UCLA Medical Center

Hello Everyone,

I'm 66 years old - 6'1 and my weight is 175.

I've been dealing with paroxysmal atrial fibrillation and flutter for approximately 10 years.

My CHADS score is 1 based on age. Normal BP (on the low side) and cholesterol at normal levels too.

I recently wore a 14 day Zio heart monitor, and the finding showed I had a 41% burden.

They gave me a beta-blocker, but because my heart rate is normally in the high 40s it's not something I can do. I'm taking a baby aspirin and 400mg of magnesium glycinate.

They are recommending ablation. It will be performed at UCLA in Los Angeles. I'm not sure I want to have it just yet. They lay out a lot of potential complications, but I know it's a very safe procedure--depending on who does it.

My question: has anyone had ablation at UCLA or Cedars-Sinai? I live in Los Angeles and I can go anywhere to have it done.

If you live in Los Angeles - or if you've had ablation performed here - I would love to hear who did your procedure. Even if you don't live in Los Angeles I'd love to hear from you.

Thanks in advance.

Wow, that's a hefty burden. Are you symptomatic? How high does your rate go during episodes?

Yes, I do get symptomatic when it's bad. I can feel my heart pounding and breathing can be an issue. It very often wakes me up at night.

This is from the Ziopatch Final Interpretation: Ziopatch for 14 days and 3 hrs w/ underlying sinus w/ HR 44 to 219 and avg of 83 bpm with no significant pauses.

Rare PAC's, couplets, triplets, w/ 10 SVT runs w/ fastest 13 beats at 220 bpm, the longest 12 beats w/ avg rate of 111 bpm w/appearance of atrial fibrillation/flutter (41% burden), ranging 43-218 bpm (avg of 106 bpm), the longest was 22 hours 3 mins w/ an avg rate of 109 bpm.

Rare PVC's, couplets w/ intermittent bigeminy

I can’t help you with doctors in LA, but I had my second ablation in NY about 3 weeks ago. I’d think with such a large burden and having had it for 10 years, you’re looking at more than 1 procedure. Good luck!

If you want an ablation, one of the top ablating EP's, Andrea Natale is at Los Robles a few days a month. Natale's home base is in Austin but works in CA at Los Robles and Scripts a few days a month. Many of our members travel long distances to go to Natale. You are close.

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CaliGuy
They are recommending ablation. It will be performed at UCLA in Los Angeles. I'm not sure I want to have it just yet. They lay out a lot of potential complications, but I know it's a very safe procedure--depending on who does it.

Exactly, it depends on who's doing it. More than most cardiac procedures, afib ablations are a fine balance of knowledge, experience, and skill, with a heavy emphasis on experience. UCLA is a large institution and it has many EPs. Do you know which one of them will do it? How many have they done? Being a large institution also means they will have many relatively inexperienced EPs, and if you haven't specified a choice of doctors then they're free to assign you to the EP hired yesterday who has done zero on their own.

UCLA is also a teaching hospital, so a Fellow will probably do some of it, rather than the board-certified EP you think is doing it all. How much will the Fellow do, and how many have they done?

These are questions you need answered before you proceed.

And if you live in the LA area and are free to travel, then see George's answer above. That's a hands-down answer for you.

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GeorgeN
If you want an ablation, one of the top ablating EP's, Andrea Natale is at Los Robles a few days a month. Natale's home base is in Austin but works in CA at Los Robles and Scripts a few days a month. Many of our members travel long distances to go to Natale. You are close.

Thank you for this. I definitely know who he is, but I didn't know he came to Los Angeles.

I'll be calling on Monday.

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jasams
I can’t help you with doctors in LA, but I had my second ablation in NY about 3 weeks ago. I’d think with such a large burden and having had it for 10 years, you’re looking at more than 1 procedure. Good luck!

thank you!

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Carey

They are recommending ablation. It will be performed at UCLA in Los Angeles. I'm not sure I want to have it just yet. They lay out a lot of potential complications, but I know it's a very safe procedure--depending on who does it.

Exactly, it depends on who's doing it. More than most cardiac procedures, afib ablations are a fine balance of knowledge, experience, and skill, with a heavy emphasis on experience. UCLA is a large institution and it has many EPs. Do you know which one of them will do it? How many have they done? Being a large institution also means they will have many relatively inexperienced EPs, and if you haven't specified a choice of doctors then they're free to assign you to the EP hired yesterday who has done zero on their own.

UCLA is also a teaching hospital, so a Fellow will probably do some of it, rather than the board-certified EP you think is doing it all. How much will the Fellow do, and how many have they done?

These are questions you need answered before you proceed.

And if you live in the LA area and are free to travel, then see George's answer above. That's a hands-down answer for you.

Thank you very much for this! These are the things that I've been thinking about--every day! lol

I am 15 years older than you and had my first ablation almost six years ago when my afib went persistent after living with it for 17 years, the second five years ago and the third a month ago along with a Watchman FLX implant. In my not so humble opinion, when you're looking for an EP to work on your main drive pump you want the absolute best you can find. Where you live that's Dr. Natale, working from either Los Robles/Scripps or Austin. As far as teaching hospitals are concerned, let the youngsters learn on someone else. I had afib longer than the first EP I saw had been a doctor. You have too much living to do to settle for a clinical EP. Good luck!

Here in Belgium, top grade hospitals are nearly always teaching hospitals. Beware of this, as said.
My PVI and first touch-up were performed in such an institution. For my touch-up, I asked for a CS, and the EP agreed, but when the booked day came, he said "no, we're going to make a GA, since you've to be perfectly motionless". I was furious and utterly nervous. Then, there were far too many people for my taste in the lab, and the touch-up was a complete mess. I don't know what really happened and who was operating, but I doubt we were in the best conditions for a successfull procedure. Needless to say this EP lost my confidence.

Welcome CaliGuy to Afibbers forum!

Your have just collectively been given the keys to the kingdom for making a very wise choice in this field of AFIB ablation from Carey, GeorgeN, JayBros and Pompon. You are indeed fortunate to live within shouting distance from two centers to choose from at which to access Dr. Natale ... literally the most experienced ablation maestro on the planet with more AFIB ablations under his belt than any other human being.

And it is further comfort to know that its not only the unprecedented volume of ablations Natale has done that sets him apart, but the fact that over 75% of his annual case load is with persistent and long-standing persistent AFIB cases ... the most challenging kind and no other EP anywhere on earth has performed anywhere near this percentage of the most challenging cases in the field ... meaning there is essentially nothing your heart can throw at Dr Natale that he hasn't seen before and addressed already many times over.

So you can relax now, your heavy lifting job of deciding who to go too is done. :-)

Cheers!
Shannon



Edited 1 time(s). Last edit at 03/20/2022 01:32PM by Shannon.

Los Robles Hospital is in Thousand Oaks, CA, just off Highway 101, perhaps an hour from UCLA.

The way to start with them is to call 805-852-9100, which is their Arrhythmia Center, and talk with the new patient person. You'll find the process well organized, clean and friendly all the way through, including the people in the procedure room, who I met and exchanged greetings with on my way in.

Dr. Natale practices there usually the last 3 days of a middle week of each month. He and my Cardiologist had several communications in the 3 months between my starting the paperworkand leaving the hospital 13 months ago

I had my Natale ablation there and the process was straightforward and well organized. I did all the paperwork on line ahead of arriving, arrived the afternoon before the procedure for blood tests and pre-op physical, met with Dr. Natale and his PA, spent the night in a local hotel, arrived at the hospital at 6:00AM for the procedure, met with Dr. Natale and his PA afterward, was released about 3:00 PM, spent another night at the hotel, saw Dr. Natale and his PA about 9:00 the following morning and drove the 3 hours home.

I suggest booking the first morning appointment for the procedure as delays can and do happen in all medical procedures.

I sent a two lead Kardia reading to his PA weekly for the first year and will continue doing that monthly this year.

Should I need another procedure I'd do the same things at the same place.

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JayBros
I am 15 years older than you and had my first ablation almost six years ago when my afib went persistent after living with it for 17 years, the second five years ago and the third a month ago along with a Watchman FLX implant. In my not so humble opinion, when you're looking for an EP to work on your main drive pump you want the absolute best you can find. Where you live that's Dr. Natale, working from either Los Robles/Scripps or Austin. As far as teaching hospitals are concerned, let the youngsters learn on someone else. I had afib longer than the first EP I saw had been a doctor. You have too much living to do to settle for a clinical EP. Good luck!

Thank you, Jay

Very good information. I feel the same way about letting the youngsters learn on someone else. lol

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Pompon
Here in Belgium, top grade hospitals are nearly always teaching hospitals. Beware of this, as said.
My PVI and first touch-up were performed in such an institution. For my touch-up, I asked for a CS, and the EP agreed, but when the booked day came, he said "no, we're going to make a GA, since you've to be perfectly motionless". I was furious and utterly nervous. Then, there were far too many people for my taste in the lab, and the touch-up was a complete mess. I don't know what really happened and who was operating, but I doubt we were in the best conditions for a successfull procedure. Needless to say this EP lost my confidence.

Thank you, Pompom!

I appreciate you. This is exactly what I'm trying to avoid. Good luck to you.

Quote
Shannon
Welcome CaliGuy to Afibbers forum!

Your have just collectively been given the keys to the kingdom for making a very wise choice in this field of AFIB ablation from Carey, GeorgeN, JayBros and Pompon. You are indeed fortunate to live within shouting distance from two centers to choose from at which to access Dr. Natale ... literally the most experienced ablation maestro on the planet with more AFIB ablations under his belt than any other human being.

And it is further comfort to know that its not only the unprecedented volume of ablations Natale has done that sets him apart, but the fact that over 75% of his annual case load is with persistent and long-standing persistent AFIB cases ... the most challenging kind and no other EP anywhere on earth has performed anywhere near this percentage of the most challenging cases in the field ... meaning there is essentially nothing your heart can throw at Dr Natale hasn't seen before and addressed already many times over.

So you can relax now, your heavy lifting job of deciding who to go too is done. :-)

Cheers!
Shannon

Thank you, Shannon!

You're right, I feel much better about the entire thing. I was very hesitant to use UCLA because of the obvious - and because I didn't like the EP I met from UCLA.

I'll be calling Dr. Natale's office tomorrow.

Quote
ggheld
Los Robles Hospital is in Thousand Oaks, CA, just off Highway 101, perhaps an hour from UCLA.

The way to start with them is to call 805-852-9100, which is their Arrhythmia Center, and talk with the new patient person. You'll find the process well organized, clean and friendly all the way through, including the people in the procedure room, who I met and exchanged greetings with on my way in.

Dr. Natale practices there usually the last 3 days of a middle week of each month. He and my Cardiologist had several communications in the 3 months between my starting the paperworkand leaving the hospital 13 months ago

I had my Natale ablation there and the process was straightforward and well organized. I did all the paperwork on line ahead of arriving, arrived the afternoon before the procedure for blood tests and pre-op physical, met with Dr. Natale and his PA, spent the night in a local hotel, arrived at the hospital at 6:00AM for the procedure, met with Dr. Natale and his PA afterward, was released about 3:00 PM, spent another night at the hotel, saw Dr. Natale and his PA about 9:00 the following morning and drove the 3 hours home.

I suggest booking the first morning appointment for the procedure as delays can and do happen in all medical procedures.

I sent a two lead Kardia reading to his PA weekly for the first year and will continue doing that monthly this year.

Should I need another procedure I'd do the same things at the same place.

Wow!! Thank you for all of this information.

I actually live about 50 minutes from Dr. Natale.

I'll be calling on Monday.

Just wanted to give you guys an update.

I have an appointment today with Dr. Natale's NP.

I saw my cardiologist yesterday. He wants me to try Rythmol.

Went into afib last night at 6PM after being in NSR all afternoon, took a Rythmol (75mg) and was back in NSR at 9PM.

And then I woke up at 4am this morning in afib.

I'll keep you guys posted.

Quote
CaliGuy
I saw my cardiologist yesterday. He wants me to try Rythmol.

Went into afib last night at 6PM after being in NSR all afternoon, took a Rythmol (75mg) and was back in NSR at 9PM.

And then I woke up at 4am this morning in afib.

Don't know what your normal pattern is, so whether converting in 3 hours normal for you, or do you attribute the Rythmol for the conversion?

75 mg is a very low dose of Rythmol, so possibly a somewhat higher dose taken chronically (Rythmol.is commonly taken every 8 hours if used chronically), might keep you in NSR. Something to talk about with the docs.

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GeorgeN

I saw my cardiologist yesterday. He wants me to try Rythmol.

Went into afib last night at 6PM after being in NSR all afternoon, took a Rythmol (75mg) and was back in NSR at 9PM.

And then I woke up at 4am this morning in afib.


Don't know what your normal pattern is, so whether converting in 3 hours normal for you, or do you attribute the Rythmol for the conversion?

75 mg is a very low dose of Rythmol, so possibly a somewhat higher dose taken chronically (Rythmol.is commonly taken every 8 hours if used chronically), might keep you in NSR. Something to talk about with the docs.

Thanks, George!

Lately I have not converted in 3 hours, but this could be a fluke. I'm not getting too excited. lol

I'm gonna do 150 mg today and see what happens.

I always like to start low just in case of side-effects.

You just can’t self medicate and arbitrarily pick a dose. What dose did your EP prescribed?



Edited 1 time(s). Last edit at 03/24/2022 01:38PM by susan.d.

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susan.d
You just can’t self medicate and arbitrarily pick a dose. What dose did your EP prescribed?

You're right, Susan.

He told me to try with 75mg at first and If I could tolerate it to go to 150mg.