Re: Natale success?

[Guest guest]

In a message dated 7/27/04 3:42:00 PM Eastern Daylight Time, KageyD@...

writes:

> Other doctors may be giving it a try on much more difficult cases, and

> thus having a lower overall success rate. Just curious.

>

>

Kathleen,

I think your observation is accurate, although no PVA is a cake walk. But

many are less difficult than others and these have to be ID'd before the

procedure is done. My EP, Dr. Mark phson at Beth Israel Deaconess Medical

Center

in Boston made that same comment a couple of years back. He said if he hand

picked all his PVA candidiates like Andre, he could claim the same success rate.

But we take them all he said. Our success rate is 50% to 60% because of this.

I think it was an honest answer. That's why I like the good Doctor.

He's quite accomplished. Read about him. Keyword-Dr. Mark phson

Rich O

[Guest guest]

In a message dated 7/27/04 3:42:00 PM Eastern Daylight Time, KageyD@...

writes:

> Other doctors may be giving it a try on much more difficult cases, and

> thus having a lower overall success rate. Just curious.

>

>

Kathleen,

I think your observation is accurate, although no PVA is a cake walk. But

many are less difficult than others and these have to be ID'd before the

procedure is done. My EP, Dr. Mark phson at Beth Israel Deaconess Medical

Center

in Boston made that same comment a couple of years back. He said if he hand

picked all his PVA candidiates like Andre, he could claim the same success rate.

But we take them all he said. Our success rate is 50% to 60% because of this.

I think it was an honest answer. That's why I like the good Doctor.

He's quite accomplished. Read about him. Keyword-Dr. Mark phson

Rich O

[Guest guest]

In a message dated 7/27/2004 6:58:04 PM Eastern Standard Time,

james@... writes:

It may be important to clarify what the definition of success is.

Being unable to induce AF at the end of a procedure might be termed a success.

Being in permanent NSR and med free 12,24 or more months down the road are

perhaps the more useful figures to see.

--

D

Yes-This is exactly my point in many of my previous posts over the year-What

and how is success defined, what and how is cure defined, what followup is

done to arrive at these various rates??? Also, why do most others EP's report

significantly lower rates of " success " , " cures " than Dr. Natale?- I have never

been able to figure this out--He is certainly very talented but the ablation

procedure and equipment are also being used by other very talented Eps

also-Statistics can be manipulated to show anything and I have never been able

to

medically understand the diffference in Dr. Natales rates and others-I am not

accusing anyone of anything but this is a very competitive area of medicine and

hospitals/drs. are not the most honest of places/people in the world when it

comes to their failures and their mistakes-jerry

[Guest guest]

Kathleen;

This question has come up previously on the board. I'm of the opinion that the

records of ANY Dr. in a hospital environment performing invasive procedures must

be meticulous. This of course would include follow-up procedures ( " a touchup " )

and routine follow-up (I will be going to CC on Sept .8th for CT Scan & echo, at

which time I expect to be discharged by Dr,. Natale) All those things are

detailed & documented in only the manner a hospital would do.

Call me naive, but because of all the records available I don't think Dr. Natale

or the Cleveland Clinic would " cook the books " - they would have too much to

lose for no gain. I believe them when they quote 85% first time & 95% touchup.

(I admit to being biased, after all that's why I went to CC for the PVA !)

Thor

Natale success?

Does anyone have a reference to the scientific literature in which Dr. Natale

has published his widely acclaimed success rates - 85 percent first time, 95

percent on touch-up for those who need a second try. Everything I hear tells

me he's good, no question about it, but I'm a real skeptic for success rates

at

that level until I see it in the official medical literature. Often such high

success

rates come from very careful selection up front, to make sure there are no

failures. Other doctors may be giving it a try on much more difficult cases,

and

thus having a lower overall success rate. Just curious.

Thanks for the help. Kathleen

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

Kathleen;

This question has come up previously on the board. I'm of the opinion that the

records of ANY Dr. in a hospital environment performing invasive procedures must

be meticulous. This of course would include follow-up procedures ( " a touchup " )

and routine follow-up (I will be going to CC on Sept .8th for CT Scan & echo, at

which time I expect to be discharged by Dr,. Natale) All those things are

detailed & documented in only the manner a hospital would do.

Call me naive, but because of all the records available I don't think Dr. Natale

or the Cleveland Clinic would " cook the books " - they would have too much to

lose for no gain. I believe them when they quote 85% first time & 95% touchup.

(I admit to being biased, after all that's why I went to CC for the PVA !)

Thor

Natale success?

Does anyone have a reference to the scientific literature in which Dr. Natale

has published his widely acclaimed success rates - 85 percent first time, 95

percent on touch-up for those who need a second try. Everything I hear tells

me he's good, no question about it, but I'm a real skeptic for success rates

at

that level until I see it in the official medical literature. Often such high

success

rates come from very careful selection up front, to make sure there are no

failures. Other doctors may be giving it a try on much more difficult cases,

and

thus having a lower overall success rate. Just curious.

Thanks for the help. Kathleen

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

In a message dated 7/27/04 4:34:24 PM Eastern Daylight Time,

susanr20z03@... writes:

> Kathleen, I just had a consult with Dr. Natale on July 16. I

> specifically asked him about success rates. So here, from the

> horse's mouth, is his answer: 80%, (not 85%) for the first one, 95%

> after a second one. As far as making a selection up front, he told

> me (and don't hold me to this figure because I didn't write it down)

> that 20% of his practice is people who have already had one or two

> ablations at other centers and were not cured.

>

I didn't have my PVA by Dr. Natale. Time did not allow for it. I chose

another path and have no regrets. That being said. Given all the testimonials on

this board and additional public information, it sounds like Dr. Natale is #1

in

ablation technique, AF research, staff support and bed side manor. The guys a

winner.

I think all our talk about success rates should not take away from his

accomplishments and compassion for his patients. If I needed another PVA, I

would go

to Dr. Natale. Period. You gotta go with the winna! (Boston Talk)

Rich O

[Guest guest]

In a message dated 7/27/04 4:34:24 PM Eastern Daylight Time,

susanr20z03@... writes:

> Kathleen, I just had a consult with Dr. Natale on July 16. I

> specifically asked him about success rates. So here, from the

> horse's mouth, is his answer: 80%, (not 85%) for the first one, 95%

> after a second one. As far as making a selection up front, he told

> me (and don't hold me to this figure because I didn't write it down)

> that 20% of his practice is people who have already had one or two

> ablations at other centers and were not cured.

>

I didn't have my PVA by Dr. Natale. Time did not allow for it. I chose

another path and have no regrets. That being said. Given all the testimonials on

this board and additional public information, it sounds like Dr. Natale is #1

in

ablation technique, AF research, staff support and bed side manor. The guys a

winner.

I think all our talk about success rates should not take away from his

accomplishments and compassion for his patients. If I needed another PVA, I

would go

to Dr. Natale. Period. You gotta go with the winna! (Boston Talk)

Rich O

[Guest guest]

In a message dated 7/27/04 4:34:24 PM Eastern Daylight Time,

susanr20z03@... writes:

> Kathleen, I just had a consult with Dr. Natale on July 16. I

> specifically asked him about success rates. So here, from the

> horse's mouth, is his answer: 80%, (not 85%) for the first one, 95%

> after a second one. As far as making a selection up front, he told

> me (and don't hold me to this figure because I didn't write it down)

> that 20% of his practice is people who have already had one or two

> ablations at other centers and were not cured.

>

I didn't have my PVA by Dr. Natale. Time did not allow for it. I chose

another path and have no regrets. That being said. Given all the testimonials on

this board and additional public information, it sounds like Dr. Natale is #1

in

ablation technique, AF research, staff support and bed side manor. The guys a

winner.

I think all our talk about success rates should not take away from his

accomplishments and compassion for his patients. If I needed another PVA, I

would go

to Dr. Natale. Period. You gotta go with the winna! (Boston Talk)

Rich O

[Guest guest]

Thor, thanks. I'm sure the hospital records are meticulous, no question about

Cleveland's high standing. But I know from a friend's experience that Natale

puts all his prospective patients through a very thorough screening and many

tests, and good as he is I'm still suspicious that he's got such a high rate

because he doesn't take on high-risk cases. When (and if....) the best of

surgeons publish their work in the peer-reviewed journals, they give details of

the patient population, their techniques, and the results. What's missing in

the

" stories " about Natale is a full description of his patient population,

including

those he rejects for ablation. The testimonials come only from those he's

accepted for ablation, we don't hear from those he's rejected. Kathleen

[Guest guest]

Thor, thanks. I'm sure the hospital records are meticulous, no question about

Cleveland's high standing. But I know from a friend's experience that Natale

puts all his prospective patients through a very thorough screening and many

tests, and good as he is I'm still suspicious that he's got such a high rate

because he doesn't take on high-risk cases. When (and if....) the best of

surgeons publish their work in the peer-reviewed journals, they give details of

the patient population, their techniques, and the results. What's missing in

the

" stories " about Natale is a full description of his patient population,

including

those he rejects for ablation. The testimonials come only from those he's

accepted for ablation, we don't hear from those he's rejected. Kathleen

[Guest guest]

Thor, thanks. I'm sure the hospital records are meticulous, no question about

Cleveland's high standing. But I know from a friend's experience that Natale

puts all his prospective patients through a very thorough screening and many

tests, and good as he is I'm still suspicious that he's got such a high rate

because he doesn't take on high-risk cases. When (and if....) the best of

surgeons publish their work in the peer-reviewed journals, they give details of

the patient population, their techniques, and the results. What's missing in

the

" stories " about Natale is a full description of his patient population,

including

those he rejects for ablation. The testimonials come only from those he's

accepted for ablation, we don't hear from those he's rejected. Kathleen

[Guest guest]

> Does anyone have a reference to the scientific literature in which

Dr. Natale

> has published his widely acclaimed success rates - 85 percent first

time, 95

> percent on touch-up for those who need a second try. Everything I

hear tells

> me he's good, no question about it, but I'm a real skeptic for

success rates at

> that level until I see it in the official medical literature.

Often such high success

> rates come from very careful selection up front, to make sure there

are no

> failures. Other doctors may be giving it a try on much more

difficult cases, and

> thus having a lower overall success rate. Just curious.

>

> Thanks for the help. Kathleen

********

Kathleen, I just had a consult with Dr. Natale on July 16. I

specifically asked him about success rates. So here, from the

horse's mouth, is his answer: 80%, (not 85%) for the first one, 95%

after a second one. As far as making a selection up front, he told

me (and don't hold me to this figure because I didn't write it down)

that 20% of his practice is people who have already had one or two

ablations at other centers and were not cured.

He does three ablations per day, every day. I don't think any

one in the country has done as many as he has--over 1000, he told me.

His waiting list is now up to 8 months.

To tell you the truth, I was surprised when he gave me the figure

of 80 % for the first one, because other people have have had him up

to 95% for the first.

[Guest guest]

> Does anyone have a reference to the scientific literature in which

Dr. Natale

> has published his widely acclaimed success rates - 85 percent first

time, 95

> percent on touch-up for those who need a second try. Everything I

hear tells

> me he's good, no question about it, but I'm a real skeptic for

success rates at

> that level until I see it in the official medical literature.

Often such high success

> rates come from very careful selection up front, to make sure there

are no

> failures. Other doctors may be giving it a try on much more

difficult cases, and

> thus having a lower overall success rate. Just curious.

>

> Thanks for the help. Kathleen

********

Kathleen, I just had a consult with Dr. Natale on July 16. I

specifically asked him about success rates. So here, from the

horse's mouth, is his answer: 80%, (not 85%) for the first one, 95%

after a second one. As far as making a selection up front, he told

me (and don't hold me to this figure because I didn't write it down)

that 20% of his practice is people who have already had one or two

ablations at other centers and were not cured.

He does three ablations per day, every day. I don't think any

one in the country has done as many as he has--over 1000, he told me.

His waiting list is now up to 8 months.

To tell you the truth, I was surprised when he gave me the figure

of 80 % for the first one, because other people have have had him up

to 95% for the first.

[Guest guest]

> Does anyone have a reference to the scientific literature in which

Dr. Natale

> has published his widely acclaimed success rates - 85 percent first

time, 95

> percent on touch-up for those who need a second try. Everything I

hear tells

> me he's good, no question about it, but I'm a real skeptic for

success rates at

> that level until I see it in the official medical literature.

Often such high success

> rates come from very careful selection up front, to make sure there

are no

> failures. Other doctors may be giving it a try on much more

difficult cases, and

> thus having a lower overall success rate. Just curious.

>

> Thanks for the help. Kathleen

********

Kathleen, I just had a consult with Dr. Natale on July 16. I

specifically asked him about success rates. So here, from the

horse's mouth, is his answer: 80%, (not 85%) for the first one, 95%

after a second one. As far as making a selection up front, he told

me (and don't hold me to this figure because I didn't write it down)

that 20% of his practice is people who have already had one or two

ablations at other centers and were not cured.

He does three ablations per day, every day. I don't think any

one in the country has done as many as he has--over 1000, he told me.

His waiting list is now up to 8 months.

To tell you the truth, I was surprised when he gave me the figure

of 80 % for the first one, because other people have have had him up

to 95% for the first.

[Guest guest]

Thanks, , I understand and that's good info. The test of good science,

though, and good medicine, is ultimately when it's published in peer-reviewed

literature, and I'm just hoping he's done that. The best surgeons do. There

are

highly specialized medical journals for just such communications among

experts. (Cleveland just got a number one rating for Cardiology nationwide in

USNews and World Report, so I know they're good, as is Natale - I'm just

nosey, I'd like to see the data in its full form - if it's available). Kathleen

[Guest guest]

Thanks, , I understand and that's good info. The test of good science,

though, and good medicine, is ultimately when it's published in peer-reviewed

literature, and I'm just hoping he's done that. The best surgeons do. There

are

highly specialized medical journals for just such communications among

experts. (Cleveland just got a number one rating for Cardiology nationwide in

USNews and World Report, so I know they're good, as is Natale - I'm just

nosey, I'd like to see the data in its full form - if it's available). Kathleen

[Guest guest]

Thanks, , I understand and that's good info. The test of good science,

though, and good medicine, is ultimately when it's published in peer-reviewed

literature, and I'm just hoping he's done that. The best surgeons do. There

are

highly specialized medical journals for just such communications among

experts. (Cleveland just got a number one rating for Cardiology nationwide in

USNews and World Report, so I know they're good, as is Natale - I'm just

nosey, I'd like to see the data in its full form - if it's available). Kathleen

[Guest guest]

-Thanks, Rich, I appreciate the reference. I have a friend who's " in process "

post ablation with Natale, and his experiences have been mixed thusfar,

including having talked with Dr. Natale in person almost not at all at any

stage,

and not yet in nsr two months post-ablation though everyone remains

optimistic. I'm not rushing to ablation, no need, but I'm keeping my eyes and

ears open and appreciate the good words about your own experiences.

Kathleen

[Guest guest]

-Thanks, Rich, I appreciate the reference. I have a friend who's " in process "

post ablation with Natale, and his experiences have been mixed thusfar,

including having talked with Dr. Natale in person almost not at all at any

stage,

and not yet in nsr two months post-ablation though everyone remains

optimistic. I'm not rushing to ablation, no need, but I'm keeping my eyes and

ears open and appreciate the good words about your own experiences.

Kathleen

[Guest guest]

-Thanks, Rich, I appreciate the reference. I have a friend who's " in process "

post ablation with Natale, and his experiences have been mixed thusfar,

including having talked with Dr. Natale in person almost not at all at any

stage,

and not yet in nsr two months post-ablation though everyone remains

optimistic. I'm not rushing to ablation, no need, but I'm keeping my eyes and

ears open and appreciate the good words about your own experiences.

Kathleen

[Guest guest]

In a message dated 7/27/04 2:18:07 PM Pacific Daylight Time, KageyD@...

writes:

> I'm still suspicious that he's got such a high rate

> because he doesn't take on high-risk cases

I'm exceedingly high risk because of the previous damage ... yet he still

said he thought he could fix my a-fib, so that statement may not be entirely

true. Then again, it hasn't happened yet, so who knows, right?

Toni

CA

[Guest guest]

Kathleen:

I guess a " very thorough screening process " is a relative term. In my case, as

with many other Cleveland grads, I contacted Cleveland directly. , one

of Dr. Natale's nurses, discussed the procedure with me & asked that I fax my

medical records to her. I did so, and a few days later called her to make sure

she had received them. She literally said " I think so, yes, here they are. Would

you like me to go over them while you're on the phone ? " She did so, and after

less than 5 minutes pronounced me a good candidate for the procedure & scheduled

my initial my appointment for all the tests required & the PVA the following

day.

It was that simple for me. I understand your point that some may not qualify,

but in my numerous conversations with Dr. Natales nurses the last 10 months it

is my impression they are not cherry pickers.

All that said, I applaud your diligence. Anyone considering a PVA should

thoroughly examine the procedure from all possible angles. You just can't learn

too much, in my opinion.

Good Luck To You !

Thor

Re: Natale success?

Thor, thanks. I'm sure the hospital records are meticulous, no question about

Cleveland's high standing. But I know from a friend's experience that Natale

puts all his prospective patients through a very thorough screening and many

tests, and good as he is I'm still suspicious that he's got such a high rate

because he doesn't take on high-risk cases. When (and if....) the best of

surgeons publish their work in the peer-reviewed journals, they give details

of

the patient population, their techniques, and the results. What's missing in

the

" stories " about Natale is a full description of his patient population,

including

those he rejects for ablation. The testimonials come only from those he's

accepted for ablation, we don't hear from those he's rejected. Kathleen

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

Kathleen:

I guess a " very thorough screening process " is a relative term. In my case, as

with many other Cleveland grads, I contacted Cleveland directly. , one

of Dr. Natale's nurses, discussed the procedure with me & asked that I fax my

medical records to her. I did so, and a few days later called her to make sure

she had received them. She literally said " I think so, yes, here they are. Would

you like me to go over them while you're on the phone ? " She did so, and after

less than 5 minutes pronounced me a good candidate for the procedure & scheduled

my initial my appointment for all the tests required & the PVA the following

day.

It was that simple for me. I understand your point that some may not qualify,

but in my numerous conversations with Dr. Natales nurses the last 10 months it

is my impression they are not cherry pickers.

All that said, I applaud your diligence. Anyone considering a PVA should

thoroughly examine the procedure from all possible angles. You just can't learn

too much, in my opinion.

Good Luck To You !

Thor

Re: Natale success?

Thor, thanks. I'm sure the hospital records are meticulous, no question about

Cleveland's high standing. But I know from a friend's experience that Natale

puts all his prospective patients through a very thorough screening and many

tests, and good as he is I'm still suspicious that he's got such a high rate

because he doesn't take on high-risk cases. When (and if....) the best of

surgeons publish their work in the peer-reviewed journals, they give details

of

the patient population, their techniques, and the results. What's missing in

the

" stories " about Natale is a full description of his patient population,

including

those he rejects for ablation. The testimonials come only from those he's

accepted for ablation, we don't hear from those he's rejected. Kathleen

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

The testimonials come only from those he's

> accepted for ablation, we don't hear from those he's rejected.

Kathleen

Well, actually, a bunch of people in the group have gone to Natale

for consults about ablations. I haven't heard one post that he's

turned them down.

[Guest guest]

The testimonials come only from those he's

> accepted for ablation, we don't hear from those he's rejected.

Kathleen

Well, actually, a bunch of people in the group have gone to Natale

for consults about ablations. I haven't heard one post that he's

turned them down.