Upcoming Ablation

Hi again. It's been a while, but I'll be having my ablation this Friday, November 7th. I consulted three EPs - Drs. Barett, Reddy, and DiBiase, and decided on Dr. DiBiase. Dr. Reddy wanted me to be on Amiodarone both before and during the ablation. (I wrote the forum at the time about that.) Dr. Barrett looked at his watch when I started asking him questions, and so that was that. Dr. DiBiase, though, answered all my questions patiently, courteously and thoroughly. (I found myself wishing I had more to ask him!) It's my impression that Dr. Natale won't be in New York again this year - though, of course, I could be wrong - (Shannon, I know that you would be the expert on that!) - but I have complete confidence in Dr. DiBiase. The ablation will be at Montefiore Hospital (in the Bronx). I have to be there at seven on Friday morning. I will be given a TEE, to make sure there are no clots and, if all (hopefully) goes well, the procedure will start soon after. I will then stay overnight and probably be released late Saturday afternoon or early evening. Having read many of the accounts here over the years, I'm wondering if there's any advice you could give me - preparation, during, and/or after. I'll admit I'm not looking forward to the one - three month "blanking period" nor, of course, to the procedure itself. And I do want to get back to work quickly. I will be seeing the doctor after a month, then every few months for a while. I had a recent CAT scan of the chest, which was fine. I wore a Zio patch for two days - out of fourteen, because it wasn't attached properly and kept falling off. But they told me they got enough info from the two days it did work. It said I'm in a-fib 39% of the time, and go in and out on my own. (I've never had an ECV, and it's mostly "silent.") So it's still paroxysmal, in contrast to what a (very uncommunicative, and insulting) cardiologist once told me, who had insisted it was chronic, or near permanent. I'm guessing it will be a simple PVI-type ablation, but don't really know. They will implant a "loop recorder" in my chest, which will record until the battery runs out - one to three years - which I fully agreed to after it was explained; then they will remove it. I will call them for info from it. (I guess it's like an internal Zio patch / holter monitor. It looks like it could fit on a keychain. The wonders of technology! Glad this isn't the Middle Ages anymore!) That will show what my "burden" still is, if any. I'm hoping it will be zero, so I can get off the warfarin at some point, but I probably won't know for 1-3 years. (This may simply be wishful thinking though. I hope not. I hate being on medication, if you want my honest opinion, though I do know it's helping me a lot.) (I currently take warfarin and metoprolol, having had a TIA in February, as I once posted about here (and got, I might add, in gratitude, a lot of great and useful and generous responses)). (I may not post much here, on the forum, because my experience level is still very low - much of what I know is from this website - but I do read everybody's postings on a regular basis. I just wish I could offer more. Maybe, after this ablation, I will be able to offer more.)

I really appreciated talking with you, Shannon, on the phone, some months back. You really gave me some good advice and, as usual , were very generous with your time. (I don't know how you do it.)

I finally had a sleep apnea test last Saturday night. I was supposed to have one a few years ago at a local HIP center, but it fell through because of a very poor doctor. So I decided to have it done at Cornell Weill. I won't know the (complete) results until I see my E.N.T. doctor, which won't be till after the ablation.

I'm having my INR tested again tomorrow. Dr. DiBiase had wanted a weekly reading, to prepare for the procedure, so I will be faxing a copy of it tomorrow to his office.

So, again, to the forum, thanks for listening to my concerns. Any advice - or suggestions - no matter how "small" they may appear - would be much appreciated. Everyone, have a great day!

Ha! Dr Barrett is always looking at his watch but nonetheless is a very experienced EP. I know what you mean though. When he was at Mass General he answered all my questions over about a half hour period.

afhound99,

Thanks for your response. Dr. Barrett did seem like he knew what he was talking about, and I know he studied with Dr. Natale, which is a huge plus, but maybe I just wasn't in the mood to be rushed once again out of yet another cardiologist's office (or feeling I was being rushed). I figured if it was that way before the ablation, it would be the same after, when I'm sure I will have a lot more questions. I also was a bit put off by the fact that he asked me something and, when I told him I couldn't remember the answer exactly, but that it was all contained in the large pile of papers that constituted my medical records and which was sitting on the desk right behind him, both he and his assistant got up and went over to the desk and spent a lot of time turning over page after page after page, which took a lot of time. It struck me then that neither of them had done much more than glance at those pages beforehand, and I had spent a lot of time and effort having them sent over. His office had had them for quite some time before my appointment. Anyway, your comment was much appreciated and I'm sure you're right about him. Thanks. And I hope things are going well with you!

Best of luck on your upcoming ablation portofcall39! I had an ablation 2.5 years ago and have been in NSR since. Best decision I ever made. Let us know how it went when you can.

Jim

Yes thanks Jim, worked out real well.. he only (vaguely) remembers me from my English accent..

Hi Portofcall,

You are more than welcome, Im glad to see you made your choice from three well trained men and all three are very capable, especially with paroxysmal AF, and it's a very good choice you have made as well, in my book. I know Dr Di Biase quite well now and very much respect him and have no qualms at all in strongly recommending him.

He was chosen by Dr Natale to sponsor him after an outstanding medical career in his education phase in Italy where he had been tagged through the country and caught the attention of EP leaders in the US as well as a rising star in the EP world early on. Dr Natale concurred and offered to entirely sponsor and fully mentor him here in the US as he moved toward full US medical license as well. That allowed his Medical University their in Italy to contribute to his sponsorship knowing he was going to such an elite mentor that would only shine back with favor on the university as well.

He has been Dr Natale's right hand man, literally, for the last 7 years and Andrea has told me a number of times how proud he is of Luigi and what a smart and skilled ablationist he is. He has 'the touch' which is more or less an innate skill, that is then honed by experience into great skill. And just last month Dr Natale told me he fully supports and recommends Dr Di Biase for AFIB ablation as he is more than ready as indicated too by the fact that he recently earned the prestigious appointed as Director of EP at Montefiore Medical Center and Albert Einstein Medical College in NYC at the young age of 40.

That he is so far ahead of the curve at 40 is a real boon in my book, when and if, Dr Natale ever retires from active practice (likely not for another 10 years or longer I hope), Dr. Di Biase would very likely be my first choice as my active follow up EP to take over my own care whatever that may require by then ( hopefully it will entail only just meeting for routine periodic follow ups and to talk story about the old days :-). Dr Natale is pretty young himself at 53, so at my age of going on 63 in five months, he may well be active as long as I'm around. But hopefully, I'll get some more years yet too after Dr N. has hung up his catheters and I would feel very comfortable trusting my heart to Dr DiBiase as well.

Consider, too, that Dr DiBiase was Director of AFIB research the last 6 years or so at St Davids, the largest volume AFIB center in the world and the top research center with around 3.5 peer reviewed publications a month in major medical journals ... that is a LOT! He also was in charge of animal research as well, which is a great way to hone one's ablation skills, for the few that get to experience that kind of practice on much smaller hearts and vascular systems.. getting it right there makes it easier to get it right with more room to work with.

But most of all, Dr DiBiase has been right there assisting Dr Natale for many years now, and in the process observing and assisting in such a wealth of the world's most challenging cases in real time, and one could not possibly ask for a better mentorship and education for an up and coming new star on the AFIB ablation scene than he has been so fortunate to receive.

He's a very nice guy too as you noted, Portofcall, and very easy going like his mentor, and has a rather dashing Italian persona and knows his stuff. He also knows how to do more complex ablations being trained for such a long time by as good a mentor as there is anywhere in the world.

Outside of Dr Natale in this specialized area of medicine you'd be hard pressed to do any better and he is right there in your backyard.

Best wishes too you and give Dr DiBiase my best next time you see him.

Cheers!
Shannon



Edited 2 time(s). Last edit at 11/08/2014 11:15AM by Shannon.

Thanks, Shannon. I'll let you (and the forum) know how it goes tomorrow.

All the best, Port, for a succesful procedure and prompt recovery!

/L

Thanks, Larry G. I appreciate it.

Best wishes Portofcall!
Shannon

Thanks, Shannon. I'll let you know how it went on Sunday. (I'm glad you - and Dr. Natale - think so highly of Dr. DiBiase.)