I went to OSU's Ross Heart Hospital Wednesday to see Dr. Hummel (a very personable fellow, who used layman's terms to describe the process) regarding the FIRM ablation that they are performing there. I was somewhat disappointed - because of an office move my records had not been forwarded to his new office, so he scanned them after I arrived. We also drove 3-1/2 hours each way and waited 1-1/2 hours to be seen. They have only performed 26 FIRM ablations there. He said they use a "basket" catheter which is larger on both sides of the heart and do the PVI as well as the FIRM ablation. It takes twice as long because they are basically doing 2 different procedures, which he said entails twice the risk. He listed all the complications that can happen - tho he said the ones he'd done had all gone well - and did not seem especially encouraging. He said I could: 1. Wait until the medication I'm on fails and then do the FIRM ablation, as time goes by they will have more experience and data. 2. I can go ahead and have the FIRM ablation now. 3. Because my afib episodes seem to be vagal in nature, he said I could consider a mini-maze. He asked if I would like to talk to Dr. Sirak about the 5-box mini-maze and I jumped at the chance. So we waited a bit longer and spoke with him. He is claiming a 96% success rate, says he has done 350 over the last few years with less than 1% complication rate and thought he could help me. Dr. Sirak used a lot of scientific terms and which were harder to grasp, but he seemed passionate about the procedure and competent. He said it would entail 3 nights in the hospital. He also said to email him with questions if I thought of any after I left.If anyone is interested in this procedure, his website (ohioafib . com) describes it and afib in general and compares catheter ablations and the mini-maze procedure and also has a video showing the 5 box procedure. It was a tremendous amount of information to take in in such a short time and I felt like my head might explode by the time we left:P I am going to have my records sent to the Cleveland Clinic for a opinion -- you can do that with or without an actual visit -- and perhaps see what my local hospital (University of Michigan) offers in the way of the mini-maze. For now I am not in a crisis situation, but I am only too aware that I could be at any time and I want to have an action plan if (actually when) my afib shows up again. I don't want to have to make a decision this important while in crisis mode. I hope this info is of some help to anyone considering this procedure. I am slightly overwhelmed, but want to continue gathering information and let it percolate thru my stressed out brain and hope I will be able to come to a decision that is right for me. I would like any thoughts or advice anyone has on all of this.
Thanks for sharing your "learning"... as I am a permanent AFib none applies to me. I am sure fibrosis has set in and one who is not in permanent AFib needs to keep in mind that binging in AFib makes it harder to stop. I believe one who goes back and forth between AFib and NSR will not be likely to develop atrial fibrosis and can still be cured.
Dr. Hummel said my left atrium is somewhat enlarged, but not terribly so. I Thanks for your input. I am acutely aware that I don't have forever to decide this and was really feeling stressed in December when I had 2 afib episodes 2 weeks apart. I was totally blindsided because my doctor had thought I could get off the anti-arrythmics and all of a sudden I was confronted with needing to find another answer. All I know for sure is: I don't want a permanent pacemaker unless there are no other options, I don't want to go into permanent afib if it can be avoided, and I don't want to try anymore anti-arrythmics. That pretty much just leaves ablation and/or a mini-maze as my options. Having 2 or 3 ablations and then possibly having to have a mini-maze to get rid of the afib after all doesn't seem logical. I am still pondering, but leaning toward a procedure I guess. The Cleveland Clinic seems a logical next step, at least to get an opinion. Thanks again for your support and advice. DD
That is a lot to take in and a lot to decide. If it were me I would do lots and lost of research into both procedures. I did a quick search on this forum for Mini Maze and a few posts popped up so check them out and see what others have said, I would then go online and get even more information on it and the FIRM procedure so you are fully informed what to do. The main thing I have found with cardiologists is they are fairly nonplussed about stuff. They have seen so much nothing much phases them so they can come off a bit cavalier about our personal case but that doesn't mean they don't want to help. It just seems when it come to arrhythmia procedures not matter what kind they not able to highly recommend anything because most arrhythmias are not deemed dangerous. I kind of think that mentality should change because over time it is detrimental to a person's heart but the way my EP put it to me is he is getting paid, my arrhythmia is not technically a danger to me but if he had it and he could he would ablate himself. But the bottom line is I think they try to tread a fine line trying to not seem like they are just after our money especially considering the high expense. I say this to not totally rule out the first doctor but the main thing I would do is really do as much research as you can so the fear about the procedures is allayed a bit. Then you can sit with both and make a better gut decision on which truly is the best option for you. I do not want to push you either way but I do kind of agree that doing something is better than nothing because from what I have been reading is afib does generally get progressively worse so it might be wise to try something to fix it for good. But do research so you can make your choice once you have both options clearly understood. I wish you the best of luck and much success whichever route you choose to take. Please keep us up to date.
As always, you have a way of breaking a problem down and making it seem more manageable. Doing the research is a good idea because the more I know the better off I am, tho I know everyone doesn't feel that way. You are right, when I have the information, my choice will become clearer. Dr. Sirak is the one who does the 5 box thorascopic mini-maze procedure and I believe there are quite a few posts from people who have had that done. Thank you for your advice, I am truly grateful. I want to have a plan in place in case I find myself in a crisis situation again. That is no time to be trying to figure out complex issues and I believe I will rest easier knowing what my next move is when it becomes necessary. Thank you again and bless you for all your support and help over the years. You've been such a help to so many.
I was on a website the other day and an expert on the forum (not certain he was a cardiologist or EP but I think he was) made a comment to the effect of, huge amounts of research time and money are going into a 'cure' for Afib due to so many affected individuals. It was that 'expert's' opinion that a 'cure' would be developed in the next 5-10 years. I thought that was rather encouraging. Due to your research, you probably know all about the latest efforts at a cure. Sounds like the FIRM ablation and/or the 5 box mini-maze are on the cutting edge of those efforts that may soon result in a procedure for afib with a very high success rate. I think we're fortunate to live in a time when technology evolves so quickly that it's not out of the question that a true 'cure' could exist in the near future.
I know we have follow each other's posts for years now, but I repeat as the subject was raised.
I underwent a mini-maze while I was open for mitral valve repair. My surgeon gave me about a 60% chance at a cure as I had an enlarged left atrium. At that time I was in AFib, but had a few months before been in NSA with the help of electrocardioversion and propafenone (rythmol). So it seems I had not yet reached a fibrosis state of the atrium. My surgeon didn't change his diagnosis following surgery and I was in NSR when I came out of surgery. As state before, that lasted about 30 days. My Cardiologist commented "he did a mini-maze" not a full "maze" - which caused me some feeling of being short changed. Still all I read about is mini-maze, not full maze. The rest of my cardiologist's comment was it takes less time to do a min maze. To this I add I didn't use the surgeon he recommended - hum, I didn't ask it that surgeon always did a full maze, whatever that is.
So, my experience says if one has an enlarged left atrium the mini-maze in not a 90% or better success rate as if heard on this forum for the 5-box. I do not have any specific data, just a poor memory on what I read here.
I am one of those 26 who have had a FIRM ablation with Dr Hummel. I have been a serious competitive runner for 32 years and when the A-fib started, I could no longer run. Now, 3 months after the ablation, I am up to 8 miles without stopping. The procedure took 8 hours as my heart was much more damaged then the Dr had thought, but the recovery was easy and I was only in the hospital for one night. After researching regular ablations, I know that this would not have been the case without the FIRM concept. I am not 100% but there is no cure for A-fib at this time and I am happy with the success I have had.
I am really glad to hear of your success with the FIRM procedure. Very impressive. How long had you suffered from afib before the procedure? Were you in persistent or permanent afib? What sort of odds did Dr. Hummel give you? Could you possibly elaborate on the procedure itself -- how you felt, were you put completely out, etc.? Are you still on meds? Still having any episodes at all? There is a journal entry you can use on this board or you could just put it in another post. I am most interested in this for all the reasons I listed in my posts above. Your post gives me hope that there is a cure out there. I note that I am only a few years older than you, so maybe there is also hope for me. I am pretty stable now (but not knowing how I'm going feel any given day and prone to dizziness and all the stuff that goes along with afib and the medications to keep it at bay), so I have been dragging my feet in going any further with this. You must have had your procedure about the time I was there for an evaluation -- mid July. Thank you again so much for letting me know your outcome. I will keep you in my thoughts and hope your recovery continues to go well.
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