Second opinion on an ablation

Posted by oopsla @oopsla, Apr 24, 2023

What are the steps to getting a second opinion or maybe better expertise in getting an ablation for AFib? I had the procedure done 1.5 years ago. In the last half a year I've had more Afib episodes then ever in my entire life times 10. The doctor wants to do another but I think it is very prudent on me to get a second opinion or higher credentials at the very least.

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Ask the first EP what he/she would do differently, or what they'd look for. If they seem dismissive, find another EP. It isn't credentials that matters, it's skill. That comes with performing between 6-12 ablations every week, 48 weeks of the year. You want a grumpy, grizzled, 45 year old EP at the top of her class who hasn't seen a beach or a restaurant in 10 years. No, really. One of the very best, if you can see him inside of 5 months, is Dr. Andrea Natale in Austin Texas.

I am just finished the blanking period for my second ablation inside of seven months. The gentleman who performed my second is the same as the one who did the first. He told me up front that his success rate was near 75%, a bit higher with a second stab at it, which I granted him. I am now off everything except for a statin and apixaban, both of which are for life. BTW, my EP was Dr. Paul Novak who practices in Victoria, British Columbia, Canada. He was the Canadian Cardiovascular Trainee for 2002. Not too shabby.

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Get an expert doc. I will be 79 next month and had my only ablation, mitral valve repair, and LAAC all done by Doctor Boulton at WakeMed in Raleigh, NC. No AFIB ever since and off of Eliquis a few months after the surgery. I just cut my lawn. A 76 year-old buddy of mine had virtually the same procedure done by Doctor Boulton, six months after mine. He is doing great too.

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@gloaming

Ask the first EP what he/she would do differently, or what they'd look for. If they seem dismissive, find another EP. It isn't credentials that matters, it's skill. That comes with performing between 6-12 ablations every week, 48 weeks of the year. You want a grumpy, grizzled, 45 year old EP at the top of her class who hasn't seen a beach or a restaurant in 10 years. No, really. One of the very best, if you can see him inside of 5 months, is Dr. Andrea Natale in Austin Texas.

I am just finished the blanking period for my second ablation inside of seven months. The gentleman who performed my second is the same as the one who did the first. He told me up front that his success rate was near 75%, a bit higher with a second stab at it, which I granted him. I am now off everything except for a statin and apixaban, both of which are for life. BTW, my EP was Dr. Paul Novak who practices in Victoria, British Columbia, Canada. He was the Canadian Cardiovascular Trainee for 2002. Not too shabby.

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How can we Canadians have an ablation to be done in USA?

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You have to pay. They'll take anyone who qualifies for the procedure (after a thorough workup and consultation, of course), and whom they can fit into the schedule inside of a few months. Dr. Andrea Natale flies routinely to at least six other hospitals in the western USA and sees several patients each week. If he takes you, you would pay whatever rate they command. The idea is that it isn't free any more than Canadian health care is free. But in the USA you pay directly. You may have insurance that would pay a portion of the costs.

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