Well, if you're already going to do a cardiac MRI anyway you could ask about it.by Carey - AFIBBERS FORUM
I’m scheduled for a (insurance paid) cardiac mri. I’ll see what it says. The mri is for another cardiac reason Thanks Carey. It’s spilled milk. But I’m curious that’s all. This study was done for a reason so somebody thought it’s of value.by susan.d - AFIBBERS FORUM
To see fibrosis you need an MRI with delayed enhancement. But I can't see any reason for you to undergo one. If it shows you have (or do not have) fibrosis, so what? There's nothing to be done about it. I had one prior to an ablation because the EP wanted to know how much fibrosis he was dealing with and where it was. It's a long, expensive procedure. I doubt any insurance companyby Carey - AFIBBERS FORUM
I wondered about the statement below. I had my posterior wall ablated three times. Can the fibrosis “stiffen left atrium” show on an echo? What perimeters (size thickness etc) on the echo shows fibrosis? Or only a MRI will detect it? “However, extensive RFA of the posterior wall may cause fibrosis and “stiff-left-atrium” syndrome. 2 3 Magnetic resonance imaging after PVI demonstrates that edemby susan.d - AFIBBERS FORUM
Quotemjamesone Thanks for posting. I can't get much from the link without a paid subscription. If you have one, could you (or anyone) paste the study here, or if not allowed, send it to me via PM. What I do know is that the first generation PFA is a very blunt instrument compared to RF, so what it can do outside the pulmonary veins is limited. Curious to see how far they have gone with it.by GeorgeN - AFIBBERS FORUM
Thanks for posting. I can't get much from the link without a paid subscription. If you have one, could you (or anyone) paste the study here, or if not allowed, send it to me via PM. What I do know is that the first generation PFA is a very blunt instrument compared to RF, so what it can do outside the pulmonary veins is limited. Curious to see how far they have gone with it. Jimby mjamesone - AFIBBERS FORUM
Have a PFA scheduled for my persistent Afib.by Dini - AFIBBERS FORUM
Thanks, Susan. Looks promising.by gloaming - AFIBBERS FORUM
One of the authors was my EP and he was recommended by Dr. N, and another was recommended by my local CA EP. They are supposed to be highly regarded.by susan.d - AFIBBERS FORUM
Wow, great outcome and great story! Could be very helpful to our European followers. If you want to copy and paste this to a new topic so it appears on page 1 that would be fine with me. This is an old thread so it appears on page 5 or something like that, so most people won't see it.by Carey - AFIBBERS FORUM
Following is a long overdue update on my quest to undergo a PFA in Germany - my first (and so far only) ablation. Mission accomplished on 21 December 2023 in Frankfurt am Main, Germany, and it was textbook perfect. The PFA was performed by the CCB Privatklinik team led by Prof. Dr. Boris Schmidt and Prof. Dr. Julian Chun, employing Boston Scientific's Farapulse technology. It was an amaby MarionGlenn - AFIBBERS FORUM
ESOlution "Firsts" in PFA ??? Oddly and sadly -by KingFizzy - AFIBBERS FORUM
It's nice to see. The Kaplan-Meier estimate seems to be fairly well supported as far as PFA goes.by gloaming - AFIBBERS FORUM
Good news, male or female, no difference in outcomesby sldabrowski - AFIBBERS FORUM
So sorry you had to endure this. You are not alone: A novel platform allowing for pulsed field and radiofrequency ablation: first commercial atrial fibrillation ablation procedures worldwide with and without general anesthesia Where I live, the EP at a big hospital does not use anesthesia during an ablation. I was waiting for an appointment for an PM checkup and a lady was so streby susan.d - AFIBBERS FORUM
It's available now at centers where they already have the equipment and training. I would expect those to be the centers where clinical trials were conducted.by Carey - AFIBBERS FORUM
Medtronic made history in December - Question is, when will this be available to patients as an option?by sldabrowski - AFIBBERS FORUM
Here's some new info concerning "Pulsed Field Ablation" vs. conventional "Thermal Ablation": 1. 2.by ama1952 - AFIBBERS FORUM
Epilogue on my quest for U.S. health insurance coverage for a PFA performed outside of the U.S. The procedure specified by my insurance provider was as follows: -- Obtain a "letter of medical necessity" from my primary EP making the case for me to undergo catheter ablation. The letter did not specify the type of catheter ablation or the provider - only that I was a good candidate fby MarionGlenn - AFIBBERS FORUM
I discussed this with an EP in Amsterdam as I was interested in PFA due to perceived safety. He indicated not all facts are known of PFA. A few weeks later he told me that at a conference he learned about silent embolisms happening with PFA. He indicated an experienced operator (200 ablations per year at least) will have same success rates and risk profile and and the risks are well known.by hds - AFIBBERS FORUM
That's the claim, however, the US trials mandated that only the senior investigators could perform the ablation, a far cry from how it may be done in many teaching hospitals. So maybe the "less operator dependent" claim comes from European studies where it's out of trial. But if so, that may bring a more consistent ablation result to more people. However, there is a concern thby mjamesone - AFIBBERS FORUM
From what was explained to me by an ep who does PFA -- currently it is a pretty blunt tool, limiting it's effectiveness outside of the pulmonary vein although may have some utility for atypical flutter, but not typical. So I guess it would depend where the "touch up" is needed. Hopefully, future generations of PFA will allow it to be used in more areas. Jimby mjamesone - AFIBBERS FORUM
QuoteFibberMcGee I met with my EP yesterday. I have been needing a second touch up ablation and was hoping the pulsed field ablation would be a good thing for me. My EP said that the pulsed field ablation is not specific enough for the fine tuning and site specifics needed for a second ablation. Well, that isn't great! Any one else have more information?by Daisy - AFIBBERS FORUM
I met with my EP yesterday. I have been needing a second touch up ablation and was hoping the pulsed field ablation would be a good thing for me. My EP said that the pulsed field ablation is not specific enough for the fine tuning and site specifics needed for a second ablation.by FibberMcGee - AFIBBERS FORUM
I don't know since I think everyone doing them during clinical trials were probably all more experienced operators at bigger centers, but I guess we'll find out over the next year or two.by Carey - AFIBBERS FORUM
Am I right in thinking that this device probably increases the % of successful ablations even when done by a 'less skilled/experienced' operator?by Joe - AFIBBERS FORUM
https://news.medtronic.com/2023-12-13-Medtronic-creates-history-with-FDA-approval-of-its-novel-PulseSelect-TM-Pulsed-Field-Ablation-System-to-treat-atrial-fibrillationby Carey - AFIBBERS FORUM
QuoteGeorgeN Natale normally reserves work on isolating the left atrial appendage (LAA) till ablation #2 as LAA isolation has a 60% risk of requiring lifetime anticoagulation or placement of a Watchman device (or similar) - LAA isolation isn't the only thing he may do in ablation #2.. True, though he isolated my LAA on my index ablation because I had both Afib and Aflutter and he couldnby Daisy - AFIBBERS FORUM
Thank you everyone for the replies. GENERAL QUESTION TO ALL: Just a weird question, and I am sorry to ask. I have a fiancee and sexual activity was a big trigger to my PAC’s, leading to Afib, so I had completely stopped having any sexual activity, fearing it will worsen my disease. This has greatly affected my relationship with my fiancee and we are just in our early 20’s… Can I take any adviby Brian - AFIBBERS FORUM
Hi Brian, your research and analysis is impressive and that sets you up for good therapeutic outcomes. If it would be easy for you to be prescribed a “pill in the pocket,” that might be an interim step to get you out of this miserable cycle. Flecainide is the most common one—no more than 200 mg if you are under 154 lbs. no more than 300 is you are over. And if that doesn’t work, you might consideby Daisy - AFIBBERS FORUM