Atrial Fibrillation Forum A forum for sharing experiences and treatment options regarding atrial fibrillation and other atrial tachy-arrhythmias. https://www.afibbers.org/forum/index.php Tue, 25 Aug 2026 17:58:43 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,201816,201827#msg-201827 Re: Left Atrium Reverse Remodeling https://www.afibbers.org/forum/read.php?9,201816,201827#msg-201827 Qwackertoo AFIBBERS FORUM Tue, 25 Aug 2026 12:59:32 +0000 https://www.afibbers.org/forum/read.php?9,201786,201826#msg-201826 Re: AFib after ablation https://www.afibbers.org/forum/read.php?9,201786,201826#msg-201826 GeorgeN AFIBBERS FORUM Tue, 25 Aug 2026 12:38:35 +0000 https://www.afibbers.org/forum/read.php?9,201816,201825#msg-201825 Re: Left Atrium Reverse Remodeling https://www.afibbers.org/forum/read.php?9,201816,201825#msg-201825
I never had an Ablation, but I did have reverse remodeling after going from chronic AFIB to NSR and having an enlarged heart. It took about 18 months.

I think maintaining NSR is the main thing to worry or not worry about , unless your heart is way enlarged.

Keep in mind also that the results from an Echo are subjective to the Dr. or technician who reads the Echo. I would trust comparison read by the same Dr, alot more than echo comparisons by different Dr's.]]> The Anti-Fib AFIBBERS FORUM Tue, 25 Aug 2026 10:24:58 +0000 https://www.afibbers.org/forum/read.php?9,201786,201824#msg-201824 Re: AFib after ablation https://www.afibbers.org/forum/read.php?9,201786,201824#msg-201824
You may be interpreting things too negatively. NSR with occadional SVE's and PVCs does not mean your ablation has failed. Those arrythmia's are fairly common and usually benign. I still get them at times, and it's not a problem.

Yes, I only had one episode, but you only had two. My friend has had two as well, and no more since then. I'd still stay positive on this ablation, unless things change.

Jim]]> mjamesone AFIBBERS FORUM Mon, 24 Aug 2026 19:55:05 +0000 https://www.afibbers.org/forum/read.php?9,201778,201823#msg-201823 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201823#msg-201823 gloaming AFIBBERS FORUM Mon, 24 Aug 2026 19:53:22 +0000 https://www.afibbers.org/forum/read.php?9,201778,201822#msg-201822 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201822#msg-201822 The EPs Shannon was talking about who stop short of isolating the LAA for rational reasons are EPs who understand how to know it needs isolating, how to do so, and what the risks and benefits are. Unfortunately, that doesn't describe the average EP even today,

Carey,

It looks like you were referring to my quote and not Shannon's. It was a confusing attribution.

ie I wrote: "Other EPs may deliberately stop short of isolating the LAA, not because it wouldn't necessarily help, but because of the resulting stroke/anticoagulation issues.It's risk vs benefits. So instead they may ablate other areas that might also be driving the AF, It's about how aggressive you want to be. It's not which is the right approach, it's what is the right approach for you."

So maybe we do have some agreement here. To clarify, I was never talking about the average EP, but the elite's. Within this group, it's not about skill, it's about weighing benefits vs risks of isolating the LAA. Natale seems to be more willing than many other elite EPs to isolate the LAA for the same patient. Therefore, again, it's really up to us as patients to decide for ourselves which approach we are comfortable with.

Jim]]> mjamesone AFIBBERS FORUM Mon, 24 Aug 2026 19:13:21 +0000 https://www.afibbers.org/forum/read.php?9,201786,201821#msg-201821 Re: AFib after ablation https://www.afibbers.org/forum/read.php?9,201786,201821#msg-201821 Unfortunately for me, I had my first afib 6 months after the ablation, then another afib not even a full month after the first one.
After my first episode 6 months following ablation - my EP had me wear a monitor for one month. During that time, my readings picked up
numerous Sinus Rhythm with SVE or Sinus Rhythm with PVCs. Rare readings of Normal Sinus Rhythm. Clearly the Ablation failed or the issue re-routed and found a way through. I don't know. It's beyond upsetting for me to have to go through this all over again. Especially only 6 months later. I can only hope that this time might increase my chances of relief. I fully understand that there is no "cure" for Afib. I've lived with this now for four years but I've had the PVCs since my 20s. My dad had Afib and I understand it's usually hereditary. So I am hoping for the best at this point. If I could afford to, I'd definitely be heading to the Mayo Clinic. Right now I am being treated at Yale Hospital in CT which has a top notch group of Cardiac Care Doctors.]]> JeannieCT AFIBBERS FORUM Mon, 24 Aug 2026 18:27:16 +0000 https://www.afibbers.org/forum/read.php?9,201778,201820#msg-201820 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201820#msg-201820 Over on Mayo Community Connect Forums, one person stated he dismissed Natale because he insisted on performing an LAA isolation without even seeing him. I pointed out to this person that his three previous failed ablations might have been the clue to someone as skilled and experienced as Natale. Nope, he was not having hit.


Is this the discussion at Mayo Connect? Apparently the person finally did have an ablation without isolating the LAA and is doing fine. It was his sixth ablation.

"I would also recommned UCSF and Dr. Gerstenfeld. I spoke with Dr. Natalie and he was hell bent on ablating my atrial appendage without seeing me. Saw Dr. G and my appendage was fine. He and his team took the time and used both RFA and PFA with the Aferra system this last May. I am now 3 months out and no fib no flutter and exercising regularly. I was an avid cyclist doing 100 mile rides in about 5 hours. I will add this was my 6th ablation. Dr. G and team spent 5 hours finding the problems. I will add to that Dr. G specializes in abnormal rythms following ablations.'

[connect.mayoclinic.org]

Jim]]> mjamesone AFIBBERS FORUM Mon, 24 Aug 2026 16:20:00 +0000 https://www.afibbers.org/forum/read.php?9,201778,201819#msg-201819 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201819#msg-201819
SMH.]]> gloaming AFIBBERS FORUM Mon, 24 Aug 2026 15:08:09 +0000 https://www.afibbers.org/forum/read.php?9,201816,201818#msg-201818 Re: Left Atrium Reverse Remodeling https://www.afibbers.org/forum/read.php?9,201816,201818#msg-201818
A dated article: [pmc.ncbi.nlm.nih.gov]

From this year, good news: [www.sciencedirect.com]



[www.jacc.org] This study is sobering. About 43% of the sample, all persistent with their AF, had recurrent AF within one year of their ablation.]]> gloaming AFIBBERS FORUM Mon, 24 Aug 2026 14:55:14 +0000 https://www.afibbers.org/forum/read.php?9,201778,201817#msg-201817 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201817#msg-201817 Carey AFIBBERS FORUM Mon, 24 Aug 2026 03:15:31 +0000 https://www.afibbers.org/forum/read.php?9,201816,201816#msg-201816 Left Atrium Reverse Remodeling https://www.afibbers.org/forum/read.php?9,201816,201816#msg-201816
I guess it is what it is and either it has reduced or maintained size and hasn't gotten worse with no a fib and PAC's getting fewer each passing month.

I've had 1 Echo since Ablation, back in March and previous one was April the year before and it was basically same size, not smaller not larger. Had first go round with ablation in August then re-do & Watchman in October so didn't expect any remodeling to begin until sometime after last October. And it very well could have gotten larger from last April 2025 until the ablation(s) so it could have remodeled some, I'll never know. Getting slight anxiety worrying about it. They used the words "marked enlargement" here locally and these two new Echo + CTA will be local too. Per Natale's office it should be fine to do locally vs returning for a 4th time to TX. Last time I saw them was last December.

Anyone have successful reverse remodeling after ablation(s)? How long did it take?

Thanks]]> Qwackertoo AFIBBERS FORUM Mon, 24 Aug 2026 00:55:57 +0000 https://www.afibbers.org/forum/read.php?9,201778,201815#msg-201815 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201815#msg-201815
Telehealth was for my convenience to save me a trip from so far away. In fact, I chose Natale over another doctor at another facility because Natale did offer this virtual appointment.

I am not trying to cast aspersions on Dr. Natale. But he did not bring this up, and I did not know what questions to ask. I have already admitted I did not know enough going in, and that is on me. I am offering up my experience so that others may be better prepared than I was.

Before deciding on Natale, I had an in-person appointment with an EP in my home state who I decided against using. He did not mention anything about the LAA either, and this would have been my last visit with him before the day of the procedure, if I had gone on to make that appointment. From what I have learned on this website, I suspect this doctor would have not gone near my LAA, and I would have wakened still in A-fib.

I am thankful Dr. Natale got me into normal sinus rhythm. I only want others to have as much info as possible. So perhaps the biggest thing I learned was prospective patients should learn about isolation of the LAA and bring it up if the doctor doesn't.

I am still hopeful that I got the best possible care and outcome for my specific condition.]]> nonthumper AFIBBERS FORUM Mon, 24 Aug 2026 00:53:09 +0000 https://www.afibbers.org/forum/read.php?9,201778,201814#msg-201814 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201814#msg-201814
Quote
mjamesone

I also question the 60% figure you cite if it means that the don't need either AC's or Watchman after the isolation. But even so, that still still a high percentage.

Jim

Quoting Shannon on the 60%
[www.afibbers.org]

Quote

Other EPs may deliberately stop short of isolating the LAA, not because it wouldn't necessarily help, but because of the resulting stroke/anticoagulation issues.It's risk vs benefits. So instead they may ablate other areas that might also be driving the AF, It's about how aggressive you want to be. It's not which is the right approach, it's what is the right approach for you.

This should be a discussion with the EP prior to the ablation and I'm pretty sure Natale brings this up, if I recall correctly from discussioins with friends who've gone through the process with Dr. N.]]> GeorgeN AFIBBERS FORUM Mon, 24 Aug 2026 00:22:27 +0000 https://www.afibbers.org/forum/read.php?9,201808,201813#msg-201813 Re: Accidental electrical shocks after ablation https://www.afibbers.org/forum/read.php?9,201808,201813#msg-201813
Skin and leather are pretty good insulators, until they are wet. If you lick your fingers, you can get a shock from a 12 volt car battery.

I have had enough of an education in electricity to know that the total power is a function of both the volts and amps. That is why a 30,000 volt spark wire hurts like heck, but doesn't kill you. Amperage is less than one tenth of one amp,

Lightning burns because it is crazy high voltage, driving crazy high amperage.

My welder has an open circuit voltage of about 30 volts. But the capability of flowing 200 amps if there is a good path for current, such as the electrode touching steel. Even my wet gloves don't allow that much current to flow. I don't want to measure it, though.

Seems like I read somewhere that it takes about one amp to kill your heart. My concern was it seems like heart electrical activity is measured in milivolts (1/1000 of one volt), and I am guessing millionths of one amp. So whatever gave me the tingle from the welder is higher than I would like for my repaired heart.

I just need to be more careful. Priorities change.]]> nonthumper AFIBBERS FORUM Sun, 23 Aug 2026 22:44:03 +0000 https://www.afibbers.org/forum/read.php?9,201778,201812#msg-201812 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201812#msg-201812
Quote
nonthumper
I don't think I would have liked it if I had woken up from my procedure and he had stopped short of isolating the LAA, leaving me in A-fib, pending further discussion and another procedure.

No, you wouldn't have liked it at all. I spent 7 years dealing with exactly that. Three EPs with impressive credentials, 5 ablations, and none of them even knew how to figure out that my LAA was the source, much less how to isolate it. And then I wised up, went to Natale, and in the shortest ablation I ever had, he stopped it cold by isolating my LAA.

This is why there's an annual conference dedicated solely to LAA isolation issues and education. The conference is ISLAA, and Shannon and I were lucky enough to be able to attend one in Kansas City prior to COVID. It was very interesting and the speakers were all EP elites. It's a valuable skill but still too many EPs haven't been trained in it and some even refuse to learn because their training (years ago) was to stay away from it. Those are the ones you'll hear dissing EPs like Natale, calling him "overly aggressive" and "a cowboy."]]> Carey AFIBBERS FORUM Sun, 23 Aug 2026 22:18:03 +0000 https://www.afibbers.org/forum/read.php?9,201778,201811#msg-201811 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201811#msg-201811 how might other EP's treat persistent A-fib without isolating the LAA?

Other EPs may deliberately stop short of isolating the LAA, not because it wouldn't necessarily help, but because of the resulting stroke/anticoagulation issues.It's risk vs benefits. So instead they may ablate other areas that might also be driving the AF, It's about how aggressive you want to be. It's not which is the right approach, it's what is the right approach for you.

Jim]]> mjamesone AFIBBERS FORUM Sun, 23 Aug 2026 22:03:27 +0000 https://www.afibbers.org/forum/read.php?9,201808,201810#msg-201810 Re: Accidental electrical shocks after ablation https://www.afibbers.org/forum/read.php?9,201808,201810#msg-201810
Quote
nonthumper
So am I running the risk of outside voltage burning some new pathways through my ablation scar tissue? Probably nobody knows for sure, but safer to avoid.

No, that's not a thing that happens unless we're talking lightning or industrial voltages, in which case you'd be dead anyway.

Really, I wouldn't worry about it beyond just the normal safety measures. Just make sure you're aware of where your hands are. You don't want to touch a live electrical source with one hand and have the other hand grounded. That creates a pathway directly through the heart. However, even that's not dangerous with low voltages because it can't easily penetrate the skin. Skin is a pretty good insulator and most body tissue isn't a good conductor. When people receive really major shocks such as lightning, most of the current travels through veins and arteries because they're full of salty water.

And finally, remember what a cardioversion is. It's the intentional routing of pretty substantial voltage (1000-2200 volts) directly through the heart, and it's done all the time with afib patients. Nobody develops new pathways because of an ECV.]]> Carey AFIBBERS FORUM Sun, 23 Aug 2026 21:55:32 +0000 https://www.afibbers.org/forum/read.php?9,201808,201809#msg-201809 Re: Accidental electrical shocks after ablation https://www.afibbers.org/forum/read.php?9,201808,201809#msg-201809
I’m hoping you will be fine.]]> susan.d AFIBBERS FORUM Sun, 23 Aug 2026 21:14:00 +0000 https://www.afibbers.org/forum/read.php?9,201808,201808#msg-201808 Accidental electrical shocks after ablation https://www.afibbers.org/forum/read.php?9,201808,201808#msg-201808
I don't expect to get a shock when arc welding, but this morning there was some moisture on the steel and my gloves, and I felt that little tingle. I feel stupid for not considering this before. Maybe I can't risk welding any more.

I know electrocution occurs when electricity cross someone's chest and involves the heart. So am I running the risk of outside voltage burning some new pathways through my ablation scar tissue? Probably nobody knows for sure, but safer to avoid.]]> nonthumper AFIBBERS FORUM Sun, 23 Aug 2026 20:58:15 +0000 https://www.afibbers.org/forum/read.php?9,201753,201807#msg-201807 Re: My TEE checkup of my Watchman https://www.afibbers.org/forum/read.php?9,201753,201807#msg-201807 Qwackertoo AFIBBERS FORUM Sun, 23 Aug 2026 20:53:40 +0000 https://www.afibbers.org/forum/read.php?9,201778,201806#msg-201806 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201806#msg-201806
The way I read the notes that Natale made on my initial procedure, he kind of snuck up on the LAA. He tried ablating several other regions of my heart first, and when that did not convert me to NSR, he went ahead and isolated the LAA.

Now there is some blame on me for not boning up ahead of time. I have to admit I went into the procedure without the knowledge that if my LAA was isolated, then I may be on blood thinners forever. Of course, if I had no ablation, that would have been the case anyway.

I don't think I would have liked it if I had woken up from my procedure and he had stopped short of isolating the LAA, leaving me in A-fib, pending further discussion and another procedure.]]> nonthumper AFIBBERS FORUM Sun, 23 Aug 2026 20:51:00 +0000 https://www.afibbers.org/forum/read.php?9,201778,201805#msg-201805 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201805#msg-201805 Natale only uses that tenchnique when required to solve the problem.

I have a problem with the word "required". I'm sure he uses LAA isolation when he believes it's necessary to achieve a durable result, but other highly experienced EPs may treat the same patient without the isolation. My point is that his approach is different from many at the top level, not that it's good or bad. As a patient, it's up to us to do the homework and see if an EP's approach aligns with what we want. In my specific case, his Natale's approach didn't, and that is why I looked elsewhere.

I also question the 60% figure you cite if it means that the don't need either AC's or Watchman after the isolation. But even so, that still still a high percentage.

Jim]]> mjamesone AFIBBERS FORUM Sun, 23 Aug 2026 16:40:05 +0000 https://www.afibbers.org/forum/read.php?9,200587,201804#msg-201804 Re: Endurance athletes have a four times higher risk of irregular heartbeat, and this may be why https://www.afibbers.org/forum/read.php?9,200587,201804#msg-201804
I am in the same boat. Very high level pool and open water swimmer. Age 72. I miss the competition - especially because others my age can still push themselves. After more than 1-2 minutes of higher exertion exercise (>110 bpm), I have to stop.

I read your reply about what you do now and I have a similar routine. Have you investigated what is possible so you can return to higher, longer periods of higher intensity exercise?

Just wondering if my racing days are over....

Thanks

Paul]]> oldswimmer AFIBBERS FORUM Sun, 23 Aug 2026 15:42:21 +0000 https://www.afibbers.org/forum/read.php?9,201778,201803#msg-201803 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201803#msg-201803
Quote
mjamesone
Once isolated, anticoagulation and the Watchman becomes less of an option and more of a necessity.

My recollection is the odds of needing anticoagulation after an LAA isolatiron are approximately 60%. I have a friend that required several years after an isolation with Natloe to have TEE results that passed and he no longer requires anticoagulation. That being said, I have a number of personal friends who are very greatful that an isolation solved their rhythm problem. Certainly, Natale only uses that tenchnique when required to solve the problem.]]> GeorgeN AFIBBERS FORUM Sat, 22 Aug 2026 20:23:26 +0000 https://www.afibbers.org/forum/read.php?9,201778,201802#msg-201802 Re: Afib Has Returned https://www.afibbers.org/forum/read.php?9,201778,201802#msg-201802
If this is something appealing, I'd then reconsider the Watchman and also discuss with Dr. Natale, under what cirumstances to do, or not to do, an LAA isolation, which is something he practices more than most EPs. Once isolated, anticoagulation and the Watchman becomes less of an option and more of a necessity.

Jim]]> mjamesone AFIBBERS FORUM Sat, 22 Aug 2026 18:51:51 +0000 https://www.afibbers.org/forum/read.php?9,201801,201801#msg-201801 Magnesium Glycinate https://www.afibbers.org/forum/read.php?9,201801,201801#msg-201801 Thanks

Steve]]> JAYHAWK AFIBBERS FORUM Fri, 21 Aug 2026 17:26:11 +0000 https://www.afibbers.org/forum/read.php?9,201749,201800#msg-201800 Re: Watchman clot still there https://www.afibbers.org/forum/read.php?9,201749,201800#msg-201800
Quote
swhanson
Susan- I know your frustration. If your doc is not talking to you clearly about your condition and is giving you information in a language other than yours, they are working for their benefit, not yours. Definitely find another doc. There are good ones. Good luck. -Sven

I saw my EP and he read though my records. Apparently the staff radiologist that my hematologist asked for an opinion my EP thinks highly of. He said if this radiologist thinks nothing should be done, then he trusts her. He said she is the most cautious person he knows and if there was any risk factor, she would had spoken.

However my ep is concerned about my newest symptoms. He wants to rule out pacing induced cardiomyopathy. My last echo was in February and my EF was 50, after my PVC ablation in January showed 39. So in one month it jumped from 39 to 50. Tuesday I’m getting a new echo. It won’t show clots but I couldn’t convince my EP for a TEE. It’s my third clot in my body-two while on Eliquis.

If my EF jumped up so quickly can it drop as quickly for pacing induced cardiomyopathy? I had a 50% PVC burden before my ablation that had dropped my EF. My EP doesn’t believe that high doses of prednisone (120mg in 13 hours) and bronchitis could lower my EF.]]> susan.d AFIBBERS FORUM Fri, 21 Aug 2026 15:59:53 +0000 https://www.afibbers.org/forum/read.php?9,201753,201799#msg-201799 Re: My TEE checkup of my Watchman https://www.afibbers.org/forum/read.php?9,201753,201799#msg-201799
And I was skeptical, but it all worked out. Flew into Austin the afternoon before the procedure, spent one night in Austin before the procedure, then flew out the same afternoon as the procedure.

I did not need to bring along a driver so long as I used a taxi or Uber.

So having to spend just one overnight took a lot of the sting out of the travel, even though I dislike the air travel experience these days. Making it worse, the airport in Austin is too small for the volume it handles. On the upside, I was able to fly on Southwest Airlines, which operates out of a charter airport in Minneapolis and was cheaper than the major carriers.

Lastly, I was surprised how much the doctor performing the TEE was able to learn from it. I think they really have that dialed in, and I think it is a good idea to return to Austin for that initial TEE after the Watchman is placed.]]> nonthumper AFIBBERS FORUM Fri, 21 Aug 2026 12:31:46 +0000 https://www.afibbers.org/forum/read.php?9,201786,201798#msg-201798 Re: AFib after ablation https://www.afibbers.org/forum/read.php?9,201786,201798#msg-201798 For example, I have had three family members with prostate cancer. The two that started their surgeries with their local hospital survived a few years, but ultimately passed away. The one who started off by going to Mayo is still with us 10 years later. So maybe their cases were different, but I have seen similar play out many times. And that is why I decided to follow the advice of this website, and go right to one of the top rated doctors.

Just an FYI. When the prostate cancer is found/diagnosed is the key. If the cancer has not spread from the prostate, surgery should be very successful. My prostate was removed about 30 years ago and that was the end of the story. The skill of the surgeon is also key if one is to be able to have erections down the road.]]> Ken AFIBBERS FORUM Fri, 21 Aug 2026 12:31:19 +0000