1 year post Pulsed Field Ablation

Hi all. Yesterday was my 1 year anniversary of my PFA ablation with Dr. Natale in Austin. I just completed my last heart monitor reading of the 1 year follow-up study (I had to send 1 minute recordings once a week, and at 6 months and 1 year did a 1day recording with a small device that was essentially taped to my chest). I'm delighted to report that the PFA ablation has been a complete success to date. May it continue to be so.

No doubt that my 10+ year afib trip could have gone differently than it did, and there is seldom a right or wrong on how to approach things like this. But for what it is worth, I want to say that I am happy with my decision to reluctantly accept and deal with my more or less once a month afib for about 10 years - until it starting getting out of control last February. I am someone who feels his heart beat very clearly - I can even feel it as I sit here in sinus rhythm - so it was not an easy path. I grew alot from my experience dealing with the discomfort and fear, and did my best to frame it for what it was and what it wasn't.

What it was for me: weird and scarey, with a very small concern about increased stroke risk. I wasn't taking blood thinners, and I say small concern because of the (to me) somewhat inconclusive evidence about whether paroxsysmal episodes well under 24 hours long actually increased stroke risk (I recall there was a pretty recent study indicating short episodes can in fact cause strokes, and I haven't really integrated that into my priors. If I had seen that study 10 years ago I might have been more concerned, and I am not making a statement about what your stance should be about the risk of stroke if you have paroxysmal afib).

What it wasn't for me: it wasn't in the same league of severity as many other conditions that I was aware I was fortunate enough not to have. Cancers, actual cardiovascular disease, etc etc. (I don't say this to minimize the fact that afib can significantly increae your risk of stroke and lead directly to CVD). At times I tried to see my afib travails as an opportunity or trial run for how to deal with my inevitable decline and death.

In any event, when my afib started becoming a daily affair last February, my awareness of the increasing stroke risk, along with my increasing discomfort, led me to pursue an ablation. I signed up to get an RFA ablation with Dr. Natale in southern california, and then discovered that he was already well-versed with PFA ablation and was participating in the Medtronics trial study in his Austin facility. So I changed my plan to that, and as I've said before I couldn't have been better tended to at that facility. If you can physically and financially afford the time and travel, I would recommend a trip to the Austin facility, and would recommend the PFA if you are eligible for the study or can talk Dr. Natale into a compassionate care exception.

I was concerned that the albation might have been more difficult because the 10 years of paroxsysmal afib caused some remodeling in my heart. Although the trigger areas did spread out some from the pulmonary vein to the back wall of the atrium, it was apparently not a problem to deal with - at least for Dr. Natale.

I'll end with my only caveat. There is no long term track record for PFA - I'm only one year out. But the advantages are a quicker recovery time because the heart doesn't get inflammed in the same way with this technology, and it is supposedly a safer procedure (although the risk is pretty small at this point with RFA with an experienced provider). And my heart one year out is quiet as a mouse.

I am grateful for this site, and for all of those who have made such intelligent contributions. My best wishes for each of you going forward. Ralph

Ralph, thank you very much for sharing your one year update. It’s wonderful that everything had gone so well and as expected. I am new to this group but not to AFIB and recently had my first appointment with Dr Natale to discuss an ablation. I am currently waiting for the next PFA trial to open up in Austin.

Thanks again for sharing and wishing you good health

Congratulations!

Thanks so much, Ralph, for your detailed report. Congratulations! Great news for all of us.

I have been inquiring about PFA recently and Dr. Natale has confirmed that, at this time, it is not being done for patients with pacemakers, defibrillators, or Linq monitors as there are still some questions about how the PFA energy would affect them. He expects that it will just take a bit longer for PFA to be approved for these patients.

So, I have started the process for an RFA in Austin with Dr. Natale. Should I need a touch up later, PFA might be a possibility.

Quote
Daisy
So, I have started the process for an RFA in Austin with Dr. Natale. Should I need a touch up later, PFA might be a possibility.

Glad to hear this!

Thanks for sharing your experience!

Congratulations Ralph.
Thank You for your one year update.
I am pleased to hear about your success . I am planning to go the same (PFA) route but in Europe, maybe in Bordeau France which is nearer to my country.

Ben



Edited 1 time(s). Last edit at 05/09/2022 11:55AM by ben saif.

Great update and thoughtful background reporting. Thanks Ralph! Jeff

Daisy,

Did Natale expressly say that PFA is going to be available for touch-ups in the near future?? My present understanding is that it’s for index (first) procedures only.

Cheers,

Mike

I was told that after FDA approval (no projected date given) it would be available for touch-ups, though whether it would be available to those with implanted devices, was not yet known.