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Re: Ablation questions
June 01, 2018 12:29PM
Quote
mwcf
vanlith,

Cost at Bordeaux is 16,555 Euro 'all in' including 4 nights stay in hospital accommodation for you and your partner (they monitor you via telemetry for 3 days after the procedure).

One needs to bear in mind, however, that a second 'touch-up' procedure - as and if required - would cost the same again. To the best of my knowledge a typically paroxysmal AFr would be looking at a 70-80% success rate for one procedure alone at Bordeaux.

Hey Mike, do you know if they ablate inside the LAA as Natale does (obviously neither would likely do that on pass #1 since that is the most conservative approach)?
Re: Ablation questions
June 01, 2018 12:48PM
Quote
Pompon
Carey, Wolfpack,
I'm sure you're right saying the best EP can ablate any ectopic he wants. But this supposes any ectopic showing up while the patient is in the room. I'm sure the best EP can make them showing up.
But I think it's not that simple.
My experience makes me think new ectopics may appear in the weeks or months following the ablation. We're all different. In my own case, it's like a battery charging (I don't know how and why) then needing to discharge when it's full. Now that the easiest paths (PV's) are ablated, the battery searchs for other paths. The smaller, the harder they are, the more I have PACs. Some days, I may have ten thousands of them. The following day, my heart would hardly miss a beat. Just like the day following afib. So, what discharged in less than 1hr of afib before my recent touch up procedure now needs hours and hours of ectopics.

My heart works exactly the same way WOLFPACK...it seems after i PIP with chewing 3/4 of a 150 mg propafenone within 5-7 min. of the start of my ARR ( that kills it in about 45 min. usually).....i am symptom free certainly the rest of that night because 95% of my ARR's happen in bed...so i can go back to bed (after the termination) and lie on my back or left side the rest of that night that are normally mostly no no's any other time but not right after an ARR. and that feels great knowing i can get relief for 1 night anyway and sleep well. Also as you said the next day is pretty much pac free and extrem. rare to get back to back ARR on consecutive days....but around the 48 hour mark it starts building again and the pac's return in earnest then usually between the 3-6 day mark when the heart is "fully charged" as you said its off to the races again.

I just noticed on another thread WOLFPACK you take Propafenone also....do you PIP with it or do the normally 150mg every 8 hour thing....i gave that try for a short period but did not prevent my ARR's...works incred. well for me to convert out after i go into an ARR. but cannot prevent that from happening in the 1st place.



Edited 1 time(s). Last edit at 06/01/2018 01:01PM by vanlith.
Re: Ablation questions
June 01, 2018 02:26PM
I only took the one PIP propafenone last month and haven't had to again. Prior to my ablation, I was on the XR version 2x/day.
Re: Ablation questions
June 01, 2018 04:09PM
Quote
GeorgeN
Hey Mike, do you know if they ablate inside the LAA as Natale does (obviously neither would likely do that on pass #1 since that is the most conservative approach)?

They don't ablate inside the LAA. They isolate it, much as they do the pulmonary veins, although unlike the PVs where you want 100% isolation,
they try to minimize the amount of isolation in order to retain as much contractility within the LAA as possible. And it is sometimes isolated during index ablations, especially with persistent afib.
Re: Ablation questions
June 01, 2018 06:40PM
George,

That's a question I don't know the answer to I'm afraid. I'll ask next time I email Prof Jais and let you know. I suppose as a fairly straightforward paroxysmal AFr it hadn't occurred to me that I might need any ablating of the LAA.

Mike
Re: Ablation questions
June 01, 2018 08:31PM
Quote
mwcf
That's a question I don't know the answer to I'm afraid. I'll ask next time I email Prof Jais and let you know. I suppose as a fairly straightforward paroxysmal AFr it hadn't occurred to me that I might need any ablating of the LAA.

He won't know if he needs to isolate the LAA until he gets in there, but given his success rates I'm sure he sometimes does, just as Natale does.
And as I said, they never ablate inside the LAA. They only ablate around it to isolate it.
Re: Ablation questions
June 01, 2018 09:45PM
Carey, my mistake, thanks.

Yes, I'm guessing they do isolate if they need to, but a good question to ask.
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