Atrial Fibrillation and Catheter Ablation | NEJM
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- čas přidán 1. 06. 2024
- In this instructional video, Drs. Jane Leopold, Elliott Antman, William Sauer,
and Paul Zei provide an overview of the classification and diagnosis of
atrial fibrillation, management strategies, and mitigation of stroke risk with
anticoagulation therapy.
The video also focuses on the new rhythm-control strategy of catheter
ablation therapy, with attention to the success rate, potential complications,
postprocedural monitoring for recurrence of atrial fibrillation, and consideration
of ongoing anticoagulation therapy in these patients.
The New England Journal of Medicine is the world’s leading general medical
journal. Continuously published for over 200 years, the Journal publishes
peer-reviewed research along with interactive clinical content for physicians,
educators, and the global medical community at NEJM.org.
0:00 Pathophysiology and Symptoms
3:11 Stroke Risk, Anticoagulants, and Arrhythmia Control
6:32 Catheter Ablation
10:11 Post-Procedural Monitoring and Care - Věda a technologie
I had Catherter Ablation Surgery today January 24th 2024. If you find your way to this comment, I wanted to say it was well worth it. It was a pain-free experience for me. I was very nervous, but when I was wheeled into the o.r. and saw the number of people in there for me it made me feel at rest. When I woke up, I was no longer in Afib. My doctor and all the nurses and the whole team were amazing.
what type of AFib did you have. I have paroxysmal AFib and I hardly have episodes but my anxiety of worry if I am going to get one and when . I am scheduled for a cyro on 2/21/24 I am scared . I worry if I made the wrong decision 😢
I’m 82 and diagnosed with Afib 1-1/2 year ago along with having trachycardia and braychardia, so a pacemaker was installed. Was zapped last year, but now find I am in Afib again for over a month. Praying my pacemaker doc will decide for correct choice between another cardioversion or a cryoablation at appt on Friday. Need prayers.
I was released this morning following ablation yesterday with some complications. I developed right atrial flutter and need to return for another, but shorter ablation. The procedure went well and I'm feeling better. Thanks to Department of Veterans Affairs.
@@ronchiles399I’m 29 and had a catheter ablation last month didn’t work for me, doctor couldn’t even find where it was generating from 😢 they just dismissed it saying we tried let’s see if it works it didn’t work I’m having atrial flutter more severely. I’m waiting for a review in 4 months let’s see what happens next. Please pray for me ✌️
I’m 29 and had a catheter ablation last month didn’t work for me, doctor couldn’t even find where it was generating from 😢 they just dismissed it saying we tried let’s see if it works it didn’t work I’m having atrial flutter more severely. I’m waiting for a review in 4 months let’s see what happens next. Please pray for me ✌️
Had an ablation in 2018 after feeling tired etc.
Lasted till January 2024.
Had 2nd ablation on April 22,2024, both groins went up.
Was still in afib, stayed over night, had a cardio version ( shock treatment) and I’m in sinus rhythm.
I’m learning this key things for afib.
1- being overweight
2- alcohol use- wine for me
3- eat small meals
4- watch salty foods
5- stay hydrated
I am about to have an ablation procedure. This was an excellent video explanation of what it is all about. Special thanks to the Doctors and specially, the the video writers, producers. animators, cameramen, etc, etc.
I'm scheduled to have an ablation in 3 weeks. This video was super helpful!
I’m having it done in 2 days. Wish me luck!
How did it go?
@@user-iz6yt7uq3b went well. Home within 8 hours. Already back to work. Groin was sore. Other than that , no pain. No afib occurrences either. Highly recomend.
@@user-iz6yt7uq3bit went smoothly. Groin was a bit sore, but that’s it. No reoccurring episodes of Afib as of yet. Back to full duty already. Highly recommend.
Good to know! Thanks!😊@@Streetdoc72
Did you have to have a Foley catheter?
Thanks to all the doctors and nurses working on making this a disorder that can be easily controlled or healed.
I'm Japanese and I've been wondering for nine months if I should have catheter ablation. Because of this video, I got to get a basic knowledge of atrial fibrillation and its treatment. Thank you very much.
Fantastic overview, thank you! I presently have a irregular heartbeat, which has caused some concern for myself, as I am a extremely fit and active older guy. My cardiologist has been trying to keep things in check with channel blockers and BP medicine, and doesn't want to utilise ablation quite yet.. I appreciate his conservative approach but feel I would like him to take that next step and do the surgery, any improvement right now is more than appreciated.
This fine video put me that much more at ease listening to the surgeons and their approaches to the treatment and risk assessments..
Good overview, I've been an a-fib patient since 1989, and have had 5 ablations since 2002. This video is consistent with my experience...
I just had my ablation yesterday…this is my own experience coz before i go for it i have watch alot of youtube channel and read comments..some are positive some are negative😂but actually its a straight forward procedure…i was admitted at 5:30am and its started around 8am…they have taken me to operation theater fix all the wayers…an talking to me…thats all i remember only when they wake me up said all done…so far i dunt feel any pain or discomfort its just my groins have very less pain..so dunt be scared just go for the treatment the importance is the hospital and doctor get some one experience❤
Great video - very clear and insightful.
This is amazing! Having had an ablation 2 years ago and doing a lot better, I feel better knowing that this procedure is advancing and getting better. Don’t want to go through the procedure again but, I would if I need to.
Why did it not be something to not wish go through again? I don't like most any procedures but why this one particularly with you. Did it work 100%.
@@dannylaw7367 I can agree with him. I had mine done years ago and the arterial puncture was rather painful. I was not sedated as well. Laying there knowing and feeling the catheter going up your artery up into your heart is scary and un-nerving. It is a surreal experience, having to lay there whilst they meddle with your heart. I don't think heart surgery is something anyone wants to repeat but everyone's experience is different.
I have Paroxysmal Afib. Waiting for FDA approval of Pulsed Field Ablation. Should be by the 2 or 3rd quarter of 2023. RF or Cryo Ablation seems like a blunt instrument compared to Pulsed Field Ablation has been described. 65 yo. fit and active.
I love this educational video. I hope we will see more of these! Thanks NEJM.
This is a life saving procedure on the long run.
I have AFib, and I had an ablation therapy in 2014. Before my ablation when my heart went out of rhythm, I ate jalapeño peppers to put my heart back in rhythm.
How are you feeling now?
I feel pretty good. Since my ablation I have a heart rate that misses a beat. It is no big deal.
@@TO-ps2qq That's great, getting mine on the 24th so a bit worried it could go wrong 😬
I can understand your thinking. I was concerned before mine. I tried to let everyone know, what happens to me after anesthesia.
I am glad I had it completed. My big regret is I waited 9 years from diagnosis to ablation.
Very informative. I've had afib since a PE-induced heart attack in 2011. I have idiopathic multifactor thrombophilia for which I'm currently taking Eliquis. I took Coumadin for 11 years. My cardiologist recommends I do nothing unless the afib becomes more frequent. I hope he's right!
Wonderful presentation of information which affects a huge subset of the population.
I started having Heart Rhythm issues during the pandemic. I tried several different medications to relieve the occurrence of the symptoms. For me the medications were sucking the life out of me and only Amiodorone helped to make me feel better. My doctor told me that Amiodorone had some long term side effects so it wasn't a good remedy for me. We chose an Ablation as the best option for me but it took almost 2 years to get in for the procedure. I had the Ablation two weeks ago and so far it has not worked at all. I am losing hope day by day and won't know for a few more months what will happen moving forward.
Great video! Very knowledgeable interviewees and explained things is plain, matter of fact wording.
The presentation is wonderful.
ממש תודה רבה על הסרטון מהמם
I just started having afib out of the clear blue sky. Sudden and scary. I went to a cardiologist and am going to need a pace maker but can't get one. Im looking into this
In constant afib. Did not know until doctor told me. Immediately started on Eliquis and meterplol, then Cardioversion which corrected for 48 hours. Back in afib, still can’t feel it but now I know how much better I feel when in normal rhythm. Doc wants me on chemical control Flecainide instead of ablation. That’s 42 pills a week. Im trying to get her to sign me up for ablation instead of the pills. Im 63 so I’ll prob always be on 28 pills a week regardless but better than 42. Good luck to everyone battling this common issue. 🍺🇺🇸
What’s the reasoning
@@joeskwara5823 I’ve protested the additional pills and they have agreed to do the ablation procedure. There reason was to use the least invasive method. 01 Aug… I hope it works. 🇺🇸🍺
If I were you I would contact Andrea Natale in Texas Cardiac Arrhythmia in Austin Texas. He is the best in US and is a pioneer/researcher in this ablation procedures. You surely can't find anyone better then him and most (if not all) difficult cases are directed @ him.
@@denissartisskis1625 thank you. That’s very nice of you
@@joeskwara5823 You are welcome. Just a note : if you decide to see him make sure you prepare the questions you want to ask before the visit. He is very busy man and spends most of his time in operating room making sure his patients procedure is done right and to the best of his abilities. Otherwise all the questions you did not ask him duaring the visit will be directed to his nurses. He did my procedure.
Just diagnosed with Afib last week out of the blue after heavy palpitations, I am in my 30s. Hopefully after echo and other tests things come well. However cardiologist already mentioned an ablation probability. That is why I am here.
I am 55 just had this done last Thursday. The procedure is very tolerable . If your doctor recommends it go for it .
I was out same day . Bit sore and some discomfort, but there is nothing painful about this
much younger much better,take the ablation
Had afib symptoms since my late teens. Very infrequent but discomforting and annoying when they occured...but I lived with them and ignored it. Fast forward to when I'm in my 50's and the episodes get more frequent and last longer. Came back from Hawaii July 18th 2018, a day later I'm sitting in the living room having a very long episode. My wife sees me and has had enough. She says let's go and off we went to the ER. Two months of tests, monitoring, exams..doc says I have garden variety afib. Surgery was simple enough, no pain, went home the next morning. Took it easy for a couple weeks as the doc ordered and we were back in Hawaii on a short getaway vacation November the same year. Afib surgery Sept 2018, hiking in Hawaii Nov 2018.
Long story short...don't fear the procedure. It's easy and doesn't hurt other than normal muscle soreness from the drugs they use during surgery.
@@cryhavoc38were u hiking b4 the surgery?
I’m 34 having my ablation on Oct 11.
Had Three Ablations done, then the watchman procedure. Had a stroke 2-3 weeks after COVID vaccination i was 55 not 80.
Said a prayer for you.
I am so sorry to hear that you went through so much. Sending 🙏🏻 your way for better health and peace of mind.
A lot of people had adverse effects to their heart due to the Covid vaccine… 20yo+
I just got to watch an ablation procedure first hand last week. It was an amazing experience and my client did very well. I help people find out of country heart surgeries after I had to do the same in 2022.
Why would one go out of the country for a cardiac ablation?
@@paulbentivegna8014 Because often people are put on medications and then told to wait in line for a long time. The quality of life during this wait and the further damage to the heart entices people to find other options.
@@paulbentivegna8014 more than likely coso
I go in on April 18 this very helpful very scared
This is such a new treatment am concerned that what they are proposing is going to be seen as unnecessarily risky. However, am grateful that I am merely an hour away from Brigham/MA General for care.
Not really new. And advancements continue to get better and better yearly.
Having it done at Boston Medical on Friday. If you can, Dr. Robert Helm is a Godsend. We worked on this plan for almost two years of monitoring. He has found two areas that have nerve bundles sending conflicting signals into my heart from pulmonary veins. This will require cryo and heat ablation in a three to four hour surgery. We got this!
Don’t need to know how to build a car. How is it done, would I be awake and aware or not I’ve seen multi videos some saw awake and some put the person totally out.
I had mine done yesterday. The anaesthesiologist keeps you at a dream state so that he can coach you through your breathing. The Dr. is mapping your heart and is cauterizing circles around the problem areas. If you take a deep breath, it moves the probe that burns. And you don't want to burn the wrong places. So, while you are awake, you need to conscientiously breath with shallow breaths so that the probe doesn't move. I can tell you that you will not feel a thing. I also recall starting to snore and he just moved by jaw to stop my snoring. I was asked if I felt pain during the event, and told to move my chin, but you will still be in partial state of la la land.
I'm a bit hairy, and perhaps the most painful part is the shaving and then the removal of stickers from my chest, sides, back, arms ... I would guess that there was like over 40 stickers. Perhaps a good shave at home with cream, is better than the dry electric shave that still leaves whiskers that still hurts when pulling them out. No stickers were placed at my groin, but that too is shaved now.
im 40 and going to get wolf-otsuka procedure real soon that will remove the LAA as well and perform abalation from outer side of the heart. Doc told me the younger you are and get the ablation the higher success rate. I am scared as it is a minimal invasive procedure that uses something im not sure but will have 4x 2cm scars on both side of my uper rib cage. I am not able to get on blood thinners due to Ulcerative colitis with constant bleeding in the colon.
If you have not already, please consider a gluten-free food plan, cabbage juice in the daily and buteryc acid/ hydroxibuterate
Went to V.A. today, was told I'm in a-fib a lot,,, talking about pills to take for 3 days, hospital stay, If that doesn't work, then ablation is next,,, Really dragging me out,,,,,,, Had this Medtronic 8 years now, battery to be changed soon,,,
I have paroxismal supraventricular tachycardia (psvt) . Does anyone have this too? If someone else has this, I have a question for you: does it require surgery? I use medication to keep it under control.
Yes. Get the surgery
Yes, tried various meds for two yrs. some worked for a while, with some side effects( Raynaud's syndrome). Afib came back every time, 40- 50+hr. duration. Going in for this in Boston first week of Feb. Fingers crossed. Have bad symptomatic afib, so tired of it. Great doctor, can't wait to get my active life back. 62, not dead yet!!
meds not working for my SVT or PVCs :(
@@uk7769It took two years of various meds and monitoring with an implanted loop recorder to finally isolate my issue as a pulmonary vein issue, sending conflicting charges into the heart. Going in Friday for a cryo blation.
If my heart rate went from 55 to 85 after suffering 6 months of symptoms of AFib and they do a catheter ablation should my heart rate return to the 55 because it did not it has stayed at 85 doctor's response was that's not my problem That's The ventricle doing that I'm just here to fix the atrium flutter what's your take on that
not very good bedside manner is it? I'd look for a second opinion and maybe a different, kinder doctor.
Orange county california....try Dr. Aseem Desai 😊 very nice and very professional! Probably performed a thousand ablations... having mine done in 4 weeks... excited and ready to put this behind me! Hate all the meds and lack of energy!
This is crazy how many of us are suddenly effected by this.
Dr John Campbell has some good information on this also, from the UK. Seems more people worldwide are being effected.
Good luck to everyone 💓 🍻✌
DOAC's can strongly interact with supplements by way of CYT P450 supergroup pathways and most MD'd aren't yet even aware. Be very careful with interactions if you're taking orthoemolecular supplements.
I have white wolffe syndrome and they going to burn something in my hart never dizzy or pain
I also have that also
@@phoenixflash1 I just had my ablation this past week. It was really easy. WPW syndrome is easily fixed with ablation.
I just had my ablation this past week. It was really easy. WPW syndrome is easily fixed with ablation.
ممتاز
I’m 36 getting ready to have a ablation 😢
Did you get it done? Mine is set to take place the beginning of October...big time nervous! I hope all is good and you are doing well?
@wza223-fo3mc I ended up getting my cryoablation Sept. 20th. Dr. Desai in misson viejo cali. is my doctor. Let me tell you this dr. know what's up! Everything thing was smooth and professional! Everything is going well and I should be getting off blood thinners in a few weeks (blanking period is up) I feel so much better. My heart doesn't race. I just got back from yosemite (hiking and biking)
Still in sinus rythem. It's scary to get it done, but once you get it done, you look back and think that wasn't hard at all! If your Dr. Says you need the procedure I would definitely listen to what they are saying. Easy peasy! If I had to do it again I definitely wouldn't hesitate! I hope this helps!
@@edc1969 thanks for sharing did you ever find out what caused your afib?
@wza223-fo3mc No, don't know what caused it or how long I was living with it. Just started getting out of breath and tired. Did vape thc, but I quit cold turkey when I started worrying about the afib. I'm feeling much better . Hope this is helpful! Take care!!
Why would you Ablate the inside of the pulmonary veins when they are just muscle? The problem is on the outside of the heart. You're trying to burn up to that area and you do probably get some of the outer nerves but most people need 2,3,4 or more to get some relief. I don't like those percentages.
WELLDONE
it ends when you kick the bucket
well intentioned for sure but these people themselves don't appear very healthy
Experimenting on patients 😂😂😂😂Lucky profession 😂