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Questions to  ask EPs or Surgeons about their Procedures for Treating  Atrial Fibrillation

 

The questions below can be copied and pasted into your email, or you can use the list to prompt you when you call a doctor's office to ask questions.

 

I would suggest that you call first to find out whom to email or call, and to introduce yourself as a prospective patient, so that they will be expecting your message or call. You may want to arrange to email some details of your case, followed by a telephone call, if necessary.

 

The questions can also copied to Word or another word processor where you can edit them or set up tables or forms for you to type or write in answers. You can make a separate sheet for each doctor you contact.

 

The best way to get answers to your questions is to ask them face-to-face during a paid consultation. Here you can benefit from the back-and-forth attention to detail that can be so difficult when using email or the phone.

 

Make sure you get answers to all your questions. It is easy to get carried away by a doctor's enthusiasm.

 

The traditional patient role has been to be passive and obedient. Nowadays, more doctors are allowing  well-informed patients to be active in determining the treatment that will be most effective for them.

 

You will need to select questions based on the type of procedure you are asking about (CA vs. surgery).

 

 

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Questions for EPs, surgeons or one of their staff about their procedures to treat AF

 

Please note: The most important questions are in bold face.

 

[Say that you appreciate very much the person's taking the time to answer your questions.]

 

[Say how you heard of the doctor to whom you are consulting. Referral from another doctor known to the one you are contacting to may help make sure you get your questions answered, and might get you other special treatment, such as being put ahead on the waiting list..]

 

[Begin with a brief history of your AF, including duration and frequency and what has been tried. Also include any work that has been done on your heart or that you think might need to be done. Keep in mind that some EPs at least give lip service to the criteria that the patient must have failed one or more antiarrhythmic drugs.  Failure can usually mean inability  to tolerate side effects as well as lack of effectiveness. ]

 

[Then say something like: " I have a some questions. I realize that you may not be able to answer all of them...]

 

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1) How many [name of the procedure for your type of AF]  procedures have you done?

 

2) What is your success rate for the approach you would use for my type of AF?

 

3) Are there any other patient characteristics that you have found make a difference in your success rate?

 

4) What percentage of successful patients are off all anti-arrhythmic medication?

 

5) How long do you follow your patients to determine if they still have episodes of AF? How do you determine this?

 

6) What percentage of patients like me need a second procedure? What is the success rate for the two procedures?

 

7) Under what circumstances do you discontinue Coumadin?

 

8) What complications have there been using this procedure? What steps do you take to avoid complications?

 

9) Is there anything else that is new or special about your procedure, such as new techniques or technology that distinguishes your method from that done at by other doctors or at other centers?

 

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Setting things up

 

1) Do you use any particular criteria in selecting patients? Are there patients you will not accept? I have [a heart or other condition you suspect might make a difference]. Will that make a difference in whether you accept me or in the success rate?

 

2) How long a wait would there be for an initial appointment, and for the procedure?

 

3) What do I do next? What records do you need and to what number do I have them faxed? What tests would I need to have and when?

 

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Optional questions about the procedure

 

1) How long does the procedure take?

 

2) How long is the hospital stay?

 

3) What is the range of time until full recovery for different levels of activity; for example, for office work and construction work? After how long would there be no exercise or work restrictions?

 

4) [For surgery] What incisions are made?

 

5) [For CA] In addition to PVI, what lines are attempted or other work is done?

 

6) What device and energy source are used. What are the advantages and disadvantages of this method?

 

7) How is transmurality or isolation assessed or assured?

 

8) [For surgery] Is there any kind of EP evaluation done to select areas for ablation or isolation.?

9) [For surgery] Is EP evaluation done to make sure the work was successful?

10) [For catheter ablation] What imaging system is used to help the EP to visualize what he is doing?

11) [For Maze surgery] How much time is spent on the heart-lung bypass machine?

12) What is your position on the controversy over whether to remove the LAA

 

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And finally:

 

 Are there treatments in the pipeline that I should consider waiting for? If I were to call you back in one or two years, what new procedures or other developments in the field would you be telling me about?

 

The ultimate question is always, "What treatment would you have if you were me and, if I don't come to you, who would you have do it?" But, you don't want to ask that ---- or do you?

 

[Say "Thanks you very much for your help!" ]      

 

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