Natale simply got tired of coddling Mandrola and quit doing so. Mandrola seems more interested in recent years in building a following on WebMD by writing adversarial opinions. To hear him tell it, ablations are bad, LAA isolation is bad, isolating the posterior wall is bad, LAA occlusion devices (eg, Watchman) are bad. In fact, to hear him tell it, afib is your fault for leading a bad lifestyby Carey - AFIBBERS FORUM
Not so sure its controversial. I think its more of contradicting opinions and or personalities. I have never met Dr. John but have followed him for many years up until a few years ago. Have even had email correspondence with him many years ago. He has become more of an internet celebrity with hints of a pumped up ego than anything else. He has changed vastly over the years. I have met DR. Nby rocketritch - AFIBBERS FORUM
Hi all, Can somebody explain to me what is the controversy between Dr. Natale and Dr. Mandrola going on in Twitter? I´m not a regular on this social network so I´m a bit lost when I open it and find some threads that are hard to follow. Cheers, Fraviby fravi - AFIBBERS FORUM
QuoteCarey I wonder if they could convert an Afib patient (who also had an implanted defibrillator) by activating it? If it were programmed to do so I don't see why not, but they'd have to be super-careful with the programming. For example, an ICD shock is a decidedly unpleasant event, so they'd have to set a limit on how many shocks it would deliver. It's one thing to trby Daisy - AFIBBERS FORUM
QuoteDaisy I wonder if they could convert an Afib patient (who also had an implanted defibrillator) by activating it? If it were programmed to do so I don't see why not, but they'd have to be super-careful with the programming. For example, an ICD shock is a decidedly unpleasant event, so they'd have to set a limit on how many shocks it would deliver. It's one thing to try eby Carey - AFIBBERS FORUM
I would take Mandrola's opinions with a big grain of salt. I have no idea why he's talking about the sinus node because an afib ablation doesn't touch that either. Inflammation from the burn lines is more than enough to explain the elevated heart rate. The vagal nerve doesn't need to be involved.by Carey - AFIBBERS FORUM
QuoteCarey Just a quick follow-up Carey. I've not read that Felcanide will lower heart rate. Have you or others found that it does ever so slightly? Perhaps enough to offset a potential rise due to the afib procedure itself. Yes, it can lower heart rate slightly. It did for me. Not sure where you heard that the increased heart rate after ablation indicates the vagus nerve was burnedby keeferbdeefer - AFIBBERS FORUM
QuoteCarey sigh... Mandrola.... As far as I can tell, he's an EP who thinks the only treatment for afib that has any value is lifelong amiodarone. What is the evidence for this statement about Mandrola?. From what I have read his primary treatment is lifestyle changes, followed by drug therapy, followed by ablation. Also, as far as amiodarone, the only reference I can find is a JACC 2by safib - AFIBBERS FORUM
I know that some of you have been members of this forum for over a decade, but that doesnt mean you know more than others or have any more authority over anything other than your opinion, which you're free to share. Carey is right, stick to the article and findings argued by Mandrola, then state your opinion and let others challenge it, plain and simple. Remember that none of us are medicallby johnnyS - AFIBBERS FORUM
QuoteElizabeth So we are supposed to have one view on this broad which is "ablations are great when done by Natalie and some others". Even Dr. Natalie has to do more than one ablation for a patient. On this board some have had 3 done by him. There are some tragic stories about some ablations outcomes, which we usually don't read about them on here. I recall a few years ago a doby Carey - AFIBBERS FORUM
The problem with all these arguments is no 2 cases are the same. My flutter/fib was definitly coming from outside PVI, it took 3 failed ablations with another "top guy" to go to Natale and get my life back on the 4th try. I was in congestive heart failure at age 40, and getting ready to file for disability and spend my life doped up on beta blockers on the couch. So while I likby Fibrillator - AFIBBERS FORUM
Mandrola becomes more and more of a disappointment to me and I have been following him for years. Have even had email correspondence with him. He seems more interested these days in self promotion than furthering his craft. Which leads me to believe he has reached his limits as an EP.by rocketritch - AFIBBERS FORUM
sigh... Mandrola.... As far as I can tell, he's an EP who thinks the only treatment for afib that has any value is lifelong amiodarone. The STAR AF trial was very limited in the lesion sets it looked at. Mandrola is -- as usual -- greatly exaggerating its importance. Instead of looking at the approaches that don't work someday he might want to look at the ones that do, as proven thouby Carey - AFIBBERS FORUM
The studies are well known and I've seen them before. I've also seen his articles before and view them with the same disregard that the electrophysiology community views them. You need to keep in mind that Mandrola's thing is writing a blog and articles for WebMD, and his primary objective is to drive readers to those sites. He does that by writing contrarian, alarmist articlesby Carey - AFIBBERS FORUM
QuoteCarey Was reading earlier and came across this post where the EP cites two WATCHMAN studies if you're interested in reading the opposing viewpoint. Sigh... Mandrola. Yeah, no thanks, I've read his drivel enough. Feel free to skip to the studies thenby Leo J - AFIBBERS FORUM
QuoteLeo J Was reading earlier and came across this post where the EP cites two WATCHMAN studies if you're interested in reading the opposing viewpoint. Sigh... Mandrola. Yeah, no thanks, I've read his drivel enough.by Carey - AFIBBERS FORUM
Maryann, I follow a diet that is more restrictive than Wheat Belly, and a part of it is no grains. It did not change my afib. That being said, I am aware of a number of case studies where diet did positively impact afib. Changes by the people in these case studies have included long extended water fasting, low carb and keto diets (including one friend who reversed ~15 months of persistenby GeorgeN - AFIBBERS FORUM
QuoteThe Anti-Fib Quote johnnyS: "Most EPs have no clue about the pacs/afib connection other that the stating "it's benign." That's why I'm looking into research data out there and it pretty much confirms my suspicion of how afib begins. " Quote Wolfpack: "I wouldn't say that. Any competent EP certainly knows that PACs precede AF. They wiby johnnyS - AFIBBERS FORUM
Stress is your mortal enemy right now because stress is the mortal enemy of afib. Until you can get your stress under control with weight loss, exercise, and more natural methods, a light dose of an anti-anxiety med would probably be helpful for you. Your PCP should be able to prescribe something. No need for a psychiatrist. I don't know how much you know about afib, but you might startby Carey - AFIBBERS FORUM
Carey, when you're speaking about the cost of the procedure, I think we can't make a fair comparison between different countries, because health insurance systems are different too. There may exist motivations, other than strictly medical, to make the procedures cheaper or costlier. I remember having read something from Dr Mandrola about a trip he made in Germany and how he had been suby Pompon - AFIBBERS FORUM
Quotejpeters From "Ten things to expect after AF ablation", John Mandrola: "A majority of patients have chest pain for a few days after the procedure. The severity of the pain varies a lot. Most often, it hurts to take a deep breath or cough. Some patients say their chest feels tight. These symptoms are likely due to irritation of the lining of the heart, called the pericardium&by Carey - AFIBBERS FORUM
Quotemwcf Serious question. Is PE a very rare occurrence in the top US centres as opposed to elsewhere in the world? From "Ten things to expect after AF ablation", John Mandrola: "A majority of patients have chest pain for a few days after the procedure. The severity of the pain varies a lot. Most often, it hurts to take a deep breath or cough. Some patients say their chesby jpeters - AFIBBERS FORUM
QuoteBrian_og Here's an answer to the OP question Inga is saying that propofol is a good alternative, but propofol renders you unconscious too so I'm not sure what she means. And I have no idea why Mandrola says he can't use propofol. EPs use propofol routinely. I've been put under with it for every one of my six ablations.by Carey - AFIBBERS FORUM
Quotebolimasa You mean Dr John right? My comment that you quoted here was about my EP Dr. Marrouche. He's the one I'm hoping is good. I was referring to Dr. Mandrola, yes. Sorry if I misled. Dr. Marrouche is widely respected.by Carey - AFIBBERS FORUM
Quotebolimasa When I read Dr. John's blog, he makes the recovery sound like a nightmare. Recovery from ablations is a breeze for most people. It's a few days of a lifting and exercise restriction, some mildly tender insertion sites, and perhaps a little fatigue. I've had far worse head colds. Mandrola is a self-promoting writer who makes a practice of making a fool ofby rocketritch - AFIBBERS FORUM
Quotejpeters You mean Dr John right? My comment that you quoted here was about my EP Dr. Marrouche. He's the one I'm hoping is good. I just read his blog. I think he's not convinced ablation works? ....but that doesn't mean you won't think it works....something along that line... oops...that's Mandrola. Mandrola does not seem terribly hip on ablation. He seby bolimasa - AFIBBERS FORUM
Quotebolimasa You mean Dr John right? My comment that you quoted here was about my EP Dr. Marrouche. He's the one I'm hoping is good. I just read his blog. I think he's not convinced ablation works? ....but that doesn't mean you won't think it works....something along that line... oops...that's Mandrola.by jpeters - AFIBBERS FORUM
You’ll be back to work after a week most likely. Giving a presentation should be no problem at all. 20,000 steps on a FitBit is no problem. Go for it! Ignore Mandrola.by wolfpack - AFIBBERS FORUM
Oops.... I just realized I got my Dr. Johns mixed up. I'm was thinking about Dr.John Day..... another AFib author. Early on I though Mandrola was interesting..... Then I read his blog post about girl scouts... I then pretty much wrote him off...by bolimasa - AFIBBERS FORUM