NO you dont have to be in AFIB Carole, Dr Natale, or any EP, will trigger your AFIB as part of their mapping process during the Electro-physiology initial 30 to 40 mints of your procedure where they get a thorough real time understanding of just how your arrhythmia manifests and where in the left and right atria the triggers are. As Rob noted, during a first index procedure Dr Natale will do hby Shannon - AFIBBERS FORUM
HI Folks, The following is a quickly dashed off letter to Louise who had sent me this article on the LARIAT risks issue yesterday and I replied to her with the following. I do not have the time at the moment to polish it up much and so please forgive any typos etc This is yet another generalist article looking mostly in the rear view mirror and not at current practices with, in this case tby Shannon - AFIBBERS FORUM
Hi Craig, Please remind me again, did you have a full LAA isolation or a did Dr Natale just delay your LAA, I think it was a full one if I remember correctly, right? Sorry Its hard to keep track of everyones procedure details when I hear so many variations each week and month. But if you did have a full LAA isolation, I would have expected you to have had a 6 month TEE a long time ago by now?by Shannon - AFIBBERS FORUM
Many thanks Larry, Dennis, JohnB and Craigh, I appreciate the best wishes! Just finished the 3rd Annual International Symposium on Left Atrial Appendage conference here in Marina Del Rey along the LA coast near LAX airport. It was another really excellent conference. I really enjoy this conference best of all that I have attended so far in the AFIB world after having gone last year as wellby Shannon - AFIBBERS FORUM
Good summary of the LAA issue Bill, And thanks folks for the best wises for Magdalena, she has been a real trooper and takes great comfort in knowing she has a truely elite level kidney surgeon. All the other docs and staff at MD Anderson speak of Dr Christoper Wood there with a similar level of respect and reverance that may of us feel about art Natale. A resident physician who is workingby Shannon - AFIBBERS FORUM
Hi Mike, A quick note from Houston where my wife and I are resting tonight before our flight home tomorrow after a literal marathon week of endless testing, scanning, biopsy and doctor visits at the enormous MD Anderson Cancer Center her for planning my wife's renal cell carcinoma surgery on her left kidney, as well as other necessary evaluations. Her first step is the kidney cancer openby Shannon - AFIBBERS FORUM
Judianne Your doc seems not to have a lot of experience with Warfarin resistance if he is having you take only two 1mg incremental dose changes with only 3 weeks prior to ablation when you have not responded at all to initial warfarin dosing! It is very unlikely to work that way with so a slow tentative ramp up with only 3 weeks left before your ablation. if you have warfarin resistance aby Shannon - AFIBBERS FORUM
Hi gmperf, First off, the ocular migraines do happen on occasion four some people from the transeptal puncture but as you noted in your first ablation when you experienced that it was self-limiting and so too will this occurrence resolve on its own before long. The coronary sinus (CS) runs along the bottom border of the left atrium and upper border of the left ventricle passes close to theby Shannon - AFIBBERS FORUM
Wait a minute John21, I fully understand that docs are not always right about their prescriptions, and there are many cases where EPs and Cardios put people on blood thinners prematurely just to cover their behinds even when their own guidelines say such a drug is contraindicated, but in the case of needing a blood thinner after an LAA isolation ablation or even without such an ablation shouldby Shannon - AFIBBERS FORUM
Hey Jackie, Great to hear your formal report and Im so pleased you are on the other side of this fence now. It's certainly been quite a journey and each of us with so many years under our belts have a unique journey to share, though with so many common hallmarks and landmarks along the way. The PVCs will typically settle down with the lesion healing and the nutrient regime should helpby Shannon - AFIBBERS FORUM
The current Aug/Sept issue of The AFIB Report is dedicated solely to exploring my experiences over the last three months beginning with the surprise small stroke in early May up through the recent repair of my leak within the previous fully closed left atrial appendage that was the result of an initially successful LARIAT procedure performed last August 2013 exactly one year ago. We won'tby Shannon - AFIBBERS FORUM
That's great to hear Russ, Dr Wolf is certainly an expert in that procedure as its pretty much his baby to start with as an extension of the Cox maze, of course. It certainly has its place as well, though as you noted the success rates for catheter ablation are more variable based on the skill and experience of the operator, it's also true that its important to chose a very skilled mby Shannon - AFIBBERS FORUM
Hi David, Very sorry to hear of your TIA, the gold standard for determining if you had one, and whether or not it was from a likely embolic origin around the LAA or perhaps from a cerebral artery spasm, is via a combination MRI and MRA (magnetic resonance angiography done with gandolinum contrast dye). They should find evidence of a small lesion in the brain if it was even a small CVA (cerebraby Shannon - AFIBBERS FORUM
Hi Mark, So sorry to hear of your recent conversion back to AFIB from happy NSR. Its always a big disappointment when that happens. However, you came back to the right place with the right idea to make your absence from NSR as short lived as possible. One question, are you now in persistent AFIB? Also, have you ever adopted The Strategy protocol for magnesium, potassium and other heart quieby Shannon - AFIBBERS FORUM
Barbs touch up ablation went very well as expected and hopefully this one night in the hospital is not too restless with the nurse coming in and out and the machines beeping and such. I had written a new thread about her procedure earlier and no realize I must have accidently erased it when I was make a few typo edits ! In any event , this smaller version I felt best to put in this main thrby Shannon - AFIBBERS FORUM
Hi All, Barb asked me to make a post for her to let everyone know she is doing just fine after what Dr Natale aid was a textbook procedure for a follow up case. No prior areas ablated needed redoing and the only two focal areas the required addressing was one new focal spot along the lower posterior wall near the esophagus area and the actual flutter trigger source was found and ablated alongby Shannon - AFIBBERS FORUM
Thats great to hear AFjun14, That means it's very unlikely for anything outside of your LAA while have reconnected that was previously ablated by Dr N. It was just at 6 years ago when Dr Natale started doing gradually more LAA ablation and isolation. If he saw any LAA triggering during your prior ablation at that time six years ago, it is very likely he would have still only delayed thby Shannon - AFIBBERS FORUM
Going straight to a Lariat is an option afjun, but first you want to make sure your only remaining triggers are in the LAA and that all other areas of prior triggering are firmly ablated and with no reconnections. Again dr Natale has by far the most experience in ablating and isolating the LAA successfully and after your multiple ablationns would absolutely be the one to consult about the next beby Shannon - AFIBBERS FORUM
Be very careful with a hybrid approach for persistent AFIB KenKY, It has its place when compared to run of the mill catheter ablationists who struggle to get consistent results with a standard PVI for paroxysmal AFIB, and it can be useful for folks with extremely enlarged LA diameters and with very long standing persistent AFIB most of whom have a host of other co-morbities. But the hybrid proby Shannon - AFIBBERS FORUM
Welcome Tic toc, It's great to read that you recovered from your stroke, which is a particularly rude way to find out you have AFIB to begin with. Please take the time, if you have not already, to review our archives and search for the topics of interest via the advanced search box found at the top right of this forum page, that you mention in your first post as we have addressed allby Shannon - AFIBBERS FORUM
Hi All, Im back home from the 2nd Annual International Symposium on the Left Atrial Appendage held in Orlando last week. It was a very interesting and informative conference and very well attended by a broad range representing all of Cardiology. Interventional Cardiologist, Cardiovascular Surgeons as well as many EPs were in attendance and the unique perspective of all the major sub-specialtieby Shannon - AFIBBERS FORUM
Thanks for the report Iatrogenia, but be aware that this not recent news and is still far from proven, This report is nearly two years old now, and the excitement over FIRM has muted considerably. It is a modest resolution system at this point and the jury is still out whether it may or may not add any real value over careful 3d EAM mapping in experienced hands. This hype of a 2.5 minute ablby Shannon - AFIBBERS FORUM
Hi tsco, Welcome to Afibbers.org and sorry to hear you have had a rough go of it. I presume this will be your first left side ablation, in other words the first one in the left atrium for atrial fibrillation/Flutter as compared to your earlier three ablations which, if I glean what you are saying above, sounds like they were for SVT and typical right atrial flutter for the most part? Is that cby Shannon - AFIBBERS FORUM
Hi PH, One other point in your post above, you were asking Professor Jais about getting LAA isolation and he suggested that if you didn't have any activity there in the LAA then it wouldn't do you any good to just automatically ablate that area, which is absolutely true. But by the way that was worded he may have been under the impression that the LAA isolation was a fixed conclusby Shannon - AFIBBERS FORUM
Hi Sammy, You are on the right track, just first confirm exactly what is going on with an EKG. You can always get an older model Iphone 4.5 with unused models costing very little and then add the AliveCor case/monitor that fits that model phone and use it exclusively for checking arrhythmia, but if you can catch this for sure on a standard twelve lead EKG too that is the good standard for confby Shannon - AFIBBERS FORUM
b](Thanks to Onewaypockets for releasing his nearly full ablation report. below I'll try to highlight in bold some of the terms and abbreviations along with a few observations that might be useful for to him and others here.) Report Status: Finalized Anesthesiologist ROSE, BARRY M MD Electrophyslologist NATALE, ANDREA MD Procedure Type Ablation: EPS w/Ablation of A-Fib, EPS &aby Shannon - AFIBBERS FORUM
You are in the right place now and heading to the right place in three days Oneway! You will do fine so no worries at all, Michelle will take good care of you during and after the procedure as Morna has no doubt done in helping with your INR. Just realize you have made the very best choice you possibly could for a Captain to guide and perform your ablation process. That is the one main decby Shannon - AFIBBERS FORUM
A quick note to let everyone know Dennis C, Our NYC friend who had his PVAI ablation with Dr Natale last June at St. Luke's and has been doing well on the AFIB front, is just out from his big surgery today at Mt Sinai to have an Aortic root Aneurysm repair by Dr Allan Stewart who is Director of Aortic Surgery there as well. Dennis' wife, Deborah, just called me to give me the updaby Shannon - AFIBBERS FORUM
Hi LOn, Really sorry to hear about your scary CVA event and glad it was so quickly and professionally treated and sounds like you will make a full and complete recovery which is a relief! This is a good example of why I think its important to also maintain and on-going natural blood thinning regime for life, even after getting the green light to go off pharmaceutical blood thinners. Itsby Shannon - AFIBBERS FORUM
Hi Louise, Tell your friend to tell his brother to run for the hills!! Any EP that would make such a statement in this day and age should be tarred and feathered out behind the barn! To tell a permanent afibber that a single ablation will end his entire affair with AFIB for the rest of his life is being beyond disingenuous! This type of AFIB can be the most challenging to get good long tby Shannon - AFIBBERS FORUM