Our Summary

This paper discusses a new system for treating abnormal heart rhythm, specifically atrial fibrillation. The system includes a multielectrode catheter called VARIPULSE™ and a generator called TRUPULSE™. They use a technology called pulsed field ablation (PFA) to selectively target and destroy problematic heart tissue without damaging surrounding areas. This technology is less likely to cause collateral damage compared to other methods like radiofrequency ablation or cryoablation. The system also includes a three-dimensional mapping system (CARTO 3™) which helps guide the catheter to the right spot and ensure that no problem areas are missed. The paper provides a detailed guide on how to use this system, from choosing the right patient to how to adjust the catheter correctly. The authors note that as this system is used more widely, the recommended process may change based on new experiences and findings.

FAQs

  1. What is the new system for treating abnormal heart rhythm discussed in this paper?
  2. How does the pulsed field ablation (PFA) technology work and how does it compare to other methods like radiofrequency ablation or cryoablation?
  3. What is the purpose of the three-dimensional mapping system (CARTO 3™) included in the system?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac ablation is to make sure to follow all pre-procedure instructions provided by the healthcare team, such as fasting before the procedure and stopping certain medications as directed. It is also important to have a clear understanding of what to expect during and after the procedure, including potential risks and complications. Lastly, make sure to follow all post-procedure care instructions, including taking prescribed medications and attending follow-up appointments to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended cardiac ablation are those with abnormal heart rhythms, specifically atrial fibrillation. These patients may experience symptoms such as palpitations, shortness of breath, fatigue, or dizziness. Cardiac ablation may be recommended for patients who have not responded well to medication or other treatments for their abnormal heart rhythm. Additionally, patients who have structural heart disease or other risk factors for complications from atrial fibrillation may also be candidates for cardiac ablation. Ultimately, the decision to recommend cardiac ablation is made on a case-by-case basis by a cardiologist or electrophysiologist after a thorough evaluation of the patient’s medical history and condition.

Timeline

Before cardiac ablation:

  1. Patient experiences symptoms of abnormal heart rhythm, such as palpitations, shortness of breath, dizziness, or chest pain.
  2. Patient undergoes various tests, such as electrocardiogram (ECG), echocardiogram, and Holter monitor, to diagnose the specific type and cause of the arrhythmia.
  3. Patient may try medication or other conservative treatments to manage symptoms and control the arrhythmia.
  4. If medication is ineffective or not well tolerated, patient may be recommended for cardiac ablation.

After cardiac ablation:

  1. Patient undergoes pre-procedure preparations, such as fasting and medication adjustments.
  2. Cardiac ablation procedure is performed, where the catheter is inserted into the heart and targeted areas of abnormal tissue are destroyed using PFA technology.
  3. Patient is monitored closely during and after the procedure for any complications or arrhythmia recurrence.
  4. Patient may stay in the hospital for a day or two for observation and recovery.
  5. Patient is discharged with instructions on post-procedure care, including medication management and follow-up appointments.
  6. Patient may experience minor discomfort, fatigue, or palpitations in the days following the procedure.
  7. Patient gradually resumes normal activities and may notice improvements in symptoms over time.
  8. Patient undergoes follow-up appointments and monitoring to assess the success of the ablation and address any concerns or complications.

What to Ask Your Doctor

  1. What is cardiac ablation and how does it work to treat abnormal heart rhythms such as atrial fibrillation?
  2. Am I a suitable candidate for cardiac ablation with the VARIPULSE™ and TRUPULSE™ system?
  3. What are the potential risks and complications associated with cardiac ablation using this new system?
  4. How does pulsed field ablation (PFA) differ from other ablation methods such as radiofrequency or cryoablation?
  5. How successful is this new system in treating atrial fibrillation compared to traditional methods?
  6. How long does the procedure typically take and what is the recovery process like?
  7. Will I need to take any medications or have additional treatments after the ablation procedure?
  8. Are there any lifestyle changes I should make after the procedure to improve the success of the treatment?
  9. How often will I need follow-up appointments to monitor my heart rhythm after the ablation?
  10. What are the long-term outcomes and prognosis for patients who undergo cardiac ablation with the VARIPULSE™ and TRUPULSE™ system?

Reference

Authors: Nair DG, Gomez T, De Potter T. Journal: J Cardiovasc Electrophysiol. 2024 Sep;35(9):1817-1827. doi: 10.1111/jce.16366. Epub 2024 Jul 14. PMID: 39004800