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Cleveland Clinic docs Q&A forum addresses a lot of questions raised here

Posted by researcher 
Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 18, 2013 04:29PM
Questions on AF management, non-drug, drug and ablation and comments on anticoagulation and evolution in technology. Thanks to Mellanie True Hills for putting this together.

[www.stopafib.org]
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 18, 2013 09:36PM
Excellent info but now I have a big brain cramp. Fortunately, I have an appointment next week at MA General heart center. That should relieve the cramp.
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 18, 2013 11:16PM
Dr. Saliba:

"We cannot talk about a cure for atrial fibrillation; mainly, because we do not understand the true mechanism of the disease. "
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 19, 2013 09:42AM
Ralph, I had an ablation there 3 mths ago. You're in good hands.
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 20, 2013 08:19PM
Dr. Saliba: "There are data about long term success rates. Usually the recurrence following the first 2 years is 3-5% per year. There is data up to 5 years where success rate has dropped down to 50%"

That's pretty depressing and I don't consider that very good odds. Only 50% afib-free after 5 years. And they speak of AFib as a progressive disease (meaning it always gets worse) and anti-arrhythmic medications and ablation only delay the journey to persistent and permanent AFib.
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 21, 2013 02:18AM
Yes but elsewhere it's said:-

"Furthermore, when patients with recurrent atrial fibrillation undergo second ablation we almost invariably find reconnection of several pulmonary veins. Re-isolation of the veins generally results in long term success"
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 21, 2013 08:22AM
Diane

Remember that the 5 year data is based on ablations done when the procedure was much newer than it is now, and there were many EPs still learning how to do it. One of the Bordeaux EPs told BarryG that she cringed when she thought about what they were doing 5 years ago.

I am definitely in the 'cringe' department having had my ablation in Bordeaux in January 2003 after 18 months of persistent AF, but I am one of the lucky ones for whom it is still working.

Gill
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 21, 2013 09:31AM
But what do they mean by "long-term success"?

I'm glad Gill brought up the point about how they were doing it 5 years ago vs. now. That is a good point. Hopefully the 5-year, 10-year, etc. success rates will improve dramatically with today's methods when using a top EP.
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 21, 2013 01:34PM
Dianne,

You may be interested in the actual long-term data from the Cleveland Clinic. The 5-year success rate depends very much on who did the procedure(s) and whether or the patient was afib-free at year 1 of follow-up [www.afibbers.com]. If the patient was afib-free at 1 year the 5-year success rate of 87% sounds reasonable and is quite in line with the findings of our 2009 ablation/maze survey [www.afibbers.org].

Hans
Re: Cleveland Clinic docs Q&A forum addresses a lot of questions raised here
January 22, 2013 09:09AM
Hans, that's great news. I'm surprised that the Cleveland Clinic doctors wouldn't have said that in their interview.
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