Thanks Shannon - will get subscription.by researcher - AFIBBERS FORUM
Thanks Shannon I get it. My concern is not with racial profiling at all. I would like to see genetics research done on the narrowest gene pool to first gain an understanding on the role of genetics. For example the Icelandic population using DeCode Genetics as a model instead of trying to solve the genetics on a wide population. that seems like the easiest way to go and perhaps it has been doby researcher - AFIBBERS FORUM
Mellanie, Sounds like a worthwhile project but then I am not sure if the genetics of AF has been unlocked for ANY race or ancestry. The title of the project implies that it has been solved for Caucasians.by researcher - AFIBBERS FORUM
Followup Q&A with Dr. Szill-Torok with regards to his group's experience with contact-force catheters and remote magnetic navigation. >>>>>> Dear Dr Szili-Torok, I reviewed with interest the results presented in your original paper and subsequent webcast. I would appreciate your comments with regard CF ablation and magnetically assisted ablation. 1. With reby researcher - AFIBBERS FORUM
Certainly do it before the cruise, as a dry run - pun intended.by researcher - AFIBBERS FORUM
Thanks Shannon for making the edit to my second post regarding the whole paper. Below is a link to the Stereotaxis robotic AF ablation trial done in Monaco and reported about a year ago. The patient mix in the Monaco trial was 60/40 paroxysmal/persistent and the purpose was to compare the effect of general anesthesia to conscious sedation. There was only a minor difference in success rate betwby researcher - AFIBBERS FORUM
I don't know what Natale currently thinks of robotics in AF ablation. He still prefers his own hands as far as I can tell. However, he has been increasingly supportive of robotics in VT ablation via magnetic navigation. There are two very different robotic systems available, one uses robotic control of magnets (Stereotaxis) and one uses robotic control of cables (Hansen). Below is a liby researcher - AFIBBERS FORUM
Mike, I would be still be cautious since this is a single center result and there must be some questions regarding the results for the company (Hansen) not to mention the 12 month success rate difference between robotics and manual, but rather just highlight the reduction in x-ray exposure. I think the information offered in the paper could have been improved by revealing the experience of theby researcher - AFIBBERS FORUM
There have been very good strides in Robotic navigation for ablation of both AFIB and VT... there are still some limitations relative to the true elite level maestros but it does offer a lot for less experienced operators too. the main thing for the top tier operators is the greater flexibility and reduced time for them to do the procedures themselves when a big variable site ablation is in stby researcher - AFIBBERS FORUM
Murray, Hope it gets better for you soon. Perhaps the phrenic nerve was injured during the ablation but I think the EP would have monitored for phrenic nerve capture during pacing and mapping. I was thinking perhaps PV stenosis but I doubt that and I am sure they will check it out for you to make sure that is not what it is. Most cases of phrenic nerve palsy resolve with no long term consequeby researcher - AFIBBERS FORUM
Pretty amazing results on Hansen robotic system if true. I have my doubts but results just came out from Claudio Tondo's Italian lab and Natale is one of the co-authors - on a mix of paroxysmal and persistent (71%/29%) patients randomized to robotic (n=40) and manual (n=40), 90% success rate for the robotic arm at one year versus 65% success rate for manual arm. I have not been a fan of thby researcher - AFIBBERS FORUM
It's been a long road. Best wishes for long term NSR.by researcher - AFIBBERS FORUM
Yes, that is the current view although the same group at UCSF looked at their 15 year data set and wrote about PAC's as "Wolf in Sheep's Clothing" with regard to what is classified as subclinical AF and increased risk for stroke if PACs is frequent enough. That data wasn't as quantitative as the study on PVC and heart failure so inconclusive as to when one has to start wby researcher - AFIBBERS FORUM
Apache and George, I was strictly referring to PVCs and not PACs. In Weiss's presentation, the PVC patients were described as highly symptomatic and that also resulted in high demand for services from heart failure specialists. So that is a small subset of patients of heart failure patients with symptomatic PVCs. Weiss said that PVC ablations for those patients offered tremendous reliefby researcher - AFIBBERS FORUM
Natale group in Austin has the tools to do it and it will probably be done by Burkhardt who handles many of their VT ablation cases. PVC ablation takes precise mapping and navigation so it should be done with robotic magnetic navigation which Natale's group has. Weiss at Intermountain do a lot of them for their heart failure patients and he says it offers immediate relief just like SVT ablby researcher - AFIBBERS FORUM
AF results from a group of high volume centers shows statistical significant advantages for CF catheter over non-CF catheters, see link below. In summary, VT comparison results do not apply to AF as far as CF catheters are concerned probably because of more demanding navigational flexibility.by researcher - AFIBBERS FORUM
oldrunnerdude, Sorry to hear that you are going through this. AF happens to many endurance athletes. RE - "The EP guy who I met when I was CV'd explained that he passes a single catheter from my groin into my right ventricle, up into the right atrium and then through the wall of the heart into the left atrium where he ablates a specific area where one of the arteries (veins ?) meetsby researcher - AFIBBERS FORUM
Davos 2015 - More on the question of substrate and whether successful ablation stops or reverses LA fibrosis. Presentation by Gerhard Hindricks.by researcher - AFIBBERS FORUM
Regarding the new catheter trial, did they tell you the name of it. The most important question would be whether the catheter is used only for mapping or if also serves as the ablation catheter. If it is the latter, then I suggest passing on being a guinea pig.by researcher - AFIBBERS FORUM
Right, authors noted 10% burden as important in their data set. There were 18 patients in the watchful waiting cohort so I would treat the 10% burden number as something that needs further refinement. Another issue is the way AF burden is currently classfied - from 2014 classification paper by Mass General "We sought to develop and validate a patient-generated score and classification scheby researcher - AFIBBERS FORUM
AF progression measurements over a 12 month period - Randomized cohort of watchful waiting (with medications) vs ablation vs healthy cohort control. Also see editorial comment on article.by researcher - AFIBBERS FORUM
Apache, I think the cross over point came a year ago at the 2015 symposium when John Day of Intermountain showed that it was riskier to remain in AF compared to getting an ablation based upon his analysis of AF patient dementia data that they have collecting for many years at Intermountain. The topic of dementia is hitting me particular hard at the moment, my best tennis friend MRI scans came baby researcher - AFIBBERS FORUM
Substrate ablation of low voltage areas (scarred areas are low voltage when mapped under sinus rhythm) has been gaining momentum in the last couple of years. I am not sure how it started but the germination of the idea probably has to do with the fundamental studies that imaged scars and how the scars behaved electrically compared to healthy tissue. Anyway, it has been proven over the last coupby researcher - AFIBBERS FORUM
Here is some data on how well the group does on AF ablations. Results seem consistent with other tertiary referral centers.by researcher - AFIBBERS FORUM
Merry Christmas to Shannon and everybody else too. It is a beautiful day.by researcher - AFIBBERS FORUM
Just more confirmation data from what we have learned over the last few years. I am not sure why some doctors still cling to the idea that more data needs to be gathered to prove that AF results in blood clots that increase dementia risk. cited article link belowby researcher - AFIBBERS FORUM
Shannon, Dr Day wrote that lighter skin equates to faster rate of absorption. I thought like you before I read his blog. I checked a few medical sites and he is right. The darker the skin, the slower the rate of absorption. It probably has something to do with human adaptation to latitude dependent exposure.by researcher - AFIBBERS FORUM
Shannon, Que's one sentence summary is a little misleading. Clearly Vit D is critical to overall nutritional health and not just about AF, although stress from not being in good health is probably a big risk factor in AF by itself. John Day reviewed the data because his level was below range. So he wrote about options to fix it. His biggest message from my read is that you can over do iby researcher - AFIBBERS FORUM
Andrea, I see that Dr. Mihaela had more recent training with Dr. Kuck and Dr. Ernst so she has excellent mentorships. I hope she works out well for your aunt if she can't travel to Bucharest. She completed her fellowship in 2009. Do you know how many ablation procedures she has done?by researcher - AFIBBERS FORUM
Hi Andrea, Sorry to see that your mother is going through such a hard time with AF. You do have a very good EP in Bucharest, Dr. Radu Vatasescu. He has done well over 3000 ablations by now and he does very difficult cases.by researcher - AFIBBERS FORUM