Electrophysiology | Pulsed-Field Ablation

Pulsed-Field Ablation - Advancements in EP Technology

While most patients don’t know much about electrophysiology until they are referred to an EP by their primary care physician or cardiologist, our field represents a technological powerhouse in medicine. Not only have we developed some of the most advanced minimally invasive and exceptionally effective medical procedures over the past couple of decades, but we are improving them regularly, as evidenced by an exciting new technology known as Pulsed Field Ablation or PFA.

PFA is a revolution in Afib treatment

While the specific treatments for atrial fibrillation may not be at the top of your newsfeed, one of the most significant technological advancements in electrophysiology is happening as we speak. Afib ablation has been the gold standard in atrial fibrillation treatment for the best part of a few decades. The most effective treatment option has been a procedure known as cardiac catheter ablation.

This elegant, minimally invasive, safe, and effective procedure involves threading a catheter from a small incision in the inner thigh up to the heart. At this point, the electrophysiologist deploys targeted heat (generated by RF waves) or cold (generated by a balloon catheter) to destroy problematic heart tissue, causing additional, fast, or erratic heartbeats. These procedures have seen incredible evolution with improved technology and a transition from fluoroscopy – radiation-based continuous X-ray guidance – to safer and more efficient ultrasound guidance. However, no matter how experienced the electrophysiologist, there was always the nagging risk, albeit low, of thermal ablation damage to surrounding structures like nerves and the esophagus.

Pulsed-field ablation changes all that

By employing a radically different way of destroying malfunctioning heart tissue, PFA has maintained the excellent results we’ve seen with thermal ablations while reducing the risk of collateral damage. PFA achieves this by using an incredibly rapid electrical pulse to electroporate the targeted cells permanently. This perforates the outer protective shell of the targeted cell, at which point it dies and is absorbed into the surrounding heart tissue. By not using heat or cold therapy, surrounding structures remain unaffected, eliminating some risk.

We’ve also found that PFA offers yet another significant benefit: It allows us to speed up the procedure, thus reducing the time the patient remains under general anesthesia. The possibility of even performing a PFA without general anesthesia is currently being studied. This is especially important for our advanced-age patients and those more sensitive to anesthesia.

Is PFA available yet?

The newness of the PFA procedure and the incredible demand for PFA-capable ablation systems means that not all medical centers nationwide have access to this game-changing technology. Fortunately, we can access this technology right here in Tampa and are currently performing PFA procedures on appropriate and qualifying patients.

Most importantly, Dr. Tordini’s mantra remains the same. Earlier detection and treatment are always preferable, regardless of the advances in modern electrophysiology. When arrhythmias like atrial fibrillation are found in their earliest stages, patients have the broadest range of treatment possibilities and the highest chance of successfully treating the arrhythmia. If you are having chest palpitations, do not delay seeking the care of a qualified electrophysiologist like Dr. Tordini for a comprehensive diagnosis and treatment plan.

We look forward to bringing you more information on the ever-evolving field of electrophysiology. In the meantime, if you have been diagnosed with atrial fibrillation, we encourage you to visit Dr. Tordini to learn more about whether PFA may be an option and the steps you should take to treat any heart rhythm-related concerns you may have.

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