No response from Natale's office re: stats

A few weeks ago I was promised by Natales nurse that I would be faxed some information regarding his stats. You might recall that in another thread I said that it was great to get info. from the web and these boards in particular, but before I let someone burn my heart I need to see some cold hard data. I am a little defated that none was forthcoming. Any ideas why?

Subsequently I spoke with my EP about ablation. He says that there is currently a new study underway (paid for by the Nat'l Inst. of Health) that will run over several years and follow patients who have been seperated into two groups: ablation and drugs only. He is not very pro ablation in my situation, but when I asked if having an ablation with Natale could give one an edge, his response was that he would not recommend Natale, even to a member of his own family. He said that he has been in his lab and watched him work and he definitely would not recommend him.

This is rather disconcerting. Does this mean that some EPs find his approach too aggressive. Input please.

Lynn, your EP is referring to the CABANA trial. It has been going on for a while now so we will get a 5 year update coming up at the heart rhythm society meeting in May. I really don't expect anything earth shattering in terms of findings - that ablation beats drugs in quality of life and complications requiring hospitalization - as smaller trials have shown in the past few years. It is hard to comment on what your EP thinks of Natale's clinical approach without understanding what he is objecting to. It would be great if you can get him to be specific about what he is objecting to.

Lynn, in all fairness I have seen Natale before and he did great with me however I have sleeked opinion from two eps in louisville and one in Cleveland who feel he would def be the greatest but is very aggressive. This may be a great thing it occasionally may not be. So I have heard aggressive possibly overly at times but still highly recommended

Shannon,

I could not use your link without a user name and password.

Shannon, just wondering if you received my pm this morning. I just checked my pm box to see if I had a reply and then went to the sent folder and there is nothing in the sent folder.

Hi Lynn,

I did get your PM reply and many thanks, but just got back to the hotel after a very busy two days. Flying home first thing in the morning and will be back in Sedona tomorrow evening. Will try to answer in full on Sunday or Monday. Got good news on the communication front with Dr N's office, as the assistant there you spoke with on the phone ( to remain nameless in public) that you mentioned in the PM is one that has had a few issues with timely follow up in the past. I spoke with Dr N about the issue today who is taking care of the situation and also has a new assistant assigned to those of us from this website who are either patients of his or who are interested in a consult with him in order to better facilitate responsive communications between his office and those of us here who are making inquires, as well as former ablation patients who need to connect with him.

So that should help going forward and will get you all the stats you might want shortly. Anyway, will discuss it will you in the next few days but its time to chill a little after a non stop last two weeks. Hope you understand.

It was a wonderful conference with many very interesting and insightful discussions on everything from every aspect of AFIB ablation and the various approaches.

More on all that later,

Have a nice weekend!

Shannon

Hi researcher,

I totally agree with your view about CABANA, its a nice idea but its very unlikely anything earth shattering will come out in the interim follow-up report at HRS in May, assuming they even still stick to that time schedule now that they are trying to adjust the original end points to make the full study more likely to show at least some useful results within all of our lifetimes. The problem with respect to learning much of real value that we don't already pretty much know in the shorter term of the next 5 years of so, is that much of the data and conclusions that would be drawn from it will be more or less obsolete by the time of reporting, as the procedures and tools themselves will have advanced too far beyond this mostly look back study.

That is why there is this push to rewrite the end point targets now, to at least try to salvage the effort and glean some more relevant results in a more reasonable real world time frame.

Plus one of the big problems with this type of study is that while under the best case scenario, it might more or less convey the overall state of affairs when combining all quality and skill levels of ablationist into the pot, the take home message will still need to be underscored that excellent long term results very much can and are being achieved regularly over a reasonable ablation process of one to two max with a more rare occasional third procedure being needed, when the person chooses a top tier center and highly experienced ablationist in handling all degrees of AFIB ablations.

There is still a big gulf between what an average or lower experienced EP at a smaller center can accomplish overall and that of the upper echelon operators and that message has to be re-emphasized. Otherwise we have EPs like the fellow Lynn is seeing who may be very unrest and well-intentioned when looking at overall stats but then derives a misleading message, by not knowing who to send her and others like her too where very solid and consistent results happen every day, even if something aground 1.5 procedures on average might be required for long term freedom from AFIB.

Instead, many patients like Lynn are not getting that message from their EPs who are further down the line and who apparently do not see the forest very clearly due to too many obscuring trees.

Shannon



Edited 2 time(s). Last edit at 03/02/2014 02:43PM by Shannon.

Oops Lynn,

I was adding a small comment to my first reply to your initial post to start this tread a short while ago and accidentally hit the delete button Again I have more of these buttons now at the bottom of each message as the administrator moderator and on occasion, especially when a little tired at night and using my iPhone as I was a short while ago, those buttons are very tiny on the iPhone and I hit the delete my message button and erased that whole long first reply,

Oh well, no biggie, I"m sure you read it anyway and just as well. We can speak during the week if you wish to discuss some of this in an easier and more expedient way. Will get you some of the stats you were looking for as well as you will get a response before long from Dr N's Austin office as well.

take care,
Shannon