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My A-Fib Update: Touch-Up Ablation and Closure of My Left Atrial Appendage
Background: I received my first catheter ablation back in 1998 at Bordeaux, France where they invented the procedure. (I was their first US patient.) After this ablation, I was A-Fib free for over 21 years. This is an update to my own A-Fib story (Story #1 under Personal A-Fib Stories of Hope.)
In 2018 my GP detected an irregular heartbeat, though I was unaware of it and had no symptoms. I had a Medtronic Reveal LINQ Insertable wireless loop recorder/monitor installed. (See Has My A-Fib Returned?)
Steve Ryan with Dr. Natale and his nurse before his ablation.
It eventually showed that my A-Fib had reoccurred−at age 80. This wasn’t surprising to me since my ablation procedure back in 1998 was primitive compared to what’s being done today. At that time, none of my Pulmonary Veins (PVs) were completely isolated.
I had a “modern” ablation in 2019 and was much improved. But my loop recorder showed Very Late Recurrence of A-Fib—I still had paroxysmal A-Fib.
Very Late Reoccurrence and the Left Atrial Appendage (LAA)
Recent research shows that the Left Atrial Appendage (LAA) is responsible for a great deal of A-Fib recurrence, (See LAA Under-Recognized Trigger).
Dr. Andrea Natale performed my re-do, touch-up ablation on August 19, 2021 at Los Robles Hospital in Thousand Oaks, CA. He isolated both my LAA and coronary sinus and other areas of my heart which had developed non-PV triggers. (See A-Fib Free Again.)
Need to Close Off My LAA
Unfortunately, the ablation work done on my LAA reduced its ability to contract properly. I was aware of this potential problem and discussed it with Dr. Natale. Because my LAA wasn’t contracting properly, there was a greater danger of forming an A-Fib clot there. But instead of going on heavy-duty anticoagulants for life, I opted fer a Watchman occlusion device to close off the LAA. So, a few weeks later I had the Watchman installed.
A-Fib Free, Once Again!
After my LAA was closed off I was on ½ dose Eliquis for a while. They also did a CT scan June 27, 2022 to make sure the Watchman was seated properly and didn’t have any leaks.
I’m now once again, A-Fib free! All is well.
My Battery Died!
LUX-Dx implantable loop monitor
My doctor continues to monitor my heart through my LINQ loop recorder (a tiny cardiac monitor implanted just under the skin near my heart). In June, the battery on my 3 year old Reveal LINQ loop recorder died. I now have a newer version (Boston Scientific LUX-Dx). It was installed by Dr. Shephal Doshi at St. John’s in Santa Monica, CA on July 7, 2022. This one should last 4½ years.
Technology marches on! My old loop record used a recording/transmitting device at my bedside. This new one seamlessly sends the daily data to my cell phone, then to Dr. Doshi for review. All has been quiet since.
Editor’s Comments
A-Fib Recurrence is Discouraging, But it Happens. It’s certainly discouraging to have A-Fib reoccur after 21 years. But on the positive side, I had 21 years of being A-Fib free! I was able to lead a normal, very active life (running, sprinting, high jumping, lifting weights, swimming, participating in track meets, etc.) I didn’t worry about A-Fib reoccurring and was surprised when it did at age 80. (In cancer research, anyone who is in remission for 5 years is considered cured. The same should hold for A-Fib.)
Why Does A-Fib Reoccur? We don’t know why A-Fib reoccurs in a small number of patients. It’s probably related to aging. But the good news is that EPs today know how to fix it and restore people to normal sinus rhythm.
Running on All Cylinders! I’m back to normal, running with no A-Fib. I may have lost some heart pumping ability when my Watchman was installed to close off my LAA. But it doesn’t seem to have much of or any effect. Curing my A-Fib was much more important. My speed isn’t what it used to be. But I am 81 years old and also had to have my left hip replaced two years ago which by itself made me seconds slower.
The bottom line is that, even though at age 81 I’m well past “my expiration date”, I’m in great health and am very active. I can’t thank enough all the EPs and researchers who made this possible.
Select an EP Who Maps and Ablates the LAA. No matter what kind of A-Fib you have, if closing off your LAA, make sure your EP knows how, is experienced at, and routinely maps and ablates the LAA. This may produce a more successful ablation and save you from a recurrence of A-Fib.
Concurrent Installation? Today, there is a trend toward closing off the LAA at the same time as your catheter ablation. If you are considering a catheter ablation, I urge you to discuss this issue with your EP.
To learn more about the Left Atrial Appendage, see my article, The Role of the Left Atrial Appendage (LAA) & Removal Issues.
