Posted by Bill Kilgore on December 12, 2002 at 17:00:15:
In the spirit of sharing information with all those who are seeking a cure for their atrial fibrillation, I will jot a few thoughts about my recent PVI at the Texas Heart Institute in Houston, Texas. Dr. Jie Cheng made the prudent and patient-friendly decision to abort the procedure when I could not be made to lie still, even under deep sedation. He had just begun to ablate when I began to move around. The more sedation, the more I flopped like a fish on a dock. He said they will have to use a general anesthesia, next time. It would not have been safe to convert to a general anesthesia, because that requires placing a tube down the throat and I was already anti-coagulated. Here is the play by play of the PVI the way I experienced it. Five days before the day of the procedure I stopped coumadin. I begin Lovenox injections which last for 12 hours and allow for controlling the level of anticoagulation. On the day before the procedure I had my Trans Esophageal Echocardiogram. After the procedure, I had to lie still with the sheaths in the veins in my groin and neck and femoral artery until the level of anticoagulation went down. About five hours post procedure they removed the sheaths and placed sand bags on my legs for four hours. When the sand bags came off, I lied still for another four hours. Then, I was allowed to get up. They immediately began anticoagulating me with heparin through the IV, as this is a necessary precaution after a heart procedure. I was released from the hospital the next day. I was using Lovenox and taking Coumadin and had just taken the last scheduled Lovenox injection when... Four days after the procedure, I experienced a pseudo aneurysm in the femoral artery and returned to the hospital for two days. The pseudo aneurysm was closed in the ER by a doctor applying pressure with the blunt end of a doppler ultrasound sensing instrument. The next day, they verified that the pseudo was still closed with the doppler ultrasound. I learned that this happens to about five of one thousand patients who come through the heart catheter lab each month. I really came to appreciate my doctors (John Seger and Jie Cheng) and their constant attention during this crisis. I learned that the femoral artery is sometimes used to monitor blood pressure on a real time basis so that any damage to the heart can be immediately detected during the PVI procedure and steps can be taken to stabilize the patient. So, the femoral artery was not needed for a catheter as a part of this procedure but was used to monitor blood pressure as a precautionary measure. On the day of my release – the second time – Dr. Cheng was very enthusiastic. He had just worked on a young, 21 year old lady who was in refractory, chronic a fib for two years and has a 15% ejection fraction. She could not be converted with shocks or pharmacology. He showed me her strip off the ECG monitor that showed she was in NSR for the first time. This was step one of two procedures. The first ablation targeted the substrate that had been remodeled via a-fib. Her next procedure will target the triggers – more like the PVI. If she reads this, I want her to know that her success gave me an uplifted feeling and I hope for her continued success. I am in NSR right this moment and I might just decide to recover and climb some more mountains before I try this again. To check out the best hospitals in the US get the current January issue of Consumer Report or go to usnews.com and click on "Best Hospitals" somewhere near the right-hand side of the page. #1 for heart the Cleveland Clinic. #7 for heart The Texas Heart Institute.
- Re: PVI last Dec 5 Ed Wehan 23:14:21 12/12/2002 (0)
- Re: PVI last Dec 5 John W. Gross 18:50:21 12/12/2002 (0)