Having ablation done in Austin in a few weeks

I had one done (standard PVI only) at Cedars Sinai in Los Angeles in July, it was not successful.

I'm having a second one done in November in Austin by Dr. Natale.

I hope it is successful. I'm having a hard time determining what the odds of success are, I wish I could get a bit of a better idea.

I'm 52, very healthy, at ideal weight, active, no other health issues whatsoever. I don't smoke, drink alcohol or even drink caffeine. I have persistent long-term (at least a year, probably much more) afib.

My biggest concern is my left atrium is enlarged. At my last CT 4 months ago, they said it is 190ml, while normal is around 70ml. I'm trying to figure out how that affects the odds of a successful ablation, but haven't found much.

My second concern is affecting the LAA. My understanding is that Dr. Natale will not ablate that unless absolutely necessary, and even if he does, there's still a 50% chance that it will still pump effectively enough.

Thoughts?

I probably should have posted this as an update in my original thread from June, which has more detailed background info

[www.afibbers.org]

Also, I did have a sleep study done, and they found mild sleep apnea (shallow breathing, not the wake up gasping type. I don't wake up during the night). My blood oxygen would sometimes get as low at 85%. I had a second one done where they fitted me with a CPAP machine, which I should be getting this week.



Edited 1 time(s). Last edit at 10/15/2017 04:45PM by Mac.

I don't think anyone can give you realistic odds, but I think you've chosen the guy who will maximize them. The enlarged atrium isn't a good prognostic sign, but Natale successfully ablates people far worse off than you on a routine basis. His success rate with difficult cases is higher than most EPs' success rate with first-time, simple cases.

I underwent an ablation with him 7 weeks ago. Wednesday is the end of my 2-month blanking period, and I haven't experienced so much as a stray PAC since the procedure, which is truly remarkable considering my history (15 years of paroxysmal afib and flutter, 5 failed ablations in 7 years). I think you made the right decision and you'll come out of this free of afib in the end. Good luck and make sure to post an update!

You will do just fine Brian, send me your date and we can chat again before you head to Austin as well,.

Your LA diameter is not close to the largest Dr Natale has successfully ablated, I can promise you that, having seen your report LA measurement.

You made the very best choice that is humanly possible;e to make, up front, for your second procedure and that is what really counts most in the long run. So you can truly relax in that knowledge and it is very much a reassurance to know you did the one job you are called on to get right in this business.

One thing I can tell you too with great confidence is that after this procedure with Dr Natale, at least 98% of your entire dealings with Atrial arrhythmia will be behind you in the rear view mirror! It could we'll be 100% done too very easily, though I cannot call that for sure whether or not another brief touch-uo might be required, but the vast majority of your journey toward long term freedom from all AT will be done in November!

Be well and lets talk soon!
Shannon

Thanks Shannon! I appreciate the encouragement. I'm confident it's the right path, but am starting to get a little jittery as the date gets closer, flights and hotel are booked, etc.

That is what I am for Brian:-) ... I am the pre-ablation jitter tamer ... Ha! . ... AFIB is the ultimate mind twister! It loves to play games with your head. Especially after fixing an ablation date and then for many Afibbers suddenly their hearts go stone cold quiet all the way leading up to the ablation. That is guaranteed to make your mind jump through a hundred hoops of "What If" speculation,. My job is shooting down those clay pigeons of doubt that arise so predictably some folks are suggest I must be clairvoyant (no, I am not since I can often so closely call what they are thinking of in the weeks and days leading up to an index ablation. It is just good ‘ole human nature at work.

No worries you will be fine!

Shannon



Edited 1 time(s). Last edit at 10/16/2017 11:50AM by Shannon.

I finished mine 3 weeks ago. The process is Austin was the smoothest by far I have dealt with and I had three ablations prior to Natale so I do have something to compare to. Don't worry, you'll arrive, before you know it you'll be put under, you'll wake up and go wow that was easy what's for dinner.

Good luck Brian, though you don't need it, as you have made your own luck by choosing Dr. Natale and all the great folks at TCAI/St. David's.

We are of similar age, and I too had a failed ablation back in February that actually made my afib worse and added flutter. Since June 08 it's been wonderful NSR.

When you get that CPAP machine, stick with it every single night. I have one also, and it has had far greater impact than I ever imagined. I started on the sleep machine about 5 days before my Texas trip. I adapted quickly.

I had my first ablation last week with Dr. Natale. I was persistent Afib and in the consult prior to the ablation he said he thought my chances of needing an additional ablation were 35-40%. I did not have an enlarged atrium. He did have to ablate in the LAA but did not isolate it.

Your decision to go to Dr Natale is the best one you could have made. Good luck with your procedure!

Mike

Thanks all!

So, Mike, how did yours go? What was the result?

Fibrillator, how was your result?

AB Page, congrats! I know what a relief that must be. Hoping to join the NSR club soon.

On the CPAP machine, I did a test night for fitting and had no problem sleeping. It felt like I got a great nights skeep. I'm actually looking forward to getting the machine this week.



Edited 2 time(s). Last edit at 10/17/2017 12:27AM by Mac.

Well, I'm only 6 days into recovery but so far I am still in NSR. My recovery has been slowed by a cough and cold that has necessitated an antibiotic. I had the symptoms prior to the ablation but we (Dr Natale and I) decided to go ahead since the symptoms seemed to be getting better. Perhaps the throat tube aggravated the cough and sore throat but my cough got significantly worse after the procedure.

However, none of this negates the fact that Dr. Natale did a great job and I am in NSR.

It will be one month in 2 days for me and I am afib free right now and have been since procedure with maybe excepetion of 10 second run or so around week two but I don't no for sure it was Afib of course. This is the longest I have been afib free in over a year. I am still on Multaq for another month but a key difference is Flecainide, Tikosyn and Multaq prior to this ablation were essentially not working, so big difference. I've been doing this too long to declare victory yet but feel very good about the direction and current situation.



Edited 1 time(s). Last edit at 10/18/2017 08:29PM by Fibrillator.