PFA Ablation by Dr. Natale in December

So it's been 8 years since my first episode and now it's time to pull the trigger. Ablation is scheduled in late December and will be done by Dr. Natale in Austin. Pre-op consultation with Dr. Natale is in early December. While I've done extensive research throughout the years and pretty much know everything about afib and ablation, when the date is approaching, I started to feel anxious. I know I'm doing the right thing to choose Dr. Natale and to travel to Austin. But there's still risks and should I worry about anything? With all the information I've got from the past 8 years, I really don't know what to ask during the pre-op video call.

I hope I don't come across as snarky or dismissive...I'm just thinking as a dispassionate (but experienced and read-in) fellow patient who is doing just fine after a hasty second ablation (first one failed from the get-go).

If it helps you to get through the day being anxious and fearful, go ahead and continue to do that. It might pass the time until the ablation comes due. If you don't like the anxiety and the fear, then your self-teaching should deal comfortably with the latter, and you might need more reading about the former. It's day surgery....like a laparoscopy or endoscopy, or a mastectomy. It's rocket science, but everybody and their dog is sending up rockets these days.

The first ablations for arrhythmia mitigation happened in the early 1980's. That's coming up to 50 years soon. Those doing a lot of them are wizards, and the very best are gods. Natale is pleased to be among the latter category. You'll be in fine hands.

The worst about an ablation, now having had two? Lying flat on your back and being discouraged to even raise your head for the three hours after you awaken back in your cubicle. That and an extremely sore and dry throat that the helpful anaesthetist said he'd fix for my second ablation. He did, bless him.

And if you'd like to be in the same camp as I, I couldn't wait for my first ablation. I knew of them, and learned all I could immediately, and waited for a referral that I was beginning to fear might never come. Fortunately, my cardiologist was okay with the concept and offered to refer me when my heart was sliding toward persistent AF four years in (I'm in Canada, where there are gatekeepers at every turn, and you must be referred up the specialist chain). Would I go back for a third ablation if/when the time comes? Yewbetcha, and I'd hand Dr. Novak a fine bottle of scotch before the third surgery as thanks for his success earlier (three years free of AF...that's worth millions to me). I was so pleased, and grateful, that I called his office on the first anniversary and thanked him and his staff for that wonderful year free of AF.

After having 25 surgeries/ablations, I just figured worrying is counterproductive and there is no advantage to worry. Each of my 4 ablations I tell them before the ablation “lets rock and roll” and give me the good stuff (propofol) so I can have my four second high. Sometimes I was able to get a slower injection to enjoy it longer. It’s my lemonade of thinking of something positive I look forward to in a unsure situation.

Plus I ask if I can keep the donut foam pillows they usually discarded. They are useful to keep. I recently used it to prop up my leg after surgery, and to supplement a hard uncomfortable chair’s comfort. If you have hemorrhoids, the donut center hole is perfect.

You have to take it in perspective. I’m scheduled for my 5th ablation in January overseas, I won’t have a voice nor understanding a word they say unlike you. I will be discharged afterwards while you wine and dine on excellent food. I will be awake because my PVCs otherwise will be suppressed while you will be spared of pain. I can’t play my usual mind game to think of anything positive this time, not one thing. That said, Kong1018- your ablation in comparison will be excellent in Austin, a 5 star retreat. Enjoy it. I heard the food is good too and you will get a private room.

Good luck in awakening up in NSR afterwards.

I know how you are feeling, been there done that. In my case, the pre-op phone call, I was en route to Austin and had just pulled into a Buc-ee's parking lot. First call with his PA, as Dr. Natale was still with a patient in the cath lab, then second call about 3 hours later with both Dr. Natale and the PA, we had just pulled into yet a second Buc-ee's parking lot for lunch LOL. Call will happen very, very fast, plus I had already asked most of the questions to the PA on the first call. I too, had read & studied for months/year(s) at that point but most of the questions and concerns were ones he couldn't know until he actually got "in there" otherwise it would have been burdening Dr. Natale's valuable time consumed with "What IF's". And my case was actually much bigger challenge than either Dr. Natale or I had anticipated vs a quick PVI and of course everything was expertly handled via Dr. Natale and TCA. Due to the extensive"ness" I did not just bounce back like many say they do. I will freely admit the first few days (48-72 hours) were a little rough for me, mainly extreme fatigue, no pain or anything serious. I'd never had general anesthesia before so perhaps that too was part of it.

Just be both mentally and emotionally confident in your research and your ultimate choice of care and you will emerge from St. David's with flying colors and a calm heart.

I'll be back in Austin, early December, for my first TEE. We drove to Austin back in August, as I hadn't flown since a long International flight in Oct of 2022 right before my A Fib diagnosis back in Nov 2022. What a mistake driving was. Never again. I'll gladly fly back to Austin for all future TEE's etc etc. whatever it takes vs driving and vs Local.

Good Luck~!!!!

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The worst about an ablation, now having had two? Lying flat on your back and being discouraged to even raise your head for the three hours after you awaken back in your cubicle.

And you won’t even have to worry about that with Natale as he closes the venous puncture with a collagen plug. As I remember, I was in recovery for about an hour and then could sit up shortly after they wheeled me back to my room. – Probably comes to about two hours on your back, but you’re kind of out of it for much of that time.

And it used to be 6 hours. Now THAT was awful.

Thanks to everyone that shared your experiences. Hoping for the best.

Hi Kong, I had a PFA ablation semi recently, in the lead up I did a lot of research and was a bit worried. But for me the risks of the ablation were quite low compared to all the risky things I did in my youth and for me PFA has worked and I have had zero episodes since. Turns out getting the ablation was one of the best decisions I have ever made.