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Avatar universal

How to choose EP and where?

I was diagnosed with AFIB pre surgery for a broken bone. I thought I just had a severe issue with anxiety I had no idea I had a heart problem. My question is how do you research and decide where to go for the surgery and how to choose the EP that performs the surgery. I live in Chicago and we have some great hospitals ( Univ. of Chicago & Northwestern Memorial and others) in the field. But what criteria do you use to research the EP who performs the surgery? There are 5 to 7 EP's on a team, I am sure with different skills. How do you decide which to choose? They all say they can perform this ablation, how do you know who is better than who? How do you know if one hospital lab has more technology than another lab? How do you know if one lab is using the technology to avoid burning the esophagus? If I choose Cleveland clinic, that means I need to flight out there at least 5 times a year to visit with my EP post surgery to be evaluated. I have decided to have the surgery but my problem is choosing the EP to perform the ablation. Also how long will i be on the meds after the surgery (coumadin, tikosyn, metoprolol, lisinopril)?

Someone please answer my 4 questions:

Who (EP) & Where (lab)?
How long before no meds post surgery?
Can the location of problem areas be located before the surgery?
How can I research the % of patients that have a 2nd surgery and % 3rd surgery?

Thank you all
I am trying to gather as much info to plan this surgery

8 Responses
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Avatar universal
I have been on the Amiodarone since the last week of March 2010. I was kinda afraid to at first because of all the side effects, but i am taking it. When I go back to the Dr in March he is going to reduce the dosage I take with is 200 once a day. I am almost scared to go off of this, thinking I will go back into AFIb. But I don't think I will. If I do I will have the ablation done again.
Helpful - 0
996946 tn?1503249112
So how has it been on the Amiodarone?  I was afraid to try it.  Isn't it only for short-term use? I'm doing well on the flecainide so far.  I'll just be glad to get off ALL the medication!
Helpful - 0
Avatar universal
I go back to my doctor at Vanderbilt Hospital in March and he said that he will lower the dosage on the Aminodarone to see how I do. I am not on Coumadin anymore. I took the Tikosyn before and a few weeks after the procedure. I have not had of Afibs since then. I still experience some skipped beats time to time, but nothing serious. The surgery did help, because I was having episodes about every two weeks before.
Helpful - 0
996946 tn?1503249112
I had an ablation in Sept and for three months I had a-fib as bad or worse after the ablation than before it.  I was completely worn out.  Finally, after going on one, then another anti-arrhythmic drug, I was put on flecainide which I had taken yrs earlier with good luck.  The first week or two it wasn't working, then my Dr upped my med. to 400mg a day and for almost 4 wks. I haven't had any a-fib.  I will be on this until the end of Jan. but I'm wondering what will happen after that.  I did choose a very well-known EP and I don't question his credibility but he has already told me I will have to have another ablation in the spring, most likely.
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Avatar universal
You had this surgery and you still need to be on Tykosyn? Did the surgery not help you at all? Are you off any of the medications that you were on before the surgery? I understand that Coumadin may be there for life for those of us that had or will have the surgery but what about these other drugs? How long are you going to be on Aminodarone?
Helpful - 0
86819 tn?1378947492
Hi. These are not easy questions. There are several angles to this. These days you can research people on the internet. Some potential starting points are the US news best hospitals issue which identifies high performing hospitals in several medical areas. Once you have a hospital, you can often go to their website and read about their specialists. Some web sites even feature video of their doctors.  

My personal preference would be for a more experienced doctor who is very prudent in terms of risk taking, and does not have any bad history. For instance, I was able to find an article on line about one doctor who managed to injure someone really badly. I also see some doctor performing controversial procedures during research activities. My issue is not drop dead serious, so I do not need excess risk taking. While I need someone experienced, I do not need someone who will just hall off and do something risky because they are accustomed to doing it.

I prefer somebody that does not have a lot of BS, and shows genuine concern for his patients. I hate to say it, but with this sort of approach, until you meet people face to face, or actually see them in action, its really hard to choose.  On video, you know the doc is gonna be on good behaviour, as they would be (hopefully) if you met them for the first time. But I did travel on one occasion to a very well known facility, and while sitting in the waiting room, had an opportunity to witness one "highly respected" doctor do something to an older patient in a wheel chair that I did not find admirable. So much for that doctor.  He might have a great reputation for his research, but after seeing that, I would not trust him with my lucky rabbit's foot, much less my heart.

I am also a little sheepish about going with a doctor who acts too eager to start burning tissue right away.  The people in demand aren't so "needy" --- they can get all the patients they want to fill their schedules and will probably ask you to come back several months later for your procedure, as opposed to, say, "within 24 hours".

If you have time, take your time with this. Its important.
Helpful - 0
1273759 tn?1270994245
i had mine done at UVA by the head of the Atrial Fibrillation Clinic which you would think was the very best choice of dr.'s but 3 months after surgery i feel the same as i did pre surgery. if your heart has rhythm issues i'm convinced it will always have some sort of rhythm issue even if your surgery helps for a period of time.
Helpful - 0
Avatar universal
I had my abalationfor AFIB in February 2010 at Vanderbilt Hosppital in Nashville Tennessee. My doctor referred me to this hospital. The hospital is super great as with the doctor. I was on coumadin a couple of weeks before the procedure and a few weeks after. I was on Tikosyn before and after the procedure. I broke thru on the Tikosyn and was changed to Aminodarone the last week of March. I still have skipped beats every now and then, but other than that I am doing good. If you read on this site you will find people that has had this procedure done more than once.
Helpful - 0
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