Review of AF catheter ablation for females

A couple of months ago, someone asked about the differences in results and complications. Natale's J. of Afib just published a review of published experience comparing outcomes and complications. As I have posted previously, vascular complications (because of smaller blood vessels) are significantly higher for women.

Registration is required and free.

[www.jafib.com]

A bit depressing/scary...and I am a female scheduled for an ablation on Sept. 5th. ~ Barb

Barb,
I am an average sized non obese female who had a Natale ablation 6 weeks ago. It was without complications, vascular of otherwise. There was no bruising from any of the three catheter insertion sites. Dr. Natale is very experienced in ablating female patients. You are in good hands my friend.
Betty

Barb,
You made the decision now stop reading and focus on the fact that Dr Natale is one of the best!
My moms TAVR Trans Aortic heart valve replacement also had to be done thru the femoral artery, but she had to be cut by a vascular surgeon in her abdomen to thread the valve into her heart. Much more complicated procedure than what Dr N is doing to place the catheters. She had a perfect placement of the Sapien valve and no vascular complications. Her arteries are also tiny and they had no problems threading the other catheters thru her groin area.
Once inside the heart Natale is a master at his craft. He's seen it all, there will be no let's get the playbook out or call a lifeline. He wrote the book! Relax and don't think too much, just take comfort in the fact that his safety record is extremely high with the amounts of procedures he does. He did 3 ablations in Texas yesterday and stopped by to give Shannon a bear hug after the first one after he surprised him in the elevator.

McHale



Edited 2 time(s). Last edit at 08/06/2013 07:46AM by McHale.

Hi Barb,
Its 6:50am Tuesday Aug 6 and am sitting here in the prep room after having gotten the IV in place and all scrubbed down waiting for anesthesia to come in and wheel me up to one of the four EPLabs here at St Davids on the 2nd floor.

Just took a quick look at afibbers and saw this thread. Its very important to view this research in context. We all come to this with whatever backgrounds we have and while some aspects might make it a little more of an issue with women over men, that is nothing at all to fret about! It just means a women is wise to select the most experienced ablationist she can, and Barb you have the best possible option out there so take heart in the fact that you will get the best care that you, as a women in your condition, could possible hope for and relax with that.

Your job is well done ... The worry part at this point is purely optional and not particularly useful, those studies reflect the broad experience of many women with mostly average EPs. The fact that certain aspects of a woman's anatomy and biochemistry can make for a bit more challenging process is all the more reason to take comfort in the hands of a true maestro who has done literarly housands of female AFIB ablations with great success.

Should you need a touch up at some point that's just what it will be for your process and its really no big deal. The key thing is having made the right choice to follow through with the path as it unfolds with confidence and a glad heart that each step is an important step toward getting this thing further in the rear view mirror.

Got to run now they are about to wheel me up for the Lariat ! :-)...

Cheers! to all and many thanks for all the kind wishes!!

Bon Voyage Shannon

Hi Barb, Like others have said, you have one of the best hands in the world working in your case and his complication rate is going to be significantly lower than the average of published data from various centers with different levels of skill and experience. You made the right choice. What Shannon posted in the previous post is most important

" It just means a women is wise to select the most experienced ablationist she can"
Also, it would be wise to ask how about the lab is equipped to lessen the chance of vascular complications in women.

Best of luck to both you and Shannon.

Quote
Shannon
Its 6:50am Tuesday Aug 6 and am sitting here in the prep room after having gotten the IV in place and all scrubbed down waiting for anesthesia to come in and wheel me up to one of the four EPLabs here at St Davids on the 2nd floor.

Technology is amazing!

Gill

I am SO happy I found this Board years ago, because you all are so understanding and helpful. Thank you Betty for that report and McHale - for your very wise words. I couldn't help but open this post due to it's subject, but it's a good reminder that I will be in very good hands with Dr. Natale. Thanks for that reminder

And Shannon! I can't believe you had the presence of mind and were willing to take the time to comment on this while you are sitting in the Prep room waiting for your own procedure! Best of luck to YOU and thank you all for caring like you do

~ Barb

I'm a small non-obese woman, I had an ablation with Steven Hao, who was trained by Dr. Natale, on June 27. Dr. Hao said that although my heart anatomy was small and room to maneuver was limited, all went well. He seemed very confident. The catheter incision sites haven't been a problem.

Aside from a few palpitations in the first couple of weeks, I've been in NSR (knock wood), as evidenced by periodic samples from an event monitor.

I asked him about the stats in women and he said, as researcher's paper above mentions, women are referred less often then men for ablation. (He attributes this to a tendency to misdiagnose and mistreat women's cardiac symptoms as emotional problems, an interpretation I applaud.) Therefore, as the above paper iterates, there is inadequate data about ablation success in women.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

As my wife reminds me sometimes - men are wimpy, women are tough. Although that's not necessarily a good thing when it comes to AF management.

What is Dr. Natale's first name? Just want to check to see if he is on my insurance plan. Does he still work out of San Francisco, the California Pacific Medical Center?

Thanks.
Nancy M

Andrea is his first name.