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Hey NLAMA, It's all going to be fine ..: really! You've stacked the deck as much as is possible with the good decisions you have already made, including foremost who you chose to entrust your heart too for this ablation process. These last few days you can now fully relax that grip and simply enjoy the ride from here on out knowing that you've done all the logical steps, includiby Shannon - AFIBBERS FORUM
Hi Susan, The second study above you reference from Hamburg Germany describing a 17% thrombus rate in patients on NOACS that had undergone a very different approach to LAA Isolation. Certainly compared to the more successful and safer 'Ostial LAA Isolation' technique popularized by Dr Natale, in which only the mouth (aka Ostium) of the LAA is encircled by a single lesion. This, inby Shannon - AFIBBERS FORUM
You are welcome Susan, The CardioVisual app offers a wide array of cardio-related educational content from patients, up to and including EP's, Cardiologist and nurses. If you look to the far right side of the CardioVisual app's content window, you will see a vertical list of a number of more basic cardiology topics including: 'What is AFIB' and 'Treating AFIBby Shannon - AFIBBERS FORUM
Hi NLAMA ... Yes, a number of cardiac conditions can result in increased degrees of cardiac structural fibrosis over time ... including chronic progressive AFIB. Shannonby Shannon - AFIBBERS FORUM
CardioVisual app with Dr Andrea Natale discussing the importance of HPSD for Atrial Fibrillation ablation. Courtesy of CaridoVisual app and Salwa Beheiry Enjoy! Shannonby Shannon - AFIBBERS FORUM
Dr Natale doesn't directly target fibrosis for ablation. His group tried that approach many years ago, but it' never proved to be a reliable target and simply did not make any difference trying to ablate the actual fibrotic scars. However, one beneficial thing that they discovered from detecting an increase in atrial fibrosis, is a definite correlation to increased Non-PV triggers asby Shannon - AFIBBERS FORUM
Hey NLAMA, My take is that this issue isn't nearly so consequential as it my appear to you at first glance, this back and forth between Dr Natale and Dr Ousamma Walid (a former colleague who worked under Natale when Dr N. was Director of Cleveland Clinic's AFIB program during the early 2000's) is easy to misunderstand when read out of context and with the limitations of twitterby Shannon - AFIBBERS FORUM
You're more than welcome Joe and Mwcf, Keep in mind, that the better part of valor in digesting new technology is to let the maturing science convince us, and not be too quick to get super excited over company press briefings promising 'world changing' revolutions that have yet to show independent robust validation. IRE (Ir-reversible Electroporation) at this stage of its vetby Shannon - AFIBBERS FORUM
This is basically electroporation ... with an apparent twist ... otherwise more recently named Pulse Field Ablation (PFA) that we have covered extensively here on the forum over the past few years. Over the course of these last few years of PFA's development and early trials, it has proven to be a very encouraging technology. Ironically, the origins of PFA date back to early days of elecby Shannon - AFIBBERS FORUM
Hi Nlama, In addition to the great advice Carey offered above regarding assessing an experienced Watchman operator, another key factor is in knowing roughly how many transeptal punctures (TP) has an EP done (mostly during AFIB ablations for the EP), or the number of transeptal punctures an expert Interventional Cardiologist (IC) my have done during various vascular plug installs in the left atrby Shannon - AFIBBERS FORUM
Hi Susan, Flutter can and does self-terminate at times, but it also more commonly requires an ECV to terminate a flutter. This is especially true for Atypical left atrial flutter which is most commonly seen after an AFIB ablation. And an atypical left atrial flutter originating from the ostium of the LAA will almost certainly require an ECV to terminate in the short term and a successful flby Shannon - AFIBBERS FORUM
Some people can get too much Magnesium NLAMA, though in most cases it's the opposite that tends to occur with insufficient Mag. Go to our AFIB Report Archives and look up issue #138 June/July 2015 issue and read the article I wrote with liberal excerpts from an original article offered to me by my friend and renowned integrative MD, Dr. Jonathan Wright, from near Seattle Washington, titleby Shannon - AFIBBERS FORUM
What a milestone Jackie!! You know well how much I appreciate our close friendship and all of your such generous contributions and mentorship to legions of us former and current Afibbers over the last almost two decades. And you have certainly been the official honorary 'Den-mother' of Afibbers.org these many years! Your advocacy for this wonderful resource has been so welcomed bby Shannon - AFIBBERS FORUM
Great to hear Susan! And that is the same story I hear repeatedly especially in the most recent couple of years that Dr N has been going to Los Robles Med Center in Thousand Oaks CA. It quite naturally usually takes a good 6 months or more for the existing staff at a new center for Dr Natale to all become a well-oiled machine together once he begins doing procedures from 3 days to a week eachby Shannon - AFIBBERS FORUM
Good to hear from you again Victoria! I can tell you all that Dr Natale is nearly back to his normal peak voilume of ablations now at St Davids, and as SusanD noted he was in California last week at Los Robles and Scripps as well. At St Davids Medical Center they do not treat any COVID-19 positive individuals on the property at all, and all staff, physicians and everyone else get frequent PCRby Shannon - AFIBBERS FORUM
Great to hear from you Que! It has been a while... Hope all is well with you these days, and please drop me a PM with your updated cell and email! Take care Cheers! Shannonby Shannon - AFIBBERS FORUM
Hi Susan, With RF being used as the energy source for all RF ablation, it is technically correct to say that burns are made in the ablation process ... but in describing : "one's LAA as having been burnt" as if the entire LAA had been cooked or torched, the choice of words inadvertently conveys a more destructive impression than what actually occurs during a full LAA isolation.by Shannon - AFIBBERS FORUM
Great to hear NLAMA! Am glad you got the ECV and hope it holds a good long while during which you can fully sort out your best options and move to put the final KaBosh on the whole AFIB business once and for all! Will be glad to speak to you by phone on any of these topics, as it's easier for me to go more in-depth via phone at these days. Rest up and enjoy your NSR! Be well! Shannby Shannon - AFIBBERS FORUM
Welcome Salwa!! For all our forum folks, Salwa is a very dear long time friend of mine going way back to the early 2000's when Dr Natale first started doing cases at Marin Hospital in Marin county in the SF Bay Area, and she has been literally the right hand arm of Dr Natale going WAY back to I believe his time at Duke Univ. Med, even before California right Salwa?? Salwa knows all aboby Shannon - AFIBBERS FORUM
My advice, as well, is to go get your ECV asap NLAMA. Improving documented deficient levels of DHEA-Sulfate and deficient Testosterone levels in men can bring a number of important health benefits, but don't 'wing it' by yourself! Get a thorough hormonal work up by an experienced MD well-trained and board certified in a good AMA approved BHRT Fellowship program. Any ideas you mby Shannon - AFIBBERS FORUM
Holy cow Jackie! So sorry you've had to go through that stress especially during peak COVID time! But great to hear you are recovering well and are back at home with a steady heart as well 👍👍. Be well! Shannonby Shannon - AFIBBERS FORUM
Hi NotLyingAboutMyAFIB, as Carey noted above you with be alright with a single missed dose that is easily early enough not to impact your important contribution to your ablation by making sure you take your regular twice a day full dosing during the week leading up to 'ABL-Day' . Assuming you don't miss any more doses leading up to your procedure with Dr Natale, the one most criticby Shannon - AFIBBERS FORUM
Hi Cirenepurzalot and Driver, You are both more than welcome! And like you both, I'm also very grateful for Carey's many regular contributions to the forums ... which has been a big help for me as well. As is true for all you 'Old-timer' regulars here that make this such a special place for Afibbers from all parts of the world! Cheers! Shannonby Shannon - AFIBBERS FORUM
Hi Folks, Apparently, there was a mistaken choice of words used that inadvertently conveyed the wrong impression to Cienepurzalot implying that he was required to return to Austin for a TEE at 6 months after his index ablation. As it turns out, Robert does NOT have to return to Austin for a 6 mo. TEE to evaluate his LAA mechanical function after all. It's easy to see how by inadvertentby Shannon - AFIBBERS FORUM
Yes, NotLyingAboutMyAFIB, (in writing replies to your posts I think I'll use an abbreviation of your username if you don't mind as; NLAMA, for brevity's sake :-), there are a lot of good survey's I'm sure you will find interesting already posted in the archives on a variety of AFIB related topics, as Liz and GeorgeN noted above. These surveys are all still found in past iby Shannon - AFIBBERS FORUM
Below is first glimpse of a breaking Pre-proof of a small 11 patient upcoming complete study out of Paris that will be published soon. This link below: No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection is just a preliminary summary in light of the timely nature of the topic in which tby Shannon - AFIBBERS FORUM
Dear Afibbers, Obviously, COVID-19 has become a central focus for all of our lives and this truly unique event is of such importance to us all that it occupy's a good portion of every one of our days. And this is the reason why the various and increasing COVID-19 threads that are interesting and informative have remained posted on the Afibbers Forum for the past few weeks. I much apprby Shannon - AFIBBERS FORUM
Great to hear Robert and nice speaking with your again today (Thursday) Im glad we could review over the phone some of the details of how the blanking period works. Just a day at a time here RG and take er' easy! x Cheers! Shannonby Shannon - AFIBBERS FORUM
As Carey noted above, the generally acknowledged post ablation blacking period after an index ablation (and essentially the same after follow up ablations as well) is a full 3 months. However, the results of long-term follow up studies by multiple high volume ablation centers have confirmed that the actual average real-world blanking period is over at the end of the eighth week post ablation.by Shannon - AFIBBERS FORUM
As I posted just now in another thread, Dr Natale and his Texas Cardiac Arrhythmia Institute have, regrettably, cancelled the EP-Live 2020 conference that my wife and I had been very much hoping to attend the first few days of April. With the rapid expansion of this now official pandemic, we had been preparing not to go after-all, assuming EP-Live was all but certain to be cancelled. This iby Shannon - GENERAL HEALTH FORUM