Touch up ablations

I had an ablation by Dr Natale on December 15th 2020. At the time I had paroxysmal atrial fibrillation with a 51% burden. He ablated a lot of areas and I have been afib free ever since. Currently I can save a lot of money by enrolling in a Medicare Advantage plan in my area which includes all the doctors I am currently seeing except Natale. This plan and does include EPs with good reputations.
My question to the community is this: Am I correct in assuming that if I need a touch-up in the future that it would be a less complicated procedure and that my local EP should be expected to handle it effectively. Otherwise my only reason for keeping a much more expensive Supplement Plan is to keep my access to Natale open. I would appreciate any feedback.

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frankangelo
My question to the community is this: Am I correct in assuming that if I need a touch-up in the future that it would be a less complicated procedure and that my local EP should be expected to handle it effectively.

From observation here and with my friends i've sent to Natale, a second Natale ablation can include LAA isolation. For that, I would want Natale. I'm no expert, just an observer. See what others post.

The standard for a successful ablation is 12 months of NSR without antiarrhythmic drugs, so you're pretty much there. The chances of you needing a touch-up anytime in the next several years is extremely low. Maybe 10 or 20 years from now you could develop a new source of afib that's outside the isolated areas, but I don't think you're going to need a touch-up anytime soon.

But I wouldn't say a touch-up is simpler. It's generally smaller, with only a few burns, and therefore generally faster, but finding and ablating the offending area isn't necessarily within the skill set of a less experienced EP. What if the source of the afib is your LAA, for example? Most EPs simply won't ablate the LAA at all. But I think that's probably a moot issue because you're just not going to need a touch-up soon enough for it to matter.

Ok, Carey,
I will be anxious until my procedures with Dr. Natale are completed. He told me he would do 2 ablations: LAA and coronary sinus. I know we have talked about the LAA in the past, but, would you tell me again why most EPs won’t ablate the LAA. Thank you for your continued patience with me.

frankangelo , I had my first ablation with Dr Natale over 2 years ago and a touch-up ablation with him over a year ago. I have been in NSR since. In both cases I had the UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) insurance. I reside in NY. The insurance costs $16/month and it paid for all my medical bills in Austin and I am keeping it until I am gone .

See if United Health care is available in your area and if it is, check with Natale's office (and their hospital and other doctors you may need in Austin) to see if they will take it.



Edited 1 time(s). Last edit at 11/16/2021 10:17PM by JakeL.

Sorry, my post probably should have been a new topic.

Jake, I am looking at the United Healthcare advantage plans offered in my area. Orange County California. I will examine them more closely to see if there was something that is similar to yours but I don't think so. They have a freedom plus which allows you to go outside of the network but at a $40 copay for office visits I don't think it covers procedures. I will check more closely. You we're lucky to have such a wonderful Advantage plan to allow you to go to Austin. I just have to go 75 miles to San Diego to see Natale. He comes to Scripps once a month for two days.

I have checked the Advantage plans in Michigan and they will not pay for any surgery outside of my state, the only way they would pay is if it was an emergency, Also, their prescription cost for Xarelto isn't any better than what I now have.

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frankangelo
Jake, I am looking at the United Healthcare advantage plans offered in my area. Orange County California. I will examine them more closely to see if there was something that is similar to yours but I don't think so. They have a freedom plus which allows you to go outside of the network but at a $40 copay for office visits I don't think it covers procedures. I will check more closely. You we're lucky to have such a wonderful Advantage plan to allow you to go to Austin. I just have to go 75 miles to San Diego to see Natale. He comes to Scripps once a month for two days.

Medicare paid 80% for Dr Natale’s ablations…and it was discounted by provider contract. You don’t pay 20% of his bill but instead 20% of the contract price…unless you are under 62/65. Wouldn’t United Healthcare pick up the 20%? Since you live in Orange County, isn’t Thousand Oaks closer at Los Robles Hospital? He is here Wednesday (after leaving Scripps) and leaves Saturday.

Thank you to everyone who responded to my post. Your comments are always helpful. I decided to stay with a Supplement Plan for at least another year. This will allow me the freedom to go to any provider I choose including Natale. I signed up for a Supplement Plan G which covers almost all of my medical expenses except for the plan B deductible.