Bordeaux ablation

I have just returned home from Bordeaux and thought that people may find it useful to hear about my experiences at the Hopital Haute Leveque.

I paid 13,300 Euros for the entire procedure. As an EU citizen if I had had an S2 form the cost would have been 9,400 Euros. I didn't have an S2 and having already had 5 ablations in the UK with little success it seemed unlikely that I would get one.

As planned I arrived at the hospital with my husband at 8am on 17 August. Whilst I'm quite used to hospitals (I've got a long and very complex medical history) I was somewhat apprehensive, particularly about the language barrier. I need not have worried. Everyone was charming and spoke at least some English - in fact the best English speaker was the porter and we had a long conversation in his nearly flawless English. We were quickly shown into a room with two beds, one the fixed old-fashioned kind for my husband and a modern electric one for me.

I have been in permanent AF since my last ablation, in October 2013, so the whole of the first day was taken up with tests. They did all of the usual ones and then something called "cardioInsight" which maps the fibrillation. You are fitted with a heavy rubber jacket which has literally hundreds of electrodes on it and then attached to a giant ECG. Mapping is carried out and then various drugs are administered to change your heart rate and an elaborate map is made. Then you are taken to a CT Scanner where a scan is done whilst you are still wearing the jacket. The results are then used during the ablation.

I was told that I would be second in the list next day and we spent a relatively uninterrupted night. Since I had been told to stop my Rivaroxaban 2 days before the procedure they started injected me with heparin - one dose was due at 2am. In the morning my groin was shaved and I was told to shower in Betadine - a special antiseptic lotion. Easier said than done as by this stage I also had a glucose drip going (I have no idea why). I then changed into a hospital gown - surely the same the world over- and was given 2 valium type tablets and something foul tasting on a sugar cube. Shortly after this Pierre Jais visited and discussed what he would do. He had been in touch with my EP in London and realised that I presented something of a challenge. However, he was hopeful that his imaging system would assist greatly (it did).

Around 90 minutes later I was wheeled down, accompanied by my husband who came to the cath lab door. The initial experience in the cath lab was exactly the same as my previous ones, except that once ready I was left to lie on the trolley for what seemed like an eternity and my back started to really hurt. However, all that was forgotten once the procedure started. In Bordeaux the procedure is done with no GA and I would be lying if I said it wasn't painful - it was. I must have drifted off at some stage though as my husband later told me that I had been away for 7 hours, so allowing for around an hour up front and the same at the end that's a five hour procedure.

The other thing about Bordeaux is that after they've taken the catheters out they wrap your leg really, really tightly and then you have to lie on your back (not completely flat though) for 24 hours. Having survived all of that it was a relief to finally get out of bed and move around a bit. I then had all the usual post ablation tests and in total I was in the hospital for five days, which is standeard. On the Thursday evening I developed what I would call a fever of 38.4C but was told that this was usual after an ablation and would be gone by the Sunday and it was.

I could tell from the feel of my heart that I had a very thorough going over and Pr Jais confirmed that when I saw him afterwards. I had some chest pain for about a week afterwards but that gradually faded and is fine now. I'm now just over 2 weeks out and all is well. Pr Jais told me that he was hopeful for a good result and so am I. Only time will tell...

If anyone is thinking of going to Bordeaux then I can recommend it without hesitation. If you've got any detailed questions then I'd be really happy to try to answer them.

Lesley

Many thanks for sharing your very interesting story Lesley,

I'm so sorry you had to endure 5 previous ablations before being able to make it to Bordeaux, but that does happen and as you know one thing can lead to another when in the middle of such a process and before you know it they start to add up.

That is why we so urge people to shot for the top tier such as Bordeaux and a handful of others in EU and Dr Natale as well as a bit larger pool of other skilled ablationist here in the US where so many of us on this board are from and naturally have a greater familiarity with the better EPs here.

The CardioInsight vest does look very promising as a pre-ablation diagnostic tool to help plan out an ablation and I can understand how Prof Jais may have found it particularly helpful in a complex case like yours with five previous ablations that left you with permanent AFIB.

You certainly were in good hands for number 6 and here's hoping that will be the final one for you and that you regain a quiet heart from here on out.

Cheers!

Shannon



Edited 1 time(s). Last edit at 09/04/2014 02:49PM by Shannon.

Hello,

thanks for interesting post.
When I heard about your ablation done by dr. Jais my heart did not skip a bit.....
I had ablation in Bordeaux, twice, 7 years on and I am well.
Dr Jais and Dr Haissaguerre did mine.

Your post brought me back many nice memories.

I am so grateful I was able to have ablation in Bordeaux.

I wish you all the best.

Aldona.

Lesley

Who did your previous ablations, and where?

Gill

Interesting reading Lesley. Sounds like you got the full treatment. Hopefully this ablation will be the charm. Not heard of wrapping your legs and lying on your back for 24 hours before. That must have been excruciating. I guess they were being extra careful to make sure the bleeding had stopped. I hope you got the beast this time and can put it behind you.

Jim

Hi Gill

I think I'd rather not say really as I am a complex case and I wouldn't want to give anyone the wrong impression about the EP who did all of my ablations. I can say that he is based at a major London teaching hospital and is possibly one of the nicest doctors I've come across in my long experience.

I went to see Richard Schilling for a second opinion before I went to Bordeaux. He told me that I have around a 40% chance of success and it is early days yet so I'm not counting my chickens...

I've been very interested to read of your experience in Bordeaux and am heartened by how long your ablation has lasted. I hope you have many more years of blissful NSR. Whereabouts are you based?

Lesley

Hi Lesley

I do hope that your ablation is successful. I am so grateful to the doctors in Bordeaux for giving me 11½ years of nsr.

In 2002 when I first consulted Prof. Haîssaguerre only two people in UK were doing ablations, and they had only just started. I hadn't found this board at that time so didn't know the importance of choosing a skilled and experienced EP but I had done a lot of reading and research - and I got lucky! I also speak fluent French which influenced my decision on where to go.

I am based in South East London. Where are you?

Gill

Hi Gill

Yes fluent French would definitely help with those more tricky conversations. I live near Brighton.

Lesley

Lesley, thanks for writing this up and glad to see that you are on your way to NSR after such an arduous route. Bordeaux is way ahead of everybody else in the application of CardioInsight mapping. I look forward to that technology spreading to all EP ablation labs.

RE what Dr. Schilling said to you - I am confused by what he meant by "early days" since you already had 5 ablations and was permanent by the end of the 5th.

Researcher,

Not to speak for Lesley but "early days" most likely means it is very soon after her Bordeaux ablation, too soon to tell the outcome...

George

Researcher

I think that Lesley meant that it is early days since her Bordeaux ablation.

Gill

Oops! George got in just ahead of me!



Edited 1 time(s). Last edit at 09/05/2014 10:05AM by Gill.

George and Gill, I believe that Lesley wrote that Schilling gave his opinion before she went to Bordeaux. Perhaps I read it wrong in that she consulted with Schilling once again post ablation.



Edited 1 time(s). Last edit at 09/05/2014 10:41AM by researcher.

Hi Elemc,

I was told by Dr Jais after my first ablation at Bordeaux in 2007 that I was possibly one of the three most difficult cases he had ever come across and he had done 4000 so I understand your concerns. I had a further two visits to Bordeaux to rid me of Afib / Left atrial Flutter completely and I have been Afib/Flutter free since early 2010. I must note here that I was probably Afib free from that first ablation with Dr Jais but I wanted to be able to run the hills and trails like I could pre-afib but running was my trigger. I could do anything without causing an AF breakout but run, which I'm sure 95% of people who have had an ablation would not want to do anyway.

Regarding Gill's enquiry about who your previous ablations had been carried out by. I understand a reluctance to 'point the finger' so to speak but we all accept that all ablators will be doing their best without doubt, we just want to keep people informed as much as possible so they can make a better decision of who to go to.

Not trying to highjack your post but I hardly visit the BB these days, I find it pro-arrhythmic' ;-) and would just add a few more things and be gone.

I have had 5 ablations,1st in Escorts Hospital New Dehli, and four in Bordeaux Professor Haissaguerre, Professor Jais, and Professor Hocini.
My 43 daughter is now being lined up for ablation No 7 with Dr Schilling in London. Ablations No 1,2,3 and 4 were with Dr Davidson? in Manchester and 5 & 6 with Dr Schilling.

As stated above I have been Afib free since early 2010 and I am now at the stage where I can run on the tread mill for 30mins per session, use the Concept 2 rowing machine for 30 mins at a time and do general weight training for 40 mins a session , separate days each session.Although I could put most 30 year olds to shame with regards to fitness my days of 'red-lining' are over and no running over the hills but instead stick to hiking. Not trying to boast in any way but more to let the folks out there that there is a way out for many of us if I can do it.

I am currently looking into iodine which apparently is a cure for most cases of Goitre, an enlargement of the thyroid, and find that this age old cure for Goitre is not used any more so it appears that the modern cure for Goitre is to wait until it get too big and then have it cut out which on the face of it is ludicrous when proper iodine intake reduces the Goitre in the vast amount of cases. Iodine is critical to the well being of the thyroid gland and the female breast and from what I have read lately there is an epidemic of iodine deficiency which all ties in with the current epidemic of Afib and Breast cancer.

As many will know a dysfunctional thyroid is one of the many reasons for Afib but in the many years that I used to follow this BB I cannot say I ever saw any major mention or push to add iodine to the Big Three making it then Big Four. I strongly suggest that people look up iodine deficiency for a real eye opening that I missed completely in my many 1000s of hours of researching/discussion of AFib.

Just a final note. The only thing that could stop my Afib every time was Amiodarone but I could not live in that 'twilight world' that the drug left me in. I now find out via my iodine studies that Amiodarone is actually a toxic form of iodine.Maybe none toxic iodine does much the same but regular iodine may not be patentable and thus no money in it for Big Pharm. Iodine can be purchased via Han's connection with iHerb and I have just received my first order of Liquid Kelp from iHerb which I sought when I found out that my wife had just been diagnosed with early signs of Goitre. I will take the iodine rich Liquid Kelp as well, just in case my Afib had a thyroid connection.

Nearly forgot. I am nearly 65 and became a Great Grandad a month ago, you never lose it ;-)

Apologies again Elemc but just felt I had to get this iodine issue out before I disappear off the BB again.

Barry G.

Barry there is a test specific for iodine that I have taken. As always, it is best to "test don't guess" when it comes to self medicating, and of course when the appropriate test is available. My understanding is in full agreement with you that iodine is mandatory for thyroid and overall health. It is added to salt, so when many of us stop consuming foods that are processed and laced with poor quality salt we also remove this source of iodine. As an interesting side note, it then becomes important to consume enough high quality salt. Iodine is actually needed in very small quantities - less than a teaspoon per year. I am mildly deficient so take one tablet of kelp per day and will re-test after about a year.
Ron

Also I should chime in that I am 14 months post ablation. Both of mine were done by Pr. Jais in 2013, and today I am in a very happy state of NSR.
Ron

Barry,

Glad you are doing so well. I certainly remember your posts from '07.

Jackie and most vociferously, William, have brought up the iodine issue here. Here are some of Jackie's posts:
<[www.afibbers.org] <[www.afibbers.org] and a search on her iodine posts <[www.afibbers.org]

Search on William's posts <[www.afibbers.org] One thread: <[www.afibbers.org]

Keep up the NSR!

Leslie,

Congratulations and hope it continues well!

George

Don't worry about the language thing. I am from France, although I live in the US since 1990. I have done 3 ablations in Bordeaux and all my pre and post emails with Dr Jais were in English including ablation reports, so I could propagate to my EPs. I never found that there was any loss in translation.

Hi Lesley,

You are in great hands in Bordeaux, the best in Europe, and regarding your first EP who did the first five, I fully understand your found feelings toward him or her ftom their very caring and nice demeanor and very well-meaning treatment of you.

But this too is presents a good opportunity to underscore the point that we can't depend mostly on our EPs demeanor or bedside manner when it comes to criteria for selecting the best ablationist for us, particularly all the more so when we present a more challenging case than is typical.

Its wonderful when we can find this great combo of traits in our ablationist EP that is both caring, gentle and patient while also being a true maestro at addressing such difficult cases as, thankfully, you now will find in Professors Jais and Haissaguerre in Bordeaux and that so many of us in the US have come to treasure in Dr Natale. You will always appreciate and have a fondness for your first EP who was so caring toward you and who did their very best on your behalf, while Im sure now you will add to that experience with your upcoming relationship with the excellent EPs at Bordeaux who I have every confidence will help you find a happy resolution to your long journey with AFIB.

Best wishes,
Shannon