Dr. Josep Brugada in Barcelona

Hello there,

I am a 46 years old male persistent Afibber, completely asymptomatic, my heartbeat remains between 60-79 all the time and never had an episode of the 'mounster in my chest', and discovered 3 months ago on a routine medical check that I have afib. After this my life have changed completely, I stopped practicing sports, drinking coffeee, diet cokes and beers. I was trying to figure it our for how long I have this condition, and if I can recall something strange is that since November 2015 my endurance capacity in the biking peloton, diminished tremendously. I remember trying to train harder because I thought I was out of shape but now I know it was due to the afib. What I think was the root cause of this condition was my daily training routine, composed of very demanding intervals in the bike, combined with my daily caffeine intake. Besides that, another trigger was that during vacations, I used to indulge in food and alcohol binging.
Anyhow, what I really would like to ask you is if someone knows Dr. Josep Brugada in Barcelona, I am a European Union citizen and for me it will be much easier to try to get an ablation overthere. I already had two cardioversion but lasting only 10 and 15 days in NSR and then back to afib.

Thanks in advance for your help.
Best regards,

Welcome Flavi and exactly where are you located in the EU?

Dr Brugada is a very well known EP and the condition Brugada syndrome. is named for he and his brother Pedro (also and EP) in Spain.

Brugada syndrome which Josep and Pedro first characterized is a form of genetically mediated Ventricular Fibrillation which often leads to SADS (sudden adult death syndrome).

Im not sure if Josep does a lot of AFIB ablation or not or if he specialized in persistent AFIB??

I will check on this but I have not heard his name widely associated with frequent persistent and long standing persistent AFIB ablation. You really want to partner with the most experienced EP in Europe that you can get too reasonably who does almost only persistent and LSPAF cases.

Professor Haissaguerre, Jain and Hocini are all in that class of doing a lot of more advanced AFIB cases in Bordeaux France, if you can just take a train or fly there too as an option.

I will make some inquiries to see if AFIB ablation is a big focus of the Dr. Josep Brugada or not, but either way he and his brother have made some excellent contributions to the field of EP, though I think much of their focus is on VT and VF as well as CRT cardiac resynchronization therapy. IM sure they do AFIB ablation, but just not sure it takes precedent over his obvious demands for VT/VF and CRT work too. He is a very nice man as well and I had the pleasure of speaking with him in San Fran last May for the HRS conference where he delivered a late breaking clinical trial his team worked on regarding advances in CRT methodology.

Cheers!
Shannon



Edited 2 time(s). Last edit at 08/15/2016 07:11PM by Shannon.

Hello Shannon,

Thank you very much for your insights and advice. After doing lots of research and listening to different opinions I have decide to perform my procedure with Dr. Natale. I am currently living in Latin America and it was the same for me to travel either to Europre or the U.S.

I am very happy with my decision and will let you know how everything went.

Cheers

Fravi

Excellent choice Fravi,

I assumed you were in Spain or the EU.

One source for those who are in Europe and have persistent AFIB I can highly recommend are Dr Antonio Della Russo who has a real focus in persistent and LSPAF at the large AFIB ablation center in Milan Italy that is Directed by Dr Claudio Tondo who is also an excellent ablationist. Both are colleagues and have worried for years with Dr Natale as well, so they know the ropes for doing advanced procedures the right way.

But when it's Even marginally close to being in the same ball
Park as doable for an Afibber to access the maestro himself in Dr Natale, I literally can't think of any scenario in which he would not be my first choice for anyone I love and care about, which by extension applies to all afibbers who seek out our advice on our website and forum.

If you are not set up already and need contact info then send me your phone number, country and time zone and we can talk by Skype to help get the ball rolling. If you already are in the pipeline then congrats and keep us posted as you'll certainly be in the best hands as Jay, Jackie and the rest confirmed already above and as you long positive experience from your first procedure with Dr Natale is your own confirmation of that fact.

So much had progressed since your first Natale ablation and he still brings his calm humble demeanor and amazingly skilled hands to bare, only now with a decade more experience with the most difficult cases snywhere in the world a regular day at the office for him, and with all

The best cutting edge new gear that was mostly not even on the drawing board when you had your first procedure.

You will no doubt be one of the early ones to benefit from a new BioSense Webster catheter that our new friend (and super nice man) JayBrons who posted above already was one of the first of Natale's patients to have him use this new catheter on.

It combines all the great features of the two most recent new BioSense Webster state of the art catheters combining a full Contact Force sensor system as found in their Thermicool Smart Touch CF catheter with its equally excellent Thermocool SmartFlow catheter that has been Dr Natale's favorite catheter for all persistent and LSPAF cases the last almost 5 years, including the first year of its existence under FDA IDE investigative device evidence) trial.

The SmartFlow (SF), as does this new catheter has the same 56 tiny holes across the round flat metal RF tip and along the sides of the metal tip that exudes a constant stream of such smoothly distributed cooling saline flow from the complete area where RF burns are delivered that is maintains an unbroken laminar envelope completely surrounding the RF metal tip even when laid at a parallel angle to the atrial tissue!!

Not only dose this design superior cooling practically eliminating tissue charring and steam pops when properly used, but it does so even though it requires only half the volume of saline fluid flow per minute (only 15 ml/min vs 30ml/min) compared to the original Thermocool irrigated Catheter firstvysedcby Natale under similar FDA IDE investigation from late 2007 to its approval in late 2008 and onward until early 2012 when the Smart Flow was first given to him to try out. And also the two existing CF catheters including the original SmartTouch and St Jude's CF catheter both are still limited by the higher flow rate of 30ml/minute of saline which makes them not a good choice for more extended persistent and even advanced paroxysmal ablations.

Plus the SmartFlow design used in Thais new catheter is ideal for Dr Natale's trademark Gliding catheter technique in which he drags both the lasso mapping Catheter and the SmartFlow ablation catheter ( and now this new version) at a 30 to 40 degree angle to the atrial tissue and directly adjacent to the electrode(s) on the lasso that are detecting activation triggering from the ablation area he is addressing to create a continuous lesion.

This new catheter has other refinements too and is less stiff than either first gen CF catheter as well. And it looks like a real incremental improvement all around.

Take care,
Shannon

Wise choice Fravi. Although I am sure Dr. Brugada is capable of doing an excellent job for you. He is very preoccupied with Brugada patients currently. He is doing a trial with others on ablation of Brugada syndrome and it is a very complex ablation procedure. When I was researching options for my father in law's post heart attack VT, he was no doubt one of the world's experts on VT ablations at the level of Marchlinski and Nademanee. For the trial, his team did over 100 Brugada ablations over the last 2 years. That's got to be a superhuman effort if you consider that the whole of western Europe does may be a few dozen epicardial VT ablations a year. The trial results are being presented in six months.

[www.af-ablation.org]