does Dr. Natale also do ventricular ablations?

I've often read (in this forum) that Dr. Natale has performed over 8000 ablations.

However a few days ago, in a discussion with another dr (a general cardiologist) I learned that some EP's actually specialize in atrium-side ablations (eg, for afib), whereas other EP's actually specialize in ventricle-side ablations (eg, for ventricular tachycardia).

Q#1: does Dr. Natale specialize in one side of the heart or the other, or does he do both?

Q#2: what % (approx) of his 8000 ablations are atrium-side (for afib) ?

Q#3: if one needed a ventricle-side ablation, would Dr. Natale still be the top recommended EP?

Thanks,
-Ted

Ted, His group does complex VT and there seems to be a division in sub-specialties. For complex VT (which is arguably more complicated than AF ablation), Dr. Burkhardt is the man. He has done thousands of them and those patients are typically very very sick. So the answer is yes, his group can take care of that in Austin (La Jolla may not have the equipment) and Burkhardt is the top gun. Below is the link to Dr. Burkhardt's talk regarding VT ablation in Natale's group. Question - you have VT in addition to AF?

(the meat of the talk is after the 5 minute mark or so, first part deals with company sponsorship)

[www.youtube.com]



Edited 1 time(s). Last edit at 07/25/2015 05:40PM by researcher.

Hi Researcher,

I'm impressed with your ability to find videos which are "unlisted" (ie, hidden from youtube's search button). How do you do that?

Thanks for that link, it was quite useful. But I'm still looking for an answer to Q#1 and Q#2. Perhaps the best way to get an answer for those is to ask Dr. Natale directly. Oh well.

Cheers,
-Ted

Apache.

Yes Dr Natale does VT ablations and its not uncommon for people at his centers to require both AFIB and VT work. Typically, one phase before the other. Dr Burkhardt also does VT which is more his own specialty but Dr Natale mentored him there as well as with AFIB ablation.

And its not really a sided thing as in right side versus left side when distinquishing between atrial and ventricular ablation as the right and left ventricles are below the right and left atria respectively.

The vast majority of DR Natale's now over 8000 plus ablations have been atrial in nature, but he has done plenty of VT work as well, often in the same patient when required.

It's very important when looking at a man like Dr Natale in comparison to many other EPs to take into account the broad and complex scope of the type of patients that make up the lions share of his practice. With such a national and international referral system in which other EPs send their most challenging cases to Dr N. for resolution from all over the US and the world, you always have to keep in mind that his success rates and stats and such are not at all apples to apples with the more typical EP who typically sees a general typical population of patients from a give region over the course of their career in one area, and serving the general needs of the average city or community. Dr Natale sees ver challenging cases every week the likes of which the majority of EPs hardly ever run across .... or deliberately try to minimize having to address when it is foreseeable.

Its this special level of experience that also sets him apart, and just knowing that no matter what a given person's case might present, it is very unlikely to be a surprise or something he hasn't well handled before and often. And what I have learned in my years of knowing and being on both sides of his EP table is that one can feel very comfortable with him at the helm of guiding one's care in this field and if he ever feels there is another colleague he would prefer do a given procedure for you he will recommend and arrange that for you .. like he did for me with my Amplatzer ADO-II plug for my LARIAT leak plugging adventure in which he referred me to Dr Matthew Price, a close colleague and interventional cardiologist who is an expert at using these vascular plug devices at Scripps in La Jolla.

I've seen him do the same thing with many of his patients who needed various other related treatments or procedures, and with his stature and visibility in not only the EP world but all branches of Cardiology and its various subspecialties, he is in a very good position to know who is best for given types of jobs and can easily get you into see whomever might need and where ever they are ... yet another good reason for partnering with a top tier operator such as he.

Shannon



Edited 1 time(s). Last edit at 07/29/2015 10:23PM by Shannon.

Thanks Shannon, excellent answer!

Cheers,
-Ted

Here is a video directly from the source, Natale/Burkhardt live case webcast at 2014 ablation symposium. The one above is more of an overview of standard of care. This patient here had a heart attack followed by more heart attacks as he would not quit smoking, so the ventricular scar grew and they are chasing the scar with recurrent procedures. The video is heavy into technical jargon so probably less understandable than the first video.


[stdavidshealthcast.com]