Pulsed Field Ablation in Australia

[OzRob]

I just had my six-month checkup with my electrophysiologist. He was quite excited as our local hospital is commissioning a pulsed-field ablation system in 4 weeks time. Much safer than RF or Cryoablation.

This video from Medtronic explains the pulsed field technology: youtu.be/rH8SvEq398M(Not working as expected?)

I know Europe has offered Pulsed Field Ablations for a few years now, and the USA has given approval for the technology in recent months.

I have not had any AF, Pac's or PVC's for the last 16 months due to a low daily dose of Flecainide and Diltiazem, my electrophysiologist is encouraging me to still have an ablation within the next 12 months as the long term success rate of controlling AF is better when an ablation is done early on even when the meds are still effective.

I am feeling his suggestion is correct more so now that the safety of the ablation is much more improved.

People's thoughts?

[Rainfern]

OzRob you are so lucky to be offered pulse field! I learned about this from my EP at a public talk he gave. We are waiting for the NHS to be better resourced so they can afford the equipment. Thanks for the video link!

[Iamfuzzyduck]

Yes, do it!! I just had PFA. Less than 60 minutes under. Back to a modified gym workout on day 8 and ran one mile yesterday 9 days after. I’m still in recovery but the Doctors encourage workouts after a week. It is the new recommendations that people like you and me will benefit from an early ablation. I will be completely med free in 3-4 months. I am pleased I have had it done and I can go about my life. Oh and they quote a 90 percent success rate for early cases.

[OzRob in reply to Iamfuzzyduck]

Thank you for the reply. It seems that this technology is a huge advancement in treatment for AF as it removes all the major complications.

[Iamfuzzyduck in reply to OzRob]

Yes, because it only affects the cells inside the heart so it shouldn’t damage the phrenic nerve or oesophagus. But you do have to have a general anesthestic, and they do use CT or something where the dye can cause the kidneys to excrete more creatine. I’m not sure what exactly they use or if it was just the way my EP works.

[bean_counter27 in reply to OzRob]

Where's your local hospital?

[OzRob in reply to bean_counter27]

Cairns in Far North Queensland.

[OzJames in reply to Iamfuzzyduck]

interesting as my EP said 70-75% success at 12 months. It would be useful if you could check and see if your EP is talking success rate at 12 months which in any circumstances is great however if medication gives the same outcome then maybe wait until procedure is improved. This is just what’s running around in my head as I’m trying to decide now or later

[Iamfuzzyduck in reply to OzJames]

My first EP quoted 90-95% for RFA, the second 90 % for PFA. I don’t know for what time frame. I am thinking a while because that’s why they like to catch it early now. Abbot are making a new PFA system but it hasn’t been approved yet in the US, but they are in the last stages of clinical trials. There is also some query as to how much tissue should be ablated for success. I rushed to get it done because I was having runs of ectopics since my November episode that put me in ER, and I knew that as my trigger is throwing up, it could happen anytime anywhere in the world and I want to visit semi remote places or fly long haul. Also even with a renowned EP I was surprised at how soon my ablation was offered to me and didn’t want to pass it up. My heart is still in recovery but I can do everything except high cardio atm, on day 10.

[OzRob]

You could always contact Medtronic here in Australia, they may tell you which hospital are using the new Pulsed Field Machines.

[bean_counter27 in reply to OzRob]

The question was more so one of interest. I live in WA and not looking at ablation at this stage. However, would like to know it's being performed here so they have plenty of experience by the time I am seriously considering it. I doubt I would have any other form of ablation.

[OzRob in reply to bean_counter27]

I asked my EP if using Pulsed Field would be much different to the Cryoablation he currently performs. He said it would be the same procedure, so I think he would be proficient immediately. Having said that, I won't be putting my had up until they have used the machine for 6 months.

[Iamfuzzyduck in reply to OzRob]

Another reason I had it done is because my EP was involved with trials and has been doing PFA for at least two years. He does electrical mapping so he can see exactly where the rogue cells are. He also educates and trains other EPs from across the world.

[OzJames]

hi Rob I saw an EP through Mater Health Nth Sydney who has been doing Pulse for last 8 months about 50 I think he said. Since I had Flutter once he has suggested Pulse for AF and RF for Flutter to be done at same time. As mine are not as frequent I’ve decided to get another EP opinion while I decide. My guy said success rate at 12 months is 70-75% which makes me think if drugs and good lifestyle are helping atm why not wait? Be interesting to know what percentage success rate they quote you at 12 months and longer. Having said all that I heard today of a local who is 10 years AF free after being persistent AF for many years.

[DKBX]

Do it … but don’t expect a cure or fix.

I’m hoping my sixth ablation finally “fixes” it but I’m not expecting it.

[Millbrook]

Your EP is right that having ablation earlier increases your chance of a cure. Long term afib can damage the structure of your heart and creat other issues. My husband had proxymal afib that gradually developed into persistent afib. He had PFA done over a year ago and that really helped him. He is off flecanide. PFA reduces operation time and risk by 50% as compared to old technology. PFA fixed his afib and another machine fixed his flutter. All is good. His cardiologist considers it the gold standard.