Here is the link:
practiceupdate.com/content/...
It talked about the expert ep who has high volume of ablations per year in US. In UK, I don't know the annual volume of each ep, and I guess it is around 50 per year? The more the ep does a year the better he/she is. For training to become ep in US, it requires 4 years of medical school, 3 years of residency in internal medicine, 3 years of fellowship in cardiology and 2 years fellowship in electrophysiology. It takes time to become an ep. And it means nothing when it comes to ablation since it is a manual complex procedure which requires a lot of repetition to become good at it and all of that on a moving target. Imagine a sharp shooter aiming at a moving target and know where to apply the tip of the catheter and don't keep the tip at the same place too long otherwise they can cause more damages than benefits and don't leave gaps between two applications. All of that looking at a grey and white screen. I never rely on their credentials to know if they are good or not. It comes from alumni patients who speak up about their ablation outcome and evidently their annual volume. I never listened to their sweet talk. In UK you are stuck most of the time with the referral process, in the States we choose the ep we want, relying on the two criteria, annual volume and feedback from former patients.
It also talked about pulsed field ablation. I was one of the recipient of the medtronics trial, no side effects at all post ablation and it is still going well after 22 months afib free and evidently I keep all the modifiable risk factors under strict control. There is no such a thing one ablation and I am done and don't keep the modifiable risk factors under control (overweight, alcohol, smoking, high blood sugar, high blood pressure, sleep apnea, high triglycerides/cholesterol, physical inactivity, stress, bad diet (process food, fatty diet and high in carbs and salt) . Pulsed field ablation in a nutshell is safer and quicker and still it is just a new technique and in expert hands it is becoming what we are waiting for a long time in afib treatment from my point of view.
It talked also about LAA. But to find an ep to do it to avoid taking anticoagulants is possible in US and I don't know about UK.
Good readings!
Afib induced syncope update from #chinkoflight
Upgraded from paroxysmal afib into pafib…. Deep joy! Update, update!!
anterior wall afib ablation update from April 28th
Update to ‘Waiting List’ post - cardiology appointment 
A review of statin efficacy in reducing CVD - article from cardiology
