Hey Denver and George, I'm gradually getting past the Broncos loss to the Ravens when they had the game won only to give it back at the end of regulation time in the game, snatching defeat from the jaws of certain victory. Always a tough way to lose a big game they very much could and should have won. Been a die hard Bronco fan for 45 years! As some consolation, the next couple yearsby Shannon - AFIBBERS FORUM
One other thing, The Lariat procedure is not just for those who have had LAA isolation ablation and subsequent Trans-Esophageal Echocardiogram shows a delayed blood velocity emptying from the LAA below 0.4m/sec and with a corresponding absence of a consistent A-Wave on Doppler Echo imaging. It is also indicated for those with AFIB who have not had an ablation, but who cannot tolerate Coumadby Shannon - AFIBBERS FORUM
This link is to a very clear and mostly self explanatory animated video of how the new Sentreheart Lariet -II Left Atrial Appendage closure device to help minimize or eliminate stroke risk in AFIB, is installed and works. Lariet-II procedure. Note: you must have the Windows Media Player plug-in actively downloaded and installed in your browser to run the video. Or just use Internet Exploreby Shannon - AFIBBERS FORUM
One correction to my statement above that I didn't notice any precipitating triggers or feeling of my atypical left flutter about to start at any time in between my AFIB ablation and before my LAA isolation . On one occasion about a year and a half ago, I had a Jamba Juice that had an extra amount of crushed ice in it and as soon as I took the first sip ... BAM! I was in high speed flutter aby Shannon - AFIBBERS FORUM
Hi Mary, Back again ... The description of your flutter very much sounds like atypical left atrial flutter ... not the totally different and much easier typical right atrial flutter that Tom P and Gordon above reference. This type of flutter characteristically develops after an AFIB ablation. In the effort to ablate and end the AFIB the nature of the burn patterns and what they have to do tby Shannon - AFIBBERS FORUM
Thanks Hans, And a very Happy New Year to you and Judi as well! And this is an interesting and certainly plausible explanation for the welcomed effect you have discovered! I too was often triggered by cold liquids or too cold ice cream etc and a good while ago switched to mostly room temp water. In any event, should I ever have any flippies or that feeling again, I will know what to do andby Shannon - AFIBBERS FORUM
Yep I thought I was a goner with that initial 1 to 1 flutter episode and teh Dutch EP converted me at least with a large dose of IV Amioderone to a more normal AFIB/FLutter that was then 24/7 from that point onward until my ablation a little over two months later in Austin. And every EP who saw that ECG after the PIP Flec trigger said to me, "That's it for Flecanide for you, never riskby Shannon - AFIBBERS FORUM
Hi Tom. Am just back online after the last ten days mostly off the computer while traveling. Technically, all atrial arrhythmia's above 100bpm are classified as a kind of Supra Ventricular Tachycardia ('supra-ventricular' = originating above the ventricles or atrio-ventricular node). There are some minor differences between Atrial flutter ( whether it is typical right-sided oby Shannon - AFIBBERS FORUM
Great stuff PC! Glad to hear Pr Jais tracked down the flutter and zapped it earlier this year. Note sure when you started visiting the board again but I had a similar scenario too with my left atypical flutter/tachy being taking care of with an LAA isolation ablation this past august with Natale in S.F. Heart has been quiet as a kitten since. And for me as well, the flutter/tachy never once cby Shannon - AFIBBERS FORUM
I'm just at end of my four month post LAA isolation ablation blanking period which is techically over in 48 hours . And have not had a single solitary blip of any kind other than a few random PACs here and there. No flutter at all ( and not a blip of AFIB since the first ablation 4 and a half years ago) and don't expect any now .. knock on wood. Feels really good to see this beast stby Shannon - AFIBBERS FORUM
Thanks researcher for another interesting find, It certainly looks like a promising avenue of research, if for nothing more, than perhaps gaining greater insight into the autonomic triggers of AFIB via the CNS? A few questions jump to mind after reading this new renal artery denervation plus standard PVI only ablation approach. The published one year success rates of only 69% for PVI plus rby Shannon - AFIBBERS FORUM
Hi Steve, My second ablation with Dr. Natale in which he isolated my LAA was a piece of cake. Especailly compared to the much longer original needed to take care of the persistent AFIB.. which he did. I was up and about and out of the hospital before noon the next day after this one and was visiting with friends in Marin County the second day after ablation as well as taking a nice slow and eaby Shannon - AFIBBERS FORUM
Such short runs of PVCs are not necessarily at all a precursor signal for return of AFIB Lorenzo. I wouldn't worry too much about it at this time. It may well just be an indication of needing better magnesium and potassium repletion. Look up the 'PAC-tamer' links here in the search function for recipes for maintaining good Mag/Potassium levels and if you haven't yet studiedby Shannon - AFIBBERS FORUM
Thanks for that McHale, Very interesting article. I had read previously that the shape and size of the LAA can influence stroke risk and that the more persistent and long duration one's AFIB is, the greater the likelihood the LAA can grow in size and develop more lobes etc, but this is the first study with such definitive LAA shape categories correlated with increased of decreased strokeby Shannon - AFIBBERS FORUM
Hi DGM, First of all I want to answer your last question from your reply above. No. I am not saying that all left flutter after a first ablation arises only in the LAA. As noted below, in less than 30% of patients requiring a follow-up ablation was any LAA involvement discovered at all, and that includes people with both AFIB episodes and left flutter. So you are not at all automatically fby Shannon - AFIBBERS FORUM
Hi DGM and George, Yes indeed, Dr. Natale addresses GPs as and when they are found to be trouble spots in each patients. Some of the anatomical areas he addresses and ablates outside the PVAI also include areas of GP overlap and involvement. The same is true for rotors area which often overlap these over focal hot spots beyond just the PVAI. Dr. N also addresses other focal hot spots like Cby Shannon - AFIBBERS FORUM
Hi DGM, Alas, I know your question and this territory very well. Rest assured though, you've made the most important step you can towards giving yourself the best odds for a good long term outcome by choosing Dr. Natale to do the work. He is at the forefront of tracking down errant flutter circuits and the other triggers outside the usual areas. So even if you wind up needing a 'tby Shannon - AFIBBERS FORUM
Hi EB, Yep this is a good case study, and was mentioned in another post, glad you put the link up. I had sent a couple of these articles as PDFs to Hans for me to link to on the site, but got side-tracked with other things the last week and posting the link slipped my mind. This article is one of a number studies coming out showing increasing awareness and investigation into the LAA as a keby Shannon - AFIBBERS FORUM
Neroli and Laura, You should absolutely have your EP prescribe a PHilips InRatio-2 home INR meter.. Its a god send! That is a reliable machine, and the only trick to getting excellent comparable results to the venous blood draw is to compare each new box of 'strips' you get from Philips ( 12 strips per box and or ask for two boxes at a time with the same Lot number particularly forby Shannon - AFIBBERS FORUM
Hi Neroli, You mentioned your COPD and need for oxygen, is that something you need every day now? And can you give us an idea of your age as well? Just curious since if I understand it correctly this was your first ablation right? Were you in persistent AFIB or if paroxysmal had you any long episodes exceeding 24 hr duration prior to the ablation? Dr. Natale told me that he has discoveredby Shannon - AFIBBERS FORUM
Hi and Wow Neroli! What a roller coaster ride!!! So glad you are on the mend and that you went to the Pulmonologist as soon as Joan recommended you do that ASAP! Although it sounds like by that point it didnt take much convincing to get you there? And aspiration pnuemonia of all things ! .... that is a first that I've heard of from anesthesia during an ablation, though I guess it hapby Shannon - AFIBBERS FORUM
Hi MIkej, Top EPs on a redo will first confirm if any PVIs have reconnected. The more skilled the EP, the less percentage of his cases will have reconnected PVs to begin with. Then they check other anatomical structures and all other potential 'hot spots' either at ganglionated plexi, CAFEs or at the LAA as does Natale's group and Bordeaux. Keep in mind that one of the mainby Shannon - AFIBBERS FORUM
Agree too Diane, not wanting to be on cardiac drugs for life is a good reason too to go for ablation, especially since most of those drugs stop working at some point even when a person is 'lucky' enough to get a number of years of decent performance out of a drug like Flecanide. They also take a toll on the body. I was referring mostly to giving the nutritional support a really goodby Shannon - AFIBBERS FORUM
Good points Researcher! I agree fully with everything you said. And you are right too the Stereotaxis is a great concept, especially for protecting the EPs and staff from excess radiation, but both Dr. Haissaguerre and Dr. Natale told me they mainly use it for VT and other special cases where manual placement difficulties warrant its use. Maybe someday they will get all the magnetic techologby Shannon - AFIBBERS FORUM
Hi Namor and McHale, Namor thanks for the interesting smaller second preliminary report of a 14 person group of people ablated with FIRM guidance, it’s always good to keep one’s eyes and ears open for new and possibly advantageous developments in the AFIB world. However, in my view it’s still much too early to get too overly enthusiastic over Topera and FIRM ablation as some world-changingby Shannon - AFIBBERS FORUM
Dr. Natale warns strongly about drinking ANY alcohol after an ablation. Especially in the blanking period and for up to a good year or more at least until you know for sure you are stable and out the woods. In reality, any afibber that has required ablation should just swear off for good if they are smart about it at all. A glass of wine on a special event might be okay after some time. But anby Shannon - AFIBBERS FORUM
Hi Nancy, Most of us cane sympathize for sure, no fun at all having to deal with all that and especially with new docs you have to partially 'train' before they realize you know your body very well. Researchers link to the new Journal of AFIB that Dr. Natale hosts as editor is a excellent issue. I encourage you too to read that last article on AFOIBS effect on blood flow reserve.by Shannon - AFIBBERS FORUM
Diane. I paid only $1,400 out of pocket for my $81,000 total bill for a 2008 Natale ablation in Texas that included a 4 days hospital stay. So far I have only received the portion of my most recent LAA isolation ablation bill with Dr. Natale that was submitted to insurance and that shows the overall cost for the whole ablation itself including all catheters, imaging equipment used, drugs uby Shannon - AFIBBERS FORUM
Great to hear Lee of your wife's .. and your .. success! A number of us here by now have also had our left atrial appendages (LAA) isolated by Dr. Natale since your wife did in what was obviously a very early case of him doing so. Its true too, that Dr. Natale is one of the top pioneers of not only Left Atrial Appendage isolation when it is found to be a principle, or in some cases eveby Shannon - AFIBBERS FORUM
Hi Cindy, I'm glad you found the overview of the Lariet-II procedure helpful! We are all in this together and learn from each other that's for sure. I'm very sorry too to hear of all your trials and tribulations of late with your difficult time getting this beast under control, which thankfully seems well on the way to being so now, and your fall and injuries, followed on tby Shannon - AFIBBERS FORUM