Dr. Natale

Dr. Natale reviewed my records and has recommended that I go ahead with the ablation. So I assume it's a no brainer and get on his schedule. Would there be any reason I'm missing not to take this opportunity??

38 yr old Male afibb last 8+ years on flec/met last 7yrs. 4 or 5 12-60 hr afibb episodes last 7yrs and about 10-20 very short episodes while on flec/met.

Feel if I came off flec/met there would be alot more and it would be nice to put this behind me. I'm nervous and know its probably the right thing to do. Guess I'm just looking for support since he has recommended me to have the ablation.

Anyone know his waiting list time frame?

Thanks all!!
Kevin



Edited 1 time(s). Last edit at 12/27/2018 08:30PM by Kleinkp.

• You're only 38 and you've been dealing with afib for 8 years. You've spent 7 years on flec, which means it will probably quit working for you any day now. What then? Sotalol? Tikosyn? You're not going to like those drugs much.
• You've got a fairly substantial afib burden that can't be doing your atria any favors. If they aren't enlarged yet, they probably will be eventually.
• As the old saying goes, "afib begets afib" so you can count on your episodes will most likely increasing in frequency and duration in the future on a path toward persistent afib. There is also the chance that you could become persistent suddenly.
• Waiting never improves the chances of success. Quite the contrary, it just allows electrical remodeling and atrial enlargement to continue, which just makes the procedure more difficult.
• And finally, the best EP in the world has recommended ablation.

Personally, I think you should have done this 7 years ago. I can't imagine any reason why you would not take his advice.

Not sure what the current wait is. In 2017 I waited several months, but since then I know of other patients who have been scheduled in less than a month. It really just depends on his schedule, so all you can do is call and ask. I strongly recommend that you do.



Edited 3 time(s). Last edit at 12/27/2018 11:12PM by Carey.

What Carey says!

George

I agree with Carey. There is no upside to waiting any longer than it takes to get it done.

As they say, "Run, don't walk."

id do it now. It's an easy procedure especially at St David's. If Natale thinks he can help and he must by reviewing your stuff, jump on it.
One thing people maybe don't consider is , Natale prob won't be around forever. I'm talking retirement not death 😊 I'd go for it, and Carey's right Flecainide doesn't work forever
Tim

I totally agree with previous posters.
Don't fear ablation. It's not a problem. It's a solution. If you're lucky, you'll be cured (I mean afib and drugs free) for many years. You're young. Drugs are worst than an ablation with one of the best EPs in the World.

Agree with Carey. I wouldnt take black box warning meds for one month let alone 7 years over an ablation by the Maestro.

Thanks for the support and encouragement. I have a phone call scheduled with one of Dr. Natale nurses to get more details on scheduling etc today at 1pm.

I'm would be coming from Seattle area would you guys recommend bringing someone with me for the procedure?

Quote
Kleinkp
I'm would be coming from Seattle area would you guys recommend bringing someone with me for the procedure?

You don't exactly need someone with you, but after the procedure you're going to be limited to lifting no more than 10 pounds for five days. Someone who can carry your bags for you will be handy. Plus you'll be in Austin for two days following the procedure and you should feel fine. Having a friend along to go out to dinner and such would be nice.

Wife and kids want to come with me and make it a positive experience maybe go down few days early and take in the city. Thinking that might help keep me positive and ease the nerves.



Edited 1 time(s). Last edit at 12/28/2018 03:37PM by Kleinkp.

Only hurdle left is to get regence to approve the procedure. Dr. Natale and St David's are in my network so not sure why they wouldn't. Anyone know how the insurance company's look at RFA procedures?



Edited 1 time(s). Last edit at 12/28/2018 07:18PM by Kleinkp.

They'll approve it. Insurance companies have been viewing ablation as a first-line treatment for afib for a number of years.

And spending a few extra days in Austin beforehand sounds like a great idea, particularly if you go there in the winter. Summers are pretty brutal in Austin but winters are usually mild. There's plenty to do, see and eat. And if you're bringing the kids, I recommend a visit to this. A bunch of the stuff is hokey but it's a good way to kill an hour or two.

Don't bother with a rental car. It will be expensive and a lot more trouble than its worth. You can get everywhere you need to go easily with Lyft and/or Uber.

Just got off the phone with norma Dr. Natale nurse for consult and ablat in one trip. She very nice and candid reminded me that this isnt a cure which deflated me a bit. She did assure me that I'm in good if not best hands for this job.

I'm sending all paper work needed, looks like summer will be when I get it the ablation.

Don't feel deflated. Nobody can honestly call ablation a cure because it's just not, so credit Norma for being honest. Also credit Norma for being humble. You won't be in good hands -- you'll be in the best hands the world has to offer. Think of it this way: ablation is to afib what chemo and surgery are to cancer. None of them are cures, but they're the best chance you've got of living a life free of the disease.

Carey nailed it throughout this topic as usual! Totally agree with all his advice! So true about Natale not being around forever. Hope he has some great disciplles!

Good luck and enjoy Austin,

Karin

Not much more to be said here Kevin,

Other than underscoring the "run dont walk" advice to get thee in line ASAP! Starting one's 'AFIB Ablation Process' with the single most experienced and most highly skilled ablationist on planet earth is the very definition of "a no-brainer" ... all the more so when Dr Natale has already reviewed your case and recommended you have an ablation.

Some less experienced ablation EPs who are still in their broad learning-curve days, may be more likely to encourage everyone with AFIB who walks through their door to get an ablation with them, as they may feel the need to gather more experience whenever they can so as to 'hang more skins on the wall' (so to speak). Not so with a truly elite level operator with over 11,000+ procedures under his belt, like Dr Natale, who will absolutely give you his honest opinion.

I've seen Dr Natale tell folks with early stage AFIB that is still very sporadic in occurrence and with relatively short acting episodes, to consider doing life style risk reduction first and see if they cant reduce their AFIB burden significantly by losing an excess 20 to 30 pounds (or more) for those whose BMI is on the high side for their height and overall body-type before starting an AFIB ablation process and see how they do.

A case like yours, though, at your age and AFIB history that you have reported above, it is truly a no-brainer to partner up with the very best possible option that exists and embrace the opportunity to get rid of the beast once and for all by following through with this process, guided by The Maestro, until durable NSR is achieved.

Send me your cell number by the private message link above (PM), next to my name, if you would like my input in helping you get a date set with Dr Natale.

Cheers!
Shannon

I've been doing research concerning newer methods of treating afib. I've found that the newest method of treating it is a minimally invasive procedure of attaching what is called the "Atriclip" to the Left Atrial Appendage. Then, the amputation of the LAA may be performed. One interesting side effect of this amputation is a drop in Blood Pressure. The Atriclip was FDA approved a couple of years back and it seems to be the best approach to stopping afib and the possible clotting that can come from it.

I would be interested in having this procedure performed and would like to be in contact with a cardiologist who does it. The afib I have is not constant but usually pops up every so often. Hence, it is paroxysmal. I see here that a lot of people trust Dr. Natale. I would love to be able to not have to take blood thinners of any kind and to be able to drink a cold drink and eat anything I want. So, having to be able to discuss this with Dr. Natale or any other cardiologist that can help me would be nice.
Thanks

The Atriclip does not treat afib. It closes off the LAA, which protects you from stroke, but it will have no effect whatsoever on your afib. Also, the Atriclip is a surgical procedure, so you would need a cardiothoracic surgeon, not a cardiologist.

Actually, none of the procedures, including the Watchman Device that close off the LAA do anything to prevent Afib. Look here:

[www.ahajournals.org]
[www.onlinejacc.org]
[www.onlinejacc.org]
[www.ncbi.nlm.nih.gov]
[medicalxpress.com]
[ethicalnag.org]

Thanks for all the great support and guidance. Shannon in will take you up on PMing you to discuss the ablation thank you so much!!!

alxndr01 Contact Dr. Rendal Wolf 877-900-2342 he offers minimally invasive LAA removal/closure. However Carey is right LAA removal by itself is not going to eliminate Afib.



Edited 1 time(s). Last edit at 01/07/2019 06:01PM by dartisskis.