Stop afib. Org: I just finished watching the... - AF Association

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Stop afib. Org

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I just finished watching the recorded conference on afib( see below for copy to Link). After all the top US docs talked about ablation with average success rate of 70%, then a Dr Wolf spoke about the mini- maze procedure where they go in to the chest with a laparoscope, remove the left atrial appendage and apply a band somewhere else that forms scar tissue, blocking the afib. He quoted 90% success rate, no further need for anticoagulants and off all meds in 12 weeks. He said he has need doing this procedure since 1993.

My questions are has anyone here had this or know about it? If it is that successful, why isn’t it done more?

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Password: afib333

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I think there have been a few posts about the mini maze procedure here in the past. Use the search box (top right) and you should be able to find them.

Hopefully others who have experience will also respond to your message.

Thanks for the link and password Hoski. I’ll look forward to checking it out.

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Great information Hoski. Thank you. I am glad to be off all cardiac meds now. At least for me being on various rate and rhythm control drugs not to mention the anticoagulants was almost as bad as the afib. The cardiac drugs can be a life saver for many and are often necessary but , in my opinion, they are often harsh and push a-fib into the cateogory of 'which is worse? the disease or the treatment?

I had the mini-maze in April last year, followed by an rf ablation to give the full cox maze lesion set 6 months later. This was done as part of a clinical trial. I have made several posts about it.

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Hidden in reply to johnMiosh

I'll look them up. We don't hear much about the Mini maze these days. It had a lot of value. Maybe someone has realized it still has a useful place in treatment. I'll be interested in what the trials show.

johnMiosh
johnMiosh in reply to Hidden

The trial is an international one CEASE_AF clinicaltrials.gov/ct2/show...

210 participants of which I think 30 were to be selected in Sheffield. I have only met two of the other candidates, I am not sure whether they found the whole 30 as the criteria were quite strict. The study will report after three years, given selection time for candidates I would expect this to be published in 2022.

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Hidden in reply to johnMiosh

Thank you. I'm also going to do some research here (US) to see what's new with the Mini-Maze. Take care. irina

I think it is not so widely used as is more invasive do higher risk. However it is easier for doctors to access all areas so higher success rate. If people need heart surgery it’s often fine then too as the extra risk is already in place

johnMiosh
johnMiosh in reply to rosyG

It is described as minimally-invasive, but it requires three ports on each side of the chest and lungs collapsed for access. It wasn't pleasant and definitely harder to recover from than a catheter ablation, but nowhere near as bad as zipper type surgery. The problem is that the surgeon can't get access to the back of the heart; that's why I had the RF ablation six months later.

A similar procedure is carried out with full open chest, the cox maze. This allows access to the whole heart after chest incision and cutting of the breast bone. Due to the risks, they will only do this if you have another issue, e.g. valve replacement.

I had OHS in January 2016 to replace Aortic Valve and 1X CABG. They also did mini- maze procedure and stapled the left atrial appendage. This was hopefully supposed to stop Afib.

I checked my ECG results from way before operation and could not find any Afib.

But when I was discharged I had continuous Afib and they put me an AMIODARONE.

I did not come of this awful drug until May 2016 and was still in continuous Afib. The Amiodarone also gave me an under active thyroid so now have levothyroxine for life.

I now know Amiodarone should only be used as a drug of last resort.

In November 2016 I had a cardioversion and have since been in normal sinus rhythm.

So it may be that the mini maze has helped.

I am still on warfarin and aspirin as the doctors say it will not hurt to stay on it. I eventually came of all heart drugs, bisoprolol shortly after cardioversion.

Just pleased that I am still in NSR

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Hidden in reply to Norm

Hi Norm.I am curious why your doctor still wants you on Coumadin as your LAA has been stapled. I just had the Watchman procedure in January to get off anticoagulants. I only take baby aspirin now. Very happy to have Coumadin out of my life. Not critical-just interested in his rationale. I'm retired from nursing and such an information junkie about healthcare. Thanks. Happy you seem to be doing well after all that surgery. Take care. irina

ILowe
ILowe in reply to Hidden

If Norm had a metallic valve inserted, then warfarin or similar such as coumadin or sinthrome is obligatory.

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Hidden in reply to ILowe

That's true. I had forgotten about that. Take care. irina

BobD
BobDVolunteer

I think it is fair to say that OHS itself can create AF which may be why they performed the mini maze at the time. I know of several people who have had bypass surgery who then developed AF .

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Hidden in reply to BobD

I agree. I've often thought that maybe the reason so many people have A-fib is partially due to open heart surgery they had years ago before more post op preventive measures were found to have value for problem prevention down the road. I'll add dementia to my list as so many people in the 60's that I worked with often had a type of temporary memory loss after being on the heart lung machine and probably throwing smallemboli that surgeons weren't aware of at the time. Makes the case most learning takes time to understand the problems involved.

To reply to you and BobD.

May be my surgeon thought in long term it would help prevent Afib with the 90 percent success rate. Just the amount of time it took to get a CV and that is nearly two years ago and still in NSR, thank God.

The answer I was given from doctor re anticoagulants was that it would not hurt and may even still help prevent a stroke. The warfarin and aspirin do two different things. The aspirin is to help stop the platelets sticking.

I am happy with that and at present my INR stays generally within range so I only get it checked at doctors about every 10/12 weeks.

I found getting answers from hospital or cardiologist hard but I can not fault my surgeon.

I only had one major dispute between my GP and cardiologist and that was after the CV and staying on reduced level of bisoprolol. My GP stopped it completely because my pulse was too low, and cardiologist kept putting me back on it, said it would not hurt. I have been off it now for well over a year and all OK. So other than warfarin and asprin, plus the lansoprazole I don't have any drugs for my heart. Only really bad thing that has come from OHS is lack of proper sleep. Brain just don't appear to stop. But that may be something to do with that I now have prostrate cancer and have to go to toilet at least twice during night and the effect of the hormone treatment. Still I am 70 now and have a pretty good life and lovely and understanding wife. We cant't have everything.

BobD
BobDVolunteer in reply to Norm

Been there done that Norm. I had mine out about seven years ago and still get up three times a night. Had to take some of my bladder too as it was all over the place. I had three years of zoladex hormone but gladly did not grow boobs like some people. If PSA goes up again may have to go back on the implants. I have three more years than you by the way and still have my memories. I find they chime in about 4.30 am most nights and last till 6.00 when my wife gets up for work. If I'm lucky I might then get another hour and a half sleep after that before bladder wakes me again.

I know lots of people who have had valve replacement on both warfarin and aspirin which it quite correct as you mention.. INR usually 3.5 as well whereas we AFers are a lowly 2.5.

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