[HSF] A. Fib.

[Hgrmd at aol.com]

Ajit,
  Excellent points.  Nobody wants to have their chest split to  get their AF 
cured.  The key is being able to offer a full set of lesions  via a minimally 
invasive approach.  I can do that.  I just submitted  an abstract to the STS 
that outlines my methods and results in 107  patients.  Knowing the politics of 
AF, I'll be surprised if it is  accepted.  What I mean by that is the current 
big names in AF are on the  payroll of certain device companies.  It's an 
uphill battle to get power  sources from companies who don't play the game 
published, even though they may  be the most effective in my opinion.  If I'm being 
oblique and murky, I  hope you can read between the lines (I'm becoming a 
little more diplomatic in my  old age.).
  Your point about the "success" rate after a surgical maze is quite  apt.  
Cox's original papers showing a 95% success rate were based on  telephone 
interviews of the patients in which they asked the patient if they  still had 
palpitations and an irregular heartbeat.  It is well known that  patients often 
lose the ability to perceive AF, presumably due to  denervation.  
  My personal success rate is gauged on spot ECG's, 24 hr Holters, or  pacer 
checks.  Only the last method is truly reliable in assessing the AF  burden.  
Because of my interest in this field, I'm now striving getting  24hr Holters 
every 6 months for life.  As you know, a small, but steady  erosion in results 
occurs with time.
 
Hal



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