Uplifting article

Greetings
Nothing we didn't know but cheered me up.
Please link;
[www.newswise.com]

Be happy
Chris H

Chris,

Thank you for this web site. I will be making decisions soon about whether to go for an ablation or just keep increasing meds. This was truely uplifting for me.

A MUST READ for those interested in/contemplating PVA. An interesting extract from the article:

"Oral and Fred Morady, M.D., (the U-M cardiologist who is senior author on the paper) especially point to the increased success they’ve had by ablating areas of the left atrium wall, rather than just the juncture between the pulmonary veins and the left atrium.

The Circulation paper is a prospective randomized trial involving 80 patients with the paroxysmal, or intermittent, form of AF, all of whom had experienced symptoms for years.

Ever since Michel Hassaguerre, M.D. and his colleagues in Bordeaux, France, first described how AF is initiated by electrical impulses that originate in the pulmonary veins, ablation attempts have primarily focused on electrical disconnection of the pulmonary veins from the left atrium. However, another approach proposed by Carlo Pappone, M.D., in Milan, Italy, suggested that higher efficacy might be possible via ablation within the left atrium, to encircle the pulmonary veins.

It was not clear which approach would be best. So, Oral and his colleagues randomized patients to undergo ablation in one of two ways. Some had it at the junction (ostia) between the pulmonary veins and the left atrium (a procedure called segmental ostial ablation or SOA). Others had a left atrial ablation procedure that was modified by Oral and his colleagues to include lines of ablation in the left atrium in addition to encircling the ostia (a procedure called left atrial catheter ablation or LACA).

Six months after treatment, 67 percent of the SOA patients were symptom-free without medication, compared with 88 percent of the LACA patients. Only one patient had a complication."

88% success rate! Unbelievable progress in success rates in the last few years. It was 0% ten years ago.

Newman

Great paper. It really makes me think I will have this thing licked soon. I have a PVA in 8 months scheduled. I'am very impressed at how quick and how much attention this condition is recieving. The PVA's have come a long way and quickly becoming better and better. Within 2-3 years it will be very routine and hopefully the first line of cure offered to new AF patients. For those sitting on the fence for PVA it should make them feel more at ease with the procedure. Stay well to all!

Frank

My PVA with Dr. Natale is scheduled for tomorrow. How does this reported technique differ from his technique? Do I want to know?

All the best with the procedure tomorrow Fred - Natale is probably the best around at the moment, so you'll be in good hands.

Wondering how Jackie is......her procedure was yesterday if memory serves?

Mike F.

Hi Mike and all:
Interesting article. I wondered about the EPs at the U-M making themselves sound like the pioneers of ablation. No mention was made of CCF or Dr. Natale. According to US News and World Report, CCF is the #1 rated hospitel in this country for cardiology. The part that I was totally unaware of was the LACA variation. I wonder if the "lines" described are a maze type Xs. Success rate increase over standard PVA of 67% vs. 80% is a marked improvement. That's encouraging. This jumped out at me:

"Only one patient had a complication."

Wondered what the complication was. Death? Mitral valve damage? I can't think a way to find that out. I'm no mathematician, but I think that makes the rate of complication 0.8%?? I wouldn't have feared that, but with my luck I would have wound up being that 0.8%. Not bad depending on exactly what the complication was. Also, end results were at 6 months, which still sounds promising, but it would be nice to know where those persons will be after 2 years.

I see Dr. Morady oft published in Journal of Cardiac Electrophysiology, which I am not subscribed to, but my story was published in the JCE issue August 13, 2002; as described by Hugh Calkins. I have that issue around here somewhere and if I can find it, will enter the article.

Thanks Mike,
Pam

PS: Does V42 mean vagal type, YOB 42?

Pam,

Thanks for the response. Chris H. must take the credit for drawing the article to my attention - I merely quoted part of it.

I too thought that the LACA variation on the PVA theme sounded somewhat like the lesions formed by the maze procedure.

As regards V42 - V is (as you surmised) vagal, and 42 is my age......... not my year of birth! Quite a few other posters have adopted the same annotation since I suggested it some time ago.

Cheers,

Mike F.

Thanks for clearing that up Mike F V42

Pammie M51

What does M stand for Pam?

Fran

Fran:

M = mixed? I don't really know what I am. I am not an athelete. My afib episodes come more in the evenings, but I have also had them start in the middle of the night, or in the mornings. I don't have GI sort of triggers. The only trigger I have ever identified is alcohol, and those have been times that I would have to confess that my intake was over the line.
One of these days I will get Han's book so that I can identify myself.

Your ideas are welcome!
Pam

Of course is Pam. I should have thought about it more. But my brain is on standby...

Fran

Fran: I think your brain is always "top notch".

Pam