Remember that Natale's and 3 other groups in the US tried the same thing and found that they weren't anymore successful and that serious adverse events went up slightly and they presented their findings 2 years ago if recollection serves. I think what the Dutch study suggest is that you need to have a dedicated group of surgeons and ablationists that are willing to work well together -by researcher - AFIBBERS FORUM
A hybrid procedure combines minimally invasive surgical isolation of PV followed by catheter mapping and ablation of non-PV substrate.by researcher - AFIBBERS FORUM
Conclusion - unrelated.by researcher - AFIBBERS FORUM
LAA isolation is becoming a more controversial subject. At the HRS meeting, randomized results were presented by another research group (Callans and Marchlinski) that suggest that LAA isolation doesn't improve ablation success rate. Natale's group remains the lone proponent currently. More long term followup results are needed.by researcher - AFIBBERS FORUM
Chuck, If you go to the Biosense-Webster website and look under the history tab, you will get an idea about the evolution in EP tools. The initial concepts, development and testing of the tools all started with Jackman's clinic at U. of Oklahoma. Better tools seem to have enabled better understanding and treatment of different sorts of arrhythmias including AF.by researcher - AFIBBERS FORUM
My guess is that the Washington University clinic is the busiest center in that region for both ablations and surgeries.by researcher - AFIBBERS FORUM
The thermocool catheter, which is the current RF gold standard, wasn't available for the Stereotaxis magnets until 2009 so it seems they installed it a bit too early. I am shopping TVs for my father in law now that his 10 year old DLP (rear projection) TV is failing. Technology is about the same as last year, more choices and about the same price for LED TVs. Larger sizes are available coby researcher - AFIBBERS FORUM
Randy, Sorry to hear of your ordeal and glad to see you are recovering. I don't understand why your doc still have you on Multaq. It is supposedly less toxic than Amiodarone but still has many complication issues including the symptoms you described. I would ask to get off of it ASAP.by researcher - AFIBBERS FORUM
More explanation from the Mayo group about screening and why the guidelines are the way they are. I am less critical of the guidelines now but the EP profession still need to improve the screening protocol. Basic screening with ECG and echocardiogram is really not that expensive. Less than $100 for kids if done in assembly line fashion organized by athletic departments. More detailed screeninby researcher - AFIBBERS FORUM
I asked (on behalf of a female cousin residing in the UK) Janet who posted here a few years back about her London ablation experience and below was her reply. She has been doing well and not posted here since. ======================================================= I live just outside London, and had appointments with Sabine Ernst and Richard Schilling before deciding who to choose. I'by researcher - AFIBBERS FORUM
I don't agree with the guidelines as parent of kids involved in sports. The new guidelines are in response to increased screening for participation in sports and finding around 0.2% of kids with arrhythmia. I have had a co-worker die at work a few days after a marathon. I know of friends of friends who went through the same thing Mardie Fish is experiencing now. We have had deaths at locby researcher - AFIBBERS FORUM
McHale, It could been just SVT. However, SVT and sports is a dangerous mixture so my guess is that it was probably AF for him to wait and evaluate. Peggy, No simple answer. It depends on life expectancy and quality of life. In Fish's case, his "living" is physically demanding so it is a clear cut case of either take care of it or retire now.by researcher - AFIBBERS FORUM
You don't fool around with AAD's if you are a competitive athlete, unless you are retiring. Even then, the way Fish described feeling like his heart jumping out during episodes probably means his quality of life would be a big issue for someone with such a long life ahead of him. It is probably more urgent than the decision that Dr. Arena talked about here a few years ago. He was symby researcher - AFIBBERS FORUM
Aloha Elizabeth, Hope you are doing better. I don't know if anyone answered your question with regard to ICD implant. Neither pace maker or ICD do anything for AF. They are usually implanted for patients in danger of VT or VF or heart block. Not sure what the EP expertise level out in Hawaii. I think that Dr Nadamanee had done clinics out there somewhere but I am not sure if he stilby researcher - AFIBBERS FORUM
I had a tennis friend that had WPW-SVT. His ablation was successful. SVT is right sided and AF is left sided and AF is much more difficult to ablate so I suggest making sure that you really have AF instead of just SVT. As George stated, look for a center that does a high volume of ablation procedures. I can't imagine playing tournaments with SVT. You must be quite a player and you willby researcher - AFIBBERS FORUM
Angela - you may find the guidelines provided at the Heart Rhythm Society website helpful. It was recently updated and covers drugs, ablation and surgery.by researcher - AFIBBERS FORUM
Ablation is definitely being rationed to the patients that complain the loudest about their quality of life. Dan's point that ablation is a money driven decision is a very narrow view of the whole landscape. A patient that's failing drugs and requiring repeated CV's makes the hospital, drug companies and doctor groups more money while costing insurers/taxpayers a lot more money tby researcher - AFIBBERS FORUM
I doubt there is a one size fits all answer. It depends on whether someone is symptomatic, what the life expectancy is and quality of life. I think the majority will be on rate control plus anticoagulation such as my father in law. It will be hard to convince patients to not try drugs first unless they are young and active. For example, there is no question at all with WPW in kids. No reputby researcher - AFIBBERS FORUM
Janet, So sorry to hear of your painful 3rd procedure. Hope your recovery goes better this time. Did the EP explain why you were not under general anesthesia?by researcher - AFIBBERS FORUM
For some people, like one of my cousins, palpitations happened in her 20's and then stopped after college. She is probably at higher risk for AF.by researcher - AFIBBERS FORUM
Study based on hospital discharge records. People who report having palpitations appear to have an increased risk of being diagnosed with atrial fibrillation in the future, a Norwegian study showed.by researcher - AFIBBERS FORUM
Ken, What you described is not FIRM. FIRM takes a expandable basket type mapping tool (a mesh of electrodes pressed against the atrial walls) and newer software to visualize the electrical waves before ablation. The basket type tools have been around a while. The advance needed was the math and software to track the electrical waves. The latter only made it out of research within the last cby researcher - AFIBBERS FORUM
Gill, I know but PM here doesn't allow attachments. It is a 1M pdf file. Steve, Best of luck at Bordeaux. I think I would do the same in your situation. FIRM ablation protocol (as of now) still needs PVI and nobody does PVI better than the Bordeaux group. It will take another couple of years for FIRM results to be replicated or not at other labs so the 10% incremental success rate atby researcher - AFIBBERS FORUM
Gill, pls provide email address in PM if you still want copy of paper.by researcher - AFIBBERS FORUM
Steve, it is presentation number AB16-05 at HRS meeting. Check PM for my message. I will be traveling starting in a few hours and won't be able to post or send email until Sunday. I will send the files then. Steve, found the abstract available online so I pasted it in my post above. Enjoy. You are in good hands.by researcher - AFIBBERS FORUM
Well I guess Harvard is just not very good. Bordeaux presented their 5 yr at this week's HRS meeting and it is way way better than Harvard. I will add the results here in an edit later on when I get the word version of the abstract. Right now, I have the PDF version which for some reason doesn't let me do cut and paste without turning it into jibberish. The Bordeaux results are veryby researcher - AFIBBERS FORUM
Jackie, I am sure you meant the HRS annual meeting rather than Boston AF. Here is the big news that doctor John blogged about (see movie link below). It is really fasinating. A patient that under went open heart maze unsuccessfully followed by catheter ablation a few years later also unsuccessfully. A smoker and drinker, cured by FIRM ablation by focal ablation of three spots. Two in the rigby researcher - AFIBBERS FORUM
Peggy, Glad to hear that Pradaxa is working well for you. For my 90 year old father in law, he is close to the VA hospital and has been subject to periodic nose bleeds so Pradaxa is not appropriate for him. He has decided to stay with warfarin.by researcher - AFIBBERS FORUM