Now Dr. Mandrola not only likes, but ... - Atrial Fibrillati...

Atrial Fibrillation Support

32,387 members38,703 posts

Now Dr. Mandrola not only likes, but loves Pulse Field Ablation (PFA).

mjames1 profile image
19 Replies

Dr. John Mandrola previously had reservations about Pulse Field Ablation being a breakthrough in treating afib. Npw that he has personally seen it in action, he has changed his mind.

From his Substack 11/22

"Now I have used PFA. And. It is somewhat amazing. It ablates cardiac tissue quickly and easily. Patients hardly feel chest pain after the procedure."

And he goes on and on and on...

On a personal note, PFA would be my choice if I needed a catheter ablation, especially if the center was not high volume, because PFA is not as operator dependent as RFA or Cryo.

Jim

Written by
mjames1 profile image
mjames1
To view profiles and participate in discussions please or .
Read more about...
19 Replies
Jajarunner profile image
Jajarunner

Thanks for sharing that.

I'm undergoing my fourth ablation in 4.5 years soon. I'm dreading the months of recovering which it has taken me each time (six months or more to return to full or nearly full energy) especially since the other three lasted an average of 4 months before they failed.

There is a chance I will be be pensioned off on Medical grounds as my sick record is so poor with all those ablations and 10 cardioversions in that time, which I don't want. It's all very depressing but I cannot stay on amiodarone any longer.

I've heard the recovery is better with PFA and I hope Dr Mandola is correct about it's efficacy.

Reading this has really given me a boost, thank you for sharing 🙏👍🤞❤️

Tplongy profile image
Tplongy in reply toJajarunner

Have you considered a mini maze procedure if it’s appropriate for your circumstances rather than all these endless procedures?

Jajarunner profile image
Jajarunner in reply toTplongy

I think that'll be my next line of call if this doesn't work. They say it's "just" atypical flutter this time so easier to treat 🤞🤞🤞🤞thank you for the information 👍

mjames1 profile image
mjames1 in reply toJajarunner

Yes, mini maze will not work for typical (right-sided) aflutter. RF is what they usually use. High success rate. PFA not used for typical flutter last time I checked. The PFA instrument is too blunt and designed mostly for pulmonary veins.

Jim

OzJames profile image
OzJames in reply toJajarunner

There’s a new system on the horizon, have a read of my response to Jim

KenRC profile image
KenRC in reply toJajarunner

Good luck mate, hope it works out well for you!

mjames1 profile image
mjames1 in reply toJajarunner

Yes, recovery seems better and efficacy about the same as rf or cryo. Another option is mini maze, which has shown better results in difficult cases, however longer recovery.

Jim

Kennyb1968 profile image
Kennyb1968

Hey Jim - not been on for a while. My ablation has kept me symptom free for over 3 years - I'm in constant AFIB but my resting heart rate is 63 and I'm jogging 30 miles a week and still hitting the gym. Life is good and I hope this finds you well.

mjames1 profile image
mjames1 in reply toKennyb1968

Hi Ken, Good to hear from you. Glad you're doing so well!

Jim

Ppiman profile image
Ppiman

Yes - that was what I was told a few months back by my specialist when I was put on the NHS waiting list for mine. I can't say that I am looking forward to having an ablation, nonetheless, especially as my AF tends to be at a somewhat lower rate and less uncomfortable, of late, even if now far more frequent.

Steve

cockerfarley profile image
cockerfarley

Can I ask, which hospital Dr. Mandola works out of

mjames1 profile image
mjames1 in reply tocockerfarley

His practice is in Louisville, KY. USA. My understanding is that he uses ablation sparingly, so he may not be high volume, which I think is important, but perhaps a little less important with PFA.

Jim

OzJames profile image
OzJames

interesting I wonder what version he used… since the Study comparing RFA and PFA some time ago, I understand they are up to version 3 of the catheter. I would be interested to see how they compare today. I saw an EP who now does PFA for AF and RFA for AFlutter and suggested he could do both at the same time if I decide to do.

At the moment Sinus is my friend and hoping to stay there for a long while. FYI Jim there’s an Australian company Imracor conducting Aflutter ablations at John Hopkins looking towards FDA approval. Hopefully all goes well as the system is using MRI guided catheters which sound like they will be more accurate than current technology and therefore lessen the need to have 2,3 and 4 ablations.

mjames1 profile image
mjames1 in reply toOzJames

I don't know the version but I assume the latest available in the United States. Here, all the ep's who do PFA also do RF where needed in the same procedure. For example, that would cover those who have both afib and aflutter.

Jim

PeachLove profile image
PeachLove in reply toOzJames

Can you please explain what RFA and PFA refer to? Of late, I have had atrial flutter episodes, requiring cardioversion. Historically, sometimes afib has shown up also. I am now on a waiting list for ablation, but have no details as to the type. When I ask my cardiologist what procedure will be used by the ablation doctor, he says it will depend on what the doc sees when he actually does the procedure.

OzJames profile image
OzJames in reply toPeachLove

the newer type of ablation is Pulse Field which is mainly used for AF the one that’s been around for a while is Radio Frequency Ablation. The later is what your doctor will most likely do for flutter. It also is used for AF but doctors are looking at PF more as recovery is quicker and less risks. Also a company called Imracor is doing Trials in Europe and now US for an MRI guided RF ablation for Flutter. This could potentially offer a more accurate ablation due to the clarity of targets and consequently a lesser need for follow up ablations

cockerfarley profile image
cockerfarley

Thank you

EngMac profile image
EngMac

Dr. Mandrola in, I think, in the last “This week in Cardiology” post has a reply from a doctor in Europe who raises some major concerns that need consideration. Dr. Mandrola is not so positive now about PFA even though 70,000 procedures have been done in Europe.

mjames1 profile image
mjames1

What is the date?

Not what you're looking for?

You may also like...

Pulse Field Ablation

Hello Everybody, Persistent AFIB since 10/2022. 74 years. At the moment continuously in NSR post...
RVine3 profile image

pulse field ablation?

my ablation is booked for Friday 24 th at the Papworth , Cambridge. Im having a g/a so was told I’d...
madgrannyBeth profile image

Pulse Field Ablation In UK

Has anybody had a Pulse Field Ablation and if so how did it go? I understand it has only been done...
destiny234 profile image

Pulse Field Ablation yesterday

hi everyone Just wanted to update you on the pulse field ablation I had at Papworth hospital...
Tiff1 profile image

Post pulse field ablation

I’m reading about others having AFib episodes during the “blanking” period. I had my pulse field...
Jmbrph profile image

Moderation team

See all
Kelley-Admin profile image
Kelley-AdminAdministrator
Emily-Admin profile image
Emily-AdminAdministrator
jess-admin profile image
jess-adminAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.