9 days post ablation

[Guest guest]

OK, if you're not getting tired of me, I know I'm getting tired of me. I'm

hopeful this will be the last installment of my drama. Following Monday's bout

of right atrial flutter (one week post left atrial ablation for afib), with

chemical cardioversion, I experienced a short bout this morning, about one hour

(of atrial flutter). I called my EP, he said come in Friday for a " short "

procedure to ablate the site in the right atrium. I'm with that, and hopeful

that that will be that. Right now I'm feeling fine in NSR. I'm just grateful

that they have made it so easy for me, and I certainly am sympathetic with all

those people who have to travel great distances and endure excruciating approval

processes to have these procedures done. I think I'm lucky to be part of the

Emory medical system as well as working with an EP with a great reputation who

is as eager to vanquish this beast as I am to have it vanquished. As for my

afib, it already seems to be a thing of the past. I'll try to hold onto the same

optimism.

Lester

[Guest guest]

Good luck on Friday, Lester.. and just remember to keep taking it easy for a

while, while you heal - despite how good you feel....

stef

10 weeks post ablation and right as rain (so far).

Lester on lrobert@...> wrote:

OK, if you're not getting tired of me, I know I'm getting tired of me. I'm

hopeful this will be the last installment of my drama. Following Monday's bout

of right atrial flutter (one week post left atrial ablation for afib), with

chemical cardioversion, I experienced a short bout this morning, about one hour

(of atrial flutter). I called my EP, he said come in Friday for a " short "

procedure to ablate the site in the right atrium. I'm with that, and hopeful

that that will be that. Right now I'm feeling fine in NSR. I'm just grateful

that they have made it so easy for me, and I certainly am sympathetic with all

those people who have to travel great distances and endure excruciating approval

processes to have these procedures done. I think I'm lucky to be part of the

Emory medical system as well as working with an EP with a great reputation who

is as eager to vanquish this beast as I am to have it vanquished. As for my

afib, it already seems to be a thing of the past. I'll

try to hold onto the same optimism.

Lester

[Guest guest]

Which Doctor do you deal with at Emory?

9 days post ablation

OK, if you're not getting tired of me, I know I'm getting tired of me. I'm

hopeful this will be the last installment of my drama. Following Monday's

bout of right atrial flutter (one week post left atrial ablation for afib),

with chemical cardioversion, I experienced a short bout this morning, about

one hour (of atrial flutter). I called my EP, he said come in Friday for a

" short " procedure to ablate the site in the right atrium. I'm with that, and

hopeful that that will be that. Right now I'm feeling fine in NSR. I'm just

grateful that they have made it so easy for me, and I certainly am

sympathetic with all those people who have to travel great distances and

endure excruciating approval processes to have these procedures done. I

think I'm lucky to be part of the Emory medical system as well as working

with an EP with a great reputation who is as eager to vanquish this beast as

I am to have it vanquished. As for my afib, it already seems to be a thing

of the past. I'll try to hold onto the same optimism.

Lester

[Guest guest]

>Which Doctor do you deal with at Emory?

>

Ken,

Angel Leon is the chief of cardiology and the senior EP at Crawford Long

Hospital, which is the midtown hospital of Emory University. The Carlyle Fraser

Heart Center is located there and they have a nice new facility with new cath

and EP labs. I know he went to school in Miami, and did his cardiology training

in Michigan. I've been in medicine myself for 30 years (as a PA) and Dr. Leon

seems to be one of those not too common very competent doctors with a very

reassuring bedside manner.

Lester

[Guest guest]

HI Lester,

I certainly hope this solves all your problems....hopefully it will! It's

great that you're not having a-fib....Wonderful!

You asked me to list some of what Dr Wharton and I discussed:

First, I was much more impressed now that I " interrogated " him for over 30

minutes. He is at MUSC as I mentioned (ton) and has been there 3-4

years. He was at Duke prior to that. He runs the program at MUSC.

I asked him how many A-fib ablations he has performed...he said he stopped

counting after >1000. He uses the method similar to Dr Pappone but states he's

intentionally not as fast...doesn't want to miss many foci. MUSC has one of the

most up to date systems in the country. He uses 3-D visual technology

throughout the procedure to identify a-fib foci. He stated that he has never

had an atrioesophogeal perforation. He avoids this problem by limiting burn

time on the posterior wall of the heart which he says is thinner that the

anterior myocardium.

He has had only one case of PV stenosis which was resolved with a stent. Of

course he told me that there are no guarrentees, but that's no surprise!

He monitors for PV stenosis with a CT scan about 3 months after the ablation.

He states he's written a paper explaining that he feels this monitoring is no

longer needed as the occurrance is so rare (in the major facilities) but doubts

it will be stopped any time soon as the standard of care due to the continued

occurrances at lesser experienced centers.

I also asked him about post ablation a-flutter. He states he ablates for

this during the a-fib procedure because it doesn't take much more time and it

negates the problem of post ablation flutter and need for another procedure.

The a-fib ablation takes approximately 5 hours. Of course, the INR must be

in range for the preceeding four weeks or he will perform a TEE prior to

beginning the procedure. His overall complication rate is 6% but he states that

includes even minor complications such as groin hematomas (that we all know are

common during catherization).

I voiced my concerns about my (small) size and wondering if that increased

riskfor PVI or atrioesophogeal fistula...he states 1/3 of his patients are

young, athletic, 1/3 elderly and frail (small) and 1/3 obese and reiterated his

almost nil complication rate in all groups.

I asked about when he considers one " cured " and he states at 5-6 months. He

acknowleged that there was no real long term data yet (who knows what will

happen in 10 years) but from what he has seen in his patient population, he

thinks things are looking good for long term cure.

One other thing he mentioned was that although comlications are rare, it's

important to be affiliated with a major medical center so IF there is a

complication, they can identify and address it competently and abate or minimize

any long term problems.

There were other questions I had which may come to mind later and I'll pass

them along but all in all, I feel very confident in his expertise and outcomes.

So....based on his answers to my questions I'm going to keep my 8/2

appointment for the ablation and forgo the trip to Cleveland or Atlanta.

Keep us informed on your progress. I think you're doing fine. Dr Wharton

warned me about the irritable myocardium post ablation while the heart is

" healing " ...so don't be discouraged! This will soon be behind you....I can't

wait to get it over with. I came home from the gym tonight, felt great, had

supper and went into a-fib! I'm sitting here with my HR around 126-130, my

heart feels like it's pounding out of my chest, irregular as can be, I'm short

of breath and have burning in my chest when I walk around. It'll be like this

for 8-11 hours (that's my history) just long enought to make me miserable,

unable to sleep (have to keep getting up to Pee which is secondary to the BNP)

and it will stop while I'm getting ready for work....to which I will go,

completely exhausted, having to listen to all my patient's cardiac

complaints!!!!!

Oh well.....

Lester on lrobert@...> wrote:

OK, if you're not getting tired of me, I know I'm getting tired of me. I'm

hopeful this will be the last installment of my drama. Following Monday's bout

of right atrial flutter (one week post left atrial ablation for afib), with

chemical cardioversion, I experienced a short bout this morning, about one hour

(of atrial flutter). I called my EP, he said come in Friday for a " short "

procedure to ablate the site in the right atrium. I'm with that, and hopeful

that that will be that. Right now I'm feeling fine in NSR. I'm just grateful

that they have made it so easy for me, and I certainly am sympathetic with all

those people who have to travel great distances and endure excruciating approval

processes to have these procedures done. I think I'm lucky to be part of the

Emory medical system as well as working with an EP with a great reputation who

is as eager to vanquish this beast as I am to have it vanquished. As for my

afib, it already seems to be a thing of the past. I'll

try to hold onto the same optimism.

Lester