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6 month PVA update

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In a message dated 8/13/2004 11:59:37 AM Pacific Daylight Time,

tkiverson@... writes:

> For those of you contemplating the procedure, I hope this is helpful. PVA's

> may not be for everyone, but if done by the leading EP's around the world

>

Congratulations, Thor! Your report will be very helpful to those considering

ablation, I'm sure.

in sinus in Seattle

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In a message dated 8/13/2004 11:59:37 AM Pacific Daylight Time,

tkiverson@... writes:

> For those of you contemplating the procedure, I hope this is helpful. PVA's

> may not be for everyone, but if done by the leading EP's around the world

>

Congratulations, Thor! Your report will be very helpful to those considering

ablation, I'm sure.

in sinus in Seattle

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In a message dated 8/13/2004 11:59:37 AM Pacific Daylight Time,

tkiverson@... writes:

> For those of you contemplating the procedure, I hope this is helpful. PVA's

> may not be for everyone, but if done by the leading EP's around the world

>

Congratulations, Thor! Your report will be very helpful to those considering

ablation, I'm sure.

in sinus in Seattle

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Hi boys & girls

I had my PVA in Cleveland, Friday the 13th of Feb., exactly 6 months ago today.

( so there, for those fibbers that also suffer from paraskevidekatriaphobia !)

Brief history: In April of last year had a sudden onset of AF which proved to be

chronic. (57 Y.O) Had the usual stuff, rate control in my case, coumadin, EC

(lasted 6 days). I tolerated the AF well w/rate control & my Card. suggested I

treat it as a " nuisance " & get along with my life. The two reasons I decided a

PVA was for me were: Didn't want to be on coumadin for the rest of my life;

since I was chronic I was afraid of heart remodeling that could cause other

problems or eliminate me as a PVA candidate down the line.

Here' s my story to date. I've had no AF since the procedure. The first 4 weeks

were a period of adjustment both to the PVA & sotalol, (AKA BetaPace) which is

administered to " back up " the PVA for 3 months (in my case) The sotalol slowed

me down, as has been reported my many others on this board. I did tolerate it

better after a month or so. Around the 2 month mark I noticed PAC's/PVC's but

only if I took my pulse. Otherwise, I was unaware of them. After 2 or 3 weeks

they seemed to go away & I haven't caught any since.

At 3 months sotalol & coumadin were discontinued, & I immediately had what was

referred to by the CC as " sotalol bounce " - my BP & HR went up 20 or more points

from my normals. My HR was high enough (115-120) that Cleveland couldn't tell if

I had developed A flutter or just a temporary sinus tachycardia (Cleveland sends

you home with a portable 2 lead EKG which obviously isn't as accurate as a12

lead, which made a diagnosis difficult) A 12 lead EKG done locally showed sinus

tachycardia, which Dr. Natale confirmed from the fax of the strip I sent him.

Went on 180 mg verapamil per day for rate (It had worked well for me previously

when I was chronic AF) & that brought my pulse rate back into normal range (high

80's/low 90's), where it has remained.

I have mentioned previously that I really didn't feel 100% recovered till about

the 4 month mark or a little past. Till then I always had a vague tightness in

my chest & other very minor symptoms that were a reminder I had had a visitor in

my heart & it didn't like it. From that point till now I feel 100% recovered &

have no symptoms. I don't know how I will feel in 6 months or a year from now,

but as of now AF will always be a part of my life, although it is more of a

memory for me, not something I have to live with everyday.

My next step in the process will be going back to Cleveland on Sept 8th for my

follow-up. (mostly to check for pulmonary vein stenosis from the PVA) This

normally would have been done at the 3 month mark but I rescheduled for business

reasons. I expect to get a clean bill of health since I'm not symptomatic. I'll

report back on that issue later.

For those of you contemplating the procedure, I hope this is helpful. PVA's may

not be for everyone, but if done by the leading EP's around the world they

should be part of the equation. Anyone who considers a PVA is made aware the

procedure may have to repeated (the famous " touchup " ). In fact, I have 2 fib

friends I correspond with regularly who had their PVA's done by Dr. Natale one

week the other one month after mine. Both have had to have touchups, but are

doing well. The point is, neither hesitated to have the procedure again, nor

would I. I would recommend it for those leaning in that direction.

Thor

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