Normal follow-up after ablation? My EP is not interested

Hi everyone,

I'm just wondering what everyone's experience is with follow up after an ablation. I went to Bordeaux just over a month ago and had them perform my ablation. I knew before I left that my EP was not big on the idea because his office would not facilitate the TEE or anything else. Also, when I spoke to his nurse she informed me that once I had an ablation done elsewhere he would never perform a second ablation because he didn't ever want to " clean up somebody else's mess ".

I had an appointment with him yesterday in which I brought Dr. Hocini's letter to him explaining what she did and requesting follow-up at three, six and nine months. He informed me that any follow up with this procedure would need to be done with the Bordeaux team and that he really didn't see a need for me to be his patient any longer but if I started having problems in the future my GP could refer me to him again.

This is pretty much what I had expected. So now I need to arrage all follow up with my family doctor. I doubt he's going to know what to do so I'm wondering what is typical. Is there a Holter monitor that needs to be done? I'm going to email Dr. Hocini and see what she wants but I thought I would get everyone else's experience as well.

Thanks,

Monty



Edited 2 time(s). Last edit at 07/08/2015 07:01PM by montos.

Monty, that is pretty much my experience with Oregon Cardiology. It looked as if I might need a cardioversion and they wouldn't even contact the office that did the ablation as they requested.

To make matters worse, I haven't had a good followup with the EP in San Francisco that did the ablation. I don't need or want hand holding, but there is something lacking. I feel like I am on my own.

...ronH

Monty

I find it very mean spirited of your EP to take this attitude. My EP in the UK referred me to Bordeaux then took over the follow up when I got back, including provision of prescriptions and monitoring INR on a weekly basis until I stopped anticoagulation and drugs.

I had checkups at 3 months, 6 months, 12 months, then annually for many years. I also had 24 hour Holters whenever we thought it necessary. Great service from our National Health Service, and all free of charge.

Gill

Monty,.

Sorry for the inconvenience for sure, but you are much better off without this Doc handling your care. Apparently he would rather pick up his ball and go home and not treat you at all if you didn't let him ablate you.. That kind of arrogance is dangerous and very much too bad, but not at all unheard of.

There are many wonderful men and women EPs that I have met, the majority seem to fall in that category and appear to be well balanced human beings from all that I can tell, but like in any professional sphere, there are always a certain number with very large .. and proportionally fragile .. .egos!

Just consider that this EP did you a favor by, in essence, firing himself as your doctor. Saves you the eventual hassle and possible poor treatment, and thank goodness you didn't settle for him to do your ablation!. You can find a good Cardio too, though Ideally a more sympathetic and more professional EP would be best.

Best wishes and continue healing up!

Shannon



Edited 2 time(s). Last edit at 07/09/2015 10:52AM by Shannon.

Monty,

Perhaps a note to Dr. Hocini explaining the situation. Ask what tests and or other procedures the GP can/should do to follow up. I'm sure it is not the first time she will have encountered the situation.

George

The only thing I agree with your original EP here is that he should not do the touch-up Ablation if needed, but why did the Nurse throw in that negative comment at this point anyhow? You just wanted basic monitoring of your Ablation. I agree with George, your GP can do alot himself, especially if your doing well.

Hi Monty,

I am so sorry that you had that experience. I have had a very similar experience here in Gainesville, FL. My solution was to visit another cardiologist here to help me coordinate with Dr. Natale in Austin. The doctor I contacted here is an interventional cardiologist, a plumber, not an electrician. He is very willing to follow my case and provide whatever support he can. He was able to help me with a cardioversion as well as being willing to be a team player with Dr. Natale. It is comforting to have knowledgeable help nearby. Perhaps you or your family doctor could find another cardiologist locally, an EP or interventional who would do the right thing and join your team. I think that a local cardiologist, who is to your liking, might be a good choice to collaberate with your French team. I think it would be possible to contact local cardiologists and talk to them or their PAs and directly ask if they would be willing to work with your French team for your best care. My local cardiologist knows that my care is supervised by my attending doctor, Dr. Andrea Natale and that all care is to be coordinated through him. Of course he asked for my medical records and we went from there.

All The Best To You, Monty. It is possible to put together a Great Team!

Hang in there,
John

Hi,

Same situation here. My first EP told me not to come back after I had my ablation with Dr. Natale. I understand in a way and as Shannon says, it's best that he (gracefully) exited if he wasn't interested in continuing care. I did find another EP who was more than willing to see me. She has recommened a 2 week Zio patch at 6 months post ablation and possibly an echo to check for structural changes. Wondering if anyone else has experience for what is commonly prescribed post-ablation for diagnosis (Zio/Echo) and when?

Thanks
Q

Que,

Your new EP sounds like she is informed and good recommendations overall, Though you will have the 6 month follow up screening for that week to days prior to your 6 month meeting followup in which you will be monitored 24/7 from Natales office via a monitor they will send you then as well. So no real need to duplicate efforts with the Zio patch then. A structural echo is likely unnecessary but wont hurt, unless you have some symptoms that might indicate a need to investigate further.

Nevertheless, she sounds proactive and on the ball from the little we can tell from this interaction... Its really too bad a good number of EPs don't follow the professional ethics and courtesy that you used to see in most every specialty where patients were gladly followed up by other docs who did not actually do a given procedure.

It indicates a lack of confidence to me, masquerading perhaps as over-confidence.

Cheers!
Shannon

A different response.

I had my Natale/Hao/Hongo ablation about 10 years ago. Everything went fine except for an awful reaction at Marin GH to the drugs prescribed (D/C'd on the spot)) and I was immediately in NSR. No one ever suggested a follow-up at the time, and I have never had one, although in a contact with Dr. Hao several years later regarding continued use of one adult aspirin per day, he suggested an annual cardio checkup. I did not follow up as I was fine.

My PCP does an EKG every couple of years and all is normal.

Thanks Shannon. Good to know that Dr. Natale's office plans a 6 month follow up. I wasn't absolutely certain. Do you know if that typically occurs in person? I was planning to move to Hawaii somewhere around 5 1/2 months post procedure. It would be easy enough to wait another couple of weeks but it would be good to plan accordingly.

All the best,
Q

Hey Monty, I'm really saddened by Dr Lockwoods stance towards your needs. Its a piss poor attitude to take. I guess He got his nose out of joint because you decided to go to a better doctor. I wonder if he had afib would he go to a doctor with only a %60 chance of success. I'm sure your GP can find another EP should you need one. Let me know if you find a good one. I haven't seen one or had an ecg since my bordeaux ablation. I am seeing orthopaedic dr for bad knees but that's another story.

Cheers

Adrian

3 Years and counting in NSR since my Bordeaux ablation with Dr. Hocini

No regrets