New Procedure

I wonder if this new procedure will be effective for afib. If so it sure seems less invasive than a tradition ablation.

Are you talking about the radiation ablation for Vtach at Washington U. in St. Louis? I contacted them and they said that it's in it's infancy, and the trial is only for Vtach but if anything changes they would keep my info for possibly being in on a trial for afib/flutter.

I'm not sure if the procedure has a fancy name yet, but the way I understand it, it is a combination of the new precision heart mapping technique and targeted radiation from outside the body to deaden the misfiring nerves in the heart which would preclude the necessity of the invasive ablation treatment. If you click on the link in my first post you will be able to read the article describing the procedure.

This is NOT for AFIB ablation but rather is intended, as noted in the article, to treat a specific kind of Ventricular Tachy that is clearly scar based.

Shannon

Noted Shannon, but could this not in due course evolve to be suitable for AF also?

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mwcf
Noted Shannon, but could this not in due course evolve to be suitable for AF also?

Quite possibly, but it will probably be a procedure of last resort just as it was for the v-tach patients. Irradiating the heart is about as invasive as it gets and comes with a myriad of potential consequences.

Noted Shannon, but could this not in due course evolve to be suitable for AF also?

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Carey
Quite possibly, but it will probably be a procedure of last resort just as it was for the v-tach patients. Irradiating the heart is about as invasive as it gets and comes with a myriad of potential consequences.

Touche Carey,, pretty much took the words out of my mouth. It's a promising approach for VT Scar ablation but as the .article point out, it remains highly experimental and is not even close to discussing as a primetime AFIB ablation option.

As noted in the article too, there are 'expected' significant side effects that may manifest and some not until much later ... that pesky issue with radiation ... so at the moment if it more of a last resort approach to give a VT scar patient who has failed conventional VT ablation a possible lease on some more years of life.

One word of caution too, every year or two the EP world experiences a rush or two of breathless excitement over the latest very cool sounding and promising tech or new concept around the corner.

Often some younger EPs, medical reporters and a host of eager AFIB patients can get carried away an a cloud of excited anticipation, given lift by the abundance of hyperbole that is really in short supply surrounding such 'can't miss' or 'paradigm shifts'. Every now and then the fuss and hype bears fruit and is really worth getting on board over ... but far more often such great sounding ideas wind up a pale reflection of their early promise, once they are seriously evaluated in multiple independent studies and long term investigations.

The FIRM story is a classic case in point of the latter, and saying this once promising and highly-hyped new rotor-mapping system has been disappointing is an understatement of the first order, to date.

Dr Natale many years ago, when I asked him about evaluating new technology, he cautioned that we should all keep an open mind when evaluating something really new, but with a healthy dose of discriminating skepticism too until it has truly proven itself in much of top high volume ablation research centers performing large numbers of persistent and Long standing persistent AF cases every day.

It is important, he said, to keep open to the possibly of the next great step forward, while being very cautious not to jump the cart before the horse too soon that might be driven as much by marketing departments and perhaps overly eager patent holders with a lot riding on the outcome, than it is by following the science and practical experience with patients overtime.

Dr Natale cautioned that when new tech looks promising to wait before jumping on the bandwagon until you clearly see such new tech adopted on the front lines during everyday ablations at these world renowned high volume ablation centers, before getting too excited, When you see new gear or new techniques make great headway onto these elite front lines that is a pretty reliable signs it has past muster with the best operators in the world.

But mainly keep in mind that as a patient, it is largely folly to be picking and choosing technology for your own ablation. It is far better and wiser to pick the very best and most experienced operator you can possibly access and then put all your trust in your hand chosen maestro that he or she will make the right tech choices for your care!

Cheers!
Shannon

This new procedure certainly seems tricky and risky... especially in the long term.

May be several years out before it gets widely blessed.

\L