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Hi Researcher, Good summary of Natale's long standing persistent and regular persistent approach as he narrated in the video. Many EPs less sure and experienced ... And yes he has at least 8,000 right and left atrial ablations since he began helping to pioneer focal AFIB approaches and worked in concert with the Bordeaux team as they developed and published the blueprint for PVI ablatby Shannon - AFIBBERS FORUM
Hi Allen, And welcome, indeed Cryo has made some real progress in the last few years, but the best suggestion is always choose the very best. most experienced and most widely recognized as a top tier ablationist you can possibly partner with, regardless if you have to travel to the next city, state or across the US to hook up with such an elite level operator. And then let the technology usedby Shannon - AFIBBERS FORUM
Hey KenKY, Yes I recall your persistent AFIB procedure and our contact back then when you were getting set up via TCAI. You certainly did have a pretty extensive ablation with a pretty wide spread, ... kitchen sink' ... array of active sources, as I recall, in that index procedure. I was wondering if you were going to be long term 'one and done' with such a history and progressiby Shannon - AFIBBERS FORUM
Ask for a 3D TEE to define LAA morphology at the same time as you get the measurements for LAA emptying velocity and doppler A-Wave consistency at the mitral inflow, that later two will be via the 2D function of the same TEE. Shannonby Shannon - AFIBBERS FORUM
All you have to do is tell Dr Natale, you don't wish to be part of a formal training ablation for any other EPs. he understands and there is NEVER any one else taping him of the shoulder or whispering in his ear while he is in the midst of doing ablation lesions inside the heart. He runs a very tight ship during the actual procedure and everyone in the actual EP lab room itself is a highlyby Shannon - AFIBBERS FORUM
Yes Researcher, most of the big guns were there including a number of EU EPs like Claudio Tondo and a few of the Dutch and German leaders in their area, plus Francis Marchlinski and David Callans from U Penn, Moussa M. from Havard/Mass Gen, Kalyanam Shivkumar from UCLA. Gerry Tomassoni and all of Natale's groups including Connor Barrett from St Luke's in New York and Vivek Reddy'sby Shannon - AFIBBERS FORUM
Ron is doing pretty good Anti AFIB and I've been in touch with him periodically since he first reported in here and he is being well cared for. Inspoke to him just yesterday, and with the weekend and Shirley being off on Friday we are just waiting on word if he actually had any Arryhthmia at all the two days last week, but Ron told me that the jumpy heart was shortly lived and occurred onlyby Shannon - AFIBBERS FORUM
Thanks researcher, the St Davds video of Dr Natale doing a long standing persistent AFIB ablation (the most challenging kind) was done I believe at EP Live 2014 three day event hosted at St Davids every other year to train EP fellows from all over the world with real time procedures to view from the large St Davids' amphitheater education room there that has a whole wall covered with huge LEby Shannon - AFIBBERS FORUM
Really relax about all that Ted, Just send you EP results showing your diagnosis of AFIB and a summary of your last EP meeting which, if they are nay good at all, should include a decent detailed summary of your AFIB history. A recent EKG and a recent Echo if you have one, perferablly while in AFIB though that isnt really necessary. You can set up to have the consult the day after you arrive iby Shannon - AFIBBERS FORUM
No it is not worth the effort Ted, you are close enough to persistent anyway in terms of the almost certainty of having at least some degree of more extended non-PV triggers that will need to be addressed in your case with so many longer episodes you have had, many of which you terminated only by ECV ... An EP of his experience can and will determine just what your heart needs during your EP studby Shannon - AFIBBERS FORUM
Hi Researcher, In John's ablation he did only the AFIB part first and the a at portion is on hold as he has been clear of VT for a while now. So he was not going that route . When doing a left sided Extended PVAI with non PV triggers as well it's very important to have a very good line and angle through the right to left septal wall... A little too high or coming from a very differeby Shannon - AFIBBERS FORUM
Great report Bill! And such good news on your relatively easy recovery. The one small caveat we just had not had much feedback on was the possibility of post surgical pain and discomfort that might last up to a month or so... But is seems that with these more precise methods of installation now as done by Dr Hoenicki and, as I understand it, Dr Dunnington who is the Bay Area Cardiac surgeon Drby Shannon - AFIBBERS FORUM
Plus Ted, your last proposition that you might be better off with a somewhat lessor but more boring EP who is not driving advances in this field is answered in favor of the top dog by the very low rates of serious complications in spite of the degree of highly challenging case load Dr Natale addresses every week. Working in such cases a less experienced EP is sure to find him or herself over theiby Shannon - AFIBBERS FORUM
AliveCor is generally fairly accurate but is often subject to excessive noise readings and too often confuses PACs or even PVCs for what it will Start is 'probable AFIB' when it is just garden variety ectopics ... Happens all the time so no one should jump to conclusions and get all worried after a successful ablation when an ALiveCor reading says 'probable AFIB' without confby Shannon - AFIBBERS FORUM
At least we got the benefits first Anti-AFIB :-)... Maybe some bragging rights for sorting it all out too... Waller Water is definitely a handy tool that Erling concocted . Shannonby Shannon - AFIBBERS FORUM
Natales group is the largest research center in the world and thus his name is on a huge amount of research as a result. The makers of software including those who research it on the front lines put the software for mapping though extensive paces in animals and in simulations long long before the first person is ever used. They also cross check it all with Fluoroscopy in real time as they go, aby Shannon - AFIBBERS FORUM
That is the problem Moerk with just cut and pasting research articles. It often lacks the nuance of the pros and cons of various research and in separating the research from one center from its reproducibility elsewhere. While DeMRI certainly can detect some level of left atrial scarring and fibrosis, there is considerable debated among top level MRI expert radiologist and Cardio/EPs as well,by Shannon - AFIBBERS FORUM
Barb, these are the very same PVCs I have found and confirm with you know who, to be PVCs in your strips that said 'possible AFIB' several times now. Just realize that when they look like that not to worry!! only if it looks much different and you feel real ongoing arrhythmia and not little runs of PVCs then let us know. Check to your diet and any new supplements that might be relateby Shannon - AFIBBERS FORUM
Natale's group will have you sign a consent form for anything that might be deemed experimental in nature with potential for any downside adverse effect. And in this field your very best bet is partnering with a guy like him. He will tell different patients different things based on what he feels is their individual risk/benefit of participating in any given trial. The vast majority of whby Shannon - AFIBBERS FORUM
Always use the stand alone ALIVE COR out of its thin case Ted, its helps get cleaner readings and you can easily reverse the leads as George mentioned, Shannonby Shannon - AFIBBERS FORUM
You can get a general idea of fibrosis from an Echo but for taking about percentages with any accuracy requires EAM electro-anatomical Mapping and controversially still perhaps DeMRI.... though just how reliably it compares to EAM which is done during an ablation remains to be seen. With Louise, Dr Natale's feeling confident she didn't need an ablation was based not just, or even priby Shannon - AFIBBERS FORUM
Ted, Dr Natale used the Smart Touch only in some cases he deems easy paroxysmal cases from the outset that will very likely not require more extensive ablation. He does get about 25% of such cases from his large work load but the majority over 75% are more challenging cases where he tends to prefer the SmartFlow over the Smart Touch. And of course he was involved in the Biosense Webster Smby Shannon - AFIBBERS FORUM
Peggy, it appears you misread my meaning. I used the word anecdotal to refer to both natural as well as ablation-related claims that are not backed up with consistent objective evidence of such a total cure claim.. as provided by a 24/7 monitoring system like a pacemaker, LINQ etc. You apparently take that to mean I was implying that anyone who is without such objective or non-anecdotal evideby Shannon - AFIBBERS FORUM
It was wonderful news Peter and very exciting to be there, so to speak, as it unfolded :-)! And your description didn't need a disclaimer you pretty much covered the reasons why you got a reprieve very well. The LAA emptying velocity and at A-Wave at the doppler inflow of the mitral valve where the LAA empties into the Mitral valve ( or more accurately where the combination of the pumpinby Shannon - AFIBBERS FORUM
I haven't had a single blip of AFIB for 7 full years now as noted by my dual chamber pacemaker which records every mode switch, so no silent episodes of AFIB either which a fair number of people do have without ever realizing it, and no doubt regardless if there present reduction or remission in arrhythmia was via natural or allopathic means. And its true that all that many going the strictlby Shannon - AFIBBERS FORUM
Apache. Yes Dr Natale does VT ablations and its not uncommon for people at his centers to require both AFIB and VT work. Typically, one phase before the other. Dr Burkhardt also does VT which is more his own specialty but Dr Natale mentored him there as well as with AFIB ablation. And its not really a sided thing as in right side versus left side when distinquishing between atrial and ventrby Shannon - AFIBBERS FORUM
Last question first, the stroke risk for former AFIBBers who have had a successful ablation process that restored full time unbroken NSR, has been shown in a number of studies (most recently in large study at Intermountain Utah) to fall to that of those of the same age/sex matched population control group who have never had AFIB. Next question, LAA morphology applies, of course, as this just cby Shannon - AFIBBERS FORUM
Tap the screen under the waveform on the right and a little option box will appear allowing you to invert the waveform. Also you can also select the "enhanced filter' to reduce the noise a bit to get a cleaner look at the waveform as well. Don't squeeze the device between your thumb and fingers either as that will increase noise interference as well. And make sure your finger tby Shannon - AFIBBERS FORUM
Send me your cell number if you wish Carole and I'll give you the direct number to Dr N's main manager at St David's who runs the AFIB center there for him. Cheers! Shannon Also, really diving into the strategy and reviewing your dietary program, though it sounds like you are doing a pretty good job there ... just perhaps need top confirm you are getting enough high qualitby Shannon - AFIBBERS FORUM
NO you dont have to be in AFIB Carole, Dr Natale, or any EP, will trigger your AFIB as part of their mapping process during the Electro-physiology initial 30 to 40 mints of your procedure where they get a thorough real time understanding of just how your arrhythmia manifests and where in the left and right atria the triggers are. As Rob noted, during a first index procedure Dr Natale will do hby Shannon - AFIBBERS FORUM