and George, for beating me to the punch with your thorough reviews of Hans Larsen’s excellent new 3rd edition of Thrombosis and Stroke Prevention 2018!. To answer Joe’s question above: “... Was it worth buying this 3rd edition if one had recently bought the second edition ... I vote YES, indeed! Not only has Hans revised and updated many key areas of the first two editioby Shannon - AFIBBERS FORUM
Quotejpeters Well, just think how long it takes to go through 6 ablations. Ha! JP ... we can hopefully help with that caveat too! It starts by encouraging folks to partner with the most experienced EP they can possibly connect with and follow only them through to a durable permanent freedom from all AT in what should amount to an average of roughly 1.4 total ablations when factoring inby Shannon - AFIBBERS FORUM
PS ... another interesting anecdote regarding the future of cardiac related stem cell procedures is that St Davids Med Center with Dr Natale’s Texas Cardiac Arrhythmia Institute’s research department has worked closely with University of Texas Genetics Research and I believe Dell Medical School as well in the development of the first of its kind highly selective and highly purified Cardiac stem cby Shannon - AFIBBERS FORUM
Hi JPeters, I’m definitely not sensoring any mention of stem cells and AFIB, far from it! ... but I am ‘relocating’ claims of Stem Cell ‘cures’ of AFIB to the General Health forum where the topic can more appropriately be explored to every one’s heart’s content. And just FYI for the future, Thread titles with ‘Cure for AFIB’ in them almost always trigger my radar for a closer assessment, as inby Shannon - AFIBBERS FORUM
I agree Carey, it is much too early to pronounce consistent and robust stem cell-based ‘cures’ for major cardiac repair and certainly too early for promoting AFIB ‘cure’s using regenerative medicine, as promising as eventual progress in this new field will no doubt be, and will surely realize in the still somewhat distant future. And I am about to get MSC (umbilical cord derived) stem cell theby Shannon - AFIBBERS FORUM
Definitely the concesus recommendation among vast majority of high volume EPs is stopping most AAR drugs like FLEC, Propafenone, Sotalol, Multaq etc 5 days prior to an expert Ablation. Not so with AMIO where typically a bare minimum is Two weeks stoppage and that only the patient has been on lower dose AMIO (200md/day or less) for no more than 1 to 2 months. For folks on normal dose AMIO foby Shannon - AFIBBERS FORUM