Posted by L. Paul Teague on July 02, 2004 at 11:02:22:
In Reply to: Re: Ten Things Your Electrophysiologist Will Not Tell You About Lone Atrial Fibrillation posted by hutch on July 02, 2004 at 10:14:08:
Thanks for the information about your successful PVI for chronic lone AF. My statement is from a 2002 presentation by Dr. Cox.
Was your procedure a pure PVI? Or did Dr. Natale do some additonal ablations? You Operative Report should describe exactly what was done.
The Maze procedure is the gold standard for the cure of AF. It has by far the highest success rate, but that does not mean it should be the choice for everyone [e.g. your successful procedure]. Maze surgery does cost more and have a longer recovery.
About surgical skills, there are enough accomplished surgeons who know how to correctly do the procedure. You just have to know who they are -- something for which this Board can be very helpful.
The mortality rate for the Maze surgery is very low. I have not seen any complete mortality rate numbers for the entire family of catheter based procedures.
Anecdotally, I am aware of some serious post catheter procedure strokes. Published information on hundreds of Maze surgeries indicates that strokes have not been a problem.
When you go to the Cleveland, you get unbaised advice. Their interest is what is best for you based on the most up todate information. This is what is needed to make an informed decision for each individual case.
I know a lone [but not chronic] AF patient who recently went to the CC. Rather that have a catheter based procedure, he had a minmimally invasive procedure that did not require stopping the heart. The lesions on the atria were created with RF probes.
This seems to be a very promising approach that is kind of mid way between what you had and what I had. Before Dr. Cox retired, he was working on a Maze procedure that did not require that the heart be stopped. This was his ultimate objective.
Thanks for the good discussion.