Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 > 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 > 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 > 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 -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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 -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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 -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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2004 Report Share Posted July 27, 2004 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. Quote Link to comment Share on other sites More sharing options...
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