PFA vs RF ablation I want to get opinions. I now have persistent Afib, and have the chance to have a PFA at Mayo in two weeks with a Dr I’ve had virtual visits with. Because it’s new technology this Dr would be performing the PFA, but there will be other EPs in the room observing as well as reps from the company ensuring that their equipment is functioning as expected. My Dr has only done a couple PFAs, but has performed hundreds if not thousands of RF ablations. I understand that PFA showed shorter procedure times but longer fluoroscopy times, higher levels of hs troponin. I presume those numbers will go back to normal days/weeks after the procedure. Also noted that the catheter is larger than the RF ablation catheter. I can also have a traditional RF ablation with my Ep that I’ve seen for 11 years, who has done thousands of the RF ablations. This ablation would be in one month. Would like your opinions on the two options. Thanks! https://www.afibbers.org/forum/read.php?9,194836,194836#msg-194836 Sat, 19 Sep 2026 23:45:02 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,194836,195856#msg-195856 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195856#msg-195856 Carey AFIBBERS FORUM Sun, 05 May 2024 15:29:31 +0000 https://www.afibbers.org/forum/read.php?9,194836,195853#msg-195853 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195853#msg-195853 Paradigm shift in ablations from PV to non-PV triggers]]> NoTrigger AFIBBERS FORUM Sun, 05 May 2024 14:28:09 +0000 https://www.afibbers.org/forum/read.php?9,194836,195831#msg-195831 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195831#msg-195831 Carey AFIBBERS FORUM Sat, 04 May 2024 16:41:22 +0000 https://www.afibbers.org/forum/read.php?9,194836,195829#msg-195829 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195829#msg-195829 NoTrigger AFIBBERS FORUM Sat, 04 May 2024 15:42:39 +0000 https://www.afibbers.org/forum/read.php?9,194836,195821#msg-195821 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195821#msg-195821 Carey AFIBBERS FORUM Fri, 03 May 2024 15:13:05 +0000 https://www.afibbers.org/forum/read.php?9,194836,195820#msg-195820 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195820#msg-195820 Thanks for pointing me to this and other studies I found through the link. It seems to be that PV ablation is the holy grail for many so I went back to the notes of my 3 ablations to figure out what was done. As you can imagine they use a lot of acronyms in their procedure notes so it was difficult to decipher. I believe they focused on both PV and PW areas in all 3. The first one failed so I had another within months. The second one held for a little over a year which therefore qualifies as a "success" The 3rd lasted for 4 years, which feels more like a success to me. I am sure they did other areas as well but will have to clarify that when I talk to my EP next week and try to understand the flip flopping in terms of whether I should get another ablation.
I am wondering I could send you the summaries of the procedures to confirm my understanding and shed further light.
Thanks
Mary]]> NoTrigger AFIBBERS FORUM Fri, 03 May 2024 14:47:38 +0000 https://www.afibbers.org/forum/read.php?9,194836,195753#msg-195753 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195753#msg-195753
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NoTrigger
Carey - You mentioned success rates of 75 - 90% for elite EPs in the post above and I was wondering where you found these numbers.
Mary

This is a study published by Natale et al. in 2017. The list of authors reads like a Who's Who of the elite electrophysiology world.

The study group was composed of people who had failed 2 or more previous ablations, so the study group was composed entirely of difficult cases. I quote from the Results section:

Quote

At 1 year, 90% were arrhythmia free off-AAD in non-PV ablation group, and 72% who did not receive non-PV triggers ablation at the index procedure (P = 0.035). The success rate of empirical LAA and CS isolation was 78.5% and 82% after the index and repeat procedure, respectively.

What they mean by non-PV ablation group is the patients who had areas outside the pulmonary veins ablated. The LAA and CS refer to the left atrial appendage and the coronary sinus. Those were patients in whom they couldn't find sources of afib anywhere else.

I have a pre-publication copy of the study, so if anyone wants to read the whole study just drop me a PM and I can send it to you. Since it's a non-published version, I can't publish it here.]]> Carey AFIBBERS FORUM Fri, 26 Apr 2024 20:59:54 +0000 https://www.afibbers.org/forum/read.php?9,194836,195751#msg-195751 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,195751#msg-195751 Mary]]> NoTrigger AFIBBERS FORUM Fri, 26 Apr 2024 17:53:29 +0000 https://www.afibbers.org/forum/read.php?9,194836,194883#msg-194883 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194883#msg-194883 So thankful for this forum, and all of the helpful information.]]> Dini AFIBBERS FORUM Thu, 29 Feb 2024 03:08:26 +0000 https://www.afibbers.org/forum/read.php?9,194836,194877#msg-194877 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194877#msg-194877
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Dini
Based on the comment above are you saying that a PFA wouldn’t be successful because of my now persistent Afib, therefore would having the traditional RFA be a better option?

If you're referring to my comment, then what I meant was PFA alone might not be successful because it provides only a PVI ablation and persistent afib usually involves more than just the pulmonary veins. But a combined procedure using both PFA and RFA still gives you the increased safety of the PFA while allowing the EP to address other areas with RF. The PVI is where most of the risks of an ablation are, so it would be a significant reduction in risk while still allowing all the problem areas to be addressed.

Needless to say, you want a highly experienced EP for an ablation of persistent afib no matter what technology is used. Average EPs have pretty poor success rates with persistent afib (~40%), but elite EPs can achieve 75-90% success rates.]]> Carey AFIBBERS FORUM Wed, 28 Feb 2024 23:55:37 +0000 https://www.afibbers.org/forum/read.php?9,194836,194872#msg-194872 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194872#msg-194872 Dini AFIBBERS FORUM Wed, 28 Feb 2024 21:16:10 +0000 https://www.afibbers.org/forum/read.php?9,194836,194861#msg-194861 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194861#msg-194861 Dini AFIBBERS FORUM Tue, 27 Feb 2024 18:55:20 +0000 https://www.afibbers.org/forum/read.php?9,194836,194857#msg-194857 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194857#msg-194857 gloaming AFIBBERS FORUM Tue, 27 Feb 2024 08:21:46 +0000 https://www.afibbers.org/forum/read.php?9,194836,194841#msg-194841 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194841#msg-194841 make sure they're prepared to use RF outside of the pulmonary veins, if needed.

Of course, you're not going to find anyone who's done thousands of PFA's at this point and really not necessary, however
not sure how comfortable I would be being number three, which may be why so many in the room.

Jim]]> mjamesone AFIBBERS FORUM Mon, 26 Feb 2024 21:12:11 +0000 https://www.afibbers.org/forum/read.php?9,194836,194839#msg-194839 Re: PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194839#msg-194839 Carey AFIBBERS FORUM Mon, 26 Feb 2024 20:54:46 +0000 https://www.afibbers.org/forum/read.php?9,194836,194836#msg-194836 PFA vs RF ablation https://www.afibbers.org/forum/read.php?9,194836,194836#msg-194836 I can also have a traditional RF ablation with my Ep that I’ve seen for 11 years, who has done thousands of the RF ablations. This ablation would be in one month.
Would like your opinions on the two options.
Thanks!]]> Dini AFIBBERS FORUM Mon, 26 Feb 2024 20:16:18 +0000