Pulsed field ablation procedures found safe and effective for atrial fibrillation patients

Medical Xpress / The Mount Sinai Hospital / Nature Medicine ^ | July 8, 2024 | Emmanuel Ekanem et al

[ConservativeMind]

Pulsed field ablation (PFA) is safe for treating patients with common types of atrial fibrillation (AF), according to the largest study of its kind.

The "MANIFEST-17K" international study is the first to show important safety outcomes in a large patient population, including no significant risk of esophageal damage with PFA. PFA is the latest ablation modality approved by the FDA.

"MANIEFST-17K provides confidence that, unlike conventional thermal ablation, PFA with the pentaspline catheter does not cause the most feared complication of AF ablation—esophageal damage—nor does it cause pulmonary vein stenosis or persistent injury to the diaphragm," says senior author Vivek Reddy, MD.

AF is an irregular heartbeat or heart rhythm disorder. Patients with AF can undergo a catheter procedure, called catheter ablation, to treat this abnormal heart rhythm. This procedure involves making scars in small areas in the heart involved in the abnormal rhythm, which prevents abnormal electrical signals or rhythms from moving through the heart.

Two types of ablation are currently in common use: radiofrequency ablation, which uses heat energy to eliminate the problem area, and cryoablation, which uses cold energy.

These ablation modalities are associated with increased risk of potential complications, including damage to the esophagus, pulmonary vein stenosis, and injury to the phrenic nerve, which controls the diaphragm and is essential for breathing. PFA does not use temperature, but instead short high-energy electrical pulses. This catheter procedure is more precise than radiofrequency and cryoablation and does not cause damage to the esophagus, pulmonary veins, or phrenic nerve.

This retrospective, observational study analyzed 17,642 patients with paroxysmal and persistent AF after undergoing PFA procedures at 106 centers in 2021.

Researchers found no energy-specific complications among patients, including no esophageal damage, pulmonary vein stenosis, or persistent phrenic nerve injury. There was a 1% overall major complication rate.

[ConservativeMind]

This is available today and appears to be safer and better than other methods.

[ConservativeMind]

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[ClearCase_guy]

“I’d like a Pulsed field ablation in the 40-watt range.”

[Responsibility2nd]

This is available today and appears to be safer and better than other methods.

 

As far as ablation is concerened. But Cardioversion is safer and easier than these treatments. However it may not be a permanent solution. But it's a start.

This is available today and appears to be safer and better than other methods.

As far as ablation is concerened. But Cardioversion is safer and easier than these treatments. However it may not be a permanent solution. But it's a start.

[coalminersson]

just had an ablation 29 days ago. Follow up appt tomorrow.

[acoulterfan]

I had a cardiac ablation in 2017 by the renowned Andrea Natale for Afib and I have not had one instance of Afib since!!!!!