Re: catheter ablation

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Posted by Joss on March 06, 2003 at 04:31:40:

In Reply to: catheter ablation posted by bill on March 05, 2003 at 14:06:33:

Lets try and put the record straight on PVAs.
There are only a few hospitals in the world that carry out successful ablations, the ones I know of are Haut Leveque in France where the operation is carried out by Professor Haisaguerre, Dr.P.Jais, Dr Shah.Professor Haisaguerre was the main man behind realising where the ectopics come from i.e. the PVs, each of the PVs being being more likely to give off Ectopic beats with one of them being the culprit of up to 95%. This man invented the catheter for carrying out these ablations and is in my opinion the number one surgeon for this procedure. He taught Dr.Natale at CC for instance so how you lot come to the conclusion that the CC is number one in the world beats me. I have been to France for an ablation and met both Dr Jais and Professor Haissaguerre. My ablation was carried out by Dr. P. Jais who with Prof. Haissaguerre are extremely competent and efficient surgeons who are only too willing to carry out a second ablation if the first did not succeed. They now do a left isthmus line for the ablation whilst also circumferentially ablating all 4 PVs. The risk of stenosis is 1% as they ablate the ostium and not inside the vein. Their cure rate with the left isthmus line is around 85% with a second ablation which is generally the case is up to 95%. If whilst you are in their care at Haut Leveque the AFib returns they carry out a second procedure there and then for free. Bet you dont get that in your beloved CC.

There are also 2 other hospitals in the UK carrying out this procedure one in Newcastle and one in London and both having good success rates.

I had 2 ablations done in London, not done by the Hospitals i mention above but by a Dr in Harley Street. This man did not ablate all 4 PVs so those ablations did not work. I then made up my mind to go to France, as I live in the Channel Isles which are not far from France and have the procedure carried out by Prof. Haissaguere and his team. Now at 6months post op I am still not convinced that I am totally cured, but, I am 95% better than when I went in and have already made an appointment to go back if necessary. Seems some people cure slower than others.

Before going to Haut Leveque they like you to be anticoagulated for 4 weeks with an INR of 2-3 and also a TOE must be carried out to make sure there is no clot in the Atrial Appendage. You are then ablated and kept on an anti coagulant whilst in hospital, usually an injection 3 times a day then Warfarin for a month afterward if no AFib present. In total i have had 4 ablations the first two I dont realy count as the procedure was not carried out in full, and if I have to have another that will be 5.

Whilst the CC is probably the number one for mazes I am not convinced it is the number one place for ablations as Dr.Natale was taught by Haissaguerre and Jais who pionerred the procedure.

I get so irrated by American tunnel vision that I had to write this lengthy epistle to remind you people that there are other centres in this world that carry out the ablation procedures and not just your beloved CC.

I hope that this post sheds some light on ablations and their efficacy and that the Maze is not allways the way to go for AFib. As the catheter design improves so will the use of Ablation only for AFib come to the fore.

The cost of an ablation in France is somewhere in the region of £6,000.00 with a second thrown in for free, if whilst you are in their care AFib rears its ugly head. I know a person that had 3 carried out whilst in Haut Leveque, he was in chronic AFib though and just about had the maze carried out by ablation. Bet thats cheaper than America and carried out by the best in the world in my opinion.

To all people considering an Ablation, check out who has the higest succes rate and go there. You can always have the maze afterwards. Ablation succes rate for chronic /permanant AFib is not so high, you must have intermittant AFib brought on by Ectopics to be in with a chance of it being cured. I had mine for 4.5 yrs. Do not listen to any Doctor that says live with it, change your Doctor. There is a cure out there for most, whether it be the Maze, which I was contemplating at one stage or Ablation.

I hear that Haut Leveque is now booked up solid for 7 Months. Thats some experince that Haissaguerre and Jais are learning.

Regards

Joss

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