Follow up TEE

I had a Natale ablation in November 2019 with LAA isolation.

I need to schedule an appointment for a TEE.I live in Maryland and plan to drive to Austin.Do you think it is safe in regards to covid or should I wait?

Did you contact and ask Natale’s NP? Perhaps you can get it done locally.

Covid19 is going to be around for a while. I live in CA, the highest covid19 state and had my Natale LAA ablation just last Thursday. I just asked everybody to wear a mask and face shield.

I’m curious on what advice you get from his NP.



Edited 1 time(s). Last edit at 09/08/2020 07:07PM by susan.d.

The TEE they require post-LAA isolation is a difficult one with very specific requirement that they've had poor results from using outside providers, even when those providers thought they understood the requirements. You can definitely use a local provider -- that's entirely your choice -- but do so with the knowledge that it may not be adequate and they'll require a repeat so you could end up doing it twice.

Definitely talk to your NP if you're considering driving. Maryland to Austin and back is a hell of a long drive that will probably involve more exposure than flying would. They have other providers who understand their requirements and are capable of meeting them much closer to you than Austin. Do like Susan said and talk to them. Would you rather drive to Philly, NYC, or Austin?

Carey, ballpark estimate (based in each individual case I speculate) how soon after a LAA isolation does one generally get the TEE? I did ask when I woke up but the anesthesia made me fuzzy. I sort of remember 6 months but I maybe wrong. I’ll ask during my next appointment. Just curious since it was brought up.

How invasive is a TEE compared to a NM LUNG PERFUSION VENTILATION test? I had that done once. It was easy. Does a TEE usually require twilight anesthesia?

Good luck Mari! I wish you a lifetime of success in nsr!

You weren't as fuzzy as you think. They generally want the TEE at 6 months.

A TEE is (or should be*) a trivial procedure. It's a dose of propofol to knock you out and 10-15 minutes of having a tube down your throat while you're unconscious. Total time is maybe 2 hours with an hour of that being prepped (you know, stupid gown, IV, etc) and being bored waiting for the doc to show up, and then 45 minutes being bored waiting for the drug to wear off and for the nurses to come and discharge you.

* I said "or should be" above because some practitioners leave you awake for the procedure and have you gargle a numbing agent to paralyze your gag reflex. I would not agree to such a procedure if I had any choice whatsoever. Also, others may use something other than propofol such as Versed or ketamine. I would agree to those but only as a distant second choice.

I’ll get it done with Natale or under his np’s umbrella protocol in TO. They know I like propofol. The glitch is I’m allergic to iodine catScan contrast. I read a TEE uses a dye. No big deal but I will have to take 3 days of steroids beforehand and Benadryl the day of and a day afterwards if the dye contains iodine. It’s just annoying.

I don't believe they use a contrast agent for the type of TEE we're talking about.

Quote
Carey
I don't believe they use a contrast agent for the type of TEE we're talking about.

You are right. I asked today during my np visit for 127 hr accelerated junctional rhythm. I’m happy it wasn’t flutter because it’s a circus to get covid19 tested and deal with admission and zapped and skin burns. I’m burned out (pun) with getting ecv’s. Not that tachy is a picnic but it’s doable.