No. it is due to the mechanics of how the splines work, electrode placement and the shaft. Basically, you lack electrodes at the poles, the shaft end and the tip end. And then the navigation is limited since has to be placed via transseptal puncture.by researcher - AFIBBERS FORUM
Any arrhythmia after the blanking period lasting more than 30 seconds would be considered failure during the 12 months post ablation. There are a handful of studies that go out 5 years but none of them recent.by researcher - AFIBBERS FORUM
As of 10 years ago, they were in the mid 80% including patients that require second procedure. I think they are probably around 90%+ now. This is for paroxysmal patients.by researcher - AFIBBERS FORUM
That's consistent with what Pierre Jais had to say, specifically with respect to the size of the blind spot when using basket electrodes. Jais says 40%, the Dutch says more like 55% so in general agreement. Even if the FIRM concept is valid, ie stable rotors, basket electrodes aren't going to get you there. Jais and Haissaguerre have already shown in their videos that the non-PVI rotby researcher - AFIBBERS FORUM
TAF - See slide 24 in the slides below. I purposely picked Ohio State since AF patients going in get to choose all the different options available. It is good that you are achieving NSR without ablation or drugs. Best wishes that your good luck continues.by researcher - AFIBBERS FORUM
TAF - following up on discussion with regards to device implants. I noticed at Cardiostim (happening now in Milan) an entire session devoted to removing devices that doctors decided were either unnecessary or ineffective. There is less incentive to waste money under the single payer system that many European countries have. Regarding your doctors that say stats are not reliable. I would loveby researcher - AFIBBERS FORUM
TAF - those are valid questions regarding the profit motive of medical device companies. It is scary to see so many end up with pacemakers when their disease get mismanaged. Big money to be made all around. More big money to be made (prior to ACA but jury is still out on that) when a case is really screwed up. We still occasionally see a question about doctors suggesting pacemakers as the fixby researcher - AFIBBERS FORUM
your burden is low so you can ask your doctor whether it is OK for you to take an aspirin during episodes, it will give you some protection but not for about the first 20 minutes. I take 80 mg daily for many years now because of heart disease passed down from my father's side of the family tree. My father in law has had AF for 20+ yrs now. He is 93 and takes warfarin. His AF is permanentby researcher - AFIBBERS FORUM
Eric - it is great that you have improved your healthy living habits. However, I think you are underestimating the risk of living with AF at a young age. The two biggest risks are strokes over all time frames and developing heart failure over the long term. I mentioned my son's two friends and the decision process was fairly simple (they already have healthy habits as far as eating well aby researcher - AFIBBERS FORUM
Addendum - it has not been going well. First set of dentures did not fit correctly and he is losing weight as a result of his distaste of ground up meat. I don't know if that contributed to his lost of strength since coming out of PT. We found from blood work yesterday that suggest acute liver failure. This could be an infection from the PCI procedure or some other complication from theby researcher - AFIBBERS FORUM
TAF, That's partially true because other risks increase, such as phrenic nerve palsy. Medtronic has been successful in marketing cryoablation as a safer alternative to RF particularly for the younger EP's coming up on the learning curve. Usually, it is offered up as the first option and RF would be used in touch ups. That is because cryo balloon can only address PVI and not other triby researcher - AFIBBERS FORUM
Nadamanee is experienced and skilled. I have no idea about the others.by researcher - AFIBBERS FORUM
Ben, - Have you heard from any other young afib patients who had an ablation as a first line measure? Yes, one of my son's best friend age 21 had it done late last year. At first, the EP thought it was SVT. Further holter monitoring suggested AF also. There was no question that ablation was the way to go for him. He was very active. Plays soccer, surfs, etc.. Medication managementby researcher - AFIBBERS FORUM
Monty, thanks for the update. It is terrific to hear that the computational power and programming has gotten the vest to the stage where it is nearly real time. Best wishes for long term NSR.by researcher - AFIBBERS FORUM
Pierre Jais quantified one technical problem with FIRM that I have always found troublesome in terms of execution. That is how big is the blind spot with the basket electrode, Jais says 40%. So, even if FIRM is found to be useful, there is a problem with the way the mapping is done. Trials are still ongoing to see how effective it is. The Sirak data on long term persistent AF is very compelby researcher - AFIBBERS FORUM
The bias towards not offering ablation to women at the same stage of AF progression compare to men may well be happening especially if the greener EPs are practicing avoidance because of the lack of skills/experience/confidence/proctoring. I would love to see an attempt to crunch the numbers and quantify the effect. One cause could be a skillset/experience effect where high volume centers are sby researcher - AFIBBERS FORUM
"Her PCP indicated that it was nothing to worry about" Over the past 6 months, two of my son's best friends were diagnosed and ablated. The first one ablated late last year had what was thought to be SVT that turned out to be AF. The second one had episodes while overseas studying and diagnosed there. He was on a surf trip with my family in January when he couldn't get uby researcher - AFIBBERS FORUM
Shannon, In the JoAF article, the investigators also looked at the gender effect by age so I am not sure if there is still a bias that you referred - that females are ablated later in progression. That would be true if females in general develop AF sooner than males. However, I am not aware of any data that shows that. I hope that the dataset is analyzed more to tease out the impact of proceduby researcher - AFIBBERS FORUM
Really good article in the current issue of J of Afib, Natale's open access online magazine, regarding the impact of age and gender on AF ablation complication rates. Prior to this study, only meta analyses of old published studies were conducted and it was from those studies that higher vascular complications for women were noted. In this study conducted over one year 2011 at 29 Italian cby researcher - AFIBBERS FORUM
Stanford was the original research center for sleep disorders so I would stick with them if possible.by researcher - AFIBBERS FORUM
Happy for you that the stars aligned for Natale to be in NYC just when you needed him. Best wishes for continued NSR.by researcher - AFIBBERS FORUM
For (2), that's probably true because catheter contact with ventricular tissue by itself can cause PVC to trigger at the contact point. Natale has talked about this in the past and so did Peter Weiss in his ablation video. Both their groups do PVC ablations for patients that have VT or have ICD's. PVCs can cause unwanted extra shocks from the ICD. That drains the battery and also feby researcher - AFIBBERS FORUM
Peggy, STEMI is heart attack indicated by the electrical scriggles on ECG. It was confirmed by blood work. I think overall he was treated well by Stanford ER. My only problem was their rush in deciding to do a cath lab intervention without talking to family members, one of whom is a cardiologist that do PCI and surgery. A normal PCI procedure is half an hour, 15 minutes of that being the criby researcher - AFIBBERS FORUM
I am referring to my father in law with AF. He has had quite a month. It started with him falling in the garden. He was bruised and sore but nothing was broken. However, that was only the beginning of his odyssey. He is a tough WWII veteran so a fall is not a big deal to him. We asked him to take it easy but no, he had to tend to the garden a few days later and that's when he tripped oby researcher - AFIBBERS FORUM
Larry, interesting results but I would be reluctant to second guess Haissaguerre's observations. I think an apples to apples comparison would require such a study to be conducted at a single center to take out the skill and technique variation effect that is unavoidable in a multiple centers study.by researcher - AFIBBERS FORUM
Hi Charlene, So sorry for your severe reaction to Amio. I continue to question the propriety of using that drug outside of the hospital setting. OU has a couple of top experts in the world when it comes to treating complex arrhythmia, Jackman and Nakagawa. Jackman mainly consults now. They may be more convenient options for you when you seek ablation. ps. My daughter just visited Pawhuskby researcher - AFIBBERS FORUM
Shannon, I feel for your brother. Both my kids had childhood asthma and our home was like a NICU at times for the first several years of their lives. They grew out of it eventually and now that they are adults, we still worry about recurrence especially if they get bronchitis and any lower respiratory infections It's happened a few times and inhalers are always at the ready. We still havby researcher - GENERAL HEALTH FORUM
GERD happens often as a complication of AF ablation. It should resolve with time. You can ask your EP about prescribing a PPI. Actually I am a little surprised that he hasn't prescribed one for you assuming you contacted their office about the belching. How's your heart rhythm doing since the ablation?by researcher - AFIBBERS FORUM
Tom, If you had an angiography procedure done. it was probably because you already had a heart issue such as a MI and angiography was done to open up arteries. People that have had MI have a higher tendency to develop AF.by researcher - AFIBBERS FORUM
Within the last 5 months, two of my son's best friends have had to be ablated. One for AFib and one for SVT both age 20. Both were done successfully thankfully. I noticed my son who never touched the stuff until he started college has been drinking the stuff in preparation for tests or if he has to be alert for whatever special reason. Something else to worry about.by researcher - AFIBBERS FORUM