Re: cardioversion post PVA?

[Guest guest]

> have any of you been told after having a pva that didn't work, that

a

> cardioversion would get you back to sinus rhythm, and that THEN

that

> previous pva would work?

Marcelle, how about a second opinion from another doctor?

I think with chronic afib, the " regular " ablation is not as

successful as for people in occasional afib, so the doc often does a

different procedure, more like an ablation mini-maze.

[Guest guest]

Hi,

I think a second opinion would also be warranted. Also, the area of

the atrium creating the erroneous signals may not have been ablated

or isolated from the rest of the heart. The generation of the scar

tissue (via the PVI) is what electrically isolates the bad areas from

the good areas. (My understanding anyway.)

Picture a ruler. Say the left end of the ruler is toward the PV.

The right end is toward the AV node. Let's say your doctor performs

the ablation at the 2 inch mark along the ruler, and the erroneous

signals are being generated at the 2-1/2 inch mark. Your a-fib is

going to still be present.

Also, and this is strictly my opinion here, I would suspect that at

some point down the road, it will become standard procedure for those

of us who get the PVI will probably also be getting an

electrocardioversion (at least once) in the weeks/months following an

ablation. As the heart heals, (the same heart that somehow developed

a-fib before) you would want to be sure that proper electrical

activity is set up in the heart. Remember, the PVI has physically

changed the heart, and the heart is undergoing a reprogramming during

the healing process. If the heart has developed a-fib before, it may

have a tendency to do it again (or atleast try). I would not be

surprised if electrocardioversion is implemented during the healing

process to ensure proper electrical activity takes root. Like I said

though, this is just my opinion.

Bruce

> Marcelle, how about a second opinion from another doctor?

>

> I think with chronic afib, the " regular " ablation is not as

> successful as for people in occasional afib, so the doc often does

a

> different procedure, more like an ablation mini-maze.

[Guest guest]

Hi,

I think a second opinion would also be warranted. Also, the area of

the atrium creating the erroneous signals may not have been ablated

or isolated from the rest of the heart. The generation of the scar

tissue (via the PVI) is what electrically isolates the bad areas from

the good areas. (My understanding anyway.)

Picture a ruler. Say the left end of the ruler is toward the PV.

The right end is toward the AV node. Let's say your doctor performs

the ablation at the 2 inch mark along the ruler, and the erroneous

signals are being generated at the 2-1/2 inch mark. Your a-fib is

going to still be present.

Also, and this is strictly my opinion here, I would suspect that at

some point down the road, it will become standard procedure for those

of us who get the PVI will probably also be getting an

electrocardioversion (at least once) in the weeks/months following an

ablation. As the heart heals, (the same heart that somehow developed

a-fib before) you would want to be sure that proper electrical

activity is set up in the heart. Remember, the PVI has physically

changed the heart, and the heart is undergoing a reprogramming during

the healing process. If the heart has developed a-fib before, it may

have a tendency to do it again (or atleast try). I would not be

surprised if electrocardioversion is implemented during the healing

process to ensure proper electrical activity takes root. Like I said

though, this is just my opinion.

Bruce

> Marcelle, how about a second opinion from another doctor?

>

> I think with chronic afib, the " regular " ablation is not as

> successful as for people in occasional afib, so the doc often does

a

> different procedure, more like an ablation mini-maze.

[Guest guest]

> Maze nonono that is open heart surgery.On bypass and

> the side effects from that is mind altering.[Air

> bubbles] As far as cardioversion post PVA why ? you

> should be on a class2 drug for at least two months to

> prevent A-Fib. The heart only 're programs it self

> when you have a ICD for Heart Failure.Healing time is

> about a year.You also must remember that you are

> getting strange feeling because you my be ok and that

> is a strange feeling. I know.It's like cancer when do

> I know it's not coming back.Tha's why the year.I have

> talked to PVA and cancer patients all feel the strange

> feeling and all the same questions.

Hi,

Where is the year time frame coming from? My doctor, and others I've

talked to at length about this, all say that if you are still having

a-fib episodes after 6 months, that its probably a safe conclusion to

state that the first ablation didn't work. My doctor also told me,

healing time is about 3 months, which corresponds to the length of

time they put you on at least a coumadin regime.

I can't speak for everyone, but in my case, I opted for the ablation

because the anti-arrhythmic drugs were not working. So, where's the

logic in taking them now, post PVI?

As far as that strange feeling goes, yes, you can (at least I can)

definitely tell when something is going on, whether its a skipped

beat, or a-fib. I doubt you can compare the feelings that someone

with cancer has, with the feelings that someone with a-fib

experiences.

Are you also saying that the heart does not re-program itself in a-

fib? If you are, I believe there's plenty of documentation out there

that would dispute you.

Bruce

[Guest guest]

> > Bruce,

> > There is a catheter Maze procedure.

> > Happy New Year!

> > Rich O

> >

> >

> >

[Guest guest]

Hi,

I'm not up on everything regarding treatments with a-fib, and

specifically the linear ablation. Someone else out here I'm sure

knows a lot more about it than I do. From what little I know about

it, it sounds a little like the catheter maze procedure. But I

simply don't know for sure, and someone else really needs to give

their input here.

Also, I wouldn't say you were wrongly told that the PVA is the newest

method. There could be other things coming down the road that are

even better. I know Dr. Cheng is working on new things as well with

regard to a-fib. (The reason Dr. Cheng was at the hospital during my

recent last night ER visit last week was because he was working on

some paper he's preparing to present at an upcoming conference.) So,

i know new work is always being done. I think it would be fair to

say that as far as your doctor is concerned, the PVA may be the

latest and greatest thing he's heard of. Just a side note here, my

first cardio thought the latest and greatest thing for treating a-fib

(excluding drugs therapy) was to ablate the AV node, and put in a

permanent pacemaker. So, not all doctor's are up on the latest. The

best doctors to find are those that are also presenting papers, and

doing actual research in the field.

The Maze procedure has been around for a relatively long time. My

understanding is that someone came up with the idea of trying to

perform the maze procedure through catheter's (i.e., not open heart

surgery.) I don't know for sure, but I suspect that they felt that

they could generate scar tissue via catheters that would be very

similiar to the scar tissue patterns that the open heart maze

procedure would create without actually cutting through the heart

muscle. Its also my understanding that its the scar tissue that

creates electrical barriers in the heart muscle itself and as a

result of these barriers, the electrical activity is suppose to

follow a more correct path.

As far as your other post goes with finding a second opinion. A

whole-hearted YES. One thing you could do is get copies of your

pertinent medical records, and send them to other doctor's offices

around the country/world that are more in the leadership position in

this field, or doctors that you might be comfortable with. That's

what I initially did with regard to my contact with Dr. Natale's

office in Cleveland. If Dr. Cheng had not started practicing in

Houston, I would've gone to Cleveland to get worked on. They

reviewed my records and scheduled to have me come up there, without

me actually having to physically show up there first. Now granted,

if you do get an appointment elsewhere, you'll have to travel.

Well, that's my input. Talk to you later.

Bruce

> Bruce, was I wrongly told by my Dr that the PVA was the " newest "

> method? Or is that catheter maze-like procedure newer and better---

> Is that the same as a linear ablation? any info you have please---

> thanks. marcelle in FL

[Guest guest]

Hi,

I'm not up on everything regarding treatments with a-fib, and

specifically the linear ablation. Someone else out here I'm sure

knows a lot more about it than I do. From what little I know about

it, it sounds a little like the catheter maze procedure. But I

simply don't know for sure, and someone else really needs to give

their input here.

Also, I wouldn't say you were wrongly told that the PVA is the newest

method. There could be other things coming down the road that are

even better. I know Dr. Cheng is working on new things as well with

regard to a-fib. (The reason Dr. Cheng was at the hospital during my

recent last night ER visit last week was because he was working on

some paper he's preparing to present at an upcoming conference.) So,

i know new work is always being done. I think it would be fair to

say that as far as your doctor is concerned, the PVA may be the

latest and greatest thing he's heard of. Just a side note here, my

first cardio thought the latest and greatest thing for treating a-fib

(excluding drugs therapy) was to ablate the AV node, and put in a

permanent pacemaker. So, not all doctor's are up on the latest. The

best doctors to find are those that are also presenting papers, and

doing actual research in the field.

The Maze procedure has been around for a relatively long time. My

understanding is that someone came up with the idea of trying to

perform the maze procedure through catheter's (i.e., not open heart

surgery.) I don't know for sure, but I suspect that they felt that

they could generate scar tissue via catheters that would be very

similiar to the scar tissue patterns that the open heart maze

procedure would create without actually cutting through the heart

muscle. Its also my understanding that its the scar tissue that

creates electrical barriers in the heart muscle itself and as a

result of these barriers, the electrical activity is suppose to

follow a more correct path.

As far as your other post goes with finding a second opinion. A

whole-hearted YES. One thing you could do is get copies of your

pertinent medical records, and send them to other doctor's offices

around the country/world that are more in the leadership position in

this field, or doctors that you might be comfortable with. That's

what I initially did with regard to my contact with Dr. Natale's

office in Cleveland. If Dr. Cheng had not started practicing in

Houston, I would've gone to Cleveland to get worked on. They

reviewed my records and scheduled to have me come up there, without

me actually having to physically show up there first. Now granted,

if you do get an appointment elsewhere, you'll have to travel.

Well, that's my input. Talk to you later.

Bruce

> Bruce, was I wrongly told by my Dr that the PVA was the " newest "

> method? Or is that catheter maze-like procedure newer and better---

> Is that the same as a linear ablation? any info you have please---

> thanks. marcelle in FL