[HSF] A. Fib.

[Ajit Damle]

Hal,

 

I agree with you on most points. Unfortunately both the drug and device
industry is driven by physicians with conflicts of interests. That is how it
is.

 

What I do want to point out, though, is the great reluctance of patients for
invasive procedures. Combine this with the referring cardiologists
preference (bias) and you see why a. fib treatment, like the NYT said, is
all going to be endovascular.

 

Ajit

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Hgrmd at aol.com
Sent: Saturday, July 07, 2007 12:18 PM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] A. Fib.

 

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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