Wow, Din! What a trooper you are to take it upon your shoulders to interview a pack of pros, and then care enough to fill us all in on their comments. Those folks had to be impressed with your interest and professionalism. Feather in your cap, for sure. Sincere thanks for all you did. And also for the kind words in your closing.
Wish I had more time to get into this. But I’m in the middle of completing a crammed three-week course between terms... so I’m kinda strapped presently.
Anyhoot, did wanna give ya my feedback on a few items and also lay out some things I plan to follow up on when time allows.
Totally understand your take on the UoM article. It does seem a bit hyped. OTOH, the author -- presuming the truthfulness of the stated credentials -- isn’t your typical marketing / ad-guy, but a medical Phd. Moreover, I gotta believe -- based on the rep of the university -- that one or more of the participating cardios blessed the final draft.
On the paroxysmal / persistent issue. While the UoM article speaks in terms of the former, please note that the pages referenced below (from the Cleveland Clinic’s Heart Center and the University of Chicago) cite similar success stats (80 to 85% on the first ablation, and 95% for those requiring a “touch-up”; and 90%, respectively). But both pages explain that the stated procedure is indicated for both of the above flavors of AF (paroxysmal and chronic). (BTW, that isn’t the source of my original comments regarding the CC. Haven’t located that article to date. Sorry.) I agree that the exact meaning of the stated rates isn’t fully elaborated on. Easy to see how many folks could be misled.
http://www.clevelandclinic.org/heart...n_ablation.htm
http://heart.uchospitals.edu/service...rillation.html
You’re correct on the duration of the procedure. What I was alluding to wasn’t the one-hour deal, but the one involving the left atrium and the pulmonary veins. Stenosis is an important consideration that I believe is monitored at the time of the surgery and beyond. Think I’ve read that this is a concern, but a manageable one if it arises.
Also think you’re right with regard to the “who-knows-what-the future-will bring” notion. Seem to recollect that my MIA CC article defined success as remaining in NSR a year out and without meds. But years down the pike, who knows?
On the aspirin prejudice. My gut tells me the bulk of this stems from a legal basis, rather than a medical one. You know, once the industry proclaims an official protocol, God help the practitioner that deviates from it in a court of law. Throw into the mix the financial power of the big manufacturers, and its ability to persuade professional committees, politicos and the government.
Don’t mean to drag this out. But there’s a lot here.
The 20% figure for the lone species of fibbers sounds about right from what I remember.
Another interesting contrast. Unless memory fails, from my readings, the paroxysmal patient has a greater likelihood of a clot than one who is persistent.
Don’t have the access to cardios that you do. But wish we could both address those in the CC and the UoM. Haven’t seen much out of Hershey MC or the University of PA on this stuff.
Thanks for putting up with a sometimes, hardheaded student. Would love to hear your take on the above if you get a few minutes.
Best regards.
P.S. FWIW, saw a source indicating ablations were first done in 1991.
Would you like to comment?
