I had 2 pulse ablations which are supposed to be so much more effective than cryo.
I had the ablation, then went home. In a couple of hours rate was in 140s. Tried to cardiovert me 3 times. Unsuccessful. 2 days llater went in for another pulse ablation. It had been 1 month. Having regular flutter and skipped beats and shortness of breath. EP said this was normal for 6-8 weeks after ablation. Taking Amiodorone, metoprolol and Eliquis.
No Afib though
Any thoughts
Despite the hype pulsed field ablation , though faster and less traumatic, is not currently more effective than previous methods. There is still a period of recovery when strange thing will happen.
Pulse field ablation, very importantly, has an improved safety profile.
This is not strictly true, as yet. PFA is newer and more long term data is needed to fully establish its safety profile. That’s what l am told here in the UK. ( Excuse me butting in Bob!)
That concurs with all that I have read, too: safer for a range of technical reasons but especially for the highly selective way it targets specific heart cells and creates no heat transference, e.g. to the phrenic nerve or oesophagus. Also, it is far quicker so, I have read, that the total X-radiation dosage will be much less.
In terms of effectiveness, I suspect it to be similar to other technologies but perhaps may eventually prove more effective once EPs realise the extra potential of it because of its safety.
Steve
BobD is correct. I recently saw my EP and he said the outcome from both is the same. No difference. He is from Royal Papworth Hospital so ……. He has put me forward for a Catheter Ablation, so l am not arguing.
I was told the same by my EP. He said the only advantage is that they have more time and can perform more ablations
Makes you think doesn’t it?
Sure does. Mine was RF ablation, a very uncomfortable and painful experience under sedation which I believe took almost 4 hours in total including prep time.
Exactly.That's what my EP said to me when I was discussing whether to go for RF or PF.
There are a couple important advantages to Pulse Field ablation. For one it is less invasive and also has an excellent safety record. From what I've read it is also more effective in the overall objective for the patient.
I had my PFA seven weeks ago, and have had no issues since. At the one-week checkup the EP said that he didn't expect to ever see me again. I asked about the success rate, and he said in his experience the PFA success rate is much better than the older methods. A friend went to the same EP three months ago and also had a successful PFA.
I will be relocating and have an appointment with one of top EPs in the US at Baylor College of Medicine on April 7. I am anxious to hear what he recommends. I had the top EP do my first cryo ablation at Univ of Florida. Obviously that didn’t work.
Just hoping that these last 2 PFAs put so much stress on my heart in a 3 day timeframe and it is just taking longer to heal
EP said my EKG showed PACs.
Are you taking magnesium taurate as recommended by prof Sanjay Gupta London cardiologist. And co enzyme q10 may help with the pacs as it reduces inflammation. Loads of information on AFib and inflammation on Google scholar
wow we must be somewhat close. I’d be curious to know who your EP is. Mine was incredible. He is actually the director now at university Florida in Jacksonville. He just went there in October. He created a pacemaker for me.
I don’t know who the top EP is that I am meeting with my new who is also amazing because my other one left here we go again. I hate changing doctors.
My doctor in Gainesville Florida at U of F, was Dr William Miles. He retired from seeing patients to research.
I had a PFA 4 months ago. Completely successful. No AF or arrhythmia. Then, 2 weeks ago I had 2 days where I just didn't feel right, occasional arrhythmia and flutters - no AF or racing heart.Then it stopped and I've been fine again. I'm not obsessing about it and hope it was just a blip. Not sure blip is a medical term but fingers crossed!
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remember, there is no cure. This is the quality of life. It gives us breaks
Like others here: I've not read anything which says that PF ablation is 'more effective'. On the contrary, I've read plenty stating current evidence that its relative efficacy is the same. Where it scores is that the procedure is quicker.
While I haven't got an appointment date yet (on NHS waitlist), my EP has said that they now do PF where he practises and so that is what I'm expecting. His comment also was that it is primarily about speed of the op.
What I have also read is that it carries lower risk of local 'collateral damage' then RF.
At a public talk given by my EP on the latest developments on treatment for AF he explained that pulse field ablation makes it easier for the EP to avoid damage to surrounding tissue. For instance it is a safer procedure with regard to the oesophagus. It is the skill of the EP that is more likely to determine a good outcome.
I had a load of ectopic beats and unsteady heart for several months after ablation. Just take it very very easy!
Agree with Rainfern, the main attraction for me is that apparently PFA has less collateral damage risk and is quicker possibly with as a result less trauma to recover from; early days though.
I recently had a PFA which is my eight ablation and my first PFA. half of my ablations were for ventricular arrhythmias and the other half have been for atrial arrhythmias. After my most recent PFA (February 24, 2025), I left the hospital in complete heart block but off of my anti-arrhythmic medication (Multaq) and a lower dose of metoprolol. Fortunately, the heart block caused by the ablation was transient and resolved on March 6, almost two weeks later. What's even more encouraging is I have had not one single episode of arrhythmias other than my typical PVCs since my procedure in February. What that means for the long term remains to be seen but I can say that this is the first time after an ablation where this soon after the ablation I have experienced no arrhythmias.
be grateful and enjoy. Hopefully you are one of the lucky ones that will keep it for quite a while.
Thanks Dawn, I actually had the procedure at St. David's in Austin. Dr. Andrea Natale
Me too, Dr.Natale
What are your thoughts about Dr. Natale and his ability?
I think he is a very capable doctor and I am glad he performed the PFA, but I was not happy with the follow up care from my assigned nurse which was almost non-existent. Because he is a popular EP, you feel like you are on a factory line. What did you think? I go and see my cardiologist for more follow up care where I will ask for a stress test. I had a CT scan a few months back and it was I think normal, but something is not right, it doesn't function how it did before my afib attack...
It took him two tries to ablate the problem. The second ablation he used PFA which did the trick although I did end up with a transient complete heart block that occurred from the ablation. That took about two weeks to resolve but there was a lot of uncertainty around whether it would resolve or not. He is a good doctor but communication is lacking.. He is somewhat aloof and most of the discussion occurs with his support staff. I found them to be accessible but not my best experience. The best care I ever received was at Cleveland Clinic but if you want to talk about an assembly line Cleveland Clinic is definitely one. I'm glad I found him but not sure I want to travel there again. Austin is not cheap and with air fare and hotel plus food the cost is prohibitive for most people and it has put a drain on my savings.
I agree with your assessment! Sorry you had issues with your ablation though. Hope you are feeling better…
first I had Dr. Valderabano at Houston Methodist DeBakey cardiology. I don’t even want to talk about that one then I had the most incredible PE out of Lufkin CHI St. Luke’s. It proves it’s the doctor not the hospital although the hospital treated me like a his team was incredible. Dr Aditya Saini. Young and thinks outside the box and saved my life after what had been done to me. Sadly, he is now in Florida, but I’m happy for him. He is going to be famous. I have no doubt. they didn’t have a pacemaker for so he me pretty much lol OMG I entered in a wheelchair. I had six months I could not walk, pain brought tears to my eyes. When I left from my and pacemaker being hooked I had to go in a wheelchair, but I was able to stand and get into the car like a normal person again. Of course we have learning but overall just amazing. He was a with Baylor my new doctor is scott greenberg PE at Woodlands I believe I found another diamond. I will finally get to see him on the 15th. I became extremely ill in November with some type of mystery viral that has me messed up right now but if anyone can help and I can’t have Dr Saini again I believe Dr. greenberg is the one for.
one step at a time the last two years have been incredibly good until I got sick in November I need them to going I have also taken very bad the last weeks was a there’s a possibility I moved something with my pacemaker. I’m still here so it can’t be all that bad. Thinking positive is probably the number one rule with a fib and flutter.
best of are in a good place with the best people in the. What’s ironic is I moved here three years ago from Florida do you think my doctor would think I was creepy if I followed him lol I have heard from him and I had his blessings on my new PE. I believe they really know you saw the resumes and took the names off it would be hard to tell them apart cannot replace the other, but it’s nice to know the new ones out. There are doing amazing things.
Dawn, You were not happy with Dr. Valderabano in Houston. That is who I will see on April 7th.
if I hadn’t been so sick I would’ve gotten a lawyer. Please tell me he’s not gonna use his method on you the thing he has pioneered. I have so much scar tissue and if you talk about poor follow up, I don’t know if she’s still there. She’s probably his someone on the desk that messed up everything including he was do a cardioversion just so you I went into tachycardia after his dropped me like a hot potato. I could not even get phone calls back. I even tried on the Houston Methodist reaching out the fact that he used his own procedure on as you he’s from research. Keep that in mind personally he belongs back there in my mind. Never a phone call. Nothing back from him checking on me. I ended up with heart failure, which I did not have like a fool or because I was so sick. It was almost 6 months before I got another doctor thank God I did or I wouldn’t be here now. I had steady tachycardia around 200. I could not walk and if I tried to stand up the chest pain brought tears to my eyes you do what you want, but I would not send my worst enemy to him. I don’t care what the write ups on him say if my mail carrier didn’t give me the name of the doctor that became my PE. I wouldn’t be here now. I I think he’s one of those doctors that thinks he is God. I went to him because one of his trainees now works for what I did in Florida for my doctor there my PE I told him what happened. He told me to get another doctor fast when I told him what was going on with. I can’t tell you how horrible he created an odd procedure. I haven’t heard anything about it since, but I haven’t looked because the thought of him makes me go crazy. considered getting an attorney, but with all the paperwork they make us sign. I’m sure they’re covered please please really think things over.
if you want to ask me anything contact me either way on here I have no reason to lie about this man I was hoping for the best because I was already very sick. I don’t expect them to do miracles, but I don’t expect a doctor to abandon and when I tell you first this girl gave me a hard time on the phone and had someone else on the other line, his NP, etc. no one would ever call she put me on a different once that was it as I said heart rate was staying around 200. I had a implanted in Florida so they have all the figures. Please be careful he was supposed to be a rockstar.
Dr Greenberg's bio seems good, there are a few good EPs in the Houston area...
Wishing you all the best next time around.
I’m currently living the dream (six months on) after a successful cardioversion. But have already agreed in principle with my EP that if/when this fails I go straight to PFA.
The conversation was not so much about it being any more of a successful outcome regarding AFib reoccurring, but that there was growing data / evidence now showing that there were less complications as a consequence of the invasiveness of the procedure itself.
I assume with your nickname "Txlonestar" you are from Texas, USA. I also live in Texas. Had you considered having Dr. Wolf do the Wolf Mini Maze in Houston for Atrial Fibrillation?
I think a mini maze is in my future if these last PFAs don’t work. Is Dr Wolf at the med center in Houston?
Yes, he is at Houston Methodist- I met him last year, he wasn't in a rush to do a mini-maze on me but referred me to his EP who is highly competent..
Who did your ablation? I had mine done in Austin by Dr.Natale last year, he trialed the techniques and is very experienced at PFA. I have not had afib since but I did have lots of ectopics at altitude a couple of months later. It continues to improve one year on but I think my initial afib episode which I left for three days with my heart rate over 140 caused some damage. I continue to have some issues at altitude and with high cardio but no afib.. My thoughts on Dr.Wolf is he seems to have a high success rate but it is a more invasive procedure IMHO but may be worth you looking into.
I think Dr. Andrea Natale was the first doctor to pioneer catheter ablation to treat Atrial Fibrillation (AFib). My first episode of AFib was in 1993 but it became more frequent and then I was diagnosed with Paroxysmal Atrial Fibrillation (PAF) in 1999. It was treated with Flecainide and Diltiazem, with intermittent periods of Wafarin when the Afib became more frequent.
In 2010, I was referred to an Electrophysiologist (EP) in Cincinnati, Ohio, where I was living at the time ( I currently live near Fort Worth, Texas). He discovered I had Atrial Tachycardia, in addition to the AFib, and performed a successful ablation to treat the Atrial Tachycardia. In 2011, I decided to have a catheter ablation for the AFib, and was going to have Dr. Natale perform the ablation at the Cleveland Clinic in Ohio, where he was working at the time. Not sure when Dr. Natale relocated to Austin, TX, but I believe it was about that time, 2010 or so. But I ended up having a local EP in Cincinnati do the ablation. Since he performed it, I have not been in AFib. However, I started having ectopics in 2021, mostly Premature Atrial Contractions (PACs), which I am currently taking Flecainide for. I also am on the beta blocker Carvedilol.
The Flecainide seems to be controlling my ectopics well. But as a cautionary measure, my cardiologist is keeping a close eye on the extent of my coronary artery disease (CAD), as the CAST study had showed patients, who had had a recent heart attack, and were taking Flecainide for non-life threatening ventricular arrythmias, had higher mortality rates: drugs.com/sfx/flecainide-si...
In fact, I am scheduled for a Lexiscan nuclear stress test this week to better determine the extent of my CAD. I hope to be able to stay on the Flecainide because it seems to be very effective in controlling my ectopics which, to me, are almost as uncomfortable as AFib.
I am totally unfamiliar with Pulsed Field Ablation (PFA) which must be a very recent procedure.
Recently I had two Afib-RVR episodes in December and February that required cardioversion, so I consulted with an EP at the Mayo Clinic in Jacksonville. She recommended a PFA that I had two weeks ago.
The procedure went flawlessly, spent the night in their care hotel, flew home the next day. I have had three ECG's since then and monitor myself several times a day with a Kardia device and haven't recorded a single ectopic since the procedure.
I was on flecainide before the PFA and the EP is continuing that and adding metoprolol until my three month checkup.
So good, so far. 🤞
Hi Txlonestar, I live in Houston. I’ve had a MVR, dual chamber PM. On Metoprolol for A.Fib. My question, do you mind telling me where, and what EP performed your PFA’s? Thank you.
Jane
if you are trying to find one local I’m outside of Houston. I have a p.m. that was created for me. Long story, but it saved my life if you’re looking for a new EP for some reason I need one because my PE became director in Jacksonville, Florida at the University of Florida heart. if I could, I swear I would move there, but I have been blessed with what I believe is another diamond as a doctor dr scott greenberg he’s in Conroe so of my contact with them has been extremely positive. You can tell his people love him as well. Check him out. If you took the names off the resumes. I would think he was the doctor. I just lost that makes me feel safe. My other stuff was done up in Lufkin. I had an amazing team up there, but as I said, my doctor is gone, he left in October and they still had not replaced him. prior to meeting that PE I almost went to Dr. greenberg when I moved to over three years ago from Florida so I have no doubt about going to him now it’s just the waiting and starting over again in many ways you know how they all want their own testing, etc. even if it’s the same which it will not be
They're still running clinical trials on PFA in the US (it's cleared by the FDA but not available everywhere yet). I was supposed to be the first for the CO trial, but the equipment failed the morning of my ablation, so I got RF. The Dr then told me at my follow-up that they were having trouble w/ patients stroking during PFA so they had pulled back on the trials. That was in December. I don't know where the trials stand at the moment. I'm symptom free on Amiodarone. I won't know if my ablation was successful though until they ask me to go off of the AAD (in three weeks). Crossing fingers of course. I'm of the opinion though that it takes a long time for your heart to heal and the circuits to figure themselves out. I don't agree with ppl that push the envelope right away (like heavy cardio a week after ablation). I'm taking a much gentler approach and even if my flutter/Afib come back I don't think I'd jump onto the ablation bandwagon right away. I want to give my heart more time to heal, and give myself more time to maybe figure out how lifestyle changes can help me. I wish you the best of luck.
I had PFA 5 months ago and have not had a single blip since then, so as far as I am concerned, it was a 100% success. It took 1 hour 15 mins; recovery was fast, and it has much less risk, as it only affects heart tissue. Research phrenic nerve damage after ablation, and that will make you think twice about burning or freezing your pulmonary veins.
You are getting the benefit of added safety, less side effects. As far as effectiveness, every case is unique, nothing is guaranteed. Give it some time, many people have issues like yours immediately afterwards.
I live in the U.S. and had my second ablation in December 2024 after being afib-free for six years. My EP told me that the PF ablation is only available from him for those getting their first ablation. Not sure if this is true everywhere in the U.S.?
