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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
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
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
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
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
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 Lynn, Are you are the same Lynn who asked the questions about Natale ablations a few months ago? If so, just wanted to remind you that we posted a rather full analysis of the latest ablation outcome study by Natale's groups and the longest one yet published anywhere by a single center with excellent long term results. That is your best source as it is peer reviewed as well in a majorby Shannon - AFIBBERS FORUM
Did you ever buy the D Mannose powder Smack? That stuff can really help with long term prostate and urinary tract infections. I just returned last Wednesday from La Jolla where I got my Lariat-sealed LAA that sprung a leak and caused a small stroke in May, all fixed and expertly plugged by Dr Matthew Price. He is a superb interventional Cardiologist that Dr Natale referred me too as an ideby Shannon - AFIBBERS FORUM
Good news Gary, Im so glad to hear you are on the other side of the fence now after such a long slug with the beast. You've now taken by far the biggest step toward real freedom from AFIB/Flutter and hopefully are done now already, but even it you still have one touch up left at some point you can take heart that it will be significantly easier going that even the relatively easy index prby Shannon - AFIBBERS FORUM
Hi David, Very sorry to hear of your TIA, the gold standard for determining if you had one, and whether or not it was from a likely embolic origin around the LAA or perhaps from a cerebral artery spasm, is via a combination MRI and MRA (magnetic resonance angiography done with gandolinum contrast dye). They should find evidence of a small lesion in the brain if it was even a small CVA (cerebraby Shannon - AFIBBERS FORUM
Hi Mark, So sorry to hear of your recent conversion back to AFIB from happy NSR. Its always a big disappointment when that happens. However, you came back to the right place with the right idea to make your absence from NSR as short lived as possible. One question, are you now in persistent AFIB? Also, have you ever adopted The Strategy protocol for magnesium, potassium and other heart quieby Shannon - AFIBBERS FORUM
Hi Jackie, Thats the thing with flutter, especially of the atypical left atrial variety, is that it is not prone to conversion by anything other than a good jolt of Direct current to the chest. AFIB is different left flutter can been tough and the real solution for left flutter is a expert ablation process. I wasted around 15 months proving that point, thinking that if I just tried this orby Shannon - AFIBBERS FORUM
Nancy its unusual for those kind of symptoms to occur this far out from an ablation and still be related to the transeptal puncture unless your tissue there is very slow healing or perhaps you might also gave a remnant PFO (patent foramin ovale) or 'hole in the heart' , and which is not that uncommon, in the same area as the puncture? A TEE and bubble study could perhaps define whetherby Shannon - AFIBBERS FORUM
Thanks too Barb. And I will give at least an interim overview of my late developing LAA leak scenario before going back to La Jolla to get that leak properly plugged two weeks from this coming Friday July 25. And prior to writing the full soup to nuts run down of that little adventure over the last 7 weeks or so, and share what I and others have learned from the experience in full for the next Auby Shannon - AFIBBERS FORUM
Hi CraigH, You can pretty much rule out any inflammatory stenosis in the carotid artery from the duo-decapolar mapping catheter threaded down the jugular vein into the right atrium/coronary sinus area for doing global real time mapping of the full left and right atriums while the Ten pole Lasso Mapping catheter threaded up through the right femoral vein along with the ablation catheter perforby Shannon - AFIBBERS FORUM
Hi All, Barb asked me to make a post for her to let everyone know she is doing just fine after what Dr Natale aid was a textbook procedure for a follow up case. No prior areas ablated needed redoing and the only two focal areas the required addressing was one new focal spot along the lower posterior wall near the esophagus area and the actual flutter trigger source was found and ablated alongby Shannon - AFIBBERS FORUM
Thats great to hear AFjun14, That means it's very unlikely for anything outside of your LAA while have reconnected that was previously ablated by Dr N. It was just at 6 years ago when Dr Natale started doing gradually more LAA ablation and isolation. If he saw any LAA triggering during your prior ablation at that time six years ago, it is very likely he would have still only delayed thby Shannon - AFIBBERS FORUM
Going straight to a Lariat is an option afjun, but first you want to make sure your only remaining triggers are in the LAA and that all other areas of prior triggering are firmly ablated and with no reconnections. Again dr Natale has by far the most experience in ablating and isolating the LAA successfully and after your multiple ablationns would absolutely be the one to consult about the next beby Shannon - AFIBBERS FORUM
Hi Barb, This well be a piece of cake so no worries, A true touch up with a targeted area, likely around the LAA which not uncommonly can require one touch up to lock things down for the long term after it has been isolated in a prior ablation as in your case. And Duke, Barb's first ablation was last August and she had a significant case from many years of AFIB and required LAA isolatiby Shannon - AFIBBERS FORUM
Randy Wrote: ------------------------------------------------------- > Shannon, I'm puzzled why Smackman was able to get > off Xarelto in little more than half the time I'm > supposed to be on it. Smackman had persistent AF > and I recall you noted Dr Natale stopped just > short of full LAA isolation. Smackman and I are > about the same age, my AF was paroxysmby Shannon - AFIBBERS FORUM
Be very careful with a hybrid approach for persistent AFIB KenKY, It has its place when compared to run of the mill catheter ablationists who struggle to get consistent results with a standard PVI for paroxysmal AFIB, and it can be useful for folks with extremely enlarged LA diameters and with very long standing persistent AFIB most of whom have a host of other co-morbities. But the hybrid proby Shannon - AFIBBERS FORUM
Hi Craigh, Should be no problem at all arranging your follow up appointments at Scripps or CPMC when your ablation was at Austin. Happens all the time. For office visits I've see Dr N at CPMC many many times while my index ablation was in Austin. Four years later I got my LAA isolation touch up procedure needed to finish my persistent AFIB/Flutter ablation process which I did at CPMC andby Shannon - AFIBBERS FORUM
I agree that Medicare with a good Medicare supplement plan filling in the gaps has been great for me as well paying almost everything for both ablations with Dr N plus the Lariat procedure as well as 14 separate Electro-cardioversions before my LAA isolation eliminate the need for any more sudden zaps at the ER at roughly $7,500 a pop for actual billing charges by a given hospital ER for a walk iby Shannon - AFIBBERS FORUM
Peter, If you stopped Eliquis in the couple weeks before an ablation and then started it back and they found a clot on TEE just before the ablation they will cancel the ablation until you've has full month on blood thinner but the is no guarantee you would get the very favorable quick slot again for the next ablation schedule. They would try tobworknti fit you in after a forced cancellatiby Shannon - AFIBBERS FORUM
Randy, The distribution of fibrosis varies and the description I gave is a general rule of thumb and not exclusive. Also, when reading ablation reports the report on the presence or lack of scar or fibrosis is also rather general and not so specific as you might think. You can have patches and small clumps of scar or fibrosis or a narrow ridge-shaped line of scar along a part or area of the ovby Shannon - AFIBBERS FORUM
The thing to do Barb is take the time now to set up the touch up which is very likely needed. McHales Flutter happened within the first 6 weeks of his ablation and no longer than 2 months which is the blanking period. Yours is at more than 7 months which is clearly beyond any conceivable blanking period. Could you have a number or months, or even longer, of quiet from here still before thingsby Shannon - AFIBBERS FORUM
Hi Barb, Like we discussed on the phone this morning, while I was hoping you would be one and done too Barb and I know its a bit disappointing but as you know and we have discussed there was a pretty strong likelihood with your degree of fibrosis and long term AFIB that you would need one more touch up, though 'one and done's' are happening more frequently these days when it usby Shannon - AFIBBERS FORUM