Second Successful Ablation with Dr. Natale

[barbly1]

I am now one week past my second ablation with Dr. Natale in Austin, Texas. The biggest miracle of all was that when I went off of Flecainide five days before surgery, nothing happened and I stayed in sinus rhythm. My first ablation was nearly five years ago, and I tried unsuccessfully to go off of Flecainide three times during the first year post-ablation, but immediately had such miserable and chaotic rhythms that I had to go right back on it. I was so sure that the five days prior to the second surgery would be a nightmare, that I almost didn't want to get the ablation because I was so afraid that I couldn't stand that week. But, to my delight, I felt fine, except for a few weird random beats. This go round, Dr. Natale needed only 12 minutes of radiofrequency time to get the atrial tachycardia spots and to stop the circular rhythm that had developed with the A-V nodal slow pathway. Or, something like that. That was the gist of it. The previous ablation had been for afib and had taken hours. The bottom line was that when I woke up this time I had none of the chest soreness that I had after the first more extensive ablation, and by the time I could go home the next morning I felt nearly normal. The best part of all of it is that I am now no longer taking the Flecainide except as a PIP, and the hope is that I won't need to go back on it daily. I had advanced from 50 mg 2xday to 100 mg 2xday, and did not like that progression. I have been out walking the last two days, and still feel a little tired, but that may be as much from the 36 hours of driving time to and from Texas as the actual procedure. I feel so relieved and full of hope. Thanks to all here who offered me advice and encouragement, because it helped me to follow through with what I needed to do. I have nothing but praise for Dr. Andrea Natale and his team at Texas Cardiac Arrythmia. He has certainly helped get me back to normal. It was so worth that long drive to be back in his care.

[SeanJax]

I am so happy for you. He is the expert of the experts in his field. I am one of his fans. 20 months of NSR after pulsed field ablation. No medication whatsoever. What else I can ask for. I keep repeating 90% of ablation success depends on the ep. Don't waste your time with ep who did not have enough volume of ablations a year. The first question I ask the ep is his/her number of ablations performed in a year. And I go from there. When I heard evasive answers as too many a year and I just ran away from them. Not only the number of ablations but also his/her mapping tools and percentages of success. He is so skilled in what he does and he is so gifted with his hands. And he came from Europe (Italy) too. And his team post op is highly professional and very close to patients. We do have choices in the States and we know Austin is far south but it is worth the trip.

[OzJames in reply to SeanJax]

hi Sean, can I get an idea how many ablations a year would a top EP do? I’m in Australia and want to do some research in case I need ablation down the track.

[mwcf in reply to OzJames]

OK so I'm in the UK not Australia, but based on my extensive reading this last 20 years if I were in Australia top of my list would be Peter Kistler at Melbourne. 1000s of ablations during the last 15 years. Did post-doc research at the highly regarded St Barts here in the UK. A friend and colleague of Prof Pierre Jais from Bordeaux (videos of them discussing AF on Heart Rhythm TV on Youtube).

[OzJames in reply to mwcf]

thanks so much for the info

[SeanJax in reply to OzJames]

Dr. Natale (na-ta LAY) in Italian did more than 10000 ablations already. The mapping tools and the techniques play a huge role in the success of the ablation. Don’t forget he uses the tip of the catheter to ablate the rogue sources on a beating heart as a sharp shooter who aims on a moving target. Too much pressure on a same place it will cause damage and not long enough will not scar enough the heart tissue. All of that on a beating heart. You see what I meant.

I think as mcwf said 1000 ablations is very respectable number and he can be trusted.

I was so lucky to have the pulsed field ablation. No side effects whatsoever and the results are so perfect after 20 months.

As I repeat many times Afib is a progressive disease so I have an extremely healthy life style trying to manage the risk factors of Afib daily.

[OzJames in reply to SeanJax]

thanks great insight into the skill set required I will take note

[Tantaanna]

I am pleased to have contact with some one else who has had an ablation with Dr Natalie. I assume you have a watchman implant?

[barbly1 in reply to Tantaanna]

I don't have a watchman implant. I continue on my Eliquis which agrees with me very well. Maybe Seanjax has one?

[Tantaanna in reply to barbly1]

I had no problems taking xeralro wrong spelling- was on from 2014-2019. He suggested it be best for me as I age- I am 75 afib officially since I was 67

[Tantaanna in reply to Tantaanna]

that’s Dr Natalie who suggested I have the Watchman. I made three follow up TEE tests after the ablation. Had the Left appendage ablation and other touch up I. Covid year 2020-touch up 2921 and watchman, 21-22 follow up. Absolutely wonderful NSR for two years. Started Having some funky - extra beat only at night somewhere along the line- Natalie i m not worried about it But it progressed to more numerous bouts

I will continue this thread later

[SeanJax in reply to barbly1]

when you have the left atrial appendage ablated, it does not contract well after ablation and blood clot can form inside it easily. That is the reason of the watchman. The LAA is usually the source of intractable Afib and or atrial flutter. So the mapping is critical here too and the skill set of the ep is paramount here because it is tough spot to hit.

One more reason to see the expert of the experts ablationist.

[Tantaanna]

I am 1000 miles from Texas. I had had three prior ablations, many cardio versions, on Flec, amoodarone, metoprolol and Ditalzam. Was i permanent afib/flutter for a tear after my third before seeing Dr Natalie.

[barbly1 in reply to Tantaanna]

Have your symptoms resolved after seeing him and having your ablation? Hope you are doing well. We travelled from South Carolina to Texas this time, and the first time from New Mexico. It's worth it.

[Snowgirl65]

It's good reading such a success story. I hope you continue in NSR and enjoy life -- spring's on its way!

[barbly1 in reply to Snowgirl65]

Thank you. You too!