Successful ablations!!

Just doing a little personal survey...…….. how many people on this forum had successful ablations and by whom?

Thanks in advance.

I have, by Natale.

Also multiple prior failed ablations by other EPs.

Quote
whitehaven
Just doing a little personal survey...…….. how many people on this forum had successful ablations and by whom?

Thanks in advance.

What is your criteria for success? Significantly reduced afib burden? X number of years afib free? Complete obliteration of afib? Maybe we could start a poll.

After my first ablation back in 2009 in Pittsburgh (Dr. Andrew Voigt) I was afib free for 5 years. Beyond that I either self converted rapidly or used a PIP for the 1 or 2 events I would have per year up until January of 2018.

I'm currently under the care of Dr. Natale having had what I consider an index ablation with him in July 2018 after a failed second ablation by Dr. Voigt in January. I consider my ablation with Dr. Natale to be an index ablation as my afib had progressed significantly since 2009.

Dr. Voigt continues to be my go to EP locally for routine checkups.

I guess we could start with number of years afib free...…...not quite sure if there is such a thing as complete
obliteration.

Hi Whitehaven,

As we discussed on the phone this morning, I haven’t had a single solitary beat of AFIB in over 10 years after 16 yrs of AFIB progression from sporadic early stage Paroxysmal AF to eventually aggressive persistent AFIB. Following my index procedure with Dr Natale, just a couple months after he moved from Cleveland Clinic to St David’s in Austin, and confirmed by my dual chamber pacemaker that has been onboard since 2002 and monitoring every single mode switch, night and day!!

Furthermore, I can confirm many hundreds of very similar results I’ve witnessed first hand via forum members and others who I’ve followed up with during and after their Natale ABLs via their Ablation Reports. A phenomenal degree of consistently successful results confirming Natale’s prowess with a catheter.

Very impressive work by the maestro

Shannon

One unsuccessful followed by one that was successful. The latter by Dr. Natale.

Ablated 2015 by Duke University EP. No drugs. Had a breakthrough episode April 2018 which puzzled me. I think I over-supplemented iodine. Dialed that back and all’s been good. Keeping my fingers crossed but will go to TCAI when and if the index ablation reaches its limit. Meanwhile, I stay here to stay current with the technology and lifestyle advice to make that stretch of time the longest it can possibly be.

11 years of afib (didn't know it was afib for the first 5), on meds for the last 6 yrs.

Ablated 11 years ago by Dr. Kevin Wheelan, Heart Place, Baylor Hospital, Dallas, TX. I have had 4 short (2 hr.) episodes (self converted) scattered over the last 11 years. Discouraging, but I am not yet concerned. I haven't been on any meds for the last 11 years, but do take MG, K, and Taurine. I am 73 and very physically active.



Edited 1 time(s). Last edit at 02/24/2019 03:22PM by Ken.

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whitehaven
not quite sure if there is such a thing as complete obliteration.

I've been in 100% NSR for 18 months without so much as a single ectopic (that I'm aware of, and I'm always aware). I wore a Holter monitor for 8 days in 2018 that confirmed not so much as a single PAC. Close enough to complete obliteration for me, especially since I failed 5 previous ablations over a period of 7 years.

The usual definition of success for research purposes is freedom from sustained atrial arrhythmias for 1 year post-blanking period without the use of antiarrhythmic drugs. I think that's a reasonable definition. Afib that reappears after that period is certainly progression of the disease rather than a failure of the ablation.

Ablation Jaunuary 2003 in Bordeaux by Professor Michel Haïssaguerre, assisted by Dr (now Prof) Jaïs, after over 40 years of paroxysmal AF and 18 months of persistent AF. Second ablation 3 days later because of recurrence. He thought there was a gap In the lines but that was not the case - he found a very toxic focus in the coronary sinus which he said was extremely difficult to find and ablate. I am sure that a less skilled EP would not have found it.

Since then I have been in sinus rhythm - over 16 years now, take no medication. I get many ectopic beats but magnesium, taurine and d-ribose dampen them down so I hardly notice them. Now and then it feels as though AF is trying to start up, with lots of runs of ectopics but it always settles down - the lines are still doing their job.

No idea how much longer it will last but I’m grateful for the time I’ve had so far.

Gill (female, pronounced 'Jill')

I had an ablation with Dr Natale 10 months ago and am off all drugs!!!

Quote
rocketritch
After my first ablation back in 2009 in Pittsburgh (Dr. Andrew Voigt) I was afib free for 5 years. Beyond that I either self converted rapidly or used a PIP for the 1 or 2 events I would have per year up until January of 2018.

I'm currently under the care of Dr. Natale having had what I consider an index ablation with him in July 2018 after a failed second ablation by Dr. Voigt in January. I consider my ablation with Dr. Natale to be an index ablation as my afib had progressed significantly since 2009.

Dr. Voigt continues to be my go to EP locally for routine checkups.

Just a little more info..

I am currently off of antiarrhythmic drugs since October. I am still on 5 mg elequis and 25mg metoprolol twice a day. I have had one noticeable rhythm episode that lasted 30 min since.

Dr. Andrea Natale did a index ablation of my long standing persistent a-fib in Dec. 2013. I was a complete mess at the time, felt physically disabled. Not a blip of a-fib since. Zero. My complete ablation report is here under my screen name, Dr. Natale did a TON of work.

After 2 years in persistent afib, and by then sick of drugs, I had an ablation by Dr. Natale (thanks to the recommendations of this forum) in San Francisco in 2009. I was afib-free then until 2011, when I had a "touch-up" ablation by Dr. Natale in San Diego. Afib free since then, though I do have occasional ectopics.

I remain very glad that I did the ablations, and that I did them with Dr. Natale.

--Lance

Unfortunately :
- Dr Natale can't ablate the whole world of afibbers
- Not everyone can afford the travel to Austin and, when living in W-Europe, the travel to Bordeaux
- Some countries, like the one in which I'm living, have highly regulated official and national obligatory health insurance, very efficient in most of the circumstances, but for which people are taxed 30 to 40% of their hard earned cash. So, going abroad for an ablation is expensive for someone having already paid so much money for global healthcare.

Had an ablation with dr Natale in March 2008 in San Francisco after almost 10 years of Paroxysmal Afib. I was 36 at that time. 10 years in the beginning of 2018 i started having episodes again. Actually i had 3 episodes lasting about for an 1 and a half and just decided in no time to go for touchup. In August 2018 had second ablation with Natale at St. Davis. So far I am in NSR after my second procedure. On a separate note: my last episode of Afib before my first ablation was march 8, 2008. (International women's day) amazingly my first reoccurrence was March 8, 2018. Girls what are you doing to us )))))))))))))))))))))))))

Ablated December 2010 by Professor Schilling, St Barts, London. Ectopics at times have been disconcerting but calmer now. Only those who have regained NSR can appreciate the bliss. Long may it last! Remain ever in debt to Prof S for his expertise and this forum for guidance.


Kaytee

I hear you, Pompon, and sympathize. At the time of my second ablation, I was in an HMO in San Diego (Scripps Clinic). I was very fortunate that Dr. Natale was spending a few days a month at Scripps, and it was covered by my HMO. Otherwise, I would have had to seek another ablationist, and it would have been a difficult choice.

Quote
Pompon
Unfortunately :
- Dr Natale can't ablate the whole world of afibbers
- Not everyone can afford the travel to Austin and, when living in W-Europe, the travel to Bordeaux
- Some countries, like the one in which I'm living, have highly regulated official and national obligatory health insurance, very efficient in most of the circumstances, but for which people are taxed 30 to 40% of their hard earned cash. So, going abroad for an ablation is expensive for someone having already paid so much money for global healthcare.

--Lance

Had 4 ablations. Last two with Natale. Most recent April 2018. Had PACs for awhile after last ablation, then went silent for about 3 months, but about three weeks ago they came back with a vengeance. Went on low dose Flec and atenolol about a week ago. It's helped abit. I'm hoping they go away.

Index PVI ablation by Prof Jais at Bordeaux Aug 2018.

A 20hr bout of bad ectopics 3 weeks after (that sorted itself out unassisted) - after overdoing it really straining and twisting to try and unloosen a corroded valve with one wrench in each hand in the very back of a low cupboard.

Still quite a lot of ectopics but less than before. I still feel some faster NSR with high HRV along with occasional more pronounced salvos of ectopics at my classic AF time of 5am but no AF as would have been the case pre-ablation (once a month on average for the first half of 2018).

Fingers cautiously crossed but will be back over to Bordeaux in a heartbeat if/as and when needed.



Edited 2 time(s). Last edit at 03/01/2019 10:53AM by mwcf.

Please inform me: what is an "index" ablation? I see many have used this term. Does it have some uniform
medical meaning, or is it variously being used subjectively?

Quote
IDbill
Please inform me: what is an "index" ablation? I see many have used this term. Does it have some uniform
medical meaning, or is it variously being used subjectively?

Index primarily meaning 'first' ablation procedure. This typically takes the form of a PVI only unless adenosine (after PVI) still precipitates AF when the EP will look for other problem (ectopic/irritable focus) areas in the atria. That's my take on what an index ablation is anyway. If I'm way off then other way more knowledgeable folk than I here will doubtless be along to put me right!

That was a pretty good definition Mike!

Yes, an index ABL indicates the primary initial ablation that for an AFIB ABL always includes a foundational PVI at least.

More advanced operators typically also include an LAPW isolation (Left Atrial Posterior Wall Iso) and often a Superior Vena Cava Idolation (SVC-Iso) as well... such as in Dr Natale’s classic ‘Natale Extended PVAI (Pulmonary Vein Antrum Isolation) + LAPW-Iso+ SVC-Iso for early to moderately advanced Paroxysmal
Cases.

Dr Natale almost always also looks for Non-PV Triggers too in each ablation by employing Isoproterenol (Isuprel drug challenge) after all the anatomical isolations have been completed, just to confirm if any unique real time Non-PV triggers that could spoil the party are indeed active via real time electrophysiological sleuthing that not all EP ablationists are fully trained in, nor very comfortable in performing.

Taking a more comprehensive search for all offending triggers during an index procedure is one reason such EPs who look for, and address, all active triggers that are discoverable starting from the index ABL and going forward during any follow up procedures needed as well, understandably tend to have a higher ultimate success rate in the least total amount of work required in terms of freedom from all Atrial arrhythmia ... with the added caveat that said advanced EP is also elite in both there total amount of advanced ablation experience and that they possess elite skill level with a catheter as well.

In other words, you want to partner with the most experienced operator you can arrange for yourself who is entirely comfortable and capable of elite level work with even the most challenging advanced AFIB/AT cases, regardless of what degree of difficulty your AFIB might present to your EP during both the index procedure, plus any touch up work that might be required.

Shannon

18 months afib free after my 1st abation with Natale after 3 failed ablations by a "good guy" at University Hospital over a three year period. Over three years, 3 failed ablations and being diganosed with heart failure with ejection fraction as low as 25% I sit here today having had zero afib since my Natale ablation with EF of 65% and my life back.

I have a unique from birth heart feature knows as a Peresistent Left Super Vena Cava and Natale was not phased one bit of course. He eats this afib up for breakfast.

March 2011 with Natale in Austin
No issues or anti-arrhythmic medication since
(He prescribed 81 mg aspirin daily)

Steve
Spring, Tx.

18 months AFIB Free after my second ablation touch up by Dr Natale. No drugs perfect NSR

Brent
South Dakota

Did Dr. Natale put you on the meds for the extra beats? My 3rd ablation was 12/19/18 in Austin but I’m suffering terribly with PAC beats, rubs, Tachycardia. I’ve not slept through the night since my ablation due to the above. I’m on Corlanor and Metoprolol.