Pulsed Field Ablation - 2 month update

Hi Everybody. This is my 2 month post Pulsed Field Ablation report.

Not much to add since my last post – so far it has all continued to go more smoothly than I expected. I’ve been off the flecainide for a few weeks now, and no change – no afib, no ectopics. I’ve been at full physical activity for weeks – getting my steady beat up to 140 or so when running etc. with no problems. I’ve had a couple of stressful experiences which in the past would have almost certainly set off PVC’s, with a good chance of afib happening that night or the following night. But these two times – nothing. I was not expecting improved ectopics from this procedure – but so far it looks like that is what happened.

This is the longest I’ve gone without afib since it got regular for me 10 years ago. The long term data on PFA won’t be in for many years, so I am just left to hope or trust that these lesions will be as effective as those done with an RFA catheter (there isn't yet any evidence to the contrary). In any event, I’m going to do my best to appreciate this reliable sinus rhythm for as long as it lasts.

I’ll make sure to check in at some future milestones – be they positive or negative. Thanks again to all of the intelligent, dedicated, and caring people on this site. And, fyi, recruitment is still happening for the trial study at 24 locations –there are lots of locations on the U.S. east coast and mid-west, one each in Australia, Netherlands, and Ontario, but for some reason nothing west of Austin. [clinicaltrials.gov]

Nice report Ralph. We appreciate it. Wow 140 bpm after only 2 months. Nice
I still totally believe that this condition will be cured in future years as there are brilliant minds working away at new ideas
Best to your continued NSR!
Tom

Hi Ralph,
Thank you for the valuable update. I am sure many of the afibbers in this forum are following and waiting for the next update. So please continue the good work.
My question we hear always about the blanking period after the traditional procedure .Is it the same with this new procedure or there is a difference.
Kind regards,
Ben

Ben, I don't know for sure, but I had nothing during the blanking period. My understanding is that there is much less inflammation from this technology - it isn't burning tissue like the RFA catheter does. So it would make sense to me that there wouldn't be alot of activity post-ablation (I think that the blanking period is more or less a name for the period where you can expect errant electrical activity while your heart is recovering from inflammation).

Dr. Natale did not confirm that theory with me, so it is possible I am not understanding something and was just lucky. But I would bet that your chances of an easy blanking period are much better with PFA.

Great news Ralph!!

Great results! Thanks for sharing, Ralph. I do think PFA will eventually replace RF in the near future.

I was about to add "too late for me" but that's not necessarily true. Maybe 10 years down the road my afib monkey will escape the cage Natale put around it. If so, it's good to know there will be improved technology to build a new cage.

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Carey
Great results! Thanks for sharing, Ralph. I do think PFA will eventually replace RF in the near future.

I was about to add "too late for me" but that's not necessarily true. Maybe 10 years down the road my afib monkey will escape the cage Natale put around it. If so, it's good to know there will be improved technology to build a new cage.

Curious if PFA can now, or possibly in the future be used for LAA isolation?

Thanks for your report!

I thought PFA can only be used for PVI. Is this correct?

I don't believe there's any limitation on where PFA can be used.

Frank, the Medtronics PFA catheter is somehow or another designed to do more than just PVI - the study is open to persistent afibbers for example who almost certainly have triggers from other areas. Dr. Natale definitely used it to ablate areas on the posterior wall of the atrium for me. I don't know what the current limits are with the current catheters, but they are definitely wider than just PVI. I haven't been able to find any good video simulations of the Medtronics catheter.

The PFA catheter design from Farpulse - used in the prior study - certainly seemed tailored to pulmonary vein isolation. I don't know if it has been used to go beyond that. There is a good simulation of that catheter [www.farapulse.com]

So - can someone explain the difference between this and a regular ablation? I shall go off and google. I was scheduled for an ablation in April.. I had been doing good so I moved it to Oct. Then of course-- well .. you know LOL! It is funny I dig into all sorts of info for my son's health but that takes up most my band width. I should really do more research for my own stuff.

thanks. If there is a thread out there on it let me know .. I will go search as well. thanks.

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bettylou4488

If there is a thread out there on it let me know .. I will go search as well. thanks.

Scroll down to Shannon's comments in this thread: [www.afibbers.org]

Anybody knows whether
there is places in Europe offering PFA as routine or as clinical trials.



Edited 1 time(s). Last edit at 07/04/2021 11:34AM by ben saif.

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ben saif
Anybody knows whether
there is places in Europe offering PFA as routine or as clinical trials.

Clinicaltrials.gov is your friend when looking for ongoing clinical trials. First, go here, then click on the "On Map" tab. Then click Europe on the map, then click the country you're interested in to find the trial(s) ongoing in that country. There are currently trials in Belgium, Croatia, Italy, Lithuania, and the Netherlands.

PFA technology came too late for me. I think of Pulse as a lesser risk for many issues that could possibly occur including but not limited to examples of heat damage from RF technology weakening ones AV node to possibly esophagus issue afterwards. Even if one has the best EP I think IMHO it’s up to the patients heart/health conditions/God/bad luck/karma/etc that decides if one gets complications afterwards or not.

Carey,
Thank you for this information.