My ablation Doc (or why is Dr. Natale the only name I see?)

Aloha Group...

I see many (many, many many) reccomends for Dr. Natale, and VERY few for others. I'm not intersted in the why Dr. Natale as I've been a long time lurker and have read the (very good) reasons for Dr. Natale.

What seems strange to me is a lack of others that are recommended. So I'm going to throw my doc into the ring. PLEASE BE AWARE that I have no experience in choosing doc's and maybe others have/will have a different experience, but I like this guy and will see him as long as he will see me. Here's an article about him so you can form your own opinion, not just listen to mine:

[tmcaznews.com]

I believe he has his own private OR at TMC that was equipped to his spec's. He's a big name in the Cath Lab there.

What are his medical credentials? Med school, internship, residency?

Who trained him in doing ablations? Where did he receive this training?

It isn't just the number of ablations performed, but how successful have they been?

[health.usnews.com]
He is 51

His practice’s website
[www.pimaheart.com]

He has a big practice of cardiologists

I'm sure he's a fine doctor but 1000 is not a lot of ablations. It's an average experience level.

Google his reviews
[www.healthgrades.com]
3.2/5 rating

[www.vitals.com]
3/5 rating

Google review 3/5

WebMD 3.3/5

RateMDs. 5/5

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Carey
I'm sure he's a fine doctor but 1000 is not a lot of ablations. It's an average experience level.

No worries, I am not trying to recommend him, just telling the group who I use and will continue to use when or if needed.

pmc

Quote
Carola
What are his medical credentials? Med school, internship, residency?

Who trained him in doing ablations? Where did he receive this training?

It isn't just the number of ablations performed, but how successful have they been?

Susan.D's second post shows most these answers (thanks susan.d!). But I don't know how can I quantify the "successful" question?

AND...I only showed who I'm using, not trying to convince anyone he's the person to use. My real questions is: Why do I not see OTHER doctors being recommended (other than Natale)? This board CAN make you feel like if it's not Dr. Natale, it's a lesser choice, so to speak.

pmc

If it wasn't for this website, I am guessing that Natale's reputation would be no different than any other EP for most afibbers. Are there other ways to find the best at any medical procedure other than word of mouth? I don't put much faith into online star or point ratings of Doctors.

My wife was in the medical field for 40 years, nuclear medicine tech to start, but evolved into administration and management. Being in a hospital or hospitals with access to many doctors allowed us to get the inside dope on the best around. Who the doctors went to for treatment. That's how I got connected to my EP - Dr. Kevin Wheelan in Dallas. Is he as good as Natale? Who knows, but I believe he is better than the majority of EP's doing ablations.

Now in a new community/state, it's word of mouth from others that have had the same treatment and that's still a gamble.

Quote
Ken
If it wasn't for this website, I am guessing that Natale's reputation would be no different than any other EP for most afibbers. Are there other ways to find the best at any medical procedure other than word of mouth? I don't put much faith into online star or point ratings of Doctors.

My wife was in the medical field for 40 years, nuclear medicine tech to start, but evolved into administration and management. Being in a hospital or hospitals with access to many doctors allowed us to get the inside dope on the best around. Who the doctors went to for treatment. That's how I got connected to my EP - Dr. Kevin Wheelan in Dallas. Is he as good as Natale? Who knows, but I believe he is better than the majority of EP's doing ablations.

Now in a new community/state, it's word of mouth from others that have had the same treatment and that's still a gamble.

10-4, and mine was a complete gamble. My non-ep cardiologist said "I've got you set up with Peress for an ablation" and me being me, I just said "ok" and showed up. My feeling about Dr Peress are strictly post-ablation and hospital employees stories/feelings. My wife has been an RN for almost 30yrs...she's heard lots of Cath-Lab and OR's "off the record" reviews about my doc.

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pmcaz
AND...I only showed who I'm using, not trying to convince anyone he's the person to use. My real questions is: Why do I not see OTHER doctors being recommended (other than Natale)? This board CAN make you feel like if it's not Dr. Natale, it's a lesser choice, so to speak.

Well, the reality is it would be a lesser choice.

But other doctors do get recommended here. I've done so myself more than once. A lot of people want the best they can get but they're unable/unwilling to travel to Austin.

It's no competition. Who's the best is just who you believe being the best. I like this forum and the help it may bring to afibbers. I like your stories, advices, witnesses...
But I pretty much dislike this feeling I have, when reading all your posts about Natale, that if your EP is someone else somewhere else, you're screwed.

I had my first ablation done by a local EP in mid 2009. I was basically afib free for about 9 1/2 years. Same EP did the second in early 2018 which only lasted 3 months. He only went back to touch up my early PVI ablation as well as a flutter circuit. Unfortunately my triggers lye fare beyond the typical afib triggers.

During my 3 day stay in the hospital at that time, getting put on Ticosyn, he and I had a heart to heart and he bowed out of doing any more work on me. Not that he did not feel capable nor did I distrust him. He just did not have the experience or confidence required to feel comfortable ablating those areas to be able to assure me that it would be worth my while. He was also more that willing to assist me with finding or refering me to someone who could.

He is still my local EP for regular visits.He gets all of my lab reports form Dr Natale and is interested in his approach.

Quote
Pompon
if your EP is someone else somewhere else, you're screwed.

I don't think this is true. It really depends on your situation. The simple cases that are handled with a PVAI generally don't show up here. There may not be a surefire way to determine this going in, but there are some indicators. I recall a fellow from the US, about 8 years ago who posted here. His situation was similar to mine. He'd had a 3 or so month persistent episode at the beginning of his afib "career." He'd later been able to create a situation where his AF burden was minimal. This lasted quite a few years, then the burden increased and he decided an ablation was warranted. The EP's (not Natale) he consulted in the US thought he'd be an easy case. The group in Bordeaux did not. He went to Bordeaux for his successful ablation, and they were correct, he was a complex case.

In my case I rank this way:

1. Natale
2. Bordeaux team
3. Protegés of either of the above
4. High volume EP's who do a lot of afib ablations, other than just PVAI's and who are researchers. In my book, high volume is >300 procedures/year.
5. Everyone else

I would also be careful about research centers that train fellows. I'd inquire who is operating the catheters - the "name" or the fellow. I would only accept the "name" EP.

I've been on this board over 15 1/2 years. I've suggested people go to EP's in categories 1-3, depending on their situation. I don't regret making those suggestions and they have turned out well for those that took them. I'm certainly not as knowledgeable as some others, but this is my opinion and observation.

An example, I've recommended EP's in Australia from this list provided to Shannon by Prof Jais from Bordeaux. I've also recommended Sabine Ernst in the UK.

Here’s a great forum, but with members living in various countries; so, things that are usual somewhere may be rare elsewhere. Life here in Belgium, a small country of 11 million people using (officially) three languages (Dutch, French, German), is likely not the one you know in US or UK. Here, we have a national obligatory health and retirement insurance system, for which we are heavily taxed. And a VAT is added to the price of all we buy. Life is then costly, but the counterpart is that healthcare is nearly free.

France is bigger but, basically, their health system works the same way. So, if you read forums in French, you’ll rarely find the name of a Dr or EP written in the threads. Posts doing this are quickly moderated. Names (accompanied by warnings or recommendations) are to be shared in private messages. It’s perceived as normal, because one does not have to make (counter)advertisement for a service one does not directly pay for. It’s a collective effort. You’re not asked to stop being sick because it’s too expensive for the amount you've already been taxed, and your healthy neighbour isn’t relieved to contribute to the collective effort.

All this to explain how it may sound strange to me when I read arguments about Dr Natale being the best EP in the World. I’m not used to speak like this. I don’t say Natale isn’t a top grade EP, I don’t doubt he is and I don’t doubt those who write such words are convinced he really is the best, but for me, it sounds just like « Natale is God, any other EP is inferior ». That’s why I wrote that if you’re ablated by another EP, you’re screwed. But don’t take it too seriously, please, it’s 2nd degree.

Well either my EP and everyone he consulted with at a top teaching hospital here in a major city stunk after attempting my ablation 3 times as I progressively got worse and in heart failure or they were good but not good enough. Natale fixed in one shot what they could not in 2.5 years and 3 ablations as the next step was to recommend open heart surgery.

Now I turned out to be a bit more complex with a a Persistent Left Super Vena Cava. But knowing what I know now, they were not even in the same league.

Do I say that makes Natale best in world, to me, yes.