New here and grateful for this site

Hi I'm Max and I have had afib for about 2 years, I was diagnosed @ a preop check up for a total knee replacement. I knew I was exhausted and short of breath but had blown it off. I was started on Sotalol and cardioverted X2, that was effective for a week. Started on Tikosyn and it worked pretty well until the last few months. I have been going in/out of a fib and am starting to feel awful. My EP wants to ablate me-and I am terrified. I am so afraid that it won't work and may make me worse. The EP increased my beta blocker @ my last visit and I am profoundly exhausted. I do have OSA and use CPAP .Also on Eliquis. I am in the medical field and I work 45-48 hours a week, Getting time off will be a challenge. I have been reading this forum for some time and have seen some of my questions answered. It seems like everyone who had an ablation was glad they dis-is that a fair statement? And is a week off likely to be enough? Thanks so much!

What we like to advise folks considering an ablation is to choose the best EP possible for themselves. Criteria are:

1. How many complex, left-atrial ablations has he/she done? We want this number in the thousands.
2. What is his/her success rate? We define this as complete freedom from atrial arrhythmia WITHOUT the use of medication, both anti-arrhythmics and beta blockers (unless betas are needed for something else), for a period of one year or greater.

You'll likely find that these two criteria narrow the field considerably. You may expect to travel in order to have the procedure done by someone who "fits the bill". Many folks have done this, and it's not something to worry about in the vast majority of cases. You can find anecdotes and advice all over the place here. Just ask.

A week off of work should be fine. You just need to let the catheter insertion sites heal up and you can get back to normal as your body permits. It won't take long.

Don't be afraid by an ablation. IMO, ablation is a solution, not a problem.

Yes, I have found out how many he has done but am having some issues with finding out how successful they are. I get one story from the nurses and another from his office. I used to work at the hospital where he does them so I have asked around. I am going to ask more. Any other thoughts on finding out the truth?

I guess it's obvious that I really don't trust this guy. I do have an appointment later this month with another EP, who operates @ the same hospital. I think I will wait to make any decisions.

Welcome Max.

I've had 3 ablations (2 ablations with a EP local to me and a much more comprehensive Index Ablation with Dr Natale)and most likely headed for a fourth touch-up ablation since I have had a couple break through events since my ablation with Dr Natale last July. He did some work on my LAA and that's a tricky place to ablate.

Don't be hesitant in having an ablation. Be very thorough in making your choice as to who you have do it.



Edited 1 time(s). Last edit at 04/13/2019 08:08PM by rocketritch.

Hey Rich.

Good talking with you the other day! And for the sake of many newer readers here, I wanted to underscore that you had two prior ablations before your, so far, one 'index' ablation with Dr Natale. In addition, you have had struggles with the beast off and on since your 20s and you are in your early 50s now, all of which indicate a strong likelihood of a genetic influence in your case as well.

As you know too Rich, Dr Natale deliberately avoided doing a full LAA isolation on you, just to see if you might get some added milage by limiting your LAA work in this first Natale ABL to a more basic Delay of the LAA rather than full isolation just yet at your relatively young age when LAA iso is less commonly required. As such, if I recall correctly Dr Natale told you right after that first ABL with him that it was possible he might need to do a bit more work for your heart and, if that proved needed then it likely would amount to him finally needing to isolate the LAA ... and perhaps with a few quick touch up burns on the closely related coronary sinus.

And with your relatively short episodes after your most recent ablation blanking period, this is all a truly excellent omen giving you great odds for a very successful relatively small touch-up procedure during round 2 with Dr Natale very soon! And with a strong mid-90% range for being completely done for the long haul after this second Natale visit for you Rich.

One of my favorite mantras I shared with you a number of times last year during our phone 'pep rally's' prior to you heading to Austin, and that I share with all prospective ablation candidates I'm helping to connect with either Dr Natale, or the next best option for them if they can't make it to Natale for some reason to start their 'expert ablation process', is to "always expect two procedures being required for durable freedom from all AT and just be happy as a clam when it gets done in one".

So you are swinging par for the course still, and even better with a more challenging case than the average ablation patient.

When Dr Natale is working on a younger Afibber such as yourself who shows some active triggering around the LAA and/or CS, he will almost always go for an LAA delay in that first procedure, just to see how long his or her Newly restored NSR might last without full LAA Iso . But not infrequently, he will have to come back within one to two years to fully button down the LAA/CS, as the last two structures in the frontier area’s of the left and right atria that are large enough and arrhythmo-genic enough to sustain an atrial arrhythmia, and thus can less commonly cause mischief even at a younger age of early 50's or younger.

A person in their early 60s or later with a similar display of LAA/ CS triggers will almost always get the full isolation in round one.

Best wishes in the upcoming touch up, Rich, and you will do very well indeed!

Cheers, Shannon



Edited 1 time(s). Last edit at 04/12/2019 12:23PM by Shannon.

You are correct Shannon. Just throwing it out there that I have had 3 ablations without my 30 year background dealing with this was short sighted on my part.

1st ablation in 2009 at UPMC Shasyside.
2nd ablation in Jan 2018 at UPMC Shasyside which was basically just a redo of 2009 hitting hot spots where he worked before.
3rd ablation done by Dr Natale This one was a more complex ablation.
4th ablation to come will be what is considered a touch up ablation.

Sitting here today I am in far better shape than I was prior to seeing Dr Natale. Following my ablation in January 2018 my afib became persistent as the antiarrhythmic drug I had always used as PIP stopped working for me. And the new drug gave me some relief but would not maintain sinus rhythm.

My afib burden since my blanking period has been zero except for 2 short break through events that self converted and those where separated by a for period of time. The work Dr Natale has done has made a huge difference in my life and the touch up should seal the deal.