pulsed field ablation

[OzJames]

I’ve set up appointment to see an EP for first time in a month, my Cardio suggested him and says he has an interest in PFA. I’m planning ahead… currently in Sinus since my last CV 2 months ago but as you all know it’s best to have a plan B. Hopefully I stay in Sinus for a while! I’ve posted this info on some data I’ve seen. Any thoughts?

hrsonline.org/news/press-re....

[BobD Volunteer]

Interesting but I'm pretty sure that during our Patients Day presentation (October 8th) on new developments we were told that whilst PFA was encouraging, overall results were not measurably better at this stage .

[OzJames in reply to BobD]

Thanks Bob that’s what I remember reading I’ll ask this EP next month if he has any new data and I will share

[Singwell in reply to OzJames]

Less invasive I understood in terms of cellular damage. Keep us posted.

[Buffafly in reply to Singwell]

I am interested because I had a very bad AF experience this summer, only really recovered now, but I couldn’t face a long GA and have doubts about another RF for reasons mostly special to me. So looking forward to more information!

[agnostic1 in reply to BobD]

but safer in regard to esophageal damage?

[Lenlec]

interesting. Wonder if the blanking period is the same ? Does PFA create scars that need to heal like the other 2 methods ?

[OzJames in reply to Lenlec]

I’ll start a list of questions and ask the EP in a few weeks when I see him

[BobD Volunteer in reply to Lenlec]

Just to clarify. The scars form, not heal. It is those scars which block the electrical impulses. If the scars are incomplete or heal over then AF returns.

[Lenlec in reply to BobD]

Yeah true bob. So does PFA form scars ?

[BobD Volunteer in reply to Lenlec]

see below.

[TouchVeena]

What I've heard is that in certain studies the effectiveness against AF was about the same, but the side effects were nowhere near as bad. The old methods create scars about a centimeter across. PFA simply kills a few cells so we're talking about scars that are microscopic

[FindingCaradoc]

I had a UK Pulsed Field Ablation in September 2022 (at Liverpool Heart and Chest Hospital) which was a success. As far as I am aware I have had no AFib since (I had been in persistent AFib for just over 4 months prior to the ablation). The procedure was done under GA in about an hour, which I believe is significantly faster than other ablation methods. I asked about the blanking period and responses were vague and non specific, which I suspect was due to the relative newness of PFA. I erred on the side of caution, but and recovered well. As has been suggested still early days in terms of data, but I know my EP was enthusiastic about it 😊

[Lenlec in reply to FindingCaradoc]

How long before you got back to normal activities ?

[BobD Volunteer in reply to Lenlec]

Consider the same as per our recovery fact sheet is best advice.

[Lenlec in reply to BobD]

Also can people have a PAF after having previous failed cryo or rf ablations ?

[BobD Volunteer in reply to Lenlec]

Sorry no idea but can't see why not. First thought is probably won't help if ablations keep failing possilbly due to complex electrical activity.

[sunlovah in reply to Lenlec]

I have wondered this also also vice versa?

[FindingCaradoc in reply to Lenlec]

I felt generally fine in the first week (other than some minor chest discomfort) and recovered well after that. I felt I could do more, but erred on the side of caution (along the lines of the AFA recovery information) in terms of exercise as I am generally pretty active. I did some relatively gentle walks in the Lake District a month after the procedure, but nothing more strenuous for around 3 months if I recall correctly.

[Buzby62]

Hi, now you’ve created this post, there are Related posts on the right of this page or at the bottom if you’re on a mobile device. You can also use the search bar, both of these are often overlooked and can be helpful to the browsers of the forum.

[Teresa156]

Hi OzJames,

I really hope that this works out for you with a PFA…I would be really interested to know if it works for flutter too ( I noticed you also have flutter?)

I too have Afib, Aflutter and Atrial tachycardia in my episodes. I enquired about PFA at Royal Papworth here a couple of months ago and was told that it only targets Afib - at the moment, which did suggest other PFAs might target it?

[OzJames in reply to Teresa156]

Yes I had flutter once it initially started as AF then I went for a run and it switched to Flutter. I’ll make sure I ask him about it

[sunlovah]

I've been thinking along the same lines. Be interested to hear your findings and results. Please do keep us posted. Thanks

[MikeThePike]

PFA is thought to be safer than RF but no more effective at curing AF. Special precautions must be taken during surgery with PFA or you could be left with nasty coronary spasms which the surgeons won't be able to correct. Make sure you do your research before agreeing to any ablation procedure. There can be many nasty permanent side effects from ablation procedures, none of which can be cured.

[OzJames in reply to MikeThePike]

Sound advice thank you

[doodle68]

I think the availability of PFA will be a great addition to the treatment of AF and I have followed its progress from the start .

However, I understand from research that the success of an ablation is to some degree due to the experience and expertise of the EP carrying out the procedure so the more experience they have the better.

PFA is still quite new so EPs experienced in the procedure will be limited, for now I would rather stick to the older procedures carried out by an EP and team who have done many.

[OzJames in reply to doodle68]

I was thinking the same, I’ll ask the EP how many he’s done. Hopefully I won’t need it for a few years but was trying to be informed about each procedure available before I needed it.