Gerry - I am not sure why your EP would tell you that athletes are more difficult to treat. Doesn't make any sense to me since we are less likely to have co-morbidities and already live a healthy life style in general. If anything, athletes are probably the most appropriate candidates for ablation as AADs even if effective would impact training and performance too much. The fact that yourby researcher - AFIBBERS FORUM
Dr. Natale gets to play with all the new toys. That doesn't mean a whole lot when it comes to how well the new new device works and how safe it is. Balloon devices combined with optics is still at a very stage. For example, the laser balloon has a rate of 4% tamponade in expert hands which does not bode well for that. Seeing inside the heart without electrical measurements would a glassby researcher - AFIBBERS FORUM
Bruce, Sorry to hear that you have went through multiple procedures. It could be that you have a competent specialist and that your case is especially difficult. Even the top specialist sometimes do multiple procedures to give "succesful" outcomes. In those cases presented, they describe what was done incrementally and what each step was trying to resolve. I have no specific suggesby researcher - AFIBBERS FORUM
From U. of Michigan EP group ================================ Despite remarkable progress in the catheter ablation of atrial fibrillation (AF), primarily based on the elimination of pulmonary vein arrhythmogenicity, the identification of drivers beyond the thoracic veins specifically in patients with persistent AF remains problematic.1 The hypothesis that AF could be maintained by drivers in thby researcher - AFIBBERS FORUM
I use McAfee and below is their report on the web site. Seems to be clean.by researcher - AFIBBERS FORUM
Registration required. Open to public and free.by researcher - AFIBBERS FORUM
Tom link below FYI regarding AEF. Dont know if you and your EP have already considered this.by researcher - AFIBBERS FORUM
Tom, Hope all goes well with your recovery. Alexandra - It sometimes takes a couple of weeks for esophageal injury to show severe symptoms.by researcher - AFIBBERS FORUM
My father in law is 90 and he is happy. I don't think he understands the condition. He takes his rate control meds, BP med and warfarin. He is a pretty tough fellow. His doctor told him that he would be bed ridden with arthritis if he wasn't so active doing gardening. He is still independent and doing amazingly well for a guy that was supposed to be dead from prostate cancer in hisby researcher - AFIBBERS FORUM
Featured editorial on Heartwire.by researcher - AFIBBERS FORUM
It has been unusually sad to read about two old timers here that are suffering from heart failure or succumbed to its progression. I think 5 years ago, not much could be done about left sided VT other than installing a defibrillator and getting on the heart transplant waiting list. More recently, there is hope. Natale's group and others can improve lives with the latest technology. Belby researcher - AFIBBERS FORUM
There is no placebo arm in the study according to the description. You either get catheter ablation or rate control medical management. In a prior study published a few years ago, a trial comparing rhythm control medication vs. rate control medication show no difference in mortality vs time curve. This will show whether Canadian ablations, on average, are any better than drugs. The results wiby researcher - AFIBBERS FORUM
Best wishes for long term NSR.by researcher - AFIBBERS FORUM
Here is a link to the trial description. I suspect there is no one size fits all answer as life expectancy must enter the equation even if one approach proves to be superior to the other.by researcher - AFIBBERS FORUM
He has a nice blog this week on his thoughts about rhythm control drugs.by researcher - AFIBBERS FORUM
I agree Dr. Schweikert would be an excellent choice.by researcher - AFIBBERS FORUM
Check out the ones below. Dr Wilber at Loyola is probably the top ablation specialist in the Chicago area.by researcher - AFIBBERS FORUM
Janet, Glad to hear that you are still doing well with the Ernst ablation. Thanks for the reference and my cousin is doing well when we last talked.by researcher - AFIBBERS FORUM
It is a great step forward if the results hold up and it has so far. AF would be as tractable as right sided SVT with nearly as high success rates in terms of RF ablation. It will still be more complex in terms of the needs to cross the septum and do PVI as required steps.by researcher - AFIBBERS FORUM
Linda - Nademanee's group has a clinic in LA.by researcher - AFIBBERS FORUM
McHale, I think the basket electrode is pliable and probably safe since pressure is distributed over the entire atrium. The ones that seem to have the most serious complications are the ablation tools with a thick shaft (cryo balloon and laser balloon are examples) and steep learning curve.by researcher - AFIBBERS FORUM
SH, You still need PV isolation as the first step. Much like what Steve experienced in his Bordeaux Unplugged postings. First Jais did the PVI, then Haissaguerre did the "re-entry" focal points, another way of saying rotors. So it looks to me that it is being done with different mapping approaches. FIRM approach uses a basket electrode inside the atrium and Bordeaux is working witby researcher - AFIBBERS FORUM
McHale. No question he is top notch. My impression comes from two observations. First being that he co-authors a lot of research papers with Natale. Second was that a comparison table between him, Natale, Pappone, Haissaguerre and Kuck was presented at AF symposium and his results were as good as the rest. They were tightly bunched. My concern about using him would be that he likes to be inby researcher - AFIBBERS FORUM
Every now and then, posters have questions regarding the merits of cryo balloon ablation. The link below offers an in depth presentation from April 2012 and Q&A from 2 world class clinicians on the subject. Vivek Raddy's discussion at the end tells how he makes the decision on patients during the start of procedures of whether cryo has a role versus the focal RF approach. Bottom lineby researcher - AFIBBERS FORUM
Minimizing xray exposure is always a good idea particularly for young patients. Tje benefit probably outweighs risk for us oldtimers. Make sure they have the latest xray machines and 3D mapping systems. My dad died of cancer resulting from angioplasty 30 years ago back when they were still on the learning curve. The CABG was a great success though and gave him 10 good years then the cancer kby researcher - GENERAL HEALTH FORUM
He is very skilled with the laparoscopic tools. I think the main difference between his approach is the lesion sonnecting mitral annulus to the SVC and another conneting to the main PV box. In the video, it is hard to tell when and how he did that. Bordeaux group and others call their lesion line mitral isthmus ablation and attempts to do the same thing. With visual access, Dr Sirak should doby researcher - AFIBBERS FORUM
Cox maze cut and sew schematic shown in the following link. I am sure that Dr. Sirak does not imply that he has only encountered right atrial flutter failures in his results. That would be quite remarkable. Sounds like more statistics and long term followup is needed. We can discuss further later. I will be back online tomorrow,by researcher - AFIBBERS FORUM
Thanks EB for detailing your experience. Dr. Sirak doesn't count atrial flutter or tachycardia as failures so we may be comparing apples and oranges when it comes to quoted success rates. If the Dutch researchers use the same criteria, then their success rate would also be in the 90's. The cox Maze lesion set would be very difficult if not impossible without open heart surgery. If Iby researcher - AFIBBERS FORUM
Dr. Sirak is probably a very good surgeon. Problem is nobody has replicated his results. It is also not possible for any surgical procedure including the 5-bos to map substrate so any additional lesion sets or focal points required to address non-PV triggers would be missed. I am very doubtful that the 5-box alone can better open heart cut and sew cox maze III which has around 90% success longby researcher - AFIBBERS FORUM