I'm still agonising about where to go for an ablation. I've had various email correspondence with Bordeaux (both admin and Prof. Jais himself) and they have been most helpful and courteous. Bordeaux is obviously absolutely right up there at the top of the list. If I were a French national living in France OR resident in a country lacking any top tier EPs and having enough money to pay privately then clearly Bordeaux would be a total no-brainer. But as a UK resident and being of modest financial means there are cost and logistical issues that I need to factor in - not least given that there are some top EPs here in the UK - notably Schilling and Ernst. Right now if having an ablation in the UK I'm favouring Schilling - not least because he has been doing AF ablations since 1998 and openly publishes his own stats year on year for his own private (not NHS at St. Barts - where it would be his team rather than him himself doing the procedures) ablation work at London Bridge Hospital.
Bordeaux-wise, Prof. Jais estimates me to have around 80% chance of being successfully ablated for my paroxysmal AF with one procedure. Appreciating that my financial means are limited, he has also kindly said that he will do his very best to so far as he reasonably can avoid any chance of PVI reconnection.
Here are Schilling's stats for 2016 (2017 stats not available yet as the 18 month follow-up period obviously hasn't elapsed yet):
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londonafcentre.com]
In 2016 for paroxysmal AF he achieved 79% success for one procedure (no AF and no meds at 18 month follow-up - his criteria for success or failure are very clearly stated in 'Background on page 2) and 91% success with 2 procedures (average 1.2 procedures per patient). In his stats he also includes any adverse consequences he's experienced (no strokes at all). He now takes an average of 61 mins per procedure (cryo is invariably quicker to do than RF) and uses just 2 minutes of X-ray time, All of the other info on the London AF Centre website is very comprehensive and helpful also. Schilling also ablates the right atrium for AFL as part of the procedure as well as going and looking for and ablating any other problem areas (as also obviously do Bordeaux). Schilling uses the latest cryo-balloon 2 for PVI that results in far less PVI reconnection than did the earlier cryo-balloon 1 equipment. In fact, research shows that PVI reconnection rates are now almost identical for cryo-balloon 2 and for contact force catheters using RF rather than cryo.
You can view Schilling's stats from 2012 to 2016 inclusive here:
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londonafcentre.com]
One major potential issue I as a UK resident have ran into Bordeaux-wise is that they tell me I would have to have a TOE here in the UK 'a few days' before the procedure. That's all well and good except for two things. First, when giving up Flecainide as I must 5 days before the procedure then that combined with the stress of travelling on my own not speaking any French it's better than 50:50 that I'm likely to get AF AFTER I've had the TOE here in the UK 'a few days' before the ablation - which kind of defeats the point of the TOE. Secondly, it is not that straightforward for me to just get a TOE here on the NHS (I'm guessing privately might be a bit easier to organise but again at significant cost) a few days before/to suit my ablation date. So here's another good thing about Schilling and the London AF Centre: if Prof. Schilling considers that a TOE is required (his website says that it 'may' be required) then it will be done on the morning of/as part of the procedure. This to my mind at least seems so much more logical (i.e. to allow for any clot that might have formed after the TOE in the not unlikely event that AF occurs in the 5 days prior to the procedure with me having stopped taking Flecainide) not to say logistically appealing.
Another major factor is whether or not I'd need a second/touch-up procedure a few months down the line. At Bordeaux it would likely cost me another E16.5K end of. If I pay for Schilling privately for a first procedure at London Bridge and then require a touch-up the indications are favourable that I could get a second/touch-up procedure on the NHS at St. Barts on the basis that Schilling would be more likely/compelled to want to finish off his own work than let someone else do it for him.
So my decision-making process continues. My next step is to have a private consult with Schilling and then go from there.
Many thanks to all here who've responded with their views and opinions.
Mike F.
Edited 4 time(s). Last edit at 03/24/2018 11:28AM by mwcf.