Related to this topic. I received an emailer today from EP Lab digest with a direct ad campaign from St Jude Medical- There is a graphic that goes before the "what exactly does that mean? paragraph. That didn't cut and paste. If interested, check out STJ's website and look up tacticath. ============= The TactiCathâ„¢ Quartz Ablation Catheter provides contact force-sensing infby researcher - AFIBBERS FORUM
Hi Rita, Good to hear that Swarup is collecting his share of data for Biosense. Biosense is the dominant company in EP catheters so almost everyone that does clinical trials are under their consulting umbrella and the numerous centers involved should not influence how you think about new devices The trial was initiated in March 2013 and the last patients to be ablated will be September of nexby researcher - AFIBBERS FORUM
Hi Shannon, it will be nice for the EPs to have another choice. This Tacticath clearance also point out the strangeness of the FDA when it comes to evaluate medical devices. I use the word "strangeness" instead of "corrupted process" in deference to the hard working scientists there. The tacticath uses fiber optics (3 fibers thinner than hair thin) to measure force and defby researcher - AFIBBERS FORUM
Hi Rita, my advice to all posters that have asked about being involved in clinical trials for new devices is try to avoid them. The irrigated Lasso ablation catheter may well be proven to be as effective as thermocool but that is a question that will have to be addressed through lengthy trials and followup. We just won't know for a few years. The latest devices that were recently clearedby researcher - AFIBBERS FORUM
Hi Rita - best of luck with your procedure. RE - I have not heard of EnMark and I follow the new devices closely. About 3 years ago, there was a Carlsbad, CA company that was experimenting with similar concept - spline based RF ablation. The trials did not end well. The catheter burned too hot and blood clots were formed on the catheter. As a result, the trials were stopped due to strokes inby researcher - AFIBBERS FORUM
We get a number of UK members visiting this forum and this is FYI for them. Noticed an article in the current issue of Heart Rhythm regarding the single procedure manual success rate (measured at 12 months) for Schilling's group. Not sure how this compares to other groups but it is a useful data point for discussion if you are interviewing different ablation specialists in the London area.by researcher - AFIBBERS FORUM
Bert, Sorry to hear of your continued struggle. I think Young is probably your best bet at Kaiser. |2|1|Professional|/ncal/provider/charlieyoung/about/professional?professional=aboutme.xml&ctab=About+Me&cstab=Professional&to=1&sto=0by researcher - AFIBBERS FORUM
Nancy, Glad to hear that you are doing well. Best wishes for continued improvements.by researcher - AFIBBERS FORUM
Nice Duke. Best Wishes for long term NSR.by researcher - AFIBBERS FORUM
I used to give scientific talks too and I think too much is being read into what Ernst said in the video. She reviewed Middle East ablation procedures, likely King Faud hospital, and made some comments with regard to how procedures are being done there in comparison to the latest standard of care. It takes skill and experience to go beyond PVI. The main caution is disconnection of the Bachmanby researcher - AFIBBERS FORUM
George and Gill, I believe that Lesley wrote that Schilling gave his opinion before she went to Bordeaux. Perhaps I read it wrong in that she consulted with Schilling once again post ablation.by researcher - AFIBBERS FORUM
Lesley, thanks for writing this up and glad to see that you are on your way to NSR after such an arduous route. Bordeaux is way ahead of everybody else in the application of CardioInsight mapping. I look forward to that technology spreading to all EP ablation labs. RE what Dr. Schilling said to you - I am confused by what he meant by "early days" since you already had 5 ablatioby researcher - AFIBBERS FORUM
George, Can you please comment on your thoughts regarding the utility of Stress Doctor compared to AliveCor. Thanks.by researcher - AFIBBERS FORUM
Lynn, Found his name via Shannon's search page. That was 4 1/2 yrs ago. The doctor's name is Gregg Arena. He was a practicing doc and didn't want to deal with the side effects of AADs so he went straight to ablation. It worked out well for him and he spoke highly of Dr. Tchou.by researcher - AFIBBERS FORUM
I remember that. The patient was a practicing doctor but I don't remember his name. He looked at a number of EPs and decided to go with Tchou. He was successfully treated and happy with Dr. Tchou if recollection serves.by researcher - AFIBBERS FORUM
Shannon, there is an article relating to this topic in current issue of Heart Rhythm Journal.by researcher - AFIBBERS FORUM
David, I don't see much downside to it as long as it is done in combination with PVI. As noted by Jackman, PVI sites coincide with a lot GP locations (fat pads) so it is being done anyway in conventional PVI ablation already. Outside of the PVs, GP ablation has a lot of similarities with current practices that use isoproterenol challenge to locate triggers outside of PVs. Jackman and Poby researcher - AFIBBERS FORUM
Thoughts from Jackman regarding CFAE and GP as of 2 years ago.by researcher - AFIBBERS FORUM
Phil, The idea of GP triggers have been around at least 10yrs. Jackman's group did beating heart (open) experiments on dogs originally to see what was happening with electrical and chemical stimulation to force AF and mapping the hearts. That led to the discovery of the role of GP. When the GP were ablated, it was nearly impossible to reinitiate AF. Since around 2006-7, Jackman startedby researcher - AFIBBERS FORUM
Shannon, No question at all that your Lariat job is as good as it can get as far as executing the procedure as envisioned. You had the two most competent pairings in the world working on you. In your case the Lariat solution wasn't enough and I am no longer confident that the Lariat will not be prone to repeat occurrences like yours without further understanding and improvements. Watchmaby researcher - AFIBBERS FORUM
Shannon, I didn't realize that your Lariat procedure failed and I am glad that it was fixed via Amplatzer. The St Jude medical site's explanation on Amplatzer is lacking in detail. I pasted a link below that shows how it is done and that device is offered in a big range of sizes. I remember when you chose the Lariat procedure with Natale/Burkhardt that it was pretty much a lead pipeby researcher - AFIBBERS FORUM
Sally, I am very positive that your condition has improved and that you have an excellent chance for NSR (touch up may be required later). I was trying to understand how EPs make decisions on approach. I think the reason that Dr Schilling had, to minimize complication risk, is a very good reason. Women have about twice the serious vascular complication risk as men. Minimizing risk is an impoby researcher - AFIBBERS FORUM
Jackie ! Best wishes for a procedure well done and NSR for you. I am sure you and Natale will come through in flying colors.by researcher - AFIBBERS FORUM
Sally, Best wishes for procedural success. I am curious as to why Dr. Schilling chose cryo over conventional. Only 5% of the AF procedures at high volume centers are done with Cryo and closer to zero at top groups such as Natale and Bordeaux.by researcher - AFIBBERS FORUM
Eric - there are generalist and subspecialties within cardiology and your cardiologist is most probably a generalist. If you like her, keep her as changing to another generalist won't buy you much. As far as EPs around NYC, the three that are most often suggested here are Chinitz, Steinberg and Reddy. They all have very good reputations. I list Reddy last as he has in the past try to conby researcher - AFIBBERS FORUM
Thanks Shannon, I need to clarify what I meant by incorporating the findings into the mapping systems. That would be including a force-time-power integral algorithm into the systems so that RF automatically stops at the 1000 gs limit (as an example). Currently, the systems have force and direction readout and that's about it and RF titration is not automated. The navigation part would stby researcher - AFIBBERS FORUM
A very nice JAfib paper on contact force catheter and the effect of force and power and ablation-time on lesion formation and the likelihood of reconnection. All of these findings will probably be incorporated into Carto mapping systems (and others equivalent systems) so that there will be less guessing on what is required during RF application. free registration is needed.by researcher - AFIBBERS FORUM
David, after doing some more reading, I found that HCM treatment by alcohol ablation originated with a German doctor at Royal Brompton nearly 20 years ago. I don't know if they kept it up as the German doctor (he pioneered stents as well) is in his 70's. My guess is that if they did keep it up, then they have the skills and experience to deal with HCM and VT ablation. VT ablation wouby researcher - AFIBBERS FORUM
David, I haven't seen anyone with HCM post here so my guess is that you will not get first hand experience here on approaches to dealing with that in combination with AF. I have a tennis friend with HCM. It has been an ordeal for him with all the ICD lead issues and surgical interventions every few years. I don't know if there is an UK center that is busy in both AF and left sided Vby researcher - AFIBBERS FORUM
Had another episode yesterday while playing tennis. I kept more careful observation this time. I felt weakness for 2 games and then felt normal again during a side change. Sweating profusely and difficulty concentrating. Fought through it and manage to win the set. I still don't have AliveCor and not sure if I had it, whether I would run over and strap it on under such circumstances. Iby researcher - AFIBBERS FORUM