From reading about and visiting two thoracic surgeons recently, Dr. John Sirak (Ohio State University Hospital) and Dr. Robert Hagberg (Beth Israel Hospital, Boston), they are completing these ablations surgically with complete isolation of the PVI, plus over 85% success rate (success being defined by no Atrial Fibrillation, Flutter, ar VT for over 12-18 months and off medication after 6 months). Their patient population have been typically persistent or permanent AFib individuals????
Thanks for your response!
The most logical choice would be to have the SF ablation performed before the closure of the PFO. But it is still possible to cross the fossa ovalis after the procedure, but the position of the catheter may be limited in access to the posterior wall. I do not recommend a surgical approach alone, because this almost never results in complete pulmonary vein isolation ( especially in the anterior portion of the veins).