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Recommendations for an electrophysiologist

marinoperna profile image
29 Replies

Seeking recommendations for an excellent electrophysiologist with a long track record of successful ablations. Prefer the Tampa - St. Pete, Florida area but am willing to travel. i have patient ID numbers with the Mayo Clinic as well as the Cleveland Clinic.

I really don't have symptoms other than getting tired a lot more than usual. diagnosed with persistent AFib about 6 months ago, static heart beat is about 80bpm. Hoping to confirm that i don't have to do anything and waiting won't make repairs unlikely to be successful or kill me

Marino

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marinoperna profile image
marinoperna
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29 Replies
mjames1 profile image
mjames1

If I understand you correctly, you've been in afib continually for six months now, possibly with a drug to slow down your heart rate? If that's the case and you want to go the ablation route, I would make a decision very soon.

No, waiting won't "kill you" or anything like that, but it could lower the odds of a successful ablation. Alternatively, you could buy yourself a little more time and go on a rhythm control strategy where they might first cardiovert you and then put you on a drug to control your rhythm.

Mayo and Cleaveland Clinic are both highly rated but I don't have any names.

Jim

marinoperna profile image
marinoperna in reply tomjames1

Thanks Jim,

yes that's correct but the 80 bpm is without any meds. That seems reasonable even for a 72 year old with NSR (mine was 60bpm before the flutter) and that's my concern. Am i still in jeopardy with those stats. Making the Ablation a requirement in my near future?

Regards

Marino

mjames1 profile image
mjames1 in reply tomarinoperna

You mention "flutter" now. So just to be clear, are we talking about afib or aflutter?

If we're talking about afib, have you been in it CONTINUOUSLY for six months at a heart rate of 80bmp, without any medications? And if so, how do you know if it's afib at such a low rate? Was the diagnosis based on a single ecg at your doctor's office or have you monitored you heart in other ways since?

Jim

marinoperna profile image
marinoperna in reply tomjames1

Hi Jim,Slipped on the terminology. Yes, A-FibI had a cardioversion about 6 weeks ago. Successful but for about 10 hours then back to AFib. I've had about 10 ecg tests all pointed to being in AFib. I purchase a Kardiamobile which confirmed the AFib on every test except right after the cardioversion when i had my happy face on, unfortunately that didn't last long!

i have a blood pressure monitor at home that i use to check not only blood pressure but BPM. To verify, i used my machine just prior to going to the doctor and I'm generally very close to being the same, a bit higher there (still less than 90) probably due to anxiety. Have never seen higher than 90 resting. I have not check it after waling up some stairs or doing an activity.

Thanks for your concern. happy to try or reply with any questions

Marino

mjames1 profile image
mjames1 in reply tomarinoperna

Thanks for the clarification. So yes, you do seem to be in the category of "persistent afib".

You have basically three options to discuss with preferably an ep, or at least a well versed cardiologist. Have an ablation. Try a rhythm control strategy. Or leave things they way they are.

One progression might be to try the rhythm control strategy first with a drug like Flecainide, if you qualify for the drug. You can then evaluate how well that makes you feel. If you feel good, you then may decide to continue with rhythm control and not ablate. If you don't feel good enough, then you can move on to ablation. And arguably, this strategy will stop the clock of your persistent afib because if successful you will be in normal rhythm.

On the other hand, if you want to skip the rhythm control strategy and go right to ablation, you should probably have it relatively soon, say within the next few months. That's because at a certain point, the longer you're in afib the less the odds are for successful ablation. Where that point is exactly no one can really tell you.

The third option is just to leave things where they are, with the exception of taking a thinner, if you aren't on one already. You have a relatively normal rate, you aren't on any drugs that may cause side effects and you are asymptomatic other than feeling more tired than usual. For some people that might be ok, for others it might not be. That's a personal decision. However, if you do decide to leave things the way they are, then again, at some point a future ablation may have less chance of succeeding.

Good luck moving forward.

Jim

Singwell profile image
Singwell

Just for balance my EP told me it's perfectly possible to do ablation where AF is persistent nowadays. Things to check out:Success rates of your potential EP

How many procedures a year? If less than 50 avoid!

How long doing them in that hospital/clinic?

Prognosis for success of persistent AF versus paroxysmal

Kingdaddy profile image
Kingdaddy

I just got AFIB March 8th if this year, straight into early persistent. I live in VA.

2 cardioversions and Multaq unsuccessful AT Sentara Norfolk in VA. I decided that if I was going to do an ablation I would go to the best, and just had a cardioversion at the Cleveland Clinic yesterday with Dr Tyler Taigen. He used high def mapping to ID the areas needing ablation, and did both pulmonary vein isolation as posterior wall isolation.

I highly recommend Dr Taigen.

marinoperna profile image
marinoperna in reply toKingdaddy

Thank you for your reply. Please stay in touch. Wish you well for this Memorial Day weekend and all of those following

Kingdaddy profile image
Kingdaddy in reply tomarinoperna

You as well. My ablation Wednesday was very successful, nice being back in NSR.

marinoperna profile image
marinoperna in reply toKingdaddy

how bad were you prior to the ablation? how did you feel that it was necessary for you to have that surgery. honestly i worries me. it's my heart after all.I don't feel all that bad and my resting heartbeat is less than 90 without meds but I'm being told i must do something soon or forever be stuck and that I Will get worse

Kingdaddy profile image
Kingdaddy in reply tomarinoperna

There is a phrase AFIB BEGETS AFIB, which means it get worse over time. It’s a progressive disease and I felt like treating it ASAP with the best doctor I could find, at the best facility that took my insurance, would be the way to go. That’s why I had it done, and done at the Cleveland Clinic. I’m 2 days post ablation and feel no pain, extremely happy I did it. And I’m back in NSR.

marinoperna profile image
marinoperna in reply toKingdaddy

Did you go to Dr Taigen own office on Ashe in Akron or did you actually go thru the Cleveland Clinic? Curious as to which one is the better way. Still dong well?

Kingdaddy profile image
Kingdaddy in reply tomarinoperna

Cleveland Clinic (photo I took below, it's beautiful outside). I didn't even know Dr. Taigen had an office in Akron, but I did stay in Akron while there as my mother-in-law lives there. I came from VA. And yes, still doing well - no AFIB. I'll be in the blanking period for a few months while things heal, but I don't really notice anything right now.

Cleveland Clinic
marinoperna profile image
marinoperna in reply toKingdaddy

I'm from Florida so would be traveling just like you. How long did it take to get your appointment? How many times did you need to go before the actual ablation? How long did you have to stay in Cleveland? Where did you stay? Did you need to go back for follow-ups? Trying to make a planCertainly appreciate you time

Cevetello1 profile image
Cevetello1

I am in USA, residing in New Jersey. If you want the best doctor probably in the world, his name is Dr Andrea Natale. He is in Austin Texas having previously been with the Cleveland clinic. You may not want to travel that far, or maybe it is just too early in your disease to make that kind of the decision. You can read about him. He personally has done thousands and thousands of successful ablations. Keep his name somewhere should you need the very best care when it comes to ablation.

DawnTX profile image
DawnTX

I had a fabulous one in South Florida Delray Beach Dr. Mora at S. Florida Arrhythmia Center part of Delray Medical Center. I miss him very much unfortunately I moved to the Houston area so it’s a bit of travel to go back to him LOL. Even when I left he reminded me that he is my person and if I ever need to call on him to do so

marinoperna profile image
marinoperna in reply toDawnTX

Thanks for writing. a wonderful Memorial Day weekend to you and your family

DawnTX profile image
DawnTX

Dr Mora. I cried when I left him and if you need a cardiologists Dr. Cardenas also in Delray. They treated me like a queen

marinoperna profile image
marinoperna in reply toDawnTX

how long has it been (your ablation)? how are you feeling? how bad were you that you decided you had to have this surgery? I'm trying to decide my route to take!Thank you for taking the time.

Palpman profile image
Palpman

Ablation is by far not surgery. It is a simple procedure that to most is like having a tooth root extraction. Actually I'd rather have the ablation.

If the procedure is unsuccessful then it does not mean that the EP is not as good as you want him to be.

It may be that the heart is not responding to stimulus to identify the source.

It may be that the irritation of the heart muscles cause new arrhythmias or many other reasons.

It is unfair to ask the EP how successful/unsuccessful he has been.

marinoperna profile image
marinoperna in reply toPalpman

Thanks for that. But i can fix a dental root canal should something go wrong! This is my heart. There are risks and that is what i'm trying to assessHappy Memorial Day

DawnTX profile image
DawnTX in reply toPalpman

I highly disagree with you about what ablation is or is not. I just had a third this was Vein of Marshall It is a type of a dual ablation. Anytime you cut into a body it is a type of a surgery if you want to call it a procedure feel free. I have several teeth I only have one heart so when you’re playing inside my body with my heart trust me it’s not just a root canal. I had to be kept because both my Femoral and carotid arteries would not stop bleeding. If you don’t consider that important I’d like to know where you went to medical school so I can avoid doctors from there.

Palpman profile image
Palpman in reply toDawnTX

From WebMD.

Catheter ablation, also called radiofrequency or pulmonary vein ablation, isn’t surgery. Your doctor puts a thin, flexible tube called a catheter into a blood vessel in your leg or neck and guides it to your heart. When it reaches the area that’s causing the arrhythmia, it can destroy those cells. This helps get your heartbeat regular again. There are two main kinds

Lilypocket profile image
Lilypocket

I think the main thing to ask is HOW MANY the EP has done. Success is very individual depending on what the EP finds and corrects.I have finally decided to have an ablation after sitting on the fence. The Dr in question does about 600 ablations a year and feels in my own case I have a 90% chance of success( I 'm a bit skeptical and feel it would be more like 80% which is still very good). I have Lone AFib which has always self converted and no other heart issues ( that I know of). However your rate is not very high for Afib and you are not on meds I think so you could certainly live well as you are without an ablation. Or try medication for rhythm control.

Take care.

marinoperna profile image
marinoperna in reply toLilypocket

Thank Youi worries me about what my Dr. told me that if i don't fixit it soon it will be that it can't be fixed. OK fine but went on to say that it will get worse with time and could affect my longevity (and i like living!)

Lilypocket profile image
Lilypocket in reply tomarinoperna

Well many people on here live perfectly normal lives whilst being in permanent Afib. Some prefer it as going in and out of Afib knocks you out. It's true that Afib progresses and becomes more difficult to treat. I have decided to do it as the meds don't really work and I'm getting about 10 episodes a month on average. But it was my decision and neither my cardiologist or my Electrophysiologist mentioned longevity! If you are not taking meds yet and your Afib is quite slow perhaps ask for a second opinion as implying that you won't live very long if you don't have an ablation is quite frankly not very professional and not true! Of course I am only talking about Afib . If you have other heart pathologies apart from Afib perhaps your Dr is taking this into account but it seems from what you have written he is only talking about Afib.

Take care

marinoperna profile image
marinoperna in reply toLilypocket

used to get tired in the afternoon to where i needed a nap. lately i can go all day. I don't feel anything, heartbeat is less than 90 unless i do something strenuous. Hard to find local legitimate stats to get second opinions. This Dr. really has me worried. At 71 i had RP as it thought it was the best to get another 20+ years (i really like living (my mom made it to 100)). now this. if i could only verify that my af will get worse to the point to where there are no good options, i would do the ablation. just right now i having a hard time puling the trigger!Marino

Lilypocket profile image
Lilypocket in reply tomarinoperna

Well techniques for ablation are changing ( for the better) all the time so no harm in waiting for your ablation . It seems your Dr makes you anxious so maybe get another opinion to give yourself peace of mind? Take care.

marinoperna profile image
marinoperna in reply toLilypocket

thanks

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