Mandrola is essentially local for me too. I was considering him as well until I started doing my research. I soon took him off my list. The EP I did choose to do my 1st ablation was a very poor choice for me. I am fortunate to now be hitting .500. Natale and TCAI are in-network for me.by AB Page - AFIBBERS FORUM
QuoteCarey 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 of himseby bolimasa - AFIBBERS FORUM
QuoteMarkF786 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 of himseby Carey - AFIBBERS FORUM
There was a symposium a couple months ago in Park City, UT called the Western Atrial Fibrillation Symposium, which was attended by what I think most would call “all the foremost EPs and cardiologists interested in afib”, and this technique or technology (or whatever you want to call it) was one that Mandrola seemed to think held promise, from what I recall of his tweets and blog posts during thatby kbog - AFIBBERS FORUM
QuoteElizabeth Well it seems that the Cabana trial doesn't seem to think that an ablation is much better than taking drugs. Liz Except for the fact that successful ablation has zero side effects where as meds not so much. Also, this study only took into account an older segment of the affib community (over 65 I believe with some other caveats) if im not mistaken). So long term effectby rocketritch - AFIBBERS FORUM
Mike, EP writer, Dr John Mandrola mentioned one time that he got prone to minimize the possibility of flutter. Of course a beta blocker could do the same thing. I don't take beta blockers so I get prone. I'm not fanatic about it, but is generally what I do to minimize the flutter risk (which I've never had, touch wood). As an aside: the form of mag I've been using mosby GeorgeN - AFIBBERS FORUM
QuoteCarey 5. First off, I would suggest taking Dr. Mandrola with a grain of salt. He's prone to minimize the effects of afib, blame patients for their lifestyles, and intentionally stir controversy with his WebMD articles. The more I read of what he writes, the less I respect him. That said, what he's saying there is sure, you can live with permanent afib as long as the rate is contrby wolfpack - AFIBBERS FORUM
Quotewineandroses 1. The term "LAA isolation" refers to the electrical burns done during a catheter ablation around the PV? And "LAA occlusion" refers to a device (Watchman, Lariat) to completely close the LAA? Is my understanding correct? 2. Even if he has a successful ablation and has a ChadsVasc score of 2 (once he is age 75) he would still need to be on NOAC for life? Aby Carey - AFIBBERS FORUM
Quoteredalfa1961 I was mentally ready for the procedure next month but then stumbled across the article by Dr. John Mondrola in Medscape, who was very negative towards it. Mandrola is negative about everything. It's how he makes a name for himself. His criticisms of LAA closure devices were misguided and poorly grounded in reality.by Carey - AFIBBERS FORUM
If you are staying in bed, my understanding is that drops the risk of flutter. I believe that instruction was from EP Dr. John Mandrola, who himself is an afibber and has used flec.by GeorgeN - AFIBBERS FORUM
Hi George, As you noted, afibbers who require LAA isolation to achieve long term durable freedom from all atrial arrhythmia are a class of patients that often very specifically benefit from LAA Closure. The proper perspective for decision making in such LAA-Iso patients definitely supercedes much of the rather limited short term cherry-picked data analysis Dr John and his two compatriots fromby Shannon - AFIBBERS FORUM
Looks like they were using the Watchman in the trials without fixing the afib. That doesn't make sense. Usually Watchman is mentioned on this site to be used after an LAA ablation and afib is fixed. Also agree with Mandrola that it makes sense to fix all the metabolic issues. That is true for everyone, afibber or not.by GeorgeN - AFIBBERS FORUM
Readers here know of Dr. Mandrola. Check the many posts listed at this search including Shannon's published commentary in Medscape Jackieby Jackie - AFIBBERS FORUM
You all may or may not know about Dr. John Mandrola. He is a cardiac electrophysiologist who also has Afib. I absolutely love his articles and blogs where he discusses all aspects of Afib in a lighthearted yet earnest manner; and from personal experiences. Have a look at his 13 Things to Know about Afib and other articles, plus ongoing blog where he discusses variety of issues including the stateby Ritva - AFIBBERS FORUM
QuoteDr. John MandrolaIn the short-term, I use temporizing measures to relieve AF symptoms: drugs for rate control, anticoagulants for stroke prevention, and maybe even cardioversion with or without anti-arrhythmic drugs. The key is that these treatments are temporary. We aren’t shocking or medicating an AF patient with the idea that this is the fix; we are doing those things to buy time for riskby Michael777 - AFIBBERS FORUM
Hi Ralph. Like you I live in the SF bay area. When it came to choosing an ep I consulted with Dr Natale and ep’s from UCSF, Stanford and Silicon Valley Cardiology. Based on my evaluation criteria I decided on Dr Natale. I had a 90 minute ablation, no LAA isolation, 3 years ago and have been afib free since. I would take issue with some your cardiologist’s statements based on my researchby Alan - AFIBBERS FORUM
Hi Shannon! I couldn't resist "dipping my toe in the water" on this subject. Thank you for the reference to Dr Reddy article which I have now read quite a bit of... I surrender already! By his admission it is lengthy and filled with statistics, some of which I really glazed over! He is a prime partner for and compensated for his input as he mentions. But generally his articby Anton - AFIBBERS FORUM
Shannon [ PM ] Dr Vivek Reddy: In Defense of LAA closure (Rebuttal of Dr Mandrola's comments and opinion on Watchman)-Medscape December 01, 2016 02:30AM Admin IP/Host: 47-215-236-94.sdoncmtk01.res.dyn.suddenlink.net Registered: 4 years ago Posts: 2,295 In Defense of Left Atrial Appendage Closure - Dr. Vivek Reddy (The above link, allows access to the article discussed below: In Deby Shannon - AFIBBERS FORUM
Jackie, LarryG mentioned Dr Mandrola's article which was just recently quoted by Dr. Eric Topol (for those unfamiliar see Wikipedia). Essentially Dr Mandrola is questioning the (clinical trials) data. Watchman is not "better than Warfarin" in preventing strokes. It's not that simple but strokes may be caused by factors other than Watchman repaired LAA. He is afraid the currenby Anton - AFIBBERS FORUM
Hey there, J... and forum members. You've likely read Dr. Mandrola's article from late last year. But I'm placing the link to it below in case you or others haven't. Within that article is another cite to an additional article. Hoping everyone's doing well. /Lby LarryG - AFIBBERS FORUM
Hi Jackie, It's bed time now for us so will try to get back to you in the next couple days with answers for your questions above. Be well, Shannon Sorry Jackie for the delay in getting back to your and now others understandably wanting to know more about Watchman and LAA Closure in general. Alas Magdalena are on the last days of a sort vacation for the two of us right now andby Shannon - AFIBBERS FORUM
Quotewolfpack As Shannon always reminds us, the statistics really argue for one to seek out the most highly-skilled practitioner at the most reputable facility one can find. The broad-based statistics will include the leading EPs with the more pedestrian ones who only do a dozen or so procedures a year. If you isolate your research to the top tier facilities and practitioners, you will find thatby Shannon - AFIBBERS FORUM
I saw that George, and read a summary that looked good! I suspect it will be an interesting and informative read. EP Dr. John Mandrola is one of three authors of the book, and from what I know of his views and research on extreme fitness/exercise and cardiac problems, including increased arrhythmia risk, I feel confident I'll be able to endorse this work. Shannonby Shannon - AFIBBERS FORUM
Smackman, LAA closure systems will almost certainly be covered by insurance as the comparative e vetting process continues to show its advantage for a fair number of AFIB patients going forward. The most recent results from the latest and cumulative Watchman studies, improved Lariat experience the last two years and Amplatzer Amulet prospective studies from Eurooe, Canada and Asia/Austrailia/Nby Shannon - AFIBBERS FORUM
In Defense of Left Atrial Appendage Closure - Dr. Vivek Reddy (The above link, allows access to the article discussed below: In Defense of Left Atrial Appendage Closure by Dr Vivek Reddy, with only a simply free registration of your email address and username) Hi All, The above linked excellent article in Medscape by well-known and highly-regarded AFIB ablation EP and researcher Dr. Viveby Shannon - AFIBBERS FORUM
Dr Mandrola argues that implant of the Watchman should stop until further research can be done to determine if stroke risk is really reduced with its use. He points to current research that indicates a lack of superior results using the device when compared to blood thinners. He says more research is needed. I don't think this argument should concern most of us. Dr Natale seems to agree aby billk - AFIBBERS FORUM
In the short time I've been watching AF forums my opinion of Dr. Mandrola is he's a professional contrarian. That said, I believe Medscape threw gasoline on the fire with the title of the article. The article I read talked about the Watchman device being inferior to warfarin. It didn't address the other LAA closure devices in any significant depth. Let the developers of the Watchmby JayBros - AFIBBERS FORUM
This article is total bunk and once again Dr. Mandrola is playing the role of the contrarian. I've talked to Shannon on the phone at length about this article. He's going to be working on a "rebuttal" of sorts to this article. He'll be posting it soon I hope. Stay tuned. In the mean time, if you're considering an LAA occlusion, don't let Mandrola's artiby tvanslooten - AFIBBERS FORUM
I just read the article and some of the comments from general cardiologists are appalling with regards to how their patients are being managed and in one case downright refusal to refer patients to any EPs. My opinion is that Dr. Mandrola's idea may add some useful information if it is focused on centers that do less than 25 ablations per year and represent a majority of AF ablation volume.by researcher - AFIBBERS FORUM
Hey my good old friend AFhound, Good to hear from you and you're doing good and in NSR.. 'm doing well now, had a touch-up March 1. But I was totally devastated , not expecting a first attack would last 35 days but rather a few mins at first......but NO!!!......it last 35days! So I contact Jimmy Olsen who got in touch with Superman....and I was in Austin Texas on Super Tuesday forby McHale - AFIBBERS FORUM