In Canada & BC - alternatives to cardiac ablations?

[marcyh]

Hello,

I have an appointment this morning with my EP. I am paroxsysmal, severaly symptomatic, on apixaban (& BP med). and I have had two radiofrequency ablations. After a year and a half, I had another episode a few weeks ago. My EP says I am anatomically complex, with a difficult septal puncture and small atrium. I'm thinking he will want to suggest meds, which I hope to avoid since I already have all the symptoms of the side effects of beta blockers. I really don't want to take any more meds

1 - Do I have any other options in Canada? Mini maze, pulsed field ablation? Or? I am in the Vancouver area.

2 - I have been told that recently Canadian patients have been able to have procedures in the US and Canadian insurance will pay for it. I'm sure this is to reduce our wait times. Has anyone tried this?

Thanks for any suggestions,

marcyh

[FraserB]

I take it you've already been to St. Paul's Hospital AF clinic in Vancouver they do have ongoing developments in AF care. Also pulsed field ablation is now being done in Calgary, AB.

[marcyh in reply to FraserB]

Thanks, I hadn't heard that. Good to know.

Yes, my care and my ablations have been done via St. Paul's. Wonderful care there.

[FraserB in reply to marcyh]

Pulse field ablation in the past year is opening up and being offered in more CDN centres, ie, University of Ottawa Heart Institute and also McGill University Health Centre. Mini maze is still not that accessible except for St. Michael’s Hospital in Toronto. You may have already done this but search Health Unlocked posts "Mini Maze"-- you may find insights from patients who have pursued treatment options abroad.

[marcyh in reply to FraserB]

Again, thanks. I do know of one patient who has gotten help abroad. I had a good appointment this morning. The EP gave me tips on lifestyle (would you believe I have exercised too much/!) and believes I should not take a beta blocker. He wants me to carry on as is for now and I'm good with that.

[Letofeyd]

I am in BC close to you geographically. I was also paroxysmal but very frequent and symptomatic. Drugs were not working for me.I researched a lot of options in BC ( not much going on here😒), Toronto, and the US.In the end, I went to Tokyo for the minimally invasive procedure offered there by Dr Toshiya Ohtsuka.

One year on, no AFib and so happy I did it.

You can get in touch with me if you want more info. 🙂

[OzJames in reply to Letofeyd]

Hi I’ve been thinking about going to Japan as well in the future. Does the doctor have stats for 5-10 years in terms of recurrence post mini maze

[Letofeyd in reply to OzJames]

I don't have that information, but you could ask him, or internet search. He works closely with Dr Randall Wolf in Houston doing pretty much the same procedure. Both surgeons have ben operating for a long time and have a large body of evidence to share. Toshiya Ohtsuka at Newheart Watanabe Institute in Tokyo.

[OzJames in reply to Letofeyd]

Thanks I’ll email them and ask

[marcyh in reply to Letofeyd]

Thanks! I will DM.

[listerines]

Unfortunately, not a ton of options outside of meds and ablations in Vancouver/ BC. EP I see through St. Pauls discussed pulse field ablation with me for possibly 4th ablation once available in Vancouver (was not confident on time line but thought 18-24 months). The EP also shared at this time the benefit of pulse field abalation seems to be less complications stemming from the procedure but not a higher success rate with the reduction of afib (comparable to traditional RF/ Cyro ablations). He did say researchers are working on different ablation "tips" for the pulse field abalation device which he hopes will increase successes in the future. Like those are saying above your best bet might be to research out of country options re: mini maze / Wolf mini maze - seems procedure done in Japan costs far less than in USA.

I have not heard of any afib sufferers receiving treatment outside of BC and MSP picking up the tab. If you come across this please advise the group as i would like to know the details

Just for reference purposes I have a complex heart and have done quite well on flecainide/ bisoprolol over the past 3-4 years or so. No side effects except lower standing hr due to beta blockers (that said we all react different to meds). Wishing you a stable heart

[marcyh in reply to listerines]

Thanks. Good to know this much and it's good to have these connections. I'm afraid I don't have any specifics with regard to MSP picking up the tab for treatments. I do know it wasn't in the context of AFib.