Hi all. Yesterday was my 1 year anniversary of my PFA ablation with Dr. Natale in Austin. I just completed my last heart monitor reading of the 1 year follow-up study (I had to send 1 minute recordings once a week, and at 6 months and 1 year did a 1day recording with a small device that was essentially taped to my chest). I'm delighted to report that the PFA ablation has been a complete sby Ralph - AFIBBERS FORUM
I think randomized trials are great for clarifying how effective PFA is v. RFA (the Farapulse study is randomized), but personally I would want to guarantee that I got the PFA instead of leaving it to chance by joining a randomized study. As I've said before, the Medtronics study that I was in 6 months ago was NOT randomized - you knew you were getting the PFA. That study is still going asby Ralph - AFIBBERS FORUM
The Medtronics PFA trial that I was/am in is not randomized - I knew I was getting the PFA. I am almost 6 months out now with no issues - I couldn't recommend it more if it an option for you. But I always feel the need to acknowledge that time will tell.by Ralph - AFIBBERS FORUM
Just checking back in 4 months after my pulsed field ablation (PFA) with Dr. Natale. Things are still going along without a hitch. As I said in my last post at 2 months, my blanking period was completely quiet, and it remains that way. If you are thinking about an ablation, you might want to see if you are eligible for a PFA. I got mine through an ongoing trial study with the Medtronics catheby Ralph - AFIBBERS FORUM
Frank, the Medtronics PFA catheter is somehow or another designed to do more than just PVI - the study is open to persistent afibbers for example who almost certainly have triggers from other areas. Dr. Natale definitely used it to ablate areas on the posterior wall of the atrium for me. I don't know what the current limits are with the current catheters, but they are definitely wider thanby Ralph - AFIBBERS FORUM
Ben, I don't know for sure, but I had nothing during the blanking period. My understanding is that there is much less inflammation from this technology - it isn't burning tissue like the RFA catheter does. So it would make sense to me that there wouldn't be alot of activity post-ablation (I think that the blanking period is more or less a name for the period where you can expectby Ralph - AFIBBERS FORUM
Hi Everybody. This is my 2 month post Pulsed Field Ablation report. Not much to add since my last post – so far it has all continued to go more smoothly than I expected. I’ve been off the flecainide for a few weeks now, and no change – no afib, no ectopics. I’ve been at full physical activity for weeks – getting my steady beat up to 140 or so when running etc. with no problems. I’ve hadby Ralph - AFIBBERS FORUM
I will update in a few months (after blanking period, etc) and after the trial time ends at 1 year. And if something goes sideways before that I'll let you knowby Ralph - AFIBBERS FORUM
Hi everyone. I had my pulsed field ablation a week ago in Austin with Dr. Natale and his stellar team and facility, as part of a Medtronics trial study of their PFA catheter. The procedure went as smoothly as I had hoped, and this is my one week update. The procedure time was somewhat shorter than an RF Ablation, and "lesions” were done at each of the pulmonary veins, as well as someby Ralph - AFIBBERS FORUM
Thanks Susan. I appreciate the encouragement and well wishes. Pompon, my understanding is that Dr. Natale would do a little more than the PVI if needed. His nurse said something about the back or posterior wall I think. How that could be done with this catheter is not something I currently understand. He is definitely mapping with a catheter through the opposite femoral vein. There are someby Ralph - AFIBBERS FORUM
Well, a sustained uptick in afib frequency starting in February finally tipped the scales and led me to pursue an ablation. I found out that Dr. Natale is participating in the Medtronic Pulsed Field Ablation trial. I had a video interview with him and I signed up! (I don't fit into any of the exclusion categories). I’m flying to Austin for the procedure. Dr. Natale assured me it was aby Ralph - AFIBBERS FORUM
Hi Colin. I'm curious how you know that Natto is thinning your blood? Are you doing prothrombin testing, and if so what kind of results are you basing your conclusion on. Thanks, Ralphby Ralph - AFIBBERS FORUM
Hi. I live in the SF Bay area and would like info on ablation EP's in my area. Anyone know Dr. Jaime Molden at Sutter? Any particular EP recommendations for ablation in SF bay area? Is there any type of running list from someone on this site with info about best ablation docs in different areas. (I know volume of performed ablations is important) Thanks, Ralphby Ralph - AFIBBERS FORUM
Thanks! He used to do ablations at the same facility as Steven Hao (who Natale taught I think) in SF. I believe Hao is considered a good choice, but I really liked Dr. Natale's personality. Nothing has really changed much for me, its just that I'm getting older and growing a little tired of the more or less once a month drama. I'm still thinking of waiting for the newer technolby Ralph - AFIBBERS FORUM
I saw Dr. Natale in SF about 7 or so years ago in consult in San Francisco at a Sutter facility I tried contacting him again, but he apparently hasn't been there for a few years, and I can't find a valid lead on how to contact him on the internet. Can someone tell me where he does ablations in SF and how to contact him? Thanks, Ralphby Ralph - AFIBBERS FORUM
Another update - another episode on day 26, which is not encouraging for this protocol (my average is about 30 days, and I had a few that exceeded that when I started in December so I was feeling hopeful). I had my Vit D checked just a few days before and it was 61. My calcium intake is very consistently in the 350 - 500mg range (I had my water tested months ago when I started this and it isnby Ralph - AFIBBERS FORUM
I haven't checked my D level in a couple of months but I have reason to believe it is still in the high 50's given my D intake. My calcium remains around 400-500mg per day, which for me is simply the elimination of dairy and calcium fortified foods. I'll check my D level again after things get a bit closer to normal out there.by Ralph - AFIBBERS FORUM
I am 4 months into the High Vit D and Low Calcium protocol that Steve Carr outlined. I see no reason to stop it at this point since it makes sense to my brain, and the results are good but not overwhelming. I have had 3 episodes during this time - 38 days, 47 days, and then 35 days apart. All of those are on the good side for me - my average is around 30 days more or less, and 3 in a row is aby Ralph - AFIBBERS FORUM
I've never noticed any benefit from magnesium. If I take even 200mg I am negatively impacted with loose bowel. One time I rubbed probably 100mg or so of the mag oil on my chest and had pretty out of control pvcs about Half an hour later - I have no doubt it was the cause. Proving to me it is relevant, but not necessarily in a positive sense. I had been taking 100mg for the last few yeaby Ralph - AFIBBERS FORUM
I like trying to find the minimum threshold for medications to work for me - it is typically a lot lower than what is recommended. I'd be fine with Flec not working the first time bc I dosed too low. But if it turns out it is enough, then great. I'll let you all know what happens if I take it, and will also report on my ongoing experiment with Steve Carr's low calcium high vitamby Ralph - AFIBBERS FORUM
Thanks Carey. I am likely to try it next time - I'll take some Diltiazem first, and I'd try it at the low dose I mentioned out of an abundance of caution. But I'd appreciate any other input that is potentially out thereby Ralph - AFIBBERS FORUM
I've been considering using Flecainide PIP. I got scared off from using it previously because my afib episodes usually involve periods of aflutter at about 155bpm, especially when I am nearing conversion back to NSR (my fear is of the 2-1 conversion flipping to a 1-1 conversion - I recall reading it was more likely if you are already in flutter but don't recall whether that was antecdoby Ralph - AFIBBERS FORUM
Kate, see Steve's protocol which suggest high dosing for a 10 days or so. I modified it somewhat - took a bit less for a little longer. I started out at 32ng/mlby Ralph - GENERAL HEALTH FORUM
Thanks Steve for your input. I've never known Magnesium to be helpful personally, but kept taking some out of thinking it was at worst harmless (other than bowel intolerance). I will pull my morning 100mg out of the equation for this next cycle for what that may or may not be worth, but will keep everything else the same. Ralphby Ralph - GENERAL HEALTH FORUM
Initial results are in from my attempted application of Steve's Calcium and Vitamin D control protocol. On evening 38 after starting the protocol (and day 38 after my last afib) I woke to the beginning beats of aflutter at 150bpm which lasted about 10 minutes, followed by about a minute of NSR, and then the next 8 hours in either Afib or Aflutter. Way more aflutter than typical - I jusby Ralph - GENERAL HEALTH FORUM
As I am now monitoring my Calcium more closely, it occurred to me to question how much is in my tap water. A quick google entry came up with 30mg per liter, but the results actually vary alot (1mg - 130mg+) based on region I would suggest checking yours out somehow if you are trying to count your calcium, as it is possible that you are getting alot more than you think from water. As forby Ralph - GENERAL HEALTH FORUM
I've tried lots of things, but with not even close to the rigor of Steve or GeorgeN. I respect that you two, and some others here, are as disciplined and driven as you are, but that level of attention and focus has always felt like a bigger price than I was willing to pay personally (if I had to choose between that level of commitment or an ablation, I'd have chosen ablation. Fortunatby Ralph - GENERAL HEALTH FORUM
Carey, your decision to move Steve's post and your explanations of why you did it seem bizarre to me. I haven't had an ablation and don't take drugs, and have managed to reduce the frequency of my afib over the past 9 years (though the overall burden has stayed pretty constant as the average length has migrated upward), while basically eliminating previously chronic ectopics.by Ralph - AFIBBERS FORUM
Thanks everyone for your input - that includes a long phone call with Shannon. If or when I have an ablation it will be with Dr. Natale. I'm still in afib about 1% of the time, and am still cautiously hopeful that I can stay there or better for the forseeable future. I'm aware that conventional wisdom says I won't, and if I were able to bet on it, I'd bet against it also.by Ralph - AFIBBERS FORUM
I visited my very humble cardiologist this week to discuss my current situation, including the possibility of a future ablation (I've recently written here about stopping magnesium and wondering about the impact of corticosteroid use). I live in the SF bay area, and he has had many patients go to Dr. Natale for ablation. He noted his understanding that Dr. Natale is somewhat alone in belieby Ralph - AFIBBERS FORUM