Experience?

I am sure this is been posted many times over but im in a rush this morning, and wanted to ask before I forget.
How many afibbers has Dr Natale done an ablation on? Did it get rid of your afib/aflutter/SVT/Atach ? What facility did you go to. I have an appointment in Austin but saw Dr Natale in San Diego, and he said I can go ahead and cancel my Austin procedure as San Diego would be more convienent for me as I live in Las Vegas NV. Any feedback would be great as my procedure in San Diego is supposed to be the first week of April.

I know of about a dozen people on this site and others that have had an ablation by Natale, including myself. All are in NSR. I did mine in Austin (I'm from CT). I'm at the six-month mark now and haven't experienced so much as a stray PAC since the procedure. Not everyone has such a smooth time of the blanking period. I know of some who experienced episodes of afib or flutter after their ablation, but they were one-time events that didn't last. I believe Jackie here on this site has had three by Natale, but it spans a very long period of time (20 years?). I'm sure she'll be along shortly and can speak for herself.

I failed five previous ablations by three EPs, one of whom is considered one of the top EPs in the northeast. He was actually reluctant to try on me again because I was such a complex case, but Natale didn't so much as bat an eye. I went into his lab with a heart rate of 238 and came out two hours later with a heart rate of 72. It's been like that ever since. So yeah, he walks on water as far as I'm concerned.

I had an ablation with Dr. Natale in Austin exactly 1 year ago tomorrow. Before I went in, I was having AF episodes 1-2 times per week (1-3 hours long each). Nothing at all since. Zip. Zero. Nada.

I DID have some weirdness during the blanking period, and shortly thereafter, but it was in the form of bigeminy or trigeminy, not AF. Nothing like that for 8 months now, though. Dr. Natale is 100% recommended.

Carey, I've had two PVI ablations, and mini maze, and then a ablation for flutter. My heart has been doing all kinds of crazy things. I just hope I haven't damaged my heart between all the procedures, and radiation exposure.

All you can do is what your gut tells you.ive had six ablations. Two PVI one by Natale, four right side one by Natale. I def recommend Natale. I feel thru the years the procedures have helped me prolong and gave me periods of relief. I think one more PVI may finish it off. I'm not having afib so much but after two years I do have a lot of ectopics. As you mentioned I am concerned in the long run what has happened inside my heart. I do however believe the best chance is with Natale. You just have to come to the decision that this route is right for you realizing the short term risks are very minimum, the long term .....not sure we knoW. I don't think the center is so much necessary I think Natale is just so experienced he has the touch, it's kind of like someone who is taught in guitar who plays perfectly in a technical sense vs someone who is taught but has experience and has the feel and rhythm (the touch, mojo). The same song sounds totally different!
Tim

As of 2 years ago Natale had done over 8000, so now probably over 9000. About 500/yr.

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zoeysky2004
Carey, I've had two PVI ablations, and mini maze, and then a ablation for flutter. My heart has been doing all kinds of crazy things. I just hope I haven't damaged my heart between all the procedures, and radiation exposure.

Very unlikely any serious damage was done or you would be showing symptoms. The radiation exposure from an ablation is really quite low and not enough to cause heart damage.

Without question my first EP did damage. He did three ablations, all of which failed, and left me with at least three and probably four separate flutter circuits and completely reconnected pulmonary veins. The second and third EPs fixed half of that mess, leaving me with two flutter circuits, but then two years later a reconnection appeared in my PVs, adding afib to the flutter once again. Natale fixed the whole stinking mess in a little over two hours and went on to do two other ablations the same day. Rest assured you're in good hands.

Zoey - Great that you are able to see Dr. Natale! I posted the following response to Liz just the other day regarding my ablation history and the need to continue on Eliquis. My experiences with all three Natale ablations... first, here in Cleveland, Ohio, and the last two in Austin, TX... were all very positive. He is my hero. I wish you well and hope that you will let us know how you are after you are home and recovering.

I'll be thinking good, positive thoughts for you on your ablation day.

Best to you,
Jackie


Afib entered my life in May of 1995.

I had the first Natale ablation in 2003 after the initial onset eight years prior. I nearly cancelled that date because I had actually managed to be AF free with no meds and just using the core nutrients. But I did go ahead and have it because of the potential for a major insurance change. Eleven years later, I began to have episodes of a-flutter.

In hindsight, I'm quite sure that because I had begun aggressive treatment for Lyme markers ...indicating I had a previous exposure but not active Lyme... and as a result, I began experiencing the flutter. I stopped the treatment, but the flutter persisted and those sessions were incapacating. Thankfully, with Shannon's help, I was able to see Dr. Natale in Texas (August 2014) very quickly. This time, he isolated the LAA so that requires staying on Eliquis until the clearance velocity of the appendage is checked 6 mos. later and all was fine. However, not quite 6 mos after that, I started with some flutter again and flew immediately to Texas for the touch up. Eventually, I was able to take half dose Eliquis because the clearance velocity was still good... but I'm sure because of my age ... (you and I are about the same age)... Dr. Natale said it would be "best to continue" on the half dose.

I can appreciate your comment and apprehension about going for an ablation but from what Shannon has shared with us about Dr. Natale often treating patients in their 80's.... I would not lose much sleep if I had to go back again... although, I'd definitely prefer to visit Austin just for fun time with my son who lives in a suburb.

Not everyone will need three or more procedures, but my experience is that I had virtually no down-time other than following the post-procedure instructions for all three. Of course, I attribute that to Dr. Natale's exquisite expertise and I will forever be extremely grateful to have been his patient.

Jackie

I had my an ablation with Dr Natale in October 2017 (my first ablation) and have been in NSR since. It was definitely the correct choice for me.

I'm a little over five months out from Natale. It was my 4th ablation in 3 years, 1st with him. Other three were complete failures at the Univeristy system here in Chicago.

I am afib free and believe I have been since this procedure. I've been off all meds for 3 months now except the Eliquis. I still have some PVC's here and there and my heart rate spends a lot of time in the 90's but is making slow progress lower on average.

Dr. Natale changed my life as I had all but given up after all drugs failed, my HR was in AFIB and 150BPM most of the time and I do get heart failure.

I can say that my case turned about to be unique with a PLSVC but it didn't phase Natale one bit. Time will tell if I am done but clearly I cannot say enough good things about him. If someone has the means/Insurance and time I see no reason not to go to Austin.

Dr. Natale is my hero also. He did my 2nd ablation in early June '17 and NSR since. I get emotional when I talk about what he and the excellent staff at TCAI/ST David's have done for me.

Hi all - I'm a patient of Dr Natale and Shannon. Dr Natale performed his initial ablation on me on Nov 8, 2017 (had two previous by local EP). Dr Natale did some extensive work on me (or maybe its standard?); insured PVI; isolated posterior wall of left atrium; left atrial septum; floor of left atrium; left atrial lateral wall and anterior roof; isolated left atrial appendage, isolated coronary sinus; right atrial septum, lateral crista; and high right atrium. Anyway - had some breakthroughs and am now scheduled for a touch up on April 30 in Austin. Currently, I'm struggling with atrial flutter (which I didn't have before the ablation). I was told that a touch up maybe necessary so not surprised with the outcome. i was told that flutter is a common "side effect" given the ablation lines performed and was wondering if anyone had any similar experiences? Many thanks. Joe

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Josephkroussell
i was told that flutter is a common "side effect" given the ablation lines performed and was wondering if anyone had any similar experiences? Many thanks. Joe

Oh yeah, in spades, with rates up to 250 bpm. I was in flutter within a few days after my first ablation and despite a total of four more attempts by three EPs over the next seven years, I was never free of it until Natale finally cured it last August.

Yes Joe, Atypical left atrial flutter is an not uncommon manifestation when theirvis a recurrence post ablation. Look at it like an interim arrhythmia manifestation signaling typically only one more brief touch up with a maestro like Natale in the vast majority of follow up ABLs with him. People who only had a PVI only procedure(s) are not as prone to Atypical left Flutter since when they have a recurrence after such love kites amount of work being done, it is far more common for AFIB to be the recurrent arrhythmia.

Since Natale makes every attempt to zap ALL detectable offending triggers during each and every ablation he does, including any real time detected Non-PV triggers that most PVI-Only ablation EPs hardly ever even look for nor do much, if any real time electrophysiology sleuthing to find such unique triggers to your heart and as such it’s not uncommon for a person to under three or more ablations and still not have all the true elephants in the room identified and addressed.

But as a result of doing more extensive work and true real time searching for offending triggers throughout the left and right atriums, there will be a bit more Atypical left atrial flutters as a purely temporary speed bump on the way to what is generally well over 90% .freedom from all arrhythmia after the 2nd procedure in a large majority of cases. There are a much smaller percentage of cases in which Dr Natale did the Index procedure too that my need a third even smaller procedure if just a couple burns and that is it, but while a clear majority are done in one procedure, it is still common enough due to the significantly more challenging case load he has, of over 70% of his total patients being non-paroxysmal (persistent and LSPAF) in nature!

Even many heads of other large ablation centers rarely reach 10% to 15% Non-paroxysmal patient case loads. The head of UCSFs large cebter notes that under 5% of their ablation cases are LSPAF cases! So it’s very difficult to compare Natale’s group to most other decent size centers that still primarily focus on a less extended Ablation protocol.

The unequivocal results from Natale and his groups in my long experience following him and other good size centers closely over the years shows that the vast majority of Natale patient do reach true durable freedom from atrial arrhythmia in the least amount of total work required whether over a 1, 2 or 3 procedure Expert ABL process, especially when the afibber made the wise choice of begin his and ending that process with Dr Natale performing all the work that might be required for each patient.

Shannon

Many thanks! The pearls of wisdom and experience are comforting. I'm ready to kick the tires and light the fires....