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Hey Tom, Great news! Dr H, is a solid EP and. Your case was a perfect example of catching it at a relatively benign state of progression before it ran away with you too, which is another good lesson in not procrastinating too long. No worries in the indulgences in a few old triggers, to each his or her own :-). Actually, after a solid ablation(s) dark chocolate tends not to be nearly as riby Shannon - AFIBBERS FORUM
Sounds like you are persistent AFIB Smackman, and the only difference with the definition of 'long-term persistent is just that, that the duration of persistent AFIB is very long term, over a year plus without stop or conversion. Permanent AFIB is the final classification and usually is reserved for 24/7 persistent AFIB that fails all attempts at cardioversion and the patient and Cardioloby Shannon - AFIBBERS FORUM
Thanks Dennis, You have been a real trooper and I've admired very much your positive and proactive attitude with all that you have had to go through over the last year, especially with the aortic aneurysm surgery with an aortic root replacement requiring re-routing of a couple of coronary arteries as well, which in and of itself, can lead to a recurrence of AFIB, not to mention the addedby Shannon - AFIBBERS FORUM
You're welcome DD and Larry, Glad to hear things are starting to clear up quickly now that you had some treatment, as expected it would. The ECV should help zap that flutter into shape for the time being and hopefully all things will quiet down for you both. You are in great hands in any event .. And yes, a fistula, while always important to rule out when its even a remote possibility, Iby Shannon - AFIBBERS FORUM
Yes Randy , As Jim noted, the higher post-ablation HR is perfectly normal and has been correlated in several studies as with an improved outcome. Higher HR means a more thorough ablation with a greater likelihood of more transmural lesions. And as Jim also noted it can take anywhere from a low of 6 months to 2 years for your HR to return to more or less the previous normal range, perhaps givinby Shannon - AFIBBERS FORUM
Good to here, Randy! I was thinking of you knowing it was last week! Great to hear its going well, as expected in the early days. Don't worry much about a few spots along the ridge of the LAA mouth, those are more common with longer term AFIB and even with some shorter term cases. You may still be one and done and high odds for it, but even if down the road a touch up is needed to butby Shannon - AFIBBERS FORUM
Mailman52, What Dr Natale means by taking a bit more conservative approach is that he will start with a PVAI ablation and he will systematically challenge other non-PV sources to see if any other areas are triggering which is common with longer standing persistent AFIB. Its possible with Smackman's relatively young age and perhaps two year only bout with AFIB, and we don't know yet jby Shannon - AFIBBERS FORUM
Sounds like a winner KenH! While having some activity during blanking is not a certain prediction for needing one additional touch up and many people with runs of AFIB during the first couple of months go on to being 'one and done', still, the quieter that first three months the better the odds for one and done. Shannon KenH Wrote: ---------------------------------------by Shannon - AFIBBERS FORUM
HI Jackie, I should clarify my comment above that mineral rebalancing for all its major benefit for myself and so many others here should not be viewed as a 'cure', which you felt isn't correct with so many that appear to have been cured by nutritional means alone. I have and continue to universally support and promote adopting the Strategy as a first line step and encourageby Shannon - AFIBBERS FORUM
Hi PH,' I just replied to your last post in the prior thread in which you asked me the two questions and in my replies I discussed the decision to choose either Bordeaux again for a 4th ablation or Natale and let him take a fresh look at your situation. Its absolutely true either Natale or Jais will be able to tell what was previously done. The majority of Natale's work is repairby Shannon - AFIBBERS FORUM
PH Wrote: ------------------------------------------------------- > Thanks Shannon. Two follow up questions: > 1. Does Bordeaux use "contact force" catheters? > What if they don't on my chances of 4th ablation > success? > 2. More generally, and ignoring the merits or lack > thereof of Cardio Insight, do you think it is > worthwhile for me to do a 4thby Shannon - AFIBBERS FORUM
PH, You are right, an AV node ablation always includes implantation of a pacemaker as George noted above. Without one you would die rather quickly one the AV node is abated out of action. While this is rarely done these days except in cases of highly symptomatic persistent/permanent AFIB that does not respond to any other therapy including ablation, drugs and possibly maze, then this can be conby Shannon - AFIBBERS FORUM
John. The are you sure it is a SVT which as researcher said is a quite easy and straight forward right atrium only ablation? If so, perhaps Dr N is just waiting until the 9 month follow up to see if it disappears on its own and it sometimes can do. If not surely, he would recommend taking care of that in a short ablation that would not require even a transeptal puncture and has a very high curby Shannon - AFIBBERS FORUM
Hi PH, One other point in your post above, you were asking Professor Jais about getting LAA isolation and he suggested that if you didn't have any activity there in the LAA then it wouldn't do you any good to just automatically ablate that area, which is absolutely true. But by the way that was worded he may have been under the impression that the LAA isolation was a fixed conclusby Shannon - AFIBBERS FORUM
Hi Montos, RonB and Jackie, All good reports and Montos that 7+ reading is serious overdose K readings and is certainly an outlier. Do rinse and clear you mouth as RonB so accurately suggests. Also, when I took my older Cardymeter to the serum lab and did my serum test immediately in the same room right after the blood draw it would come back incredibly accurate. Over the ten times I diby Shannon - AFIBBERS FORUM
Hi Sammy, You are on the right track, just first confirm exactly what is going on with an EKG. You can always get an older model Iphone 4.5 with unused models costing very little and then add the AliveCor case/monitor that fits that model phone and use it exclusively for checking arrhythmia, but if you can catch this for sure on a standard twelve lead EKG too that is the good standard for confby Shannon - AFIBBERS FORUM
Natale typically uses around 40 watts to do the PVAI portion as well as other ticker areas of the atrial wall and lowers to 30watts along the thinner areas of the posterior wall near the esophagus just behind that thin posterior wall of the LA, as well as any work in or around the LAA. The basic equation for achieving consistent transmural lesions is combining the right ratio of wattage (powerby Shannon - AFIBBERS FORUM
Ironically Jackie, Coumadin for example and likely the NOAC class of drugs, don't have much direct bearing on reducing elevated true whole blood viscosity readings. You can have an ideal therapeutic INR of day 2.5 and still have an severely high whole blood viscosity reading using the new and only reliable Hemothix WBV machine that tests WBV in both the systolic and diastolic phases of cardiby Shannon - AFIBBERS FORUM
Typical NYT health related article filled with some generally accurate very basic info mixed in with some very misleading or outright wrong misconceptions. 'When every trace of AFIB has truly been eradicated the ONLY possible need for life long Anti-coagulation is if a TEE confirms that so much scarring from long term remodeling due to years of unaddressed AFIB might have slowed down theby Shannon - AFIBBERS FORUM
Thanks for the update McHale. There is never any doubt who does the whole show when Dr N is the EP of record on a case. He told me long ago he insist on doing all of his patients entirely as his reputation and the patients expectations are on the line each time. And Iatrogenia, The extremely limited number of PV reconnections and tiny fraction of other non-PV original burns that Natale fby Shannon - AFIBBERS FORUM
b](Thanks to Onewaypockets for releasing his nearly full ablation report. below I'll try to highlight in bold some of the terms and abbreviations along with a few observations that might be useful for to him and others here.) Report Status: Finalized Anesthesiologist ROSE, BARRY M MD Electrophyslologist NATALE, ANDREA MD Procedure Type Ablation: EPS w/Ablation of A-Fib, EPS &aby Shannon - AFIBBERS FORUM
Thanks Oneway for the excellent report, A bit later this morning I will review help translate some of the more medical-lese terms and abbreviations for those here that may not be as familiar with that lingo and what they mean and what your very comprehensive ablation implies. Your ablation and mine with Dr Natale where very similar, being the kind of soup to nuts and whole kitchen sink thatby Shannon - AFIBBERS FORUM
Windstar I second Iatrogenia's recommendation for the CPMC folks, I have been seeing Dr Natale there regularly for the last six years with just under three dozen office visits there over the years, as well as two TEE's, three Transthoracic Echos and an LAA isolation ablation and it has always been first class and smooth sailing. Also, I have the same high marks for Dr Natale'by Shannon - AFIBBERS FORUM
Great to hear McHale, Although we've kept in close touch so its no surprise and its the norm with a great EP behind the catheter. You've done well and maybe this is it already, though we have spoken about the odds with having some OSA and possibly needing a touch up at some point, but with Dr N really being so much more proactive than most and challenging the heart to find other non-by Shannon - AFIBBERS FORUM
Hi oneway pockets, After hearing your story with the longer periods of constant AFIB and the overall number of years of having it, I was figuring you might well need a more extensive first ablation. Much better to get the vast majority, if not the whole thing, done there first time. I also required a long one at almost 5 total hours duration ( which is a long time for Natale) of which 117 mby Shannon - AFIBBERS FORUM
Thanks Jackie, Ive been taking 12mg/day of Astaxanthin for a little over four years now as well. Great stuff and it has helped keep my CRP very low at 0.15 for hsCRP and that last was measured within less than only one month post my Lariat procedure. I took two 12mg softgel caps a day for the week prior and month following the Lariat. It also help similarly after my Aug 2012 LAA isolation ablaby Shannon - AFIBBERS FORUM
Can someone post a link for Smackman showing success rates for ablations done by the top people compared with the average success rates? Gill Hi Gill, I will try to finish that up tomorrow if I have time after the furnace guys finish installing a new furnace at our house in Sedona, its freezing out now and our's went kaput last week and am looking forward to shedding the polarby Shannon - AFIBBERS FORUM
A quick note to let everyone know Dennis C, Our NYC friend who had his PVAI ablation with Dr Natale last June at St. Luke's and has been doing well on the AFIB front, is just out from his big surgery today at Mt Sinai to have an Aortic root Aneurysm repair by Dr Allan Stewart who is Director of Aortic Surgery there as well. Dennis' wife, Deborah, just called me to give me the updaby Shannon - AFIBBERS FORUM
Another very interesting article there in this issue is titled : 'Exploring the Potential Role of Catheter Ablation in Patients with Asymptomatic Atrial Fibrillation: Should we Move away from Symptom Relief?" It is a very thorough look at this key issue and makes a compelling case for not just ignoring asymptomatic patients when it comes to offering ablation for them when appropby Shannon - AFIBBERS FORUM
Thats a good plan Allan, But if you have a Cauliflower or even Cactus shape LAA, you might want to consider going with a Lariat procedure .. or if you might not quality for Lariat then Watchman as second tier option. It also all depends on the emptying velocity from your LAA. While an LAA isolation can certainly make for a too low velocity to avoid blood thinners, it is very possible to havby Shannon - AFIBBERS FORUM