QuoteCarey EPs in general want you to return to normal activities as soon as possible after ablation, with the only restriction for most people being the lifting limit for the first week. Hey, Carey, do you know offhand what the thinking behind this is? (I agree this is what I've observed EPs to say, and I'm just wondering if it's "bad" beyond just losing your fitnessby kbog - AFIBBERS FORUM
QuoteCarey hoping for NSR to continue so I can stretch a return to Austin to the summer months I sure hope you like HOT weather. Made it back last week to have the touch-up ablation done. You were right Carey - it was over a hundred! But, I got it done. There was more ablating to do than I had expected - 2 of the 4 PVs had reconnected, and the posterior wall of the LA had regained coby kbog - AFIBBERS FORUM
QuoteCarey hoping for NSR to continue so I can stretch a return to Austin to the summer months I sure hope you like HOT weather. Well, I flipped back out of rhythm today, so maybe it will wind up that I try to schedule sooner after all. Damn this condition. So so tired of it.by kbog - AFIBBERS FORUM
Oops, I almost didn't see your post, Barry. Thank you to you as well for sharing your experience! So far the cardioversion is holding and I am hoping for good long-lasting results like you have had!by kbog - AFIBBERS FORUM
Cardioversion accomplished and successful - hoping for NSR to continue so I can stretch a return to Austin to the summer months, since I have two school-aged kids. This was my first cardioversion and i’m not exactly sure what I was so afraid of before. I remember nothing of either the TEE or the CV. Easy peasy - though it looks from the insurance summary that it’s not a cheap procedure! Tby kbog - AFIBBERS FORUM
Well, after almost exactly one BLISSFUL year of being in perfect sinus rhythm (thanks to index afib ablation with Dr. Natale), a good month or two of success easing back into running, etc., I noticed one day that my heart seemed to be kind of "exaggerating things" after the climb up the stairs to my 3rd floor condo. Turned out it didn't want to calm back down again, and in the nexby kbog - AFIBBERS FORUM
Hello, illustrious afibbers. I'm finally circling back after my February 2019 index afib ablation with Dr. Natale to let you all know how everything has turned out so far. First, a quick rundown of my arrhythmia history. I was diagnosed in Sept 2017 one week prior to running my first marathon. It took a month to get through a full round of tests (cardiac MRI, 14-day Zio patch, echo, stby kbog - AFIBBERS FORUM
My Kardia also started making the ultrasonic clicking noise (for no apparent reason) - my kids heard it before I did. I called customer support and was told that that sound meant it needed a new battery... I was somewhat skeptical, as I'd had it only 6 months or so and the battery life claims are much longer (1-2 years of normal use), but I bought a new battery and swapped it anyway. Didn&by kbog - AFIBBERS FORUM
I wonder if Shannon might have a specialist he could refer you to there in Paris? If not, it may be worth contacting Marla Mendelson's office at Northwestern Memorial Hospital in Chicago. She is a cardiologist & director of the Heart Disease & Pregnancy program there. (My ob/gyn referred me to her at one point.) My understanding is that she has focused over her career on researby kbog - AFIBBERS FORUM
Let’s stay on topic here, guys. Actually, I realized after I wrote my last post that the SVC is located in the right atrium. So I guess there’s my answer!by kbog - AFIBBERS FORUM
OK, thanks. I had a PVAI + PW + SVC ablation 3 weeks ago with Dr. Natale. While off flecainide in the 5 days before the procedure, I kept going in and out of rhythm, and the ECGs they did both the day before and the day of the procedure showed typical atrial flutter. Since I'd had a CTI ablation in February of 2018, I was surprised that this was possible (however I now understand that, soby kbog - AFIBBERS FORUM
Right. In this case, I am specifically asking about where the rogue electrical activity originates with typical (right) atrial flutter that appears subsequent to a confirmed afib diagnosis (in a 1yr paroxysmal AF patient) and before ANY cardiac ablation has been performed. I didn’t state my question clearly enough. Is it safe to say that whatever the left atrial activation sites are in thisby kbog - AFIBBERS FORUM
The typical treatment for atrial flutter is ablation of the CTI, and I understand that to be true because ablating the CTI should cut off the circular activation path in typical right atrial flutter. But... is the initiation source with typical atrial flutter still the myocardial sleeve of the pulmonary veins, just as it often is with atrial fibrillation? Always trying to understand better!by kbog - AFIBBERS FORUM
Having just returned from a one-trip ablation with Dr.Natale on Sunday, I would say that you won’t get lots of face time with Dr. Natale, and you will likely have an unspecified wait time to see him for consultation and any procedure you elect, if my experience was typical. Thanks to posts I had read on this site, I was very much prepared for any time with him to adhere only very loosely toby kbog - AFIBBERS FORUM
Thank you - everything has gone well so far. I’ll write a post at some point to share my experience... for now I’m enjoying this week of taking it easy and reading lots of books while I have license to loaf.by kbog - AFIBBERS FORUM
Thanks, Shannon. All this makes sense of course. Dr. Natale’s nurse practitioner, by the way, was very knowledgeable and helpful. My long conversation with her saved a lot of time (as yours with me did too). I had wondered about whether the prior CTI ablation was done well - but didn’t expect an answer before he even got inside my heart! So, looks like he might end up with a little “exby kbog - AFIBBERS FORUM
Okay... so this was somewhat unexpected, and wondering if anyone here has heard of this happening before? I’m in Austin for my ablation with Natale (tomorrow). I’ve been going in and out of rhythm for several days now - hasn’t been awful, but I’m very aware of it. When they did an EKG before the consult today, I could feel that I was in and out of rhythm during the few minutes I had the leby kbog - AFIBBERS FORUM
Thank you all for the good wishes, tips, and reassurance! I’m so happy to have found this source of experience, knowledge, advice, and support. Off flec entirely as of yesterday noon. I’ve had a few periods of more ectopics (probably PACs) than normal and a few short runs of SVT, but am hanging in there fine. Kids/family/life is keeping me busy. Trying to leave the house clean and have a fby kbog - AFIBBERS FORUM
Wow. I am so sorry that this is happening. Your brother-in-law must be overwhelmed and confused by so much happening in such a short time. It’s awfully hard to do nothing/wait when you’ve just been diagnosed with (and are experiencing) a heart arrhythmia for the first time and a specialist is infusing the situation with a sense of urgency. It sounds like he desperately needs a second opiniby kbog - AFIBBERS FORUM
I'm quitting flecainide tomorrow in preparation for afib ablation next Thursday at TCAI with Dr. Natale. I'm very optimistic about the eventual outcome, but not sure what these next couple of days off of AARs will bring. (I'm sure it will all be fine.) Wish me luck, please, and if you have any tips or advice to share about the one-trip TCAI experience, feel free to send them mby kbog - AFIBBERS FORUM
Thanks, libby - I was wondering that. If the same test conducted in the same manner can yield additional useful health information, it seems like that should be part of the report, regardless of the specific reason the test is being ordered... so hopefully that will be the case...by kbog - AFIBBERS FORUM
Huh. Very interesting. I had a cardiac MRI (including "late gadolinium enhancement") about 15 months ago and have the disc... But, I'd just as soon have TCAI do a CT scan if that's what they're used to... and I'd just as soon skip the TEE that I'd probably otherwise have to have. I think the MRI procedure might be a little different depending on where yoby kbog - AFIBBERS FORUM
Thanks for the explanation, Carey. Since it sounds like you may also know the answer to this question: Is there still x-ray exposure during the procedure as well then, or does the pre-ablation CT scan eliminate most/all of the need for that? I wish it were possible to be a fly on the wall at my own procedure. I find medical technology absolutely fascinating.by kbog - AFIBBERS FORUM
Can anyone shed light on the use of CT scan before an afib ablation (why it is needed, what information is gained)? I'm kind of assuming it shows presence/absence of thrombus, heart morphology... what other useful information will it yield? Will I have an idea of the condition of my arteries/calcification/etc from the report? I had only a TEE before my flutter ablation, and I supposby kbog - AFIBBERS FORUM
Okay... long delay between posts, obviously but a forum post from March 2018 here indicates that there may be a choice between flying to Austin once (consultation one day, ablation next day) and making two trips about a month apart. Seems as if one trip would be much cheaper, but in the scheme of things, I just want the best possible outcome. For those of you who have flown to Natale in Austby kbog - AFIBBERS FORUM
What's the best way to initiate contact with Dr. Natale's office to discuss the possibility of traveling to Austin for a consultation/ablation by Dr. Natale?by kbog - AFIBBERS FORUM
There was a symposium a couple months ago in Park City, UT called the Western Atrial Fibrillation Symposium, which was attended by what I think most would call “all the foremost EPs and cardiologists interested in afib”, and this technique or technology (or whatever you want to call it) was one that Mandrola seemed to think held promise, from what I recall of his tweets and blog posts during thatby kbog - AFIBBERS FORUM
Repeating the shout-out for any recommendations for EP in the Chicago area, though perhaps I should start a new thread. Are there folks who maintain any kind of list of things like this?by kbog - AFIBBERS FORUM
QuoteCarey As you would expect, Natale is in-network with most of the major medical plans, and insurance companies don't usually care where you go for a procedure since they don't cover travel costs anyway. Huh. I will hope that the Provider Finder on my insurer’s web site isn’t comprehensive then... maybe it only lists local providers but covers others nationwide. That thought hadby kbog - AFIBBERS FORUM
Quotevanlith A well-done PVI blocks all electrical signals from the PVs, so that prevents both reentrancy and ectopics from that area. The problem is the PVs are often not the only source of ectopics. They can come from almost anywhere in either atrium. Any average EP can do a PVI, but it takes a very experienced, well-trained EP to locate and ablate ectopic sources elsewhere. What % of ecby kbog - AFIBBERS FORUM