Pulmonary Vein Isolation report; Cleveland; longish

August 15, 2003

After several years of intermittent AF and full-time AF since

December, 2002 my cardiologist referred me to Dr. Natale at Cleveland

Clinic. I had had several cardioversions. Medications had not

helped. The referral was in the spring; due to the backlog, my

procedure was scheduled for July 31, 2003.

I take Coumadin due to an artificial valve so had to check in the

hospital earlier than most so I could get on Heparin and off

Coumadin. I went in on Tuesday, July 29 met with Dr. Natale that

day, had a TEE the following day to assure there were not clots, and

had the procedure on Thursday, July 31, 2003. Dr. Natale explained

that my valve replacement surgery made things a bit more complex than

otherwise. He and his nurses went the procedure and the risks and

benefits in great detail. The odds sounded good to me.

I had catheters in each femoral vein and one in the jugular vein.

Conscious sedation was used during the procedure which lasted about 4

hours. I remember some things such as moderate pain and a burning

sensation in the heart and the nurses telling me not to breath so

deeply, but little else. I was instructed to remain flat for several

hours, but that was difficult due to low back pain. I bled from one

of the groin sites and they had to apply pressure on that to stop

it.

They resumed Heparin after the procedure and Coumadin as well in

order to get my INR up to theraputic range for the valve. They also

started Tykosin which required that I be in a monitored bed. As it

turned out, the Tykosin adversely affected my EKG so they

discontinued that and substituted Rythmol which I will take for a few

months as a precautionary measure. My INR did not respond quickly to

the Coumadin so I remained in the hospital until Wednesday after the

procedure the previous Thursday.

The good news: I had a few PVC's in the hospital but no atrial

fibrillation. I was told that AF might recur during the first few

months, but it has not to date. So far, so good. I returned to work

the day after I was released from the hospital and started an

exercise program. I am slowly working toward getting back to jogging

which I could not do while in AF and on Toprol and Cardiazem.

I was and am very impressed and pleased with Dr. Natale and his

staff and my experience at Cleveland Clinic.

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