Natale ablation

Just returned home today from Scripps San Diego where Dr. Natale performed an ablation on me. All is well; steady rhythm, very few blips on the radar. The good doctor and his nurse practitioner, Linda Couts, were par excellence. Natale worked on me for approximately 3 hours. He was just finishing up my procedure when my left atrial appengage flew into a 200 bpm rage, causing him and his nurse to stand in awe for a moment. He said it was one of the more radical diplays of 1:1 flutter he's seen and will probaly use it as a case study at his next seminar. One for the history books. But needless to say, he had to ablate the appendage and because of this I'm unfortunately with two options now: waiting 6 months for a TEE to determine how well my heart is pumping blood, then, if blood viscocity is good, my choice will be to either have Natale do the lariot procedure or keep me on blood thinners. I don't like the later, but I don't wish to be prodded anymore by catheters.
But bottom line, the good doctor feels confident that he slew the afib dragon in my heart and gave me a long waited for clean bill of health.
To any afib sufferers who live in the Southern CA or even the South West and are conteplating an alblation, I highly recommend Dr. Natale's expertise and the Scripps Green Hospital. All were superb.

Chris

Great news Chris,

Other than I would have preferred that you not have to go through the LAA issue. We can't control how our hearts manifest this condition. Just be very glad your LAA decided to do a 200bpm 1 to 1 flutter while Dr N was still in there and watching in real time!

That was lucky stars indeed, rather than have it first kick in while perhaps midway through a transatlantic flight or some such majorly inconvenient place like that !! There is a silver lining to everything.

Plus, I just returned from were the latest info we have was shared on LAA ligation at the international Sympoisum on the LAA in Orlando, and Dr N was right there as well. Im assuming you had your ablation either on Wednesday or Thursday? Otherwise, it had to be on just this Monday I presume?

If it was just on Monday things move fast in this world as I just said goodbye to Dr Natale in front of our hotel in Orlando day before yesterday on Sunday morning and its Tuesday night here in Sedona. So if you got it done yesterday and were sprung today, that is some fasted action indeed.

Im sure Dr N was thinking "Darn, that would have been a great case to present at the Symposium" when he saw your appendage fire off like that. In any event, at the 6 month mark a TEE will determine your emptying velocity and your doppler A-wave going into the mitral valve inflow coming from the LAA outflow. You will need to have an LAA emptying velocity above 0.4meters/sec and the presence of a consistent A-Wave at the mitral inflow and then you will likely be done and won't need to deal with the anti-coagulation/LAA ligation issues.

If your velocity is less than that and/or you lack a consistent A-wave shape on TEE doppler imaging, then either the Lariat or possibly Watchman or even a stand-alone Atriclip or life long NOAC will be on the table for discussion.

There are some silver linings there as eel,l and we can discuss those by PM or phone later when you are ready to explore the possibilites. Yes, its preferable when you dont have to deal with LAA issues, but its not that big a deal either way, and its FAR FAR better to get it properly addressed and there is literally no one on the planet more skilled at LAA isolation, which is a challenging procedure, than the man behind your catheter, so count your lucky stars once again.

In any event, keep me posted as you move through this and we can talk in more depth along the way if you wish.

You're in good hands both with Dr N and here on this site. Perfect place for someone in your shoes. Best wishes ...

Shannon



Edited 2 time(s). Last edit at 03/21/2014 02:31AM by Shannon.

Thanks, Shannon for your reply.

My abaltion was on Monday the 17th, so yes, Dr. Natale moves fast. With his star power, though, it wouldn't surprise me if he didn't have his own Lear jet jettisoning him to and fro. (or angels under his wings)
Yes, I'm very grateful that Dr. N was there to witness the rage within my heart. My wife and I consider it a Godsend that the flutter did occur just at the right time.
And to be honest, I'm simply and humbly grateful for his skill with or without a possible future Lariat procedure. But my heart feels great with only an occasional blip.
My wife and I were so impressed with Dr. N's mannerism. We both likened him to an angelic character in some Renaissance painting, lovely in nature, pure in spirit.
It's good to know that there great doctors like that in the world.
I will keep all on this board posted on my progress and outcome.

HI Chris - glad to hear you were in the right place at the right time, also! Such a relief to get the Afib beast quieted back down, isn't it? I also had a Natale ablation, and also had to have my LAA isolated. No flutter, just Afib for too long.... I am now at the 6 month mark and scheduled for a TEE next week -although I am trying to get it rescheduled to the following week. I am currently taking Xarelto, and am anxious to hear if I will need to continue that indefinitely as well. Like you, I would prefer not to go in for another procedure at this point, so will probably choose continued blood thinners for the time being, if I in fact, need to stay on them. I've spoke to Shannon about this, as he is such a wealth of information and a tremendous support.

Dr. Natale was in NYC briefly - a few months - which is when I had my ablation with him. Unfortunately, he is no longer there and I have to see a back up EP until he gets some time back in NY again. I was just in the San Diego/LA area last week and passed the Scripps hospital, I believe on Monday, so that's quite a coincidence!

I will let you know what happens and how things go after I get my TEE either next week or the one afterwards.

Crossing my fingers....Barb

Good luck on that, Barb.

How has your healing process gone? Have you had any issues with afib in the last 6 months? So far my heart seems like new. It's amazing the difference from the last ablation I had 4 years ago at Kaiser Sunset L.A. The EP there was a newbie and looking back I believe that he had two fellows working on me as well. Not good. Needless to say, I was in serious afib, tachy, and flutter in less than 2 weeks post the ablation and had to be reemitted. I only had 6 months of NSR from that ablation. Fortunately this board made me privy to Dr. Natale.
Yes, the TEE and possible Lariat on my LAA....Not looking forward to that fork in the road 6 months from now, but not having afib distrupt my life anymore...the trade off is worth it.
Chris

Hey Chris,
I'm glad you're doing well and had a chance to get ablated by Natale.
We had a reunion a few months ago when Barb, Dennis C, Andey and myself all went to see Natale speak at the Carlton-Ritz for a seminar sponsored by Montefiore Hospital. They all lined up after me after Natale came to St Lukes in New York for a while to perform his magic.

Best,

McHale

Thanks, McHale. Yes, I finally had the maestro work on me and have absolutely no regrets. I know it's still early, 10 days, but my ticker feels great so far.

Chris