You are welcome AFhound99, Yes I had several normal echos over the years prior to the first ablation, the last of which had the lowest EF but that was after a more active AFIB period the prior six months to a year before that last echo which, in turn, was the last one prior to the one in Austin done in Aug 2008 two days immediately prior to my first ablation and it was that one that showed thby Shannon - AFIBBERS FORUM
You are welcome Laura and McHale. I'll try to address your pertinent questions below McHale. LAA isolation ablation is now becoming more common, largely due to Natale's group of EP's and the Bordeaux group which, until recently, has tended to ablate around and focally within the LAA but not full isolation unless necessary. That is pretty much what Natale does as well. He onlyby Shannon - AFIBBERS FORUM
McHale, Sustained NSR is your very best protection against AFIB related stroke so an ablation sounds like the best course for you as soon as you are able to have one with a top EP. You will likely need to stay on Coumadin for 6 months after the ablation in any event, particularly in light of the mini-stroke so you will have time to sort out the long term options for best protection to augmentby Shannon - AFIBBERS FORUM
Hi Lynda, Sorry to hear you are having some skipped beats which are usually PACs (premature atrial contractions) and which are common after an ablation during the healing process. Also, do you recall what areas of your heart were ablated in this second go around?? Was the Left atrial appendage isolated too? Dr. Natale told me that the LAA is a delicate structure that requires more careby Shannon - AFIBBERS FORUM
P.S. Bruce, Here is the link, mentioned above, to the Natale group study on the LAA as a fairly common source of AFIB on repeat ablations.: Left Atrial Appendage: An Underrecognized Trigger Site of AFIB'by Shannon - AFIBBERS FORUM
Hi Bruce, Can you tell us how many ablations you have had and by whom and where and also what years you had each one? This might help glean the history and give a better feel for whether you may have run your course with catheter ablation or perhaps you just haven't found the right EP yet to finish the job more satisfactorily? If your early ablations were quite a few years ago and/or wby Shannon - AFIBBERS FORUM
WOW!!! ... many thanks to all my Afibber friends here for the outpouring of Good wishes for my ablation with Dr. Natale yesterday. And Mahalo to Jackie for telling you all aboUt it and to Hans for letting you all know that it went as smoothly as possible and that Dr. Natale is pleased with the initial results. I was really touched last night reading all of your kind words of support and veryby Shannon - AFIBBERS FORUM
Many thanks Jackie, I too feel confident, as does Dr. Natale that he can finish it up this next go around. Referencing the article above Buster kindly posted from Natale's group titled: "Left Atrial Appendage: An Under-recognized Trigger Site for AFIB' .. out of a total study sample of approximately 3,800 total ablations in a 2 year time span chosen for this study period and donby Shannon - AFIBBERS FORUM
Hi Cindy, You can confirm with Dr. Natale if he actually isolated your LAA or if he just did a lot of focal burns within the left atrial appendage? Those can be too very different things. Focal ablation of Complex Fractionated Electrograms within the LAA ( if indeed such focal trigger points are called CAFE's technically when found within the LAA ?) might not necessary result in full isolby Shannon - AFIBBERS FORUM
Hi Nic, Dr. Natale told me the odds are 35% up to 40% of possibly reguiring indefinite anti-coagulation in the event of a LAA during a second and third ablation to deal with Atypical left flutter subsequent to the first ablation. Assuming full isolation of LAA is needed AND the LA ejection velocity is less than 4.0 on a 6 month post ablation TEE test. That's a real risk for needing Anti-by Shannon - AFIBBERS FORUM
Michael, What do you mean by Hybrid ablation from your research? I had a hybrid ablation with Dr. Natale in 2008 for very symptomatic persistent 24/7 AFIB and it helped greatly in quelling my AFIB itself. I have had zero AFIB since. Though after three years of mostly quiet NSR I now have had a number of episodes the past 6 months of atypical left atrial flutter which was predicted by Dr. Nataleby Shannon - AFIBBERS FORUM
I saw Natale two months ago for a follow up and we talked about the possiblity of going after that left atrial flutter trigger he was not able to get to in my first hybrid ablation for persistent afib. I've only had two LAFlutter episodes in two and a half years and zero AFIB and he said in my case the recurrance wasnt nearly frequenntly enough to go back in due to a roundly 25% added riskby Shannon - AFIBBERS FORUM
Hi John. Sorry for the delay in getting back to you, but I have just flown a few days ago from Amsterdam to San Fran and am in Marin County now getting ready for my spiral cat-scan and echo-cardiogram and such before I see Natale a week from Monday for my formal 'three month' checkup, only its at 5 months instead as I have been in Europe the past three months. Perhaps we can speak byby Shannon - AFIBBERS FORUM
Well, its been 22 days since my ablation with Natale in Texas and I haven't had as much as one ectopic beat I have noticed in the past 21 days! After those first two one hour SVT runs the during the first 24 hours after the very extensive ablation. I met with Dr. Natale last week here in San Francisco where I have been doing R&R for the past two weeks and he mentioned what a big job itby Shannon - AFIBBERS FORUM
"Mini White Paper" from Dr. Cox ( this is the post from afibcures board that contains Dr. Cox's new white paper lower down) Because of some postings I have read over the last few months, I felt it was necessary to try to clarify some information which I believe has been confusing to the lay public and especially those suffering from atrial fib. I thought it might beby Shannon - AFIBBERS FORUM