May Newsletter from Dr John Day ('The Afib Cure' book) in USA:
'As I frequently receive inquiries from my patients regarding the recently approved pulsed field ablation technology for treating atrial fibrillation (AFib) in the US, I wanted to provide a brief update. I've now treated over 100 AFib patients with this innovative approach and have observed significantly improved outcomes.
It's worth mentioning that overall the recovery period has been notably easier and faster in comparison to radiofrequency catheter ablations. Remarkably, nearly all of my patients have been able to return home on the same day as their procedure. This is particularly impressive given that many of these patients are in their eighties!
Surprisingly, even patients who did not respond well to the older technology have mostly shown very positive outcomes with pulsed field ablation. The results thus far have far surpassed my initial expectations from when I first discussed this AFib treatment approach in my newsletter eight months ago.'
Written by
secondtry
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I am a 69-year-old male with paroxysmal afib since 2005; on meds for symptomatic relief starting 2022.
In December 2023 I underwent a PFA procedure performed by Prof. Dr. Boris Schmidt, Prof. Dr. Julian Chun, and their stellar team at CCB Privatklinik in Frankfurt, Germany, who have performed several hundred (if not thousands by now) PFAs, employing Boston Scientific's FaraPulse technology.
Honestly, the experience was almost on a par with no more than a routine dental root canal procedure. I reported to the clinic at 7am; was in the cath lab by 9am; the procedure was complete by 11am; I walked to lunch in the clinic's snack bar at 3pm, and by 5pm I was discharged and in an Uber back to my hotel. I felt great, but on Dr. Schmidt's orders I took it easy that night and returned to the clinic first thing the next morning to be examined by him, after which I spent the rest of the day and evening shopping in Frankfurt - on foot. I departed Germany by air the next day to return home .
As directed by Dr. Schmidt I stopped all afib meds (except Apixaban) as of the day of the PFA procedure. At his direction I stopped Apixaban 8 weeks post-procedure. It was a huge relief to get off the meds, especially Flecainide and Metoprolol.
Since the day of the procedure, I have experienced zero (and I mean absolutely zero, nil, nada) after-effects, and I have been in NSR 100 percent of the time (I wear a smart watch that will alert me if afib is detected).
As recommended by Dr. Schmidt, post-procedure I took 10 days off from my exercise routine even though I felt just fine. I'm currently training for a70 km mountain ultramarathon in Oman early next year, with no problems whatsoever. It's like all those years of afib never happened.
I know that PFA is new, and that my case is only one data point, but in researching my options for ablation and comparing the various available technologies, there was no way I was going to let anyone get anywhere near my heart with either extreme heat or extreme cold if there was any alternative. Why go to such dangerous means when there is a much safer, quicker, and easier approach?
PFA was obviously the commonsense way to go, so I found a highly reputable and accomplished practitioner, and just did it. So far absolutely no regrets, but as in all things, only time will tell...
I'm a U.S. citizen living and working in Egypt and the UAE.
Dr. Schmidt has apparently successfully performed PFAs on patients from all walks of life, from fairly frail people to professional athletes. Yes, I'm fit, but I'm a rank amateur. I only run ultras because at my age my pace has gotten too slow to complete a marathon in 6 hours (which is usually the cut-off time). So I make it up with longer distance, i.e., I'm just an aging mileage junkie.
The cost of my PFA (all-in except for travel to and three days lodging in Frankfurt), was EUR 13,880.05. The clinic had me pay EUR 15k up front, and they reimbursed me the overpayment amount on the day after my procedure.
My U.S. health insurance policy reimbursed me for 90 percent of the total cost, so at the end of the day I was out of pocket USD 1,541.49 (not counting travel costs) - and it was well worth every single penny!
BTW I can't possibly praise the CCB Privatklinik too highly. Profs. Schmidt and Chun are absolute masters of their field and are super nice guys to boot - very friendly and approachable. The Privatklinik is a slick operation, executed with classic German precision. Going forward, if I ever need a "touch-up" ablation I'm headed straight back to Frankfurt.
the EP i saw in December suggested PFA for AF and RFA for Flutter both done at the same time. He’s done about 70 at the stage. I’ve also read competition between catheter companies is increasing with versions 2 and 3 are already being released be some of them. I’ve also read of a new procedure which going through Trials so maybe some time away and it uses live MRI guided catheter to enable far more clarity of targets compared to current mapping.
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