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If you want a second opinion on the Lariat in your case, I would definitely discuss it with Natale. Your Cardio may well not be the gy to listen too on this matter. A local Cardio, I had to see a few times in a country hospital here in northern Arizona, tried to warn me away from first my follow up ablation with Natale and then later when I first brought up the Lariat to him. He was dead wrongby Shannon - AFIBBERS FORUM
Sounds great Lon, But why did your cardio not suggest you have a follow up ablation if you are still having AFIB issues?? Did he give any specific reason even if you have a preablation TEE to confirm no LAA or left atrial clots our SEC?! In any event, Id get a consult with a true expert like Natale in the US or at Bordeaux if you are in Europe and make sure they agree ... Chances are they mayby Shannon - AFIBBERS FORUM
Iatrogenia, It's no doubt a little bit of both plus a healthy dose of looking too far into the review mirror in determining their 'feel' or sense of where ablation tech really stands now for docs especially who are not in the front lines doing ablations. This disparity also reflects the still very real gap we emphasize here between the overall quality of results from the stiby Shannon - AFIBBERS FORUM
Hi Liz,' Yes and thanks for bringing this point up. It's important not to try a so called 'pill in the pocket' approach with Xeralto or Eliquis without first getting your EP or Cardios approval as I indicated when saying you need to get this on hand supply from your Doc first. This would only be for a very short time of a few days tops. And while they warn about abruptly stby Shannon - AFIBBERS FORUM
Lon, what year did you have your ablation with Natale? If he just addressed some hot spots within the LAA, which is common when he finds activity there during a first ablation, it s quite possible the LAA is now becoming a more significant trigger source and might need full LAA isolation. In any event, check with Dr Natale as it is possible that a Lariat Procedure might do be enough to do the triby Shannon - AFIBBERS FORUM
TomB, The issue will not be resolved to the degree of confidence and satisfaction you and everyone would prefer, until and unless a very deep pocketed company or research institute was willing to fund the large scale randomized clinical trials that would be needed to get a better idea of where Nattokinase stands relative to the big pharma blood thinners. Alas, being a non-patentable substaby Shannon - AFIBBERS FORUM
Hi LOn, Really sorry to hear about your scary CVA event and glad it was so quickly and professionally treated and sounds like you will make a full and complete recovery which is a relief! This is a good example of why I think its important to also maintain and on-going natural blood thinning regime for life, even after getting the green light to go off pharmaceutical blood thinners. Itsby Shannon - AFIBBERS FORUM
Barb, you absolutely under no circumstance should stop XEralto until Dr N tells you too! As we discussed on the phone after your ablation, since you required an LAA isolation from all teh excess scarring and fibrosis that resulted in so much activity from your LAA, you cannot stop Xeralto until you get the results of the TEE in five more months. Only if your LAA flow rate is high enough can yby Shannon - AFIBBERS FORUM
Hi researcher, Dr Natale still does ablations at Scripps but only at the Scripps Green Hospital near La Jolla. His Nurse Practitioner at Scripps is Linda Couts and his secretary is named Dorie. The general phone number for Scripps Green Hospital is 858-554-9100 for those who might wish to set up a consult with Dr N during one of his periodic visits there. Since he was hired as Executive Dirby Shannon - AFIBBERS FORUM
Hi Louise, Tell your friend to tell his brother to run for the hills!! Any EP that would make such a statement in this day and age should be tarred and feathered out behind the barn! To tell a permanent afibber that a single ablation will end his entire affair with AFIB for the rest of his life is being beyond disingenuous! This type of AFIB can be the most challenging to get good long tby Shannon - AFIBBERS FORUM
Hi Michael, Don't even dare consider getting an ablation with Dr Sterns if he recommends in one breath that he would not get an ablation if he was in your shoes, and then in the next breath he says you have fully qualified for an ablation in the Canadian system now and he can schedule you within the month!! The first rule of thumb to honor at all cost is that if your EP isn't confideby Shannon - AFIBBERS FORUM
Hi Diane and Researcher, The story around the DECAAF trials is an interesting and useful one to examine in more depth, as such I started this new thread to explore it more fully with the attention it deserves. The original thread titled 'Groundbreaking Ablation Study' by Diane96883 was drifting toward to bottom of the front page so perhaps we can keep it going a bit longer with a reby Shannon - AFIBBERS FORUM
Hi Sam, Good to hear things are going well at the three month mark.. I had the pleasure of meeting Dr Nadamenee years ago in Honolulu when he would occasionally go to Queens Med Center to do ablations and worked with my local EP back then Dr Hong and we met there. He's a very nice man. No doubt he has been progressing with his CAFE approach these years. It was all the rage some 7 to 8by Shannon - AFIBBERS FORUM
Chuck, Kekora, StephanL, I realize you are all relatively new here and at this daunting process of getting up to speed with how to digest and interpret the mountain of information floating around out there. But all the lousy figures you are getting quotes on above are almost entirely from run of the mill centers and average EPs that simply underscore the very strong urging that us old-timerby Shannon - AFIBBERS FORUM
Hi Cindy! Great news on the smooth Watchman procedure!! I'm very happy for you. Sounds like a big success to me if there are no leaks at all right after installation it usually stays that way. I am set for my confirmation TEE for my Lariat two weeks from today on Monday Sept 23 at CPMC in San Fran with learning the final verdict the next day in my meeting with Dr Natale.... And yes heby Shannon - AFIBBERS FORUM
Hi Hans, I did read through the much larger study by Natale's group with Luigi Di Biase as the lead investigator listed in the authors listing on the LAA Morphology and stroke issue in low CHADS2 score afibbers. There was something like 932 patients evaluated by CT or MRI for LAA shape and size versus only 90-patients in the Japanese study. In the Natale group study they used a bitby Shannon - AFIBBERS FORUM
Hi Hans At the moment I only have the full Japanese study on hand called 'Anatomical Characteristics of the Left Atrial Appendage in Cardiogenic Stroke with low CHADS2 scores' Also there is not a clear demarcation between Lone Afibbers and those will one or more of the co-morbitities that certainly complicate the stroke risk picture for sure. And I agree it is not age, per se, buby Shannon - AFIBBERS FORUM
Hi George,McHale, Betty, I will try to answer the three questions/comments in order... George, that's a good question.. Dr N said he noticed some delay already in my LAA, no doubt from the TEE I had just before that first ablation in 08 in Austin, and that there was some further progress in that slowing velocity noted during the LAA Isolation ablation last Aug 2012. As such, we both kby Shannon - AFIBBERS FORUM
Most definitely for the vast majority of Afibbers in the Lone paroxysmal category the stroke risk is very low.. no doubt a good deal lower than Big Pharma would have us believe. Also, I'm convinced that when it really is early to middle stage ( meaning roughly within the first 5 to 8 years of AFI the vast majority without other co-factors like CVD, Hypertension, Obstructive Sleep Apnea, pby Shannon - AFIBBERS FORUM
In my experience Janet, I haven't found the supplements to work so well with taming later post-ablation left atrial tachycardias/flutters. At times they can if your activity truly is from a temporary mineral imbalance or some kind of viral or inflammatory process, but far more often the things you are discribing They are still very much worth doing but after three ablations if you are stby Shannon - AFIBBERS FORUM
Yes Bruce, I agree 'SOB' is the prefect acronym for shortness of breath for sure ... No fun at all. But your's will subside soon. Regarding atrial scar and fibrosis, its not so much that having more scar predicts the likelihood of AFIB/Flutter breakthroughs as Is implied, misleadingly in my view, with the way the data is misinterpreted in the definition of Utah Stage IV cateby Shannon - AFIBBERS FORUM
Hi Bruce, Great to hear you've taken the first big step toward a much better ablation result in this repair process your situation necessitates. Don't worry about the shortness of breath nor the water retention, it will all get better with the passing days and within a couple weeks for sure. Sounds like Dr N needed to do the whole kitchen sink scenario on you which is not surprby Shannon - AFIBBERS FORUM
Hi Chuck, An ECV cardioversion is certainly not a permanent fix .. though for a few lucky individuals it can coincide with a very long period of quiet. Getting a year of freedom from AFIB after an ECV is considered good performance. I had a total of 17 ECVs starting with the first one at the very end of my first ablation with Dr Natale when he had to cardiovert me from the elongated flutter mby Shannon - AFIBBERS FORUM
Ho Barb, Im doing fine and it will be three weeks on Tuesday since my Lariat procedure. Can hardly even see the tiny scar on my chest below the solar plexus were the Larait catheter went and the small groin catheter incision is just like any ablation. There were three groin Catheters. Two in the right femoral vein one of which was the Lariat endocardial catheter with the balloon and magneticby Shannon - AFIBBERS FORUM
You are welcome Barb, Its good to hear you plan on going for the ablation now too. I do think both short term and long term that is in your best interest in light of all the AFIB history you have shared with us as well as past efforts to control it. Don't let a temporary respite distract you either, though I had 24/7 AFIB leading up to my first ablation in 08, prior to my LAA isolatioby Shannon - AFIBBERS FORUM
Iatrogenia, As is so often the case, I concur 100% with what Jackie has just posted above. My experience too in using the very handy Cardymeter .. which I highly suggest for every afibber to have handy, even after an ablation, is that 4.1 serum equivalent potassium level on the Cardymeter or on venous blood draw was my tipping point. During the time, I was having all those left atrial flutteby Shannon - AFIBBERS FORUM
Hi Betty, Nope I haven't had the slightest evidence of lack of ANP production since my Lariat a little over two weeks ago. Have actually lost a couple pounds down to 181lbs from around 183.5 to 184lbs at 6 feet tall, which had been my steady weight for some time. That small lose of a couple pounds could well be from less exercise while I recover from the procedure. But had there been someby Shannon - AFIBBERS FORUM
Hi Janet, Id be willing to bet my bottom dollar that your EP hasn't fully addressed the main trigger source(s) for you. Either that or he hasn't been able to achieve solid transmural burns, perhaps be letting off the heat a little too quickly? In any event, SO many EPs still do not do the more complex repeat ablations correctly, even when they are busy and well known in their locby Shannon - AFIBBERS FORUM
Hi Buster, Researcher has spelled out in his post above a general overview of what I was trying to convey. However, I also want to elaborate a bit more on your question as it is very important for you and others interested in this topic to have a broad view of this issue. The main thing you need to digest is that the need to deal with life long anti-coagulation or choose one of the new miniby Shannon - AFIBBERS FORUM
Hi Tom in Hawaii, You'll have to confirm with Dr N, but I do think an intact pericardium is a prerequisite to be able to install the Lariat due to the epicardial phase with the Lariat suture system which all takes place inside that narrow pericardial space. Even if so, should you even need and want to consider LAA exclusion, there are several other options, as you know, to get the jobby Shannon - AFIBBERS FORUM