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Hi Duke, A point to clarify in Jackie's ablation report, it took a similar time frame to do as her first paroxysmal PVAI in 2003, but that's because it mainly involved CS and LAA isolation which are more time consuming to perform. But her overall procedure this time was not more extensive in burns overall. And Dr Natale had to redo only one single burn only to re-isolate one of hby Shannon - AFIBBERS FORUM
Hi Anti-AFIB, some of the info you shared above in this thread from other docs and journals that you have gathered above have some merit, but a number of these ideas are misinformed. One case in point is the case made above for anti-coagulation for low risk paroxysmal patients with a CHADS2 score of 0 which is overstated, though well intentioned no doubt, it's more a matter of over emphasisby Shannon - AFIBBERS FORUM
Hi Barb, Thanks for asking and all is doing good here. I'm pretty much back in the saddle now and looking forward to the follow up TEE on Oct 1 after which I should have the green light to drop the Eliquis for good. Hope you are doing well too. Take it easy, Shannonby Shannon - AFIBBERS FORUM
Hey Jackie, Great to hear your formal report and Im so pleased you are on the other side of this fence now. It's certainly been quite a journey and each of us with so many years under our belts have a unique journey to share, though with so many common hallmarks and landmarks along the way. The PVCs will typically settle down with the lesion healing and the nutrient regime should helpby Shannon - AFIBBERS FORUM
Hi Gill, First of all, this rather misinformed 'newbie' doesn't even have a track record with persistent AFIB with only 100 total ablations under his belt .. if that many. At least in the US, EPs usually aren't asked, nor do they seek, to address persistent AFIB, at least solo, until they get further along the learning curve. He is just talking out of his hat kind of like aby Shannon - AFIBBERS FORUM
You are welcome David and Duke, And yes Duke, with the extended PVAI ablation that Dr Natale and all members of his group perform, the ablation of a number of GPs is inherent in the procedure itself. but that is more incidental to the pathway of the circular lesion sets around the PVs and the posterior left atrial wall which bisect these GPs during an extended PVAI, rather than as a specific tby Shannon - AFIBBERS FORUM
Be glad and count your lucky stars this new fangled EP said he won't be seeing you again Gill! Its stunning the level of misinformation there exists among some doctors ... this is why we always urge a high level of discrimination when choosing and ablationist or even just an EP to listen too. You can easily get a can of worms if you are not vigilant and rather demanding ... all of which yby Shannon - AFIBBERS FORUM
Thanks David, yes I didnt think Duke was going for an only GP ablation ( and I edited some of the above post to make that more clear), but I also wanted to urge him and others not to jump the gun too quickly in assuming that ablating GPs automatically is an effective thing and should alway be done. in your case I think its a good idea as noted above, it will only insure you will get more than jusby Shannon - AFIBBERS FORUM
Duke, you are going to get GPs ablated as an inherent part of the Natale PVAI that you are in the cue for so no worries either way ... But keep in mind that Ganglionated Plexi ablation is still a very iffy procedure and Sabine Ernset only has her hunches and hopes at this point, which is fine, but does not really know yet how it will pan out. Hence the trial she is doing to try to find out if itby Shannon - AFIBBERS FORUM
Peggy, Dr Jackman has been a long time pioneering AFIB and arrhythmia researcher and has made some key contributions particularly in the earlier days of ablation development with helping to design tools and procedures etc. While he technically does do some ablations still, that is not considered his main long suit and at this stage he is mostly a respected leader, educator and lion within theby Shannon - AFIBBERS FORUM
Hi David the jury is still out in GP ablation. The Oklahoma group she is referring too is Sonny Jackman's group who has basically single handedly been leading the charge about this concept though with mostly lukewarm interest from the bulk of the EP community based on some rather equivocal results in the body of what testing and investigation that has been done so far. It is certainly a wby Shannon - AFIBBERS FORUM
Pacemakers are handy little devices when you need them, I've had one for 12 years now though I no longer have tachy Brady. Many algorithms have been tried for Atrial pacing control to interrupt atrial tachycardias like AFIB with pacers but the record has been pretty dismal at providing real control . Sometimes making the situation worse. I never hear of anyone recommending pacemakers nby Shannon - AFIBBERS FORUM
Yes then can bill medicare for the phone call it takes to monitor the INR and its usually the doc nurse who does those calls and keeps track of a patients self test INRs. And Medicare will pay for the home monitor for patients though you will have to pay some portion of the amount for the testing strips. Its very much worth it to get the most from Warfarin. Shannonby Shannon - AFIBBERS FORUM
I literally don't know of any EPs that still prescribe Pradaxa with its poor safety profile and significant GI and difficulty stopping severe bleeding, with the somewhat safer and effective Factor Xa inhibitors Eliquis, Xeralto and soon Lixiana (Edoxaban) out there, or soon to be. Warfarin with a good home meter doing weekly INR tests I would take fur sure over Pradaxa. Thanks for the linby Shannon - AFIBBERS FORUM
Alexe, Have her get tested by an MD trained in BioIdentical Hormone Replacement therapy for vasopressin deficiency. It is very common in us generally older folks and yet frequently completely overlooked in many health screening exams. Thin deeply wrinkled skin and deep set eyes are a couple signs, and having to get up to pee more than once in the night is a strong hint it could be a problem asby Shannon - GENERAL HEALTH FORUM
researcher Wrote: ------------------------------------------------------- > Shannon, I didn't realize that your Lariat > procedure failed and I am glad that it was fixed > via Amplatzer. The St Jude medical site's > explanation on Amplatzer is lacking in detail. I > pasted a link below that shows how it is done and > that device is offered in a big range of sby Shannon - AFIBBERS FORUM
Hi afjune14 The LARIAT was a better fit for me than the Watchman as I not only wanted to get off blood thinners, which for me was the second most important attribute I was seeking, but a successful LAA closure via full ligation of the LARIAT also confirms the LAA electrical isolation I mentioned above and reinforces the LAA isolation ablation I had in 2012, giving me the best overall odds of bby Shannon - AFIBBERS FORUM
Im sorry to hear that John, but as you know this is possible even in a procedure that will prove successful longer term, once the inflammation settles down and the lesions are healed up more. I don't have a lot of experience following Cryo-ablation residual breakthroughs, but I know its always a bit disappointing when that happens in any event, just hang in there and there is still a goodby Shannon - AFIBBERS FORUM
I received notes from two of you this afternoon asking me to re-post the two links to the three angiogram photos I originally linked to this morning, though buried further down within the first thread summarizing my stroke, LAA leak and repair procedure. I was asked to post these two links in a separate thread where they are easier to find than it the original thread so here they are for any whoby Shannon - AFIBBERS FORUM
Craigh Wrote: ------------------------------------------------------- > Thank you Shannon for the detailed report on your > experience. I've read the newletter and It raised > a question. If I understand the circumstance > acurately the lariet suture loosened at the LAA. > This rssulted in a hole in the center of the " > gunny sack" thus the leak. A plug deby Shannon - AFIBBERS FORUM
Thanks folks for the replies and Im glad you all enjoyed the read and got something from it. Ill try to answer the shorter topic questions from above in this post below and the couple that will need a bit longer discussion I'll address in separate posts below. *** George many thanks and yes, we are very grateful things have worked out to date in such a great outcome and with so littleby Shannon - AFIBBERS FORUM
The current Aug/Sept issue of The AFIB Report is dedicated solely to exploring my experiences over the last three months beginning with the surprise small stroke in early May up through the recent repair of my leak within the previous fully closed left atrial appendage that was the result of an initially successful LARIAT procedure performed last August 2013 exactly one year ago. We won'tby Shannon - AFIBBERS FORUM
Elizabeth, t The heart attack issue is one of the few good reasons to take an aspirin, for cardiac MI risk reduction and in the midst of an MI,. The risk reduction is mainly for those who have already experienced a first heart attack, I checked with Dr Natale and he said when he recommends a low dose aspirin to people it is to reduce such possible cardiovascular risks and is not intended foby Shannon - AFIBBERS FORUM
Good report Craig, Sounds like you are doing well indeed, the temporary SOB is just that in almost all cases, and your pulmonologist is right, minor transient occurrence of SOB can be a part of the ablation process inherently, though typically its so minor few notice it much after the first few days to first few weeks. Very active endurance exercisers are likely to notice it more in the firstby Shannon - AFIBBERS FORUM
Thanks for the correction Russ on who did your maze, I recall now too from all those years ago when you first shared with us that is was an very good cardiac surgeon doing his first mini-maze under proctored observation by Dr Schneeberger, which no doubt made you feel even more at ease going in. That is something you wouldn't likely have achieved with catheter ablation is a one and done oby Shannon - AFIBBERS FORUM
That's great to hear Russ, Dr Wolf is certainly an expert in that procedure as its pretty much his baby to start with as an extension of the Cox maze, of course. It certainly has its place as well, though as you noted the success rates for catheter ablation are more variable based on the skill and experience of the operator, it's also true that its important to chose a very skilled mby Shannon - AFIBBERS FORUM
Hi Phil, Necrosis here implies some degree of atrophy and just becoming a remnant bump in the upper left from side of the left atrium where the full left atrial appendage used to be. Over time in a fully ligated and sealed LAA, endothelial tissue will tend to seal over the seam or original mouth/ostium of the LAA and then the tissue behind that seal on the distal side of a LARIAT suture or Atrby Shannon - AFIBBERS FORUM
Hi John, Glad to hear your done with this big step and now just take the time to heal up an ease back into activity. Don't forget to reinforce you minerals and trigger avoidance during these healing phase as well. Best wishes to you, Shannonby Shannon - AFIBBERS FORUM
Hi Folks, Another brief update from Jackie today, She sounded really great and her voice was strong and clear and quite peppy really. She also remarked at how truly good she felt and not bad at all with no real pain or significant discomfort beyond some little mild tenderness in the right jugular area where the duo-deca-polar (20 pole global mapping catheter) was threated through the jugularby Shannon - AFIBBERS FORUM
You are welcome Lynn, and a few tips if flying makes you very nervous ... get a Valium or Ativan for the flight or even take a train. I flew from Amsterdam to Hawaii in full blown symptomatic AFIB/flutter at 135bpm and that was rate controlled at the time with Toprol on board then back to Austin two weeks later in same condition for my first major index ablation and a week later flew back to Hawby Shannon - AFIBBERS FORUM