Afib, dextro cardia, ablation - can it be done and where

Posted by dclifford47 @dclifford47, Oct 21 7:07pm

Diagnosed with afib about 2.5 years ago. Went through several cardioversions, was in amiodarone, am on metoprolol. My afib attacks are not horrendous. My EP, no more cardio versions and no ablations. I realize an ablation is not a small deal, but am wondering if it would put my afib to rest. Does anyone have any information or familiarity with ablations and dextro cardia situs inversus?

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Hi there. I can only speak for myself. As soon as I read about catheter ablations, I wanted one. The previous week would have been great.

If you are asymptomatic, you are way ahead of a great many of us who know immediately when we enter AF. It can be awful and unsettling. For some really unfortunate people, theirs comes one when they recline in bed at night. Imagine trying to fall asleep like that. In my case, I was symptomatic during the episodes, but they never took place at night to my knowledge. But the daytime experience was enough to make we want anything that could rid me of the symptoms. That's point one. Point two was that I did a LOT OF reading and learned that when the heart gets electrically disordered, it usually progresses from paroxysmal episodes (they come and go on their own) to persistent, and then to permanent. This can be in a few weeks or a few years, with me being the latter type. As my episodes became more frequent, I began to get snarky about being referred to an electrophysiologist, and thank the Good Lord I got a good one.

AF won't kill you, at least not soon. It can make your life awful, though, if just due to anxiety. So, I couldn't wait to get an ablation once I knew what was involved, why the heart fibrillates, and how ablations work to stop the electrical signals from entering the left atrium in more than one location. ...which is why the atrium fibrillates.

You have a complication with situs inversus of the heart. It means your heart is oriented unusually in your chest. I am insufficiently informed to comment on this, but I would really want to understand why your cardiologist has ruled out an ablation...if I read your post correctly. And I would then seek a second, and even a third opinion. In fact, I would suggest you consult with either Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin (you can google him) or with Dr. Pasquale Santangeli at the Cleveland Clinic. They're both at the tops of their EP fields. Your aim is to finally accept that you indeed are not a candidate for ablation, even a simple pulmonary vein isolation ablation, or learn that something more complicated that a real crackerjack EP would be happy to do for you is possible if you can wait in line for four or five months (if that long).

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@gloaming

Hi there. I can only speak for myself. As soon as I read about catheter ablations, I wanted one. The previous week would have been great.

If you are asymptomatic, you are way ahead of a great many of us who know immediately when we enter AF. It can be awful and unsettling. For some really unfortunate people, theirs comes one when they recline in bed at night. Imagine trying to fall asleep like that. In my case, I was symptomatic during the episodes, but they never took place at night to my knowledge. But the daytime experience was enough to make we want anything that could rid me of the symptoms. That's point one. Point two was that I did a LOT OF reading and learned that when the heart gets electrically disordered, it usually progresses from paroxysmal episodes (they come and go on their own) to persistent, and then to permanent. This can be in a few weeks or a few years, with me being the latter type. As my episodes became more frequent, I began to get snarky about being referred to an electrophysiologist, and thank the Good Lord I got a good one.

AF won't kill you, at least not soon. It can make your life awful, though, if just due to anxiety. So, I couldn't wait to get an ablation once I knew what was involved, why the heart fibrillates, and how ablations work to stop the electrical signals from entering the left atrium in more than one location. ...which is why the atrium fibrillates.

You have a complication with situs inversus of the heart. It means your heart is oriented unusually in your chest. I am insufficiently informed to comment on this, but I would really want to understand why your cardiologist has ruled out an ablation...if I read your post correctly. And I would then seek a second, and even a third opinion. In fact, I would suggest you consult with either Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin (you can google him) or with Dr. Pasquale Santangeli at the Cleveland Clinic. They're both at the tops of their EP fields. Your aim is to finally accept that you indeed are not a candidate for ablation, even a simple pulmonary vein isolation ablation, or learn that something more complicated that a real crackerjack EP would be happy to do for you is possible if you can wait in line for four or five months (if that long).

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Hi, I really appreciate your answering my post and quite adequately. Lots of good advice, which I'm sure I'll follow through on most of.
I'll keep posting as my journey progresses.
Thank you

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@dclifford47

Hi, I really appreciate your answering my post and quite adequately. Lots of good advice, which I'm sure I'll follow through on most of.
I'll keep posting as my journey progresses.
Thank you

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I would search "ablations and dextro cardia situs inversus".
You can use google scholar and also PubMED
https://pubmed.ncbi.nlm.nih.gov/?term=dextro+cardia+situs+inversus+ablation
The degree of difficulty is probably high due to your heart, arteries veins and a couple of other organs are on the opposite side of your body. Everything is backwards. I read a couple of the articles and found that a few have tried procedures used for you condition.
I would narrow down your focus to find someone or even an institution that has done this procedure successfully. Your doc obviously is not helpful. Not that he or she should try the procedure but should help you find an alternative.

REPLY
@gloaming

Hi there. I can only speak for myself. As soon as I read about catheter ablations, I wanted one. The previous week would have been great.

If you are asymptomatic, you are way ahead of a great many of us who know immediately when we enter AF. It can be awful and unsettling. For some really unfortunate people, theirs comes one when they recline in bed at night. Imagine trying to fall asleep like that. In my case, I was symptomatic during the episodes, but they never took place at night to my knowledge. But the daytime experience was enough to make we want anything that could rid me of the symptoms. That's point one. Point two was that I did a LOT OF reading and learned that when the heart gets electrically disordered, it usually progresses from paroxysmal episodes (they come and go on their own) to persistent, and then to permanent. This can be in a few weeks or a few years, with me being the latter type. As my episodes became more frequent, I began to get snarky about being referred to an electrophysiologist, and thank the Good Lord I got a good one.

AF won't kill you, at least not soon. It can make your life awful, though, if just due to anxiety. So, I couldn't wait to get an ablation once I knew what was involved, why the heart fibrillates, and how ablations work to stop the electrical signals from entering the left atrium in more than one location. ...which is why the atrium fibrillates.

You have a complication with situs inversus of the heart. It means your heart is oriented unusually in your chest. I am insufficiently informed to comment on this, but I would really want to understand why your cardiologist has ruled out an ablation...if I read your post correctly. And I would then seek a second, and even a third opinion. In fact, I would suggest you consult with either Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin (you can google him) or with Dr. Pasquale Santangeli at the Cleveland Clinic. They're both at the tops of their EP fields. Your aim is to finally accept that you indeed are not a candidate for ablation, even a simple pulmonary vein isolation ablation, or learn that something more complicated that a real crackerjack EP would be happy to do for you is possible if you can wait in line for four or five months (if that long).

Jump to this post

Hi! I live in Canada and have had AFib since 2016. I have been under the care of a cardiologist and have had more frequent episodes of fibrillation. I have been booked for a catheter ablation but because of our lousy healthcare system I have to wait for a date for three to six months. Apparently it’s due to lack of gov’t funding. I am 78 and the prognosis is good since I’m healthy other than the AFib. The palpitations are becoming more frequent so I will be glad to get the surgery done.

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Your story is like mine. Getting an ablation, but from the 'right' electrophysiologist, is 75% certain to have you back in NSR for a long time, maybe permanently. If it turns out you need a 'touchup' or a redo, the probability of success rises to 80%. Good luck.

REPLY
@gloaming

Your story is like mine. Getting an ablation, but from the 'right' electrophysiologist, is 75% certain to have you back in NSR for a long time, maybe permanently. If it turns out you need a 'touchup' or a redo, the probability of success rises to 80%. Good luck.

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Thanks so much for your follow up info. I see my EP the beginning of Dec, and this will be my main topic of discussion. I've been told there is no one local that has experience with dextro cardi and ablation, there may be someone in LA. I'll keep you posted.
Thanks again.

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@teacher2001

Hi! I live in Canada and have had AFib since 2016. I have been under the care of a cardiologist and have had more frequent episodes of fibrillation. I have been booked for a catheter ablation but because of our lousy healthcare system I have to wait for a date for three to six months. Apparently it’s due to lack of gov’t funding. I am 78 and the prognosis is good since I’m healthy other than the AFib. The palpitations are becoming more frequent so I will be glad to get the surgery done.

Jump to this post

Sorry to hear it's going to take so long for an appointment. Hopefully sooner than later. You're not the first I've heard from regarding the time lag in Canadian appointment scheduling. Whenever it happens, wishing you luck for a successful ablation that lasts permanently. Please keep us updated. 😁

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@dclifford47

Sorry to hear it's going to take so long for an appointment. Hopefully sooner than later. You're not the first I've heard from regarding the time lag in Canadian appointment scheduling. Whenever it happens, wishing you luck for a successful ablation that lasts permanently. Please keep us updated. 😁

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Thankyou!

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