Video: A Live Case of Catheter Ablation for Long-Standing Persistent A-Fib Through 3D Mapping & ECG Images
Presented entirely through 3D mapping and ECG images, a live demo of ablation for long-standing, persistent A-Fib is followed from start to finish. Titles identify each step. No narration, music track only (I turned down the volume as the music track was distracting.)
3D mapping and ECG images show the technique of transseptal access, 3D mapping, PV isolation, and ablating additional drivers of AF in the posterior wall and left atrial appendage. (8:03) Produced by Dr. James Ong, Heart Rhythm Specialist of Southern California.
NOTE: Before viewing this video, you should already have some basic understanding of cardiac anatomy and A-Fib physiology.
YouTube video playback controls: When watching this video, you have several playback options. The following controls are located in the lower right portion of the frame: Turn on closed captions, Settings (speed/quality), Watch on YouTube website, and Enlarge video to full frame. Click an icon to select.
If you find any errors on this page, email us. Y Last updated: Sunday, February 19, 2017 Return to Instructional A-Fib Videos and Animations
In A-Fib for 15 Years, Eventually is Incapacitated, Unable to Work
By Terry Traver, Thousand Oaks, CA, September 2016
I’m a sixty-five year-old male and live in southern California. I am writing this because, as great as Steve’s site [A-Fib.com] is, there aren’t many stories from the west coast.
For over 15 years I suffered with A-Fib. It was not so bad. I stopped using caffeine and chocolate and cut back on my [alcohol] drinking.
Every three months or so I would have an episode that would last about 15 hours and then I would be fine.
Meds never really helped in my case.
A-Fib Progresses to the Point Where I Can’t Work
In 2011, my A-Fib became severe to the point where I was almost completely incapacitated [Persistent Atrial Fibrillation]. I was not even able to work.
Luckily, through a friend I was put in touch with Dr. Anil K. Bhandari, a clinical Electrophysiologist (EP)] at Los Angeles Cardiology Associates in downtown Los Angeles.
Ablation and a Touch-up at Good Samaritan Hospital in Los Angeles
In March 2012, I went in to Good Samaritan Hospital for a catheter ablation (wonderful Hospital and staff). I knew I was a difficult case, so I was not surprised when I had to return in July 2012 for a second touch up ablation (I think Dr. Bhandari was more disappointed than I was).
I knew I was a difficult case, so I was not surprised when I had to return in July 2012 for a second touch up ablation.
Afterwards, no sign of A-Fib. I felt great! At my 30 day return visit and I was told to use up the remainder of my meds and then discontinue them.
A-Fib Free for Five Years
I’ve been A-Fib free for five years. I still doesn’t drink coffee but enjoy chocolate and an occasional cocktail without worry.
Dr. Bhandari and the ablation was the best thing I could have done. I would like to add that the procedure is very easy. I was home the next day. I had no pain and had a short recovery time.
I have nothing but great things to say about my experience with Dr. Bhandari, his staff and Good Sam. Hospital, I live 40 miles north of L.A. and the drive was worth it.
What I wish I knew then or did differently:
• I would have had the ablation much sooner. No G.P. [family doctor] ever mentioned ablation as an option. I only heard about it from a friend!
• I had never heard of an electrophysiologist (EP), and wish I had seen one sooner.
• I would learn more about what my insurance covered and what expenses I could negotiate.
I also want to thank Steve Ryan for this wonderful web site. Good luck
P.S. For the guys: For bladder control during the catheter ablation, instead of a urinary catheter, Dr. Bhandari uses a condom. No insertion. Just sayin’.
I’m still amazed when an A-Fib patient tells me his family doctor didn’t refer them to a cardiologist, and more importantly, to an Electrophysiologist.
Atrial Fibrillation is a problem with the electrical function of your heart. Most cardiologists deal with the pumping functions of the heart (think ‘plumber’). It’s important for A-Fib patients to see a cardiac Electrophysiologist (EP)—a cardiologist who specializes in the electrical activity of the heart (think electrician) and in the diagnosis and treatment of heart rhythm disorders.
Terry writes that his GP did not refer him to an EP. Thank goodness a friend stepped in to help him.
It’s so important for patients to educate themselves to receive the best treatment. To learn how to find the right doctor, go to our page: Finding the Right Doctor for You and Your Treatment Goals.
The longer you wait, the worse A-Fib tends to get. Look at Terry’s story. His disease progressed to Persistent Atrial Fibrillation and was incapacitating.
A-Fib is a Progressive Disease—Seek your Cure ASAP!
Note: Dr. Bhandari is still with Los Angeles Cardiology Associates (213-977-0419), also now works at Cedars Sinai in Los Angeles.
If you find any errors on this page, email us. Y Last updated: Tuesday, February 7, 2017
Patients with long-standing Atrial Fibrillation are often the hardest to make A-Fib free. Because of having been in A-Fib for so long, they may have developed many A-Fib producing spots in their heart besides in the Pulmonary Veins (PVs).
Patients with long-standing Atrial Fibrillation are often the hardest to make A-Fib free
To make them A-Fib free, the electrophysiologist (EP) must ablate (isolate) not only the Pulmonary Veins, but also many non-PV triggers. Isolating the Left Atrial Appendage (LAA) significantly increased the success of catheter ablation in long-standing persistent A-Fib patients.
BELIEF Trial—LAA Isolation 76% Success Rate
In a randomized study (BELIEF trial), 173 patients with persistent A-Fib either received standard ablation plus LAA isolation or standard ablation alone. (If patients continued to have A-Fib, they could have a repeat ablation which included LAA isolation.)
At 2 years, 76% of patients who had received standard ablation plus LAA isolation were free of arrhythmia vs 56% of patients who had received only a standard ablation.
Dr. Luigi Di Biase, who presented the findings at the European Society of Cardiology 2015 Congress, stated “We do believe (LAA isolation) should be the standard of care in patients with longstanding AF.”
Isolating the LAA improved long-term freedom from persistent A-Fib.
But 52% Had Impaired LAA Function
Isolating the LAA can cause problems. If many burns have to be made at the LAA to achieve isolation, they may reduce the ability of the LAA to contract properly. … Continue reading this report…->