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Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation

Posted by Poppino 
Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 06, 2023 10:37AM
Time flies. I call 2021 my yr from hell. Cardioversion 144 flutter. 3/29 flutter ablation in Charlotte. Lasted 6 weeks. Was actually worse. Left atypical flutter. May 25 HR 181 my alltime high! With Shannon’s & Carey’s guidance i ended up in Austin. 8-6-21 ablation by Dr Natale. LAA isolated. Posterior wall etc. ive never had it again . I was back in Austin 2-16-22 Dr Natale placed my Watchman. Off eliquis late that summer: so 2021 was 2 cardioversions 2 ct scans multiple covid tests 2 trips to Austin the 3 rd in 2022. ER trips
Echocardiograms. Oh!!! And covid Dec 29 2021 not fun
But!! For all the Natale worship? Im in the front row pew
He fixed me. Forever? Im 70 maybe not we ll see. I use natto 81 aspirin olive and fish oil 400 mg ubiq 800 mg mag D 5000 C alot more. Am fit lift weights walk an hour ea day
My entire experiences in Austin were A+. Incredible
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 06, 2023 12:14PM
Congratulations. May you have a long healthy life in nsr.
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 06, 2023 12:55PM
It's great to have history....as long as the worst of it is in the past. smileys with beer
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 08, 2023 08:30AM
Glad things finally worked out for ou.

Was your unsuccessful 3/29 flutter for right-sided typical flutter or left-sided atypical flutter?

Later, when Natale ablated on the left side for atypical flutter, was it done empirically, or was he able to induce
the flutter before ablating. How long did this procedure last? Also, if the 3/29 flutter ablation was for typical flutter,
did Natale re-test or re-do the CTI flutter line on the right as well?

Thanks for any information.

Jim
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 10, 2023 10:08AM
Jim: my right flutter ablated in 2012 here in Charlotte. The atypical flutter emerged 9 yrs later. March 29, 2021 ablated here. Didnt work so i went to austin. Yes he induced flutter. LAA & posterior wall? Anyway it was 1:45 in length. I did have an afib episode 3 weeks afterwards lasting 5 hrs at 125. Afib! Not flutter. After that ive had a few 97-105 tachy things lasting 30 seconds to 30 mins. My ep here thinks its atrial tachycardia not to worry lol
Right flutter is an easy fix. Left not so. Thus Austin! Ablated then watchman 6 mo later then TEE 6 wks later. Ive been an A- since. My ep here could not get me in flutter but Natale did. Thus the difference? My ep here didnt touch LAA
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 11, 2023 01:23AM
Quote
Poppino
Jim: my right flutter ablated in 2012 here in Charlotte. The atypical flutter emerged 9 yrs later. March 29, 2021 ablated here. Didnt work so i went to austin. Yes he induced flutter. LAA & posterior wall? Anyway it was 1:45 in length. I did have an afib episode 3 weeks afterwards lasting 5 hrs at 125. Afib! Not flutter. After that ive had a few 97-105 tachy things lasting 30 seconds to 30 mins. My ep here thinks its atrial tachycardia not to worry lol
Right flutter is an easy fix. Left not so. Thus Austin! Ablated then watchman 6 mo later then TEE 6 wks later. Ive been an A- since. My ep here could not get me in flutter but Natale did. Thus the difference? My ep here didnt touch LAA

Poppino, you mention you’ve been A- since, can you give us more details please? Are you having runs or ectopics? Just curious, thanks.

Johnny
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 11, 2023 09:22AM
Johnny since my Natale flutter LAA ablation 8-6-21 ive had a handful
Of tachy runs. Short and low rate. 30 seconds and as long as 30 mins. Maybe 6? Rate 97-105. So strange. One of the longer ones was 2 weeks after Jan 2022 covid but 4 wks before my Austin watchman. An A would be perfect nsr. Im very pleased. I take it very for granted now. Im still careful with alcohol and take many supplements. My only med is 20 mg propananol twice a day
Re: Today: my 2 Yr Anniversary Dr Natale Flutter LAA Isolation
August 12, 2023 12:16PM
Congrats, Tom. I am so glad you made that very important decision to consult with Dr. Natale.

You may recall that I had my Natale ablation in 2003. My AF surfaced in 1995 and I tried various ways to help reverse it …but nothing lasted. During that time, Dr. Natale was featured in a Cleveland newspaper about his joining the Cleveland Clinic's cardiology group and talked about his ablation procedure. I saved the report and made a mental note that he’d be the one I’d see if my attempts didn’t work.

And, as I’ve posted numerous times, it was the best decision of my life! Back then. in the early years of the Afibber’s.org website and newsletter, I talked with many members who had read my posts about my ‘Natale experience’…who were interested in traveling to Ohio to have him do their ablations. So, 20 years later, here we are continuing to acknowledge and confirm the outstanding results of Dr. Natale’s experience, skill and expertise. While my 2003 Natale ablation was in Cleveland, I also traveled to Austin for A-flutter ablation and LAA isolation in 2014 and again, for a touchup the next year.

Since then, my heart remains calm and I am forever grateful.

I didn’t find a link in our forum to this post by Shannon, so thought I’d post it.
Jackie

Things I Learned and is my Pleasure to Share about Dr. Andrea Natale M.D.
Shannon Dickson Mar 10, 2021 10:35 AM EST
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(Photo : Things I Learned and is my Pleasure to Share about Dr. Andrea Natale M.D.)
Recently, I've had the honor and privilege in being asked to share some insights and highlights of my experiences, going on fourteen years, with world-renowned pioneer in cardiac arrhythmia ablation research, Dr. Andrea Natale.

This welcomed request and opportunity stems from my long association with Afibbers.org, of which for the past eight years now I have been president and editor of this twenty-one year, longest running online resource dedicated to patient education and advocacy for Atrial Fibrillation (AFIcool smiley ... the most common cardiac arrhythmia world-wide.

It was through Afibbers.org, not long after I had discovered the website back in the early 2000's, that I first learned of Andrea Natale during those fledgling years that marked the dawn of the Pulmonary Vein Isolation (PVI) ablation procedure for paroxysmal AFIB. Even in those beginning days, Dr. Natale had quickly established an international acclaim for his genuine maestro-level skill performing this highly skill-dependent procedure within the advanced field of cardiology known as electrophysiology (EP), focused on treating all cardiac arrhythmias.

Electrophysiology career
It certainly wasn't a fluke that this passionate, dedicated and dynamic caregiver became Medical Director of the world-class Cleveland Clinic's Center for Atrial Fibrillation at the young age of 38! And that legendary skill with an ablation catheter, as genuinely impressive as his expertise truly is, still is far from the only talent this remarkable physician continues to share with the wider field of EP.
Among his rich contributions, Dr. Natale has long been dedicated to hosting cutting-edge, high volume research into atrial fibrillation and ablation technology; having recruited one of the top research teams anywhere. Including now at their newly opened state-of-the-art EP Center at St. David's Medical Center in Austin. Indeed, from the very start of the AFIB ablation field in late 1998, Andrea Natale has defined the very meaning of the term 'pioneer'.

For example, he has inspired countless EPs around the world to adopt the uninterrupted anticoagulation protocol which has become the international 'gold-standard' for increased peri-procedural safety of ablations, and has also long-championed wide-spread adoption of both the circular (Lasso) mapping catheter and the ICE (intracardiac-echocardiographic camera); both contributing to enhanced ablation safety and efficacy.

As a renowned visionary and an early thought leader as well, Dr. Natale has garnered great respect and admiration among his peers in every country where EP is practiced. And recently, some of his early work from 1999 to 2001 has resurfaced in which he had pioneered such insights as adopting a more antral perspective to his 'extended PVI concept', including urging the field of EP to add posterior left-atrial wall isolation (PWI) to the basic PVI procedure, and thus leading to considerably improved average ablation success rates.

Of note, it took almost 20 years for much of the field to discover that Andrea Natale had been right all along and far ahead of the curve, in his vision for how to improve the basic PVI ablation by including the PWI.
As another example, for years Dr. Natale has pushed the field forward toward embracing more comprehensive and effective ablation strategies through his tireless educational efforts around the globe, not just for the more basic paroxysmal AFIB cases, but also to achieve similar efficacy and freedom from all atrial arrhythmia ... even for the most challenging advanced cases ... such as persistent and long-standing persistent AFIB (LSPAF). Previously, these more difficult forms of AFIB remained poorly treated.
As noted above has done so, in-part, by underscoring the need to expand ablation targets beyond a basic PVI to embrace detection and ablation of confirmed non-pulmonary vein triggers in addition to recognizing that greater success with the toughest LSPAF cases will often require carefully selecting patients for left atrial appendage isolation.

Dr. Natale devotes a tremendous amount of his valuable time to international EP conferences as a keynote speaker and thought leader. I have had the pleasure of attending many of these conferences over the last decade, and in so doing it has been inherently obvious how passionately Andrea Natale embraces his role as mentor and inspiration to numerous electrophysiologists and cardiologists from almost every country and continent, ranging from younger fellows to expert EP physicians.

In recent years, he has also joined a robust twitter EP group that works much like an on-going advanced EP fellowship program, offering uniquely valuable real-time access to elite leaders of the field. At times, this includes even in the very midst of an on-going procedure when a less experienced operator may reach out for mentorship to some of the world's top ablation experts such as Andrea Natale. Without a doubt, this is one of the most valuable uses I've seen for this online platform.

From the major centers of Dr Natale's EP career, as Director of the programs at Cleveland Clinic, California Pacific Medical Center, Scripps Hospital in La Jolla California, and most importantly at St. David's Medical Center ... he has twice duplicated creation of the world's highest volume AFIB ablation research centers ... at first Cleveland Clinic then followed by even more impressive results with his unmatched center at St. David's in Austin.

And in the process, since the mid-1990's, Andrea Natale has become the single most experienced ablation maestro in the world with roughly 11,000 ablation procedures under his belt with his consistent annual average of approximately 500 procedures a year!

As mind-blogging as that statistic is, what is even more impressive is the fact that over 75% of Dr. Natale's annual caseload is comprised of persistent and LSPAF patients, the most challenging kind. Only other EPs on the front lines of the field can truly appreciate the rarity of such an accomplishment.

It would literally be impossible to duplicate such a feat without mirroring Dr. Natale's unprecedented career path that will likely never be repeated, including having earned the trusted referral of so many other top EPs who often send some of their most difficult cases to his care when, after an ablation or two, they just aren't getting the results normally expected, and thus punt such cases to Dr. Natale to fix.

The Patients - where the rubber meets the road
No doubt, many of Dr. Natale's close colleagues can attest as well to his profound technical and scientific impact on the world of electrophysiology. However, it is his equally profound impact on all of us AFIB patients that remains Dr. Natale's heart and soul as his true motivation; and what gives all this incredible expertise such meaning.

For all of his technical accomplishments and prowess, Dr. Natale's most impressive characteristic is as a true champion for those many thousands of patients who have had the good fortune to entrust their hearts care to his hands over the years. And for the legion's more who are also now 'ex-Afibbers' that have been treated by other top EPs who took advantage of, and have thus benefited greatly from, Andrea Natale's generously shared insights and expert mentorship.

When Hans Larsen, a Canadian engineer who founded Afibbers.org in 1999, turned this valuable resource over to my care eight years ago, I hadn't fully realized what a gift that was for me as well.

Not only had I benefited enormously from a two-part expert ablation process by Dr. Natale around 13 years ago that entirely eliminated what, by then, had become an aggressive case of highly symptomatic persistent AFIB that had evolved over 16 years. And indeed, I haven't had a single beat of any atrial arrhythmia since completion of his process! Without walking in our shoes, one can't possibly feel the true impact of being freed from such an entrenched more than decade-long losing battle with the beast that having to live with advanced AFIB often becomes.

This unique gift that Hans gave to me, and that I daily get to savor as current president and editor of Afibbers.org, is to witness with such consistent regularity via the many forum posts and ocean of phone calls I so often receive from other, now largely former Afibbers, who recount to me the very same essence of my own experience that they now share as well. This, along with their own expressions of gratitude, most often courtesy of the maestro hands of Dr. Andrea Natale.

One of the consistent accounts I repeatedly hear from Afibbers who have first met Dr. Natale at the beginning of their expert ablation process, is how calm and steady he appears to be, and yet he innately conveys a truly humble self-confidence. We also hear repeatedly how well he listens too, and genuinely cares for his patients, though these traits come as no surprise to those of us who previously have experienced the very same reality. One can read such reaffirming recounts via the advanced search function on our Afibbers Forum going back over 18 years of such powerful anecdotal experiences.
Indeed, it's little wonder why a tidal wave of Afibbers from not only our forum, but from that of other top AFIB resources online, also reinforce what we know to be true, that Dr. Andrea Natale is a genuine legend in not only his technical field of electrophysiology, but in the well-earned respect and admiration of his colleagues world-wide.

Most importantly, though, he has also earned the trust, admiration and gratitude from many thousands of patients he has successfully treated. Including well over a thousand now who have sought him out from our own forum over the last two decades for their own freedom from AFIB!

Shannon Dickson
President/Editor: The AFIB Report - www.afibbers.org
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Dr. Andrea Natale is the Executive Medical Director at the Texas Cardiac Arrhythmia Institute at St. David’s Medical Center in Austin, Texas. He is a world-renowned expert in the field of Cardiac Electrophysiology, the study and treatment of the electrical abnormalities of the human heart. Dr. Natale is also a dedicated researcher, teacher, and academic writer. He has published several texts as well as hundreds of articles in medical journals and is the editor-in-chief of the “Journal of Interventional Cardiac Electrophysiology”.


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