Liz, Heartwire registration is free to the public and not too painful a process to go through as I recall. I registered ten years ago..by researcher - AFIBBERS FORUM
Happy Thanksgiving to all. A couple of informative write ups. One on RATE registry looking at AF in people with pacemakers/ICDs and John Mandrola's blog on AF advances.by researcher - AFIBBERS FORUM
This is a terrible story. I wonder if there are other factors at work. Such as whether the woman and her relatives were not assertive enough in getting attention (could be because it is a custom in Asian cultures not to stir things up and just grin and bear it), or whether ER dept is overburdened. <deleted> I referred to UCSF ER dept incorrectly. From Jackie's post, this happenby researcher - AFIBBERS FORUM
It may be growing like wild fire because Medtronic bought the small company Cryocath that pioneered the technology and aggressively marketing it to less experienced EPs. Not because it is safer or more efficacious for AF ablation, because it is not. RF with irrigation is still the gold standard and the equipment for that continues to improve..by researcher - AFIBBERS FORUM
More analysis and commentary on the results at heartwire.by researcher - AFIBBERS FORUM
Based on McHale's experience with Dr. Reddy, that he was "offered" the laser balloon procedure, I suggest that people looking for ablations in NYC look elsewhere. It is absolutely unacceptable to "offer" up an experimental procedure that has been so complication plagued compare to established tools and procedures. I PM'd McHale with the same message and my explanatby researcher - AFIBBERS FORUM
See link at NEJM. Summary numbers are shown. Ablation is still way better in terms of AF burden and hospital admissions if I read it right.by researcher - AFIBBERS FORUM
McHale, He ought to know where the skeletons are located in specific closets. He is involved with beta testing most of the devices. The Germans wrote up the results on cryo balloons and they didn't mince words although I have only found one reference to the numbers that end up with permanent phrenic nerve palsy. Aside from death, that would be terrible outcome.by researcher - AFIBBERS FORUM
Cryo complication risks is several times higher than irrigated RF. Phrenic nerve palsy is no joke at around 10% around 1/5 of that permanent.by researcher - AFIBBERS FORUM
Colin, Didn't mean to scare you. If recollection serves, it was a retrospective study of their experience from when they started a decade ago so I am sure they are quite a bit further up the learning curve and better by now. How much better I don't have any idea. I think it was the Christchurch hospital. Still I think procedure volume just because of the population size would be qby researcher - AFIBBERS FORUM
Shannon, Nice comments and summary on the status of FIRM. I also have trouble understanding why the lead investigator moved the goal post instead of sticking with the accepted HRS guidelines for definition of success, That would be no AF episodes lasting for more than 30 seconds monitored by 24 hr Holter for 2 weeks at 6 and 12 months and yearly thereafter (depending on whether group is monitoby researcher - AFIBBERS FORUM
Nancy, ER visits are never good and sorry you had to go there. Journal of Afib (Natale's open forum style magazine) just had an article on the effects of AF on blood flow reserve. The reason why you had angina during AF. This seems to me a very important reason to get rhythm control It is the last article in the magazine. The link is below.by researcher - AFIBBERS FORUM
Nancy - I don't know which Kaiser you belong to and whether they will refer you out to another region's specialty center. Kaiser in Santa Clara is probably the highest volume AF ablation center in California and they have an experienced crew there. There was a fellow here that posted on his (successful?) experience in Kaiser LA as well. Regarding waiting for FIRM and Topera. Theby researcher - AFIBBERS FORUM
Tom, Looks like yoy are doing great. Regarding "he used new catheters on me and seemed excited as to their effectiveness and burnability effectiveness " Would love to learn more about that if you have more details to share such as device name and/or brand .by researcher - AFIBBERS FORUM
Women are supposedly more susceptible to bleeding complications during ablations. I wonder if that is the reason that ablation therapy is very lopsided in favor of males. Has this been discussed on this site?by researcher - AFIBBERS FORUM
Murray, I found the following note describing how different patients "feel" arrhythmia helpful. Best of luck in your quest for inclusion in CABANA. I will be following your postings with interest.by researcher - AFIBBERS FORUM
McHale, Heart.org has new program on subject. I think you are asking important questions. I am just not much help on anticoagulants and antidotes. Sorryby researcher - AFIBBERS FORUM
RE Raddy numbers. I am sure he is way over 1000 so he is being very modest. I think after 1000 you lose track. I read about Natale doing 3000 and that was several years ago. Pappone passed 10,000 a couple of years back - they start their medical schooling at a much earlier age in Europe. And I think 1000+ means you are in the highly skilled group. Elite would be a few times higher than thatby researcher - AFIBBERS FORUM
I take 80mg aspirin daily and have no apparent issues even when I get scraped up occasionally doing sports. It has been 15 years now. Then again, even daily aspirin is controversial. Not sure what you will be comfortable with over the long term. Hopefully Reddy can get you to that at peace state of mind.by researcher - AFIBBERS FORUM
Marsha - fyi Happened upon the announcement of a series of screening/lectures below in your area. I have family in Naperville. =============================== A-Fib Lectures Physicians at Advocate Christ Medical Center have been presenting a series of free educational sessions to answer some of the most commonly asked questions about atrial fibrillation (A-Fib). Those attending the lecby researcher - AFIBBERS FORUM
The blog is reflective of a young clinician raising questions that should be raised. I am sure if Dr. Natale wrote a similar blog, it would have a different flavor. Still the general idea presented in the blog is correct, there is one heck a lot more complications and hospitalizations as a result of AADs usage compared to catheter ablation patients, quality of life issues aside. Carol, the bby researcher - AFIBBERS FORUM
It is still an unsettled issue so most doctors will choose to play it safe and recommend continuing anti coagulation post ablation. It will be interesting to hear what your EP thinks.by researcher - AFIBBERS FORUM
Gehauser, Sorry I wasn't clear. AEF stands for Atrio-esophageal-fistula. That is when the catheter burns both the heart tissue and the esophagus to the extent that holes form and introduction of air and other fluids into the circulation system occur. It is usually fatal and can take several days to develop. It is probably caused by too much force on the catheter while in ablation mode aby researcher - AFIBBERS FORUM
I would be happy with Reddy too. You have excellent choices so go with whoever you are most comfortable with.by researcher - AFIBBERS FORUM
Taking PPI came up because of the recent experience of Tom P where his EP found some unusual anatomy and had to ablate adjacent to his esophagus and PPI was prescribed as a precaution. The odds of AEF leading to death is very low, something like .01% or 1 out of 10000 ablations from the Cappato AF survery. The Germans found in their research that 10-20% of ablation patients experience esophageaby researcher - AFIBBERS FORUM
McHale, Nothing magical on my part, just a lot of combing through info. There was a partial list given on Dr. Mandrola's blog a while back in his reply to a comment asking if he knew which centers were involved in the rotor mapping experiments.by researcher - AFIBBERS FORUM
I view the skills of the 3 as very close and I would probably give Steinberg's clinic the edge for a couple of reasons. First, his lab is newest in terms of when it was rebuilt, i believe 2008-9 so he has the latest iterations of advanced tools for increased safety, reduced radiation, precise navigation even in the case of unusual heart anatomy, etc.. Second, he is involved in the trialby researcher - AFIBBERS FORUM
McHale, glad you are doing well and not showing serious symptoms from the stroke. I agree that it is time for an ablation.by researcher - AFIBBERS FORUM
McHale, I think I would put Jonathan Steinberg on the short list as well as Chinitz and Reddy. I would be more reluctant to use Reddy because I am afraid he may try to convince me to be included in some latest trial of the newest cutting edge device. That is the down side of using a star that likes to experiment and gets bored with routine things.by researcher - AFIBBERS FORUM
Dr. Nademanee is probably the top ablation specialist in LA county. He has been trying to go after rotors with the CFAE approach that he pioneered. FIRM arguably offers the complete picture while CFAE requires experience interpreting fragments of the picture.by researcher - AFIBBERS FORUM